Traditional, complementary, and alternative medicine and the provision of health care to internally displaced persons in south Kivu, Democratic Republic of the Congo

Introduction: Traditional, complementary and alternative medicine (TCAM)
providers are central for many when seeking healthcare. Internally Displaced
Persons (IDPs) are no exception. This paper seeks to better understand the use
of TCAM by IDPs and its connection with the local integration of IDPs into the
social fabric of the communities where they have taken refuge. We compare
IDPs and non-IDPs access to TCAM providers and their level of confidence
in having their healthcare needs met by these sources in Uvira and Kabare
territories of South Kivu, Democratic Republic of Congo (DRC).
Methods: We draw from a mixed method, social connections design comprised
of participatory workshops with 111 participants; a survey with 847 participants
capturing exploring access and trust of TCAM and other wealth and demographic
indicators; 24 interviews with traditional healthcare providers; and 56 in-depth life
history interviews with IDPs. Collected data were analysed using both qualitative
and quantitative approaches. Descriptive statistics (mean, percentage, and standard
deviation) and statistical tests (proportions test and t test) were used as quantitative
analysis tools whereas thematic content analysis was used for qualitative data.
Results: We show that IDPs use TCAM more than non IDPs. Access to and trust
in traditional healers seems dependent on the exact nature of the services they
offer, which varies across our sample. As such, processes of recognition and
integration of both IDPs and TCAM providers into formal healthcare systems
should be treated cautiously with an understanding of the socio-economic
rationales that displaced people and TCAM providers operate under. While
many of these TCAM providers are not highly trusted sources in South Kivu,
their highly valued treatment of certain conditions such as what is locally known
as “mulonge” (and bears similarities with the Buruli ulcer) suggest there may
be potential specific areas where collaboration could be successful between
biomedical health workers and TCAM providers