Indigenous knowledge and social experiences on cancer in Zimbabwe: A case study of Harare

Abstract

Official statistical and anecdotal evidence in Zimbabwe indicates that the incidence of new cancer cases in the country is on the rise. Apparently, this rise in cancer cases has met a lethargic response from the government and non-state actors. As such, this phenomenological thesis study aims to describe and analyse indigenous [local] cancer causing narratives, lived illness experiences and health-related help seeking behaviours of people diagnosed with cancer in Harare, Zimbabwe. This study was prompted by the paucity of qualitative analyses and sociological nuances with regard to an illness that is increasingly being diagnosed among resident black African Zimbabweans. Current empirical studies and scholarship on cancer in the country show a preponderance of quantitative analyses grounded in bio-physicist perspectives. The trend also seems to be that of exploring incidence and survival and mortality rates including survey research on the knowledge [biomedical] levels on cancer. Relevant though such studies may be, they remain superficial, as they are divorced from the intimate, lived realities of people living the experience. Grounded in Heideggerian interpretive hermeneutic phenomenology and utilising qualitative methods, namely life histories, semi-structured interviews, focus group discussions, key informant interviews and semi detached observations, the study sought to fill the existing knowledge gaps. The central thesis of this research is that an understanding of indigenous [local] cancer narratives provides comprehensive information of the illness and a combination of novel data capturing methods engendered in hermeneutic phenomenological thinking enables the extraction of novel fringe data. The thesis established cosmopolitan narratives on causes of cancer, which espoused participants’ lifeworlds as shaped in part by their socio-cultural milieu, lived experience and [biomedical] knowledge from health care professionals. The varied, novel lived-illness-experiences shared were enriched by dynamics of gender, age, level of social support, environmental factors and personality characteristics in a multiple and indeterminate fashion. Data on the health-related help-seeking behaviour of participants diagnosed with cancer illuminated the interplay of a complexity of factors, most of which were shaped by popular beliefs and/or ‘myths’ on cancer, experiential knowledge and interpretation of initial symptoms. Of note, one of the major contributions of this study is in the extraction of marginalised evidence from indigenous [local] knowledge on cancer treatment and care reflected, partly in the activities of traditional health practitioners. Taken as a whole, this evidence can assist in the framing of educational resources and inform oncology nursing and other societal support systems in the management of clients with cancer in personally meaningful ways. Cultural competence in oncological nursing management can enhance health behaviours, satisfaction, adherence, and quality of life of people diagnosed and living with cancer.