Abstract
The deterioration of government health services in Uganda since 1971 has been accompanied by a process of privatization which has made pharmaceuticals readily available outside of biomedical institutions. On the basis of material from eastern Uganda, the article analyses this development in terms of the ‘sector model’ of health care systems, with special attention to the relations between the professional and folk sectors. Folk practitioners of pharmaceutical medicine include a broad range of specialists, from government trained paramedicals in private practice to vendors bringing medicine to local markets. Like other folk specialists, they respect the customer's opinion, provide treatment by proxy and adjust their services to the customer's ability to pay. Although there are negative aspects of this development, from the local point of view there are also positive ones, which deserve the consideration of health planners.
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References
Alland, Alexander, Jr. 1970 Adaptation in Cultural Evolution, New York: Columbia University Press.
Bennett, F. J. 1989 The Dilemma of Essential Drugs in Primary Health Care. Social Science and Medicine 28:1085–1090.
Bledsoe, Caroline H. and Monica, F. Goubaud 1988 The Reinterpretation and Distribution of Western Pharmaceuticals: An Example from the Mende of Sierra Leone. In The Context of Medicines in Developing Countries: Studies in Pharmaceutical Anthropology. S. van der Geest and S. R. Whyte, eds. pp. 253–276. Dordrecht: Kluwer.
Burghart, Richard 1988 Penicillin: An Ancient Ayurvedic Medicine. In The Context of Medicines in Developing Countries: Studies in Pharmaceutical Anthropology. S. van der Geest and S. R. Whyte, eds. pp. 289–298. Dordrecht: Kluwer.
Dodge, Cole P. 1987 Rehabilitation or Redefinition of Health Services. In Beyond Crisis. Development Issues in Uganda. P. Wiebe and C. Dodge, eds. pp. 101–112. Kampala: MISR/Crossroads Press.
Dodge, Cole P. and Paul D. Wiebe, eds. 1985 Crisis in Uganda. The Breakdown of Health Services. Oxford: Pergamon Press.
Etkin, Nina L., Paul J., Ross and Ibrahim, Muazzamu 1990 The Indigenization of Pharmaceuticals: Therapeutic Transitions in Rural Hausaland. Social Science and Medicine 30:919–928.
Foster, George & Barbara G., Anderson 1978 Medical Anthropology. New York: Knopf.
Freidson, Eliot 1970 Professional Dominance: The Social Structure of Medical Care. Chicago: Aldine.
Ferguson, Anne 1985 Commercial Pharmaceutical Medicine and Medicalization: A Case Study from El Salvador. In The Context of Medicines in Developing Countries: Studies in Pharmaceutical Anthropology. S. van der Geest and S. R. Whyte, eds. pp. 19–46. Dordrecht: Kluwer.
Health Policy Review Commission 1987 Report and Recommendations of the Health Policy Review Commission Under the Chairmanship of Professor Raphael Owor. Ms. Kampala: Ministry of Health.
Jamal, Vali 1987 Ugandan Economic Crisis: Dimensions and Cure. In Beyond Crisis: Development Issues in Uganda. P. Wiebe and C. Dodge, eds. pp. 121–136. Kampala: MISR/Crossroads Press.
Janzen, John 1978a The Quest for Therapy. Medical Pluralism in Lower Zaire. Berkeley: University of California Press.
1978b The Comparative Study of Medical Systems as Changing Social Systems. Social Science and Medicine 12: 121–129.
Justice, Judith 1986 Policies, Plans and People: Foreign Aid and Health Development. Berkeley: University of California Press.
Kinuka, Rose, Robinah Ndugwa, James Engorit, and Sue, Nancholas1985 Essential Drugs Management Programme. Base-line Survey for Public Education Programme. Kampala: Uganda Red Cross Society.
Kironde, E. 1985 A Village Perspective of Health Services in Buganda. In Crisis in Uganda. The Breakdown of Health Services. C. Dodge and P. Wiebe, eds. pp. 65–68. Oxford: Pergamon Press.
Kleinman, Arthur 1980 Patients and Healers in the Context of Culture. Berkeley: University of California Press.
Last, Murray 1986 The Professionalisation of African Medicine: Ambiguities and Definitions. In The Professionalisation of African Medicine. M. Last and G. L. Chavunduka, eds. pp. 1–19. Manchester: Manchester University Press.
Leslie, Charles 1975 Pluralism and Integration in the Indian and Chinese Medical Systems. In Medicine in Chinese Cultures: Comparative Studies of Health Care in Chinese and Other Societies. A. Kleinman, P. Kunstadter, E. R. Alexander and J. Gale, eds. pp. 401–417. Washington DC: DHEW.
1976 The Ambiguities of Medical Revivalism in Modem India. In Asian Medical Systems. C. Leslie, ed. pp. 356–367. Berkeley: University of California Press.
1980 Medical Pluralism in World Perspective. Social Science and Medicine 14B, 4: 191–195.
MacCormack, Carol 1986 The Articulation of Western and Traditional Systems of Health Care. In The Professionalisation of African Medicine. M. Last and G. L. Chavunduka, eds. pp. 151–162. Manchester: Manchester University Press.
Minde, Klaus K. and Israel, Kalyesubula 1985 The Delivery of Primary Health Care in Uganda Today: Some Problems and Opportunities. In Crisis in Uganda. The Breakdown of Health Services. C. Dodge and P. Wiebe, eds. pp. 239–245. Oxford: Pergamon Press.
Nichter, Mark and Carolyn Nordstrom 1989 A Question of Medicine Answering: Health Commodification and the Social Relations of Healing in Sri Lanka. Culture, Medicine and Psychiatry 13: 367–390.
Odurkene, J. N. 1988 The Final Report on ‘Evaluation of Uganda Red Cross Society's “Public Education Programme” on Essential Drugs Management, from July 1986 to July 1987, in Three Districts of Uganda’. Ms. Uganda Red Cross.
Price, Laurie 1989 In the Shadow of Biomedicine: Self Medication in Two Ecuadorian Pharmacies. Social Science and Medicine 28:905–915.
Stock, Robert 1985 Drugs and Underdevelopment: A Case Study of Kano State, Nigeria. In The Impact of Development and Modern Technologies in Third World Health. Studies in Third World Societies, no. 34. B. Jackson and A. Ugalde, eds. pp. 115–139. Williamsburg: College of William and Mary.
Taylor, Carl 1976 The Place of Indigenous Medical Practitioners in the Modernization of Health Services. In Asian Medical Systems. C. Leslie, ed. pp. 285–299. Berkeley: University of California Press.
Uganda Essential Drugs Management Programme 1990 Findings 1986–1989. Ms. Entebbe: Danish Red Cross.
Van der Geest, Sjaak 1988 The Articulation of Formal and Informal Medicine Distribution in South Cameroon. In The Context of Medicines in Developing Countries: Studies in Pharmaceutical Anthropology. S. van der Geest and S. R. Whyte, eds. pp. 131–148. Dordrecht: Kluwer.
1991 Marketplace Conversations in Cameroon: How and Why Popular Medical Knowledge Comes into Being. Culture, Medicine and Psychiatry 15, 1:69–90.
Van der Geest, Sjaak and Susan Reynolds Whyte 1989 The Charm of Medicines: Metaphors and Metonyms. Medical Anthropology Quarterly 3:345–367.
Whyte, Michael A. 1990a “We Have No Cash Crops Anymore”: Agriculture as a Cultural System in Uganda, 1969–1987. In The Creative Communion: African Folk Models of Fertility and the Regeneration of Life. A. Jabobson-Widding and W. van Beek, eds. pp. 307–322. Uppsala: Almqvist & Wiksell International.
1990b The Process of Survival in South-Eastern Uganda. In Adaptive Strategies in African Arid Lands. M. Bovin and L. Manger, eds. pp. 121–145. Uppsala: Scandinavian Institute of African Studies.
Whyte, Susan Reynolds 1982 Penicillin, Battery Acid and Sacrifice. Cures and Causes in Nyole Medicine. Social Science and Medicine 16: 2055–2064.
1988 The Power of Medicines in East Africa. In The Context of Medicines in Developing Countries: Studies in Pharmaceutical Anthropology. S. van der Geest and S. R. Whyte, eds. pp. 217–233. Dordrecht: Kluwer.
1990 Uncertain Persons in Nyole Divination. Journal of Religion in Africa XX, 1:41–62.
1991 Knowledge and Power in Nyole Divination. In African Systems of Divination: Ways of Knowing. P. Peek, ed. pp. 153–172. Bloomington: Indiana University Press.
1991 Medicines and Self Help: the Privatization of Health Care in Eastern Uganda. In Changing Uganda: Dilemmas of Structural Adjustment and Revolutionary Change. H. B. Hansen and M. Twaddle, eds. pp. 134–148. London: James Currey.
Wolffers, Ivan 1988 Traditional Practitioners and Western Pharmaceuticals in Sri Lanka. In The Context of Medicines in Developing Countries: Studies in Pharmaceutical Anthropology. S. van der Geest and S. R. Whyte, eds. pp. 47–56. Dordrecht: Kluwer.
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Whyte, S.R. Pharmaceuticals as folk medicine: transformations in the social relations of health care in Uganda. Cult Med Psych 16, 163–186 (1992). https://doi.org/10.1007/BF00117017
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DOI: https://doi.org/10.1007/BF00117017