Umeå University's logo

Traditional medicine has been practised for millennia in the Sámi population, based on a Sámi worldview and cosmology, which includes natural remedies, prayers, drums and yoik singing. During the Christianisation of the Sámi during the seventeenth and eighteenth centuries, these practices were condemned. In recent years, however, a revival of Sámi culture has occurred and so has the practice of Sámi traditional medicine (STM) and the use of complementary alternative medicine (CAM). The aim of this study is to map the prevalence and use of STM and CAM among Sámi in Sweden today. The study population consisted of 3641 Sámi from the whole of Sweden, who had participated in the population-based cross-sectional survey Sámi Health on Equal Terms (SámiHET) in 2021. Our results show that women are more prone to use both STM and CAM than men and that younger persons are more likely to use STM and CAM than elderly persons. STM is more often used in the northern parts of Sápmi compared to the southern parts as well as a lower use of CAM in the north. This might be due to the stronger Sámi identity and easier access to traditional Sámi healers/helpers in the north as well as limited access to CAM services.

BACKGROUND: Migrants are overrepresented among people living with HIV in Sweden as they often face conditions that increased their risk and vulnerability for HIV/STI infections prior, during or after migration. Yet, there is limited research on their experiences and perceptions of living with HIV in the Swedish context. This study aims to explore migrants' experiences of living with HIV in Sweden.

METHODS: This is a qualitative study based on in-depth interviews with 13 migrants from 11 countries living with HIV in Sweden. Interviews were analysed with thematic analysis using an intersectional perspective to explore the interactions of multiple social identities such as ethnicity, socio-economic status, gender, age, and sexual orientation that shape an individual's or group's experiences.

RESULTS: The analysis resulted in a main theme: 'Prioritizing social integration-HIV ends up in second place', which is based on four subthemes: 'Better opportunities in the new country than what the home country could offer', 'Better conditions for LGBTQI people than in the home country', 'Navigating a new system: linguistic and bureaucratic challenges' and 'Feeling like a second-class resident: racism, xenophobia and multiple discrimination'. The results suggest that migrants living with HIV in Sweden experience social integration as a greater challenge than HIV infection. Although the new country offers opportunities for better living conditions, many participants described being challenged in their daily life by linguistic and structural barriers in their encounters with public services. They are facing multiple discrimination simultaneously as migrants due to their multiple and intersecting identities (e.g. being non-white, foreigners/foreign-born and non-Swedish speakers), which is compounded by HIV status and thus limit their opportunities in the new country and too often result in an existence of exclusion.

CONCLUSION: The study shows that most of the challenges that migrants living with HIV face are related to their status as migrants rather than HIV status, which is often not known by the public or authorities. These challenges are similar, but still differ depending on social position, previous experiences, time since arrival and since diagnosis. This emphasizes the importance of both intersectional, intersectoral and multisectoral approaches to address reported issues.

The transfer of traditional knowledge to new generations of traditional medicinal practitioners takes place through place-based intergenerational learning processes, which are increasingly challenged by intensified rural–urban migrations and accelerating biodiversity loss. Research on traditional medicinal knowledge (TMK) has mainly focused on the medicinal properties of different plant species while social, economic, and locational aspects of TMK learning processes have received less attention. The purpose of this article is to contribute to the research field by examining how the learning processes of TMK are affected by on-going socio-spatial transformations in rural and urban parts of the Eastern Lake Victoria region. Urbanization and migration are transforming the learning processes of TMK and affect the ways traditional practitioners are able to transfer TMK to a new generation of practitioners. Based on in-depth interviews, participant observations and focus group discussions with male and female traditional practitioners aged between 30 and 95 from rural and urban settings in Mwanza (Tanzania) and Nyanza (Kenya) in the Eastern Lake Victoria Region. The study analyzes the role of socio-spatial and migration dynamics on major intergenerational forms of learning of TMK (learning in place; being sent; ritual places); health knowledge diffusion and interactions between TMK and formal health systems. Despite some major challenges to the continuity of TMK learning due to increased migration identified by the traditional practitioners, many also saw emerging roles for TMK in primary health care for sustainable livelihoods for the younger generations of men and women in this region.

Sámi traditional healing has been practiced in the Sápmi region of northern Norway, Sweden, Finland, and Russia for millennia. This study focuses on Sámi traditional healing in Sweden. Through interviews with five active healers and 11 key informants, we found that traditional healing is currently alive in Sweden but hidden. Healers treat health problems ranging from the physical to the spiritual, including mental issues and life’s difficult situations. Low-cost methods are used: spiritual healing with prayers and the laying on of hands, consultation, and herbal remedies. Healing takes place either face-to-face or over distance. Healers charge no money but accept small gifts. Being a healer is a calling. A general concern is voiced by informants about the diminishing number of healers in Sweden.

The Sámi Indigenous populations, who live in the arctic Sápmi area across four countries–Norway, Sweden, Finland and the Kola Peninsula of Russia–have practiced traditional medicine (TM) for millennia. However, today Sámi TM is unknown within the Swedish health care services (HCS). The aim of this study is to describe the nature and scope of research conducted on Sámi TM among the four Sápmi countries. This study covers peer-reviewed research published in the English language up to 8 April 2020. From 15 databases, 240 abstracts were identified, and 19 publications met the inclusion criteria for full review. Seventeen studies were conducted in Norway, one in Finland and one in Sweden, none in Russia. In northern Norway, Sámi TM is actively used by the local communities, and is claimed to be effective, but is not accessible within HCS. Holistic worldviews, including spirituality, prevail in Sámi TM from practitioners’ selection criteria to health care practices to illness responsibilities. An integration of Sámi TM into HCS is clearly the desire of local communities. Comparisons were made between Sámi TM and conventional medicine on worldviews, on perspectives towards each other, and on integration. More studies are needed in Sweden, Finland and Russia.

As we celebrate all the dynamic and dramatic improvements in human health care in the 21st century, life in much of Africa begins with and is sustained with the support of traditional medicinal knowledge. Research on traditional medicinal knowledge (TMK) is extensive, but rather few studies have been written about Traditional Healers' (THs') own perceptions about TMK and practices in relation to changing societal dynamics.

The aim of this thesis is to examine how THs perceive on going socio-spatial transformation, including contemporary processes of urbanization, migration, commercialization and commodification of TMK, as well as changing dynamics of learning and knowledge systems between generations and genders and how these affect their medicinal healing practices in time and space.

The thesis consists of four main empirical chapters, which derive from different data sources including literature, documentation review and qualitative interview material. The findings in this thesis can be summarised as follows: First that TMK today exists side by side with modern health systems, in what are seen as complex patterns of medical pluralism that provide evidence of an evolving role the TH plays in primary health care, in the rural and urban space. Youthful migrating population dynamics that are linked to historical processes, have effectively carved an emerging cross-sectoral role of the TH in the formal space.

Secondly the developing legislation on IPR and ABS in parallel with the representation of an earlier official formal governance around TMK in Tanzania; and the difference in the sectors where TMK is anchored in the two contexts, could have paved way to some earlier collaborative mechanisms, that today provide space to enable a more natural engagement between formal and informal organizations involved in the governance of TMK in Tanzania. Thirdly, the practical ways in which TMK learning processes, which are characterized by learning systems in place, being sent and visiting sacred places that are lived by an apprentice over a number of years, have increasingly come under pressure. Fourthly the thesis shows approaches by THs, encouraging the youth to access conventional medicinal education followed by, or in parallel with TMK learned through traditional pedagogies employed by the THs themselves. The youth’s keen interest in learning TMK is seen to increase when they view improved livelihood possibilities due to the commercialization of medicinal plants. The future of TMK learning processes may be limited unless incentives are put in place for the youth regarding their future livelihoods. Fifth, gendered and generational dimensions suggest that older and some younger female THs reemphasize the values of the gift and TMK in a climate of increased commodification and commercialization of TMK, where TMK increasingly meets neoliberal processes, engaging an alternative paradigm than the gift economy, where a predominance of male TH’s in the urban space and places, increasingly define the diversification of the TMK livelihoods. The gift provided by a higher power and which is embedded in a particular cosmological view, to be used as a social service to help the community, is increasingly evolving as an emerging tested force in a changing ideological climate, with an increasing awareness of commodification, commercialization, IPR and ABS issues surrounding TMK. It implies awareness in relation to the increased benefits of commoditized and commercialized medicinal plant knowledge (which THs hold) for other individuals and institutions.

The TH profession and TMK is seen as entering a contested IPR/ABS arena at a time when increasingly socio-spatial transformations are modifying its role from that of a gift to an owned commodity. However while the practice of TMK has changed over time and space, presenting new challenges as well as opportunities, it is also seen as a threat that anyone today can sell and market TMK products.