Community Voices: Takka Efuransi
Traditional Birth Attendant(TBA), Herbalist and Spiritual Healer

Takka is a traditional health practitioner  in Kampala.  Recently she had a stroke, and one side of face remains rigid. While she has had health problems and difficulties in her marriage, she continues to serve her community as a healer, a trainer of traditional healers, community educator, and foster parent to AIDS orphans. Theta staff member, Rose translated.

C: How did masao become a healer?
Rose: She first got sick, she got headaches. At times she could find herself in the bush, and lastly, she found herself sleeping in a tree for one week.  The forefathers were traditional healers, so her family brought a traditional healer and some drums to their home. All alone she could not find a way of coming down, but when they started drumming she came down. So the father said this young girl should be a traditional healer since she gets lost when she is normal. So they took her for training when she was twelve years.

The first thing she did was to pick herbs just out of nowhere.  She went and picked herbs and started treating people. She began with a case of epilepsy. She found a woman sitting by the roadside with a child as she was walking to her farm, and she asked her what the child suffered from.  The lady said the child was sick,' that is why I am sitting here, and I don’t know where to take her'. Then Takka said 'you bring her to my home'.

She took her home and then she went out to pick leaves. In fact it surprised her father. She put the leaves in the girl's nose and she got better, and after that time she started finding medicines. She, herself, was surprised how she could know most of the medicines.

C: Did she have a vision or a voice that told her where to look for the medicines?
R:  After hearing the patient’s problem the spirits tell her where to get the medicine. The spirits on her head, they guide her, they tell where to get the medicines. They came on her the first time, she was not used to it. She felt so tired, her whole body was so painful, and she could not move or talk as she normally talks.
C: Did she grow to feel comfortable when the spirits came down?
R: When she got possessed she felt terrible so she went to those who trained her to put the spirits right. Since that time she has not had anything wrong on her body when she gets possessed.

C: What conditions does she treat?
R: She works on all diseases that are associated with pregnancy and with spiritual problems. For example, if someone can't sleep in their house, if they find themselves in the forest, if they feel things moving in their house, these are things she normally works on. She does not work on mental problems. If the ancestral spirits say it is a mental problem, she normally runs away from that, and tells them she is not able to treat such a person.

At Takka’s shrine there were two elderly women seeking treatment.  One was concerned she had been bewitched. Takka took her outside and had her stand so as to see her shadow.  Then she sprinkled cornmeal around the periphery of the shadow. Rose provided some explanation.

Rose:  The traditional way is to make a cut in the skin and put medicine in the cut.  But the modern way is for Takka to draw a picture of the person from her shadow. She then puts the medicine into the form so no charm can enter.

Takka suspects it might be something like charms.

C: Someone who was in the war and was traumatized by the war, would Takka treat someone like that?
R: She just does counseling and sends them to the hospital. She is a good counselor.
C: Can she describe her counseling?
R: An example of a person is this child who lost both parents in the war. (See interview with the girl. Takka takes these children into her home and effectively raises them.) She normally keeps these children until they are able to get organized or get jobs, and she keeps counseling them. She has some children here who are from the war torn areas whose parents have died and she keeps them here. 

C: What support groups does Takka have?
O: Her group consists of widows and young girls and boys. Boys in and out of school, she has all of them.
C: How does she mobilize her groups of boys?
O:  She started with a group of women.  Then the boys became interested because they used to come for condoms and they decided to join the group. She used to go where they normally play, talk about condoms, and counsel them. They started coming for condoms and, after the Theta training, she found a way to talk to them about HIV and STD prevention.

C: What activities does she have for them here?
R: They have brick making, they plant casaba. She keeps them busy all the time.  In fact most of them spend the whole day here drumming and practicing their music for the community education events. That will engage them, also learning how to prepare bricks.
C: What are some of the challenges in her work?
R: Basically it is financial support that she needs. She needs soap, money for basics, as some of the orphans are staying alone.  They have run away from their families.

Takka speaking of AIDS orphans: 'Most of them spend the entire day here drumming and practicing their music.'

C: What has Takka learned from Theta?
R:  They have got so many good things out of Theta. It has made her famous in this place. Many people have trust in her. More clients are coming to her. If they see people like you coming in, there is more trust in her work. They have learned how to keep their medicines hygienically, to keep records, use the referral forms that were given to them, and also the storage of medicines.
She shows us a Certificate of Merit from Theta Aids Patient Care training.
Takka’s record of patients is very neat.

R: First of all how the community sees her, they think she is very rich. Then, at the same time, she says that she gets more patients than she did in the past. People believe in her as biomedical workers come and visit her to discuss issues about HIV and that has also promoted her work. She is now cooperating with biomedical workers here at her house.
C: So what would biomedical workers want to speak about when they come here?
R: They normally come to check on her records, how many patients she has treated, and what diseases have spread in this area.  And the hygienic part of it, is she keeping her medicines fine, is the shrine ventilated well, are you treating in the open, normally those are the things they come and check on her.
C: Many people here in Uganda associate traditional healing with witchcraft. What would she say to these people?
R: She is a chairperson of an association here within this sub-county, and they have a person who looks around to check which new traditional healers come within this village.  After that, if the person identifies himself with all the requirements they have in their constitution, the person is allowed in here. But she is saying nothing has happened in her area. She has not heard of a case
C: if there was one what would they do?
R: She takes it to the government and then the government comes and looks around to identify who did what.
C: She would feel comfortable informing the government?
R: She pays for a license, the government definitely knows her. If she goes to the district they know her, so she can start there with that case and go further.
C: How does Takka plan to sustain her groups?
R: They collect money within the group and give it to one person. He does his work, and he sells his products. After that they collect money for another. For her right now, she says she has no sustainability plans, but the issue for them is to start income generating activities.
C: What activities would best help them to achieve sustainability?
R: It’s keeping poultry. At their meetings they decided on poultry keeping as an activity because their spirits don’t allow other animals like pigs.  So the group decided if they have the money, they would start a poultry farm and cattle. So they have already started with 4 cows and some chickens as a pilot to see if it works out.
C: Someone said all healers who are possessed practice witchcraft. There is a great misunderstanding and fear out there.
The husband answers. He is insisting that his wife is a traditional birth attendant. So when people come for antenatal care, she normally tells them how can I be a traditional killer?

When people come for antenatal care my wife normally tells them 'How can I be a traditional killer?'

Rose reports Takka's husband was trying to categorize the types of spiritual healers. For her, he is saying, the kind of spirits his wife has, they do not want to see anything that has to do with blood. So, even if she slaughters something, when the spirits are on her, then it will not work out on her part. So maybe it is their role to teach the public there are some spirits which are bad, and those that are good. In her case, her spirits do not want to see anything that has to do with blood. That is why she did that practice this morning with the shadow.
C: From the very beginning as a girl?
R: The spirits did not want her to have any type of meat but she begged them to eat meat.
Rose asks how Takka diagnoses her patients. She tells her that she puts down a bark cloth mat in her shrine, and and brings out her cowry shells, She throws them and asks questions: How long you will stay in Uganda? What you were thinking about?  Why you were sad?  What are you feeling now? What is good there at your home?  She can get answers from this.
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Two women join her. She looks at the hand of one of them, the nails.
C: In her community of traditional healers, are there healers that use sacrifice but that she feels are healing and not hurting?
R: Human sacrifice is not recommended for healing because that is not healing, it is killing.  But within the culture, they normally use animals or any other thing apart from human beings.  Using animals to treat, she can recommend it, but not using human sacrifice.  Those people are not healers, they are pretending to be healers.
C: Are these leopard skins?
R:  They are for different spirits. The different spirits have different categories of animals. Some have spears. Every animal has its own spirit, its owner. Same with the skins.  They cannot remove any of those things.

Some of the AIDS orphans have run away from their families.

The group is going to sing.  We walk outside past the chickens; we can hear drumming in the distance.  We go to the hut where Takka delivers babies, and then out to the farm.  The men pull a casaba plant from the ground, exposing the roots. They pull out another.
R: This is the type of project they are doing.

We are given a tour of the huts surrounding the shrine.  One is dedicated to delivering babies.  Another, with a fire in the center of the floor, is the home of the head of all the spirits.  There is only one central pole for when the spirit comes. It symbolizes the king of all the spirits.

May people are about.  When we leave the women wave goodbye.