Soc Sci Med. 1989 ; 29(9): 1099-104.

Changing traditional medicine in rural Swaziland: the effects of the global system.

Gort E.

Phelps Stokes Institute, New York, NY 10128.

Global systems theory provides a useful paradigm for understanding the evolution of traditional institutions in the modern world. More inclusive than the purely economic world systems theory, it is applied for the purpose of analyzing how the practice of traditional medicine in Swaziland has been transformed in response to political, economic, and cultural factors originating at national, regional, and global levels. Traditional practices at the local level have further been influenced by the interplay between global forces and local perceptions and needs. In particular, the impact of the cash economy and the emphasis on rural area development have implications for the manner in which healers are recruited and for the way their practices are conducted. Since many healers have moved beyond traditional categories and are currently forging new roles within the society, their activities no longer conform to models held by global actors in the field of health. The case studies provided in the article illustrate why healers may be disinterested in biomedical programs which attempt to foster cooperation between systems.