Linguistic Conceptualizations of Disease Among the Luo of Kenya

Abstract

The region inhabited by the Luo ethnic group in Kenya is disease endemic. However, disease awareness initiatives register low acceptance due to the sociocultural images of disease and illness conceptualized in the local Dholuo language in ways that may contradict modern biomedical knowledge and practice. This article evaluates the sociocultural basis of encoding descriptions of disease in the Luo indigenous knowledge system and their implications for modern medical practice. The methodology entailed use of qualitative interviews of purposively sampled Dholuo-speaking patient escorts in a provincial referral hospital. Nonparticipant observation was also conducted at funerals to monitor contextualized usage of the discourse of disease, illness, and death. The data were analyzed using qualitative content analysis and categorized into emergent themes and categories. The results revealed that Dholuo is replete with expressions that emphasize the vulnerability and discrimination of the sick. Such attitudes cause rejection of interventions and negatively influence health-seeking behavior. The expressions were relevant and acceptable to cultural insiders; hence, they could determine their understanding of health conditions thereby influencing how they make medical decisions. It emerges that the unique Luo worldview controls their perceptions on the causes of disease and prescribes community-driven remedies which may depart from the expectations of the biomedical model.

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“…Fang and Stewart (2018) found that the combined influences of health system factors, sociocultural factors, and traditional health and spiritual beliefs about hepatitis B affected the willingness of immigrant Hmong people (from the central valley region of northern California) to accept screenings and/or immunizations. Ojwang (2018) described the sociocultural conceptualizations of disease causation and experience as deeply embedded in the values, beliefs, and practices of the Luo people of Kenya, concluding that their ethnohistory informs their worldview. Rahemi’s (2019) and Rahemi, Dunphy, and Newman’s (2019) cross-sectional studies of older Iranians who immigrated to the United States during the first wave of immigrants in the 1950s revealed findings the researchers termed novel among contemporary elders.…”

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Navigating Nuances of Language and Meaning: Challenges of Cross-Language Ethnography Involving Shona Speakers Living With Schizophrenia

“…Inevitably, problems with interpretation may arise. Difficulties in interpretation can arise from lack of familiarity with professional terminology, inability to interpret the cultural meaning of symptoms and behavior, and the inability to detect paralinguistic or nonverbal behavior (Hagan et al, 2013; Ojwang, 2018). The results can include, among others, the omission of information, poor paraphrasing, lack of translatable words or culturally equivalent concepts, inaccurate translation of words or concepts, and distortion of meaning leading to understatement or exaggeration (Tribe & Lane, 2009).…”

“…Others have observed that the presence of words that are either unknown, too scientific, or unusual to patients or participants create cultural distance between the clinician and patient (Bolton, 2002; Schlemmer & Mash, 2006). In mental health practice and research, everyday words, such as depression, health, or anxiety, need to be translated and understood in their cultural context as they may carry deeper meaning for a specific group (Ojwang, 2018; Sweetland, Belkin, & Verdeli, 2014; Ventevogel, Jordans, Reis, & de Jong, 2013).…”