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50ALTERNATIVETHERAPIESsepoct2011VOL.17NO.5HaitianVodouasaHealthCareSystemingillnessthespatio-temporalconditionssurroundingthera-peuticpracticeclearlyrevealedbythepropertiesofvodoutopographythetherapistx19sincantationsintheformofprayerspraiseforlwapromisesandthanksgivingthelawsofcontiguityandsimilaritythatguidethetherapistx19sgesturesde8netheprop-ertiesofthematerialstobeusedforpreparingremediesandval-idatetheconnectionsbetweenthetherapistx19sgesturesandthedesiredeffects.CONCLUSIONTheseresearchresultsmakeitclearthatvodoux19sconnec-tionstoillnessgobeyondacare-givingdimensionidenti8edformostreligions.InsteadillnessmanagementisattheheartoftheformofvodoufoundintheHaitiancountrysidewhereitisahealthcaresystemgroundedinauniqueontology.Whatismorethereisamagicaldimensiontothevodouhealthcaresystemincaseswhereillnessiscausedbywitchcraftandthetherapistx19sroleisthereforetocountertheattackbydealingwiththepathogeniccausalagentcentraltotheexplanationfortheillness.Thereisareligiousdimensiontothevodouhealthcaresystemincaseswheretheoriginfortheillnesstheworldorderandawayofliv-ingenterintothetherapistx19sexplanationfortheillnessandarelationalbalancemustthereforebereestablishedwiththeancestorsandlwa.Insuchcasestheremedyisrelationshipandvodouaimstoreintegratethesickpersonintoanetworkofsocio-symbolicrelationsresponsibleforillnesswell-beingandqualityoflife.Thevodouhealthcaresystemiscombinedwithanindi-vidualandfamilycultofancestorandlwaworshipwhichthetherapistorganizestosmoothoverdisturbedrelationships.Thesemagicalandreligiousdimensionsdrawattentiontothemanyskillsofvodoupractitionerswhointheendfocusonwaysoflivingthevariousdimensionsofexistencethesickper-sonx19sphysicalandsocialenvironmentandtoaphysicalbodythathasbecomefragileandvulnerable.TheseaspectsarethereforecloselyrelatedtothemedicaldimensionofvodouasisstillthecaseinHaitiinProtestantandPentecostalchurches.3334Theyarealsoencounteredinmedicalpracticesthatconsistinhavingasickpersonjoinaself-helporprayercommunityorenterintoaspecif-icrelationwithinvisiblenonhumanbeingsGoddivinitiestheHolySpiritorothersorwithvariousmaterialorimmaterialele-mentsofanenvironment.MedicalpracticescomposedoftrancesandpossessionritualsasinAfricanmedicalandreligioustradi-tionsthoseinsistingoncloselinkswiththenaturalworlditscomponentsitsvisibleandinvisiblepowersasoftenfoundinshamanicpracticesthoseinvitingthesickpersontohaveaspiri-tualreligiousexperienceatransformationordiscoveryofonex19sselforonex19splaceintheworldsuchasinNewAgepracticesarebasedontheideathatdevelopingandtakingcareofrelationshipsleadtobetterhealthandcure.Symbolicandsupportedbyacer-tainideaoftherealitytheserelationshipsbecomeprominentassoonasallusionstocosmologytheuniversetheworldandasacrednaturearepresent.Moreovertheprominenceoftherela-tionshipsinthesetypesofmedicineandtherapytesti8estotheimpossibilityofadoptingareductionistapproachtotheproblemtothenecessityofremainingopenmindedaboutthesickpersonx19suniverseandwayofbeingandtothesearchforarelationalequi-libriumindicatedbyaworldx19sontology.Beyonditsethnographiccontributiontoabetterunder-standingofvodouthisarticleshowshowcloselythemagico-reli-giousandmedical8eldsareintertwinedindealingwithsufferingthatisnotmerelyphysical.Itremindsusthatitisarbitrarytolocatevodouinasinglesocial8eldforvodouisatotalsocialphenomenonfromwhichdifferentversionscanbedrawndependingonthedisciplineorsubdisciplinetowhichresearch-ersbelong.ButaboveallthisarticleinsiststhatourknowledgeofvodouberootedintheeverydayrealityofHaitiansandthatamicrosocialapproachbetakentothepracticesandknowledgeofvodoupractitionersatatimewhenanthropological8eldworkisdif8cultandcompletelyoutmodedinHaiti.21InmyviewthiswouldensurethattheknowledgeproducedbetterreflectHaitiansx19relationshiptovodouanditspractitionersandwouldenableustochallengewhatwethinkweknowonthesubject.FurthermorethisanalysisoftheconnectionsbetweenmedicineandreligionwithinvodoucanhelptoinformhealthcarepracticesintheWest.OfcourseintreatingHaitianimmi-grantstheimportanceofsuchconsiderationscannotbeover-emphasized.Thevodoucaseunderlinesthefactthatatreatmentisrelevantonlyinsofarasitisinkeepingwiththesuffererx19ssys-temofrepresentationsandvaluesbecauseitisthatsystemwhichstructuresexperienceandhelpsthesufferertode8nethemean-ingoflifetore9ectonthemeaningofeventsincludingillnesstoseehimselfaseithersickorhealthyandtotakestepstowardgreaterwell-being.Insummarypractitionersmustnotrespondsolelytoabiomedicalontologylimitedtoamaterialandvisibleversionofthepersonessentiallyanatomicalandbiologicalandhisrelationshiptoanimmediatephysicalenvironmentmadeupofpathogenicagentsforexample.Whatvodouteachesusisthatillnessisalsoanissueoftroubledinadequateandunaccept-ablerelationshipstotheworldwhichthesickpersonandhissocialgrouprefusebasedonindividuallyadoptednormsrep-resentationsandvalues.Thusthereisasymbolicdimensiontoillnessthatpractitionersneedtobeattentivetoandtodecodeintheirrolesascaregivers.Thiswillhelpthemtoidentify1howillnessisunderstoodandwhatdimensionsoflifethatmeaningrevealsandistiedto2whatsourcesofsufferinganunder-standingofillnessbringstolightwhatdimensionsoflifeareaffectedbyillnessandwhichonesneedtobeattendedtointak-ingcareofthepersonwhoisill3whichcaregiversarebestabletoofferassistancethatiscoherentwiththepersonx19sunderstand-ingofhisproblemandwithwhatheconsidersmeaningfulbothinthecausesandthemanifestationsofthatproblem.Ofcourseattentivenesstomeaningandtodifferentlayersoflogicismorecomplexinsocietieswheresystemsofmeaningaremorediverseandindividualizedandwherecaregiversoftendonotsharethesameknowledgeastheirpatients.Yetitisessen-tialinprovidingthebestpossiblecareparticularlyamongpeoplewhoserepresentationsandvaluesareverydifferentmigrantswithdifferentculturaloriginswhoareseekingholistic