Malady of Spirit

In the 1970’s Tanzania implemented a nationalized healthcare policy based on socialist ideology. Despite this low-cost system, on the semi-autonomous Zanzibar islands, a high percentage of citizens continue to go to witchdoctors, herbalists and Quranic faith healers for their medical needs. This photo work sought to understand some of the reasons - beyond the cultural- that leads people with affordable access

to modernized treatment to put their confidence in traditional methods, especially in instances of clear medical malady such as ulcers, fetal health or broken bones. The national health system is financed by small monthly deductions subtracted from each citizens paycheck and further subsidized by the government so that out-of-pocket medical costs remain low. Additionally, there are clinics within a 6 km range of every village so distance is not the major determinant.

Instead, patients and hospital administrators who were interviewed spoke of common misdiagnosis by medical personnel who -partly due to underfunding- can’t test their diagnostic hypothesis’, but prescribe medication based solely on their best guesses. Consistent with this, patients are often given the wrong medication for their unknown illness and thusly don’t physically improve. This phenomenon in combination with the very long wait times at hospitals & clinics leads many patients to lose faith in western medicine as practiced on the islands. The traditional practitioners on the other hand, generally spend a longer time examining and talking with patients which, though their medicines and recitations of the Quran are not necessarily effective in treating some of the physical issues, nurtures a sense of trust and comfort which is lacking within the more westernized medical system.

In some cases, like with childbirth, there is an amalgamation of practices. Women see medical professionals just twice during pregnancy

(once at 4 and again at 8 months for sonograms) but do not meet with an obstetrician. Instead they go monthly to a specialized traditional

healer for the physical evaluations (breech position, fetal health checkups etc) as well as to receive medicinal herbs that are believed to protect

the growing fetus from attack by a djinn (described in Islamic text as supernatural creatures that can be either good or evil, but take root in

humans forcing them to follow their will and creating illness) or dark spirit.

Because such a high percentage of the citizenry of continue to frequent the alternative healers, in 2008 the government enacted the “Zanzibar Traditional & Alternative Medicine Policy” which requires registration and skills testing for each healer as well as sets guidelines to integrate their works into the legal scope of healthcare while working to centralize and vet the efficacy of their remedies.

© Nicky Quamina-Woo - A rooster walks on top of roots used in traditional healing at BiMwanahija’s clinic
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A rooster walks on top of roots used in traditional healing at BiMwanahija’s clinic

© Nicky Quamina-Woo - Image from the Malady of Spirit photography project
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A women screams in apparent pain as a dark djinn (spirit) is leaving her body, while other women pray around her at the Shifaa Herbal clinic. People who go there believe that they can be cured of physical, spiritual and mental illnesses caused by djinn possession while listening to a Sheik recite words from the Quran.

© Nicky Quamina-Woo - Image from the Malady of Spirit photography project
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Two women believed to carry dark djinn (spirits) have private consultations with Sheik Abdul Rahman & Sheik Nsoor. In order to push the djinni out that is causing their illnesses, the Sheiks physically hold the women and speak angrily to the djinn inside of them. It is believed that the Sheiks have power bestowed on them by Allah, that gives them special strength that the djinn are afraid of.

© Nicky Quamina-Woo - Image from the Malady of Spirit photography project
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Handwritten patient files at Kidongo Chekundu Hospital, Zanzibar’s only psychiatric ward. Most families believe that mental illness is caused by djinn (spirit) possession, so rarely bring patients to the hospital until the situation is dire.

© Nicky Quamina-Woo - Image from the Malady of Spirit photography project
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Infant, Ahee Bom, lays on the bed he shares with his parents & 2 siblings in their home. After birth, his skin began to significantly darken and peel off in large strips. The traditional healer, BiMwanahija, bathed him with 2 scrubs made from medicinal leaves. Photographed here a few weeks after the process .

© Nicky Quamina-Woo - Image from the Malady of Spirit photography project
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Women face the wall to better focus on recitation of dua or prayers at the Shifaa Herbalist Clinic. They came to be to be healed of spiritual and physical illness believed to be caused by djinn (spirits), through the Quran.

© Nicky Quamina-Woo - Image from the Malady of Spirit photography project
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A Shiek pours water on the neck of a woman. It is believed that cold water while chanting verses from the Quran can be enough to help dislodge the djinn (spirit) that is causing the illness

© Nicky Quamina-Woo - Image from the Malady of Spirit photography project
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Semeni Juma holds her infant son, Abduli, age 3 months in her lap at the waiting room of traditional healer, BiMwanahija. The mother brought him in because he is very lethargic and can’t hold his own head up. BiMwanahija believes that the baby has a djinn (spirit) possession, though hospital doctors say he has an incurable brain issue

© Nicky Quamina-Woo - Worn pages of the Quran used in bestowing blessings by traditional healer, Mrisho ,in Jambiani village
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Worn pages of the Quran used in bestowing blessings by traditional healer, Mrisho ,in Jambiani village

© Nicky Quamina-Woo - Image from the Malady of Spirit photography project
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Apprentice healer, BiSalama, cuts medicinal roots with a machete at traditional healer Bi Mwanhija’s clinic. The roots will be doled out to patients to make teas to aid in healing

© Nicky Quamina-Woo - Image from the Malady of Spirit photography project
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Traditional healer, Bi Mwanahija, massages pregnant patient, Maryam Juma, 29. This is Maryam’s 5th pregnancy though she has no surviving children (3 miscarriages and 1 was stillborn). Both she and the healer believe the reason for all the failed attempts is because a troublesome djinn (spirit) has attacked each child in utero.

© Nicky Quamina-Woo - Image from the Malady of Spirit photography project
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After a Saturday session of religious recitations, two women converse. The Shifaa Herbal Clinic becomes a sort of meeting place for the women, just like a community center as women on Zanzibar generally pray at home instead of at the Mosque

© Nicky Quamina-Woo - Image from the Malady of Spirit photography project
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Eight month old, Muhammad Ali with his mother Nadra in the living room of their home. Muhammad suffers from pain resulting from an extreme incarcerated hernia (distended belly button). His mother brought him to a traditional healer to get herbs to try alleviate some of the discomfort, which she says is helping. The hospital diagnosis was surgery , but Mrs. Ali is concerned the child will die there if he undergoes the recommended procedure

© Nicky Quamina-Woo - Image from the Malady of Spirit photography project
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Patients queue outside the waiting room of traditional healer, Bi Mwanhija’s clinic. She is considered one of the best on the island specializing mainly with pregnant mothers and children. She has been in practice for more than 20 years.

© Nicky Quamina-Woo - Image from the Malady of Spirit photography project
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Traditional healer, BiMwanahija, massages infant, Abduli Juma, age 3 months. His mom, Semeni, brought him in because he is very lethargic and can’t hold his own head up. Bimwanahija believes that the baby has a djinn (spirit) possession, though hospital doctors say he has an incurable brain issue.

© Nicky Quamina-Woo - Image from the Malady of Spirit photography project
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Fatma Hamad, holds her 2 yr old daughter Khadija, while examining the child’s x-rays at Mnazi Mmoja government hospital. A month prior the child’s leg became paralyzed after a high fever and convulsions. The hospital recommended an x-ray to check for infection but ignored any testing for possible nerve damage. Finding nor relief at the hospital, Mrs. Hamad went to a traditional healer who told her the cause of the paralysis was djinn (spirit) possession.

© Nicky Quamina-Woo - Image from the Malady of Spirit photography project
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Traditional healer, BiMwanahija, holds patient Mundhir Nasoor, 4 weeks old. The baby was brought to her bc he wouldn’t feed. She diagnosed him as having too high an iron intake during gestation as the primary reason for illness.

© Nicky Quamina-Woo - Image from the Malady of Spirit photography project
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Women listen to Quranic readings at Shifaa Herbal clinic in Zanzibar, Tanzania. They believe that the recitations given by these particular sheiks can rid them of physical illness caused by djinn or malevolent spirits.

© Nicky Quamina-Woo - Image from the Malady of Spirit photography project
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A woman in the process of being cleansed of a djinn possession (supernatural being that forces people to do it’s will) that is believed to be causing her stomach pains at the Shifaa Herbalist Clinic . The act of the dispossession often leads to screaming, running, and writhing as the words from the Quran are like fire to the spirit

© Nicky Quamina-Woo - Rooftops of homes in Fuoni village just outside of Zanzibar City, Tanzania
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Rooftops of homes in Fuoni village just outside of Zanzibar City, Tanzania