Sunungurayi CHARAMBA, Midlands State University, Faculty of Social Sciences, School of Social Work, Corner Grant and Chinhoyi Street, Harare, Zimbabwe. Charamba S: suecharambas@gmail.com (Corresponding author)
Rudo MUKURAZHIZHA, Midlands State University, Faculty of Social Sciences, School of Social Work, Corner Grant and Chinhoyi Street, Harare, Zimbabwe. Mukurazhizha R: mukurazhizharudo@gmail.com (Corresponding author)
How to cite using ASWNet style
Charamba S. & Mukurazhizha R. (2023). Narratives of caregivers on management options for epilepsy condition from a Christian perspective in Africa: a case of Zimbabwe. Journal of Social Issues in Non-Communicable Conditions & Disability, 2(2), 150-162.
| Abstract |
| Epilepsy is a global, regional and national problem which affects individuals, families, communities. Epilepsy is a non-communicable disease of the brain. The diagnosis, treatment and management is very complex in nature taking into consideration that clients have different cultural, medical and religious beliefs in addressing the condition of epilepsy. The research aims at exploring the treatment and management options of epilepsy guided by The African Independent Churches (AICs) are predominantly bible churches which are led by Black Africans who were looked down upon by their colonial masters. They have the potential benefit to persons living with epilepsy, caregivers, social work practice and other stakeholders for referral pathways. The researchers used qualitative approach guided by narrative research design in having an in-depth understanding of the treatment and management options of epilepsy. Purposive sampling was used to identify key informants with the expertise of the phenomenon under study and snowballing was used to identify caregivers for clients with epilepsy as primary participants using in-depth interview guides as tools for data collection. Data was analysed thematically to come up with recurring themes generated into findings. The results indicated that use of holy water, sea salt, prophecy, exorcism, use of water to mix with porridge, soup and palp, and steaming are among the management options for epilepsy. However, there are notable similarities in use of sacrificial animals like birds, hen, blood as in African Religion. The researchers recommend the utilisation of a holistic care which embraces the bio-psycho-social-spiritual interventions package of management options as they are in line with the diverse clients in social work practice. Key words epilepsy, management, social work, Afro-centric, Zimbabwe, Africa, treatment, diagnosis, religion, spirituality |
Introduction
Epilepsy is categorised as a non-communicable disease not a mental condition or disease. Epilepsy is a complex disease, in understanding its causes, management and treatment to enhance the social functioning of such a client. In Africa it is a disease which existed since time immemorial and is believed to be linked to evil spirits and ancestral spirits (Gelfand, 1973) though medically it is not a disease. Epilepsy affects all age groups, and the caregivers have a burden of looking after the survivors. It affects individuals, families and communities differently. It is a cause for concern to health practitioners in practice as if affects individuals in social (psychological, spiritual, general side effects and economical (Tsvere et al., 2020; Mutanana, 2017). Hence the need to interrogate the treatment and management options available for use in African settings particularly African Independent Churches (AICs)which also has an Afrocentric way of assisting individuals as they were against white people dominated churches which followed Western ideologies. The diagnosis, treatment and intervention are broad in spectrum depending on the beliefs and norms of families and communities. Persons living with epilepsy are normally overprotected as they are normally locked up in their homes as they the society feel that they cannot work, cannot decide on their own, cannot marry and are no independent to carry out any activities alone.
The treatment and management of epilepsy could be complicated and multi-faceted in nature (Olinga, 2021). The problem is that when a victim has convulsions, he or she becomes unconscious and requires much attention and support for normal functioning to occur. Many people see that anti-epilepsy medication is alien to them and prefer the African way of management of epilepsy especially in the rural areas in Africa (Ademilokun, Agunbiade, 2022; Chabangu et al., 2022). The causes of epilepsy from an African perspective need to be fully understood by caregivers in order for the caregivers to use locally available resources, peculiar to their beliefs and norms which also culturally relevant to different geographical areas. Therefore, there is need to consider the Afro-centric way of management which many Africans subscribe to as they normally fail to acknowledge the medical explanation of epilepsy. This means that epilepsy can be managed using African religion, herbal treatment and use of spirituality using prophetic healing as a way of fighting epilepsy. In the Bible, there are scriptures which show that there was a son living with epilepsy where the parent confronted Jesus telling him that his disciples had failed to cure him. Jesus prayed and the demon was casted out in Mathew 17 verses 14-16 showing that epilepsy from a Christian perspective is demoniac in nature and can be managed through exorcism. On Mark 5 verse 1-9 there is a man who stayed in graveyards for many years and Jesus said come out of this man, you impure spirit and the demons were send to pigs. Management aims at reducing the frequency or elimination of the seizures in clients hence the study seeks to explore Christian management options of epilepsy.
Background
The World Health Organization (WHO) estimates that approximately 50 million people live with epilepsy worldwide, 80% being from low-income countries (WHO, 2019). Mugumbate & Zimba, (2018) posit that there is a high prevalence in Africa (10 million people are affected directly, representing approximately 20% of people with epilepsy worldwide). Epilepsy is one of the oldest recognised condition affecting all age groups. Epilepsy is a seizure disorder characterised by confusion, jerking, frothing, falling down and convulsions (Beghi, 2020; Riney et al., 2022) which can be managed through multi-faceted interventions to reduce or end the problem. WHO further estimates that the prevalence rates of epilepsy in Africa ranges from 2.2 to 58 per 1000 population. Sub-Saharan Africa (SSA) carries the greatest burden of epilepsy in the world (Ali Arazeem et al., 2022; Esterhuizen et al. 2021) and there is a lot of stigma surrounding epilepsy which may also lead to poor controlling of the Non-Communicable Diseases (NCDs) (Makhado et al., 2022; Mugumbate and Mushonga, 2013).
Magazi, Nkohla & Mmako (2018) acknowledge the complexity of management of epilepsy as it is not uniform and called for the need to individualise epileptic cases. This is clear that even the response to treatment is different and requires further research even to come up with documented articles on use of traditional and spiritual interventions. Therefore, management is key in controlling or trying to eliminate the seizures completely hence the call for a well packed package in addressing the problem of epilepsy. In African countries African medicine, herbs and use of religious interventions are most welcome to different communities as a way of preserving their cultural beliefs and values (Dewa, 2012). Many authors seem to blame the management of epilepsy through African ways. Cultural and religious beliefs are labelled as causing treatment gap especially in African and poor countries that could clash with what is recommended by a treating doctor (Magazi, 2015, Nwani et al. 2013). However, in social work there is an emerging call for indigenisation of African problems so there is inclusivity catering and embracing the use of AR and spirituality which might further lead to the integration of the management of epilepsy using a comprehensive approach rather relying on a Euro-centric way of managing epilepsy. Furthermore, high costs of surgery, scans and medication should also be considered as a contributory factor which makes caregivers and families to opt for the Afrocentric way of managing epilepsy.
Problem
Some of the modern management of epilepsy are Eurocentric in nature where surgery and use of anti-epileptic of anti-convulsion medicine are used in trying to reduce and eliminate the problem. The management of epilepsy is multifaceted with the hospitals stabilising the seizures for given periods yet other methods as spirituality in terms of religion in AICS also have claims of healing. ATR has a key role to play in the health sector especially in the management of chronic illnesses in Zimbabwe (Mabvurira, 2017). However, due to the coming in of Christianity, the use of traditional and religious interventions is blamed and seems to be regarded as a primitive way of managing treatment of epilepsy. The treatment gap is levelled against culture and religion which imply that there is little cultural inclusion which is of great value to health care provision and care for people living with epilepsy. There is a gap in literature on the management of knowledge passed by cultural and religious practitioners with African knowledge is needed as a referral point for those who embrace the use and those who fail to acquire finances to follow the medical route. Afrocentric solutions are part of addressing the global challenge of epilepsy.
Justification
Commitment to issues of human diversity is the hallmark of social work practice. Organised spirituality has rich heritage if properly documented for future use such as the management of epilepsy which seems to be a missing link in health-related issues. It’s pivotal and critical in assisting the vulnerable and their surrounding networks. The research might also contribute to research gap in the management of epilepsy. It might also inform health care practice working in multi-disciplinary settings and to other stakeholders dealing with caregivers and epileptic clients. The findings might also influence policy making like the embracing of different management options thereby increasing inclusivity of all available options. The epilepsy management options might induce hope, optimism and general wellbeing for caregivers by exploring them.
Theoretical framework
The study utilised Afrocentric overview as a way of Africanisation of knowledge and education which is peculiar to addressing epilepsy in an Afro-centric manner (Mabvurira & Makhubele, 2018; Mabvurira, 2016). The article targets African traditional religion, spirituality and social work in the management and treatment of epilepsy thus motivated to use Afrocentrism as a theory. This paradigm postulates that the main site of studying African truths cannot be located outside the context of Africa. It’s a move of appraising African philosophies which are shunned by Western in addressing the problems faced by individuals, groups and communities (Dastile, 2013) in their health-related matters specifically management of epilepsy. Nabudere (2006: 28) posits that African decolonisation and voices of Africans reclaim heritage and knowledge of oral tradition. This motivated the researchers to adopt this paradigm and using the narratives capturing the orally passed information and documenting it for future use. Furthermore, there is overwhelming evidence from literature of acknowledging the use of cultural and religious interventions with close traces to African originality in managing epilepsy. This theory ensures that everyone is included and not left out and gives an African identity in managing the complexity of epilepsy management. It is also deeply rooted in experience, Ubuntu and history of how the management of epilepsy was eliminated before the coming in of the whites thus multiple and complexity diversity should be embraced by listening to narratives generated from lived experiences. According to Igboin (2013), Afro-centricism aims at correcting the negative expressions and images that the West has painted about Africa.
Methodology
A qualitative research approach with a narrative research design was utilised by researchers in exploring the problem of epilepsy on all age groups. Ten semi-structured interviews were administered using both in-depth- interview guides for primary participants who were caregivers and key informants from the selected African Independent Churches (AIC s) including the three prophets and two church elders for diversity who claimed to know the management of epilepsy as experts. Purposive sampling was utilised for both primary and key informants. In-depth interviews were used as data collection methods utilising in-depth interview guides as data collection tools for both primary participants and key informants. Data was analysed by means of thematic analysis in order to explore emerging themes on causes and treatment options from an African perspective in managing epilepsy.
Results
The findings from the study revealed that epilepsy from a Christian perspective can be managed through exorcism through prayers, use of holy water and salt, use of cooking oil and coarse salt, sacrificial animal rituals, use of holy bath with fresh milk and steaming using burnt fatty from the sheep. This is presented in detail below:
Exorcism through prayers
The findings from the study indicated that praying is used in the management of epilepsy in AICs. This is evident from the direct words below:
We consulted a prophet who said through praying and fasting for the client epilepsy will automatically be managed. Night vigils conducted on a big mountain was conducted as a way of asking for divine intervention. We were given water known as ‘mvura yemunamato” meaning to say water interceded on behalf of the client. The water was to be used when taking a bath so as to cleanse him from evil spirits and was also used to mix with porridge as a way of cleansing the inner stomach. After consultation for over 3 months the seizures were not as severe as before visiting the prophet (Participant, 3).
Another participant concurred with the above findings:
The use of prayers coupled with faith and even baptism in big rivers has been a success story for my husband as the evil spirits vacated and left the client as they were tormented by prayers using robes commonly known as “ndaza’ known as holy robe. I was also given slim robes to be tied across the chest as a protective measure. My husband is much better now as the frequency of fits has been reduced to once a month rather 8-10 times before being assisted (Caregiver, 5).
A key informant also cemented the use of prayers in exorcising evil spirits is a successful management option for epilepsy as indicated below:
‘The key successful step to eliminate or reduce the prevalence of seizures is through praying to the Almighty so as to be given explanation on the causes and be given the “kundiso” known as steps to be taken and what should be followed to treat epilepsy. This can only be achieved after consultation with angels. In the Bible it is written that if there is anyone who is sick, they should call the elders and pray during illness episodes.’ (Key informant, 1).
Use of holy water and salt
Findings from the study revealed that the prophets used holy water and salt to manage epilepsy as indicated below:
A prophet from an AIC prayed for my husband and exorcised demons using holy water and salt by rubbing in the hands, feet and joints. The prophet told us that the Holy Spirit saw it as the work of the evil spirit dwelling in him so that he could not work but just to be confined at home. As a family because of this problem, we moved from traditional churches and moved to Zionist as a change was noted in terms of the intensity and frequency of seizures. It took use close to one year until the problem was completely solved. (Caregiver, 5).
Another participant also echoed similar sentiments below:
My child aged three was regularly attacked by epilepsy despite the fact that he was on medication prescribed by psychiatrist. This forced us to also look for alternatives in the management of the epileptic condition. We were referred to a prophet as we wanted to save the life of our child. The prophet payed for the child and gave use holy water as a form of protection from the work of the evil. It was supposed to be sprinkled in the house, around the yard, in bathing water and even to put in food taken by the child. There was noticeable change though the problem has not been completely eradicated. Now the child fits once in a moth rather than more than 10 episodes per month. (Caregiver, 2)
Another key informant cemented the findings as shown below:
As a prophet I use holy water with salt ‘mvura yemunamato ine munyu” after revelation from the Holy Spirit. The mixture can be used to reduce the frequency of attacks and seizures as the mixture is very powerful in chasing the evil spirits from attacking the person with frequent seizures. The healing process a gradual in nature for some it reduces and for others the problem may stop.
It is evident from the findings that the mixture of holy water and salt can be used as an alternative option in the management of epilepsy. The caregivers and the prophet also clearly indicate that this can reduce or eliminate the problem completely. From the social work discipline, it also shows that some of the clients faced with the problem of epilepsy might also need Afro-centric perspective of managing epilepsy and be referred to such existing services.
Use of cooking oil and coarse salt
The participants highlighted the use of cooking oil and coarse salt as a remedy in the management of epilepsy as presented below:
My child is aged 32 and is now working with the father who is a builder. When attacked since childhood we tried different options including the medical and herbalist. We consulted white garment prophets, and they administered boiled cooking oil with salt to clear froth at the chest. They explained that if the chest has too much froth it causes the individual to have fits and convulsions. When we administered, he vomited and had a running stomach, and this also necessitated expulsion of the froth. Now we administer it on our own and you can predict if he reports that he is restless. If you give in time he does not fit. (Caregiver, 4)
Caregiver 2 presented the direct words below:
For my case we stayed at the Apostolic churches in open space during the night were the use of cooking oil and salt was rubbed throughout the body of the child to chase away evil spirits and if attacked conscious was regained soon after rubbing salt. The child also drank cooking oil with salt and the excreted waste had froth which was an indication of the effective use of the mixture. (Caregiver, 2)
A church elder also confirmed the use of cooking oil and salt as indicated below:
As you know that salt is sour, use of sea salt and tokolosh salt is effective in chasing demons and evil spirits especially from ancestors who died whilst not in churches. The proclaimed prophets use it with the guidance of the Holy Spirit. Epilepsy is the work of the evil but salt and cooking oil divinely protect and can also heal the person with epilepsy (Key Informant, 1)
The direct words indicate that the use of salt and blessed water is effective in the management of epilepsy thus acknowledging the role of spirituality which has been a missing link in health seeking behaviours.
Sacrificial animal rituals
The study revealed that use of sacrificial animals like hen, pigeons, goats, from are also management options for epilepsy as presented below:
My brother had regular fits and seizures until a female prophet from our church based in a different area visited us in our home and said she had a prophetic dream on the solutions to the problem. We prayed and she said that the evil spirit which survives with blood, so she slaughters the hen and placed clothes in the same bag with clothes of the client with epilepsy and throw it in a flowing river. The notion was that the spirit had been exorcised in water. The attacks were reduced though not completely eradicated. (Caregiver, 3)
The use of animals was also supported by another caregiver as presented below:
The epileptic seizures and fits were unbearable for us despite consulting the doctors. It was during an Easter festive season when another congregant referred us to a female prophet. With the use of prophecy, she said that there was spirit of a dead person manifesting in form of epilepsy so that payment could be done. We were tasked to buy a goat for sacrificial purposes, and it was killed, and he was given certain parts to eat whilst other parts were thrown away during the night. From that day it’s now over six months with no episode of fitting again without taking any medication so we are celebrating victory from the church. (Caregiver, 1)
A key informant interviewed also supported the use of animals in the management of epilepsy as indicated below:
A pigeon can be used to deliver a patient suffering from epileptic seizures. When attacked those around capture the froth and put grains of maize and throw to pigeons so that they eat. This would mean that the burden has been transferred from the patient to the pigeon. A hen can also be used were a concept of ‘kuhaka and kurasirira’ are used meaning to say the evil spirits are transferred to the hen and is thrown away in mountains as a way of delivering the client. Its effective I have assisted many using this strategy with divine intervention from the Almighty.
It is evident from the above words that use of diversified sacrificial animals like goats, pigeon and hen where blood is spilled and splashed on the mouth is another management option. This is a similarity with the African Traditional Religion.
Steaming using burnt fatty from the sheep
The study revealed that steaming from fatty oil mixed with hot charcoal is also a management option for epilepsy in African Independent churches as indicated below:
I was told to use fatty oil from the sheep mixed with charcoal, the smoke is believed to chase away evil spirits or the witches from invading the territory. The smoke was to be spread in all rooms so that the patient will not be attacked. The client had peaceful sleep after this process especially during the night. Before visiting this church, the seizures could be more than 4 times per day, it was very effective and there was remarkable change in the reduction of the fits. (Caregiver, 2)
Another caregiver supported the same sentiments about the use of burnt fatty from the sheep as indicated below:
“Mafuta ehwai akapiswa nemazimbe wofukira murwere wekudonha chiutsi chacho chinoshanda pakudzinga mweya yerima”
Translated to “Burnt fatty from the sheep can be inhaled by the client with epilepsy and the smoke is very powerful to do away with evil spirits. The scent is very strong, but I noticed change though the problem was not completely eradicated.” (Key Informant, 2)
It is evident that even non-members of the Zionist also received healing in this church and recognised change in the frequency of seizures. The use of fatty from the sheep burnt with charcoal is believed to chase evil spirits and the witches.
Use of holy bath with fresh milk
From the study it was revealed that prophets or prophetess administered holy bath with fresh milk as a way of cleansing the client with epilepsy as indicated below:
When I visited a renounced prophetess, she prayed and mixed blessed water and fresh milk and my husband was asked to take a bath during the night outside our home premises. She explained to use that the evil spirits won’t attack him and come back to him. After about 6 months the fits were completely eradicated. (Caregiver, 5).
Another participant also reiterated the use of holy bath, milk and egg as a management option as indicated below:
The prophet went with us to a river after a night vigil in the mountain. He prayed for water, fresh milk and an egg. It was poured on my child s head and dripped down the whole body and later had a holy bath whilst the prophet was holding him tightly. The process was done thrice as he claimed that he was advised to do that by the Holy Spirit. We noticed change though it was gradual in the sense that the seizures and frequency was not as severe as before visiting the prophet (Caregiver, 1).
To strengthen the findings for the use of holy bath and fresh milk one of the key informants had this to say:
When an individual is having seizures and foam from the mouth holy bath with milk is used for cleansing purposes so that the client retains his or her pure state. This implies that the evil spirits are driven away through this process and all the burden will be lessened. (Key Informant, 3)
Discussion
In the epilepsy management plurality environment, the members also seek Zionist heath care during episodes of seizures for their relatives and loved ones. The article demonstrated that members and non-members of the Zionist seek health care in the management of epilepsy and were generally happy and contented. Watila, (2019) acknowledges the use of religion in the management of epilepsy because of acceptability to the African-Nigerian communities. Therefore, stigma should not be attached to spirituality as a contribution to treatment gap but is also an effective secondary management option for epilepsy.
AICs emerged as a movement which broke away from missionary or Western founded churches to use African ways of healing and seeking practice which embraces African overview of Christianity. Thus, the Afrocentric paradigm is best as a guiding lens in exploring the management options for epilepsy in African Independent Churches especially the Zionist. Seeking of health care through faith healing is not new as (Danilee, 1970) extensively wrote about it but the management of epilepsy was a gray area. The findings confirm that the Zionist Church even in Malawi healing and management of diseases is the core business (Munthali, Mannan, MacLachlan, & Swartz, 2016).
There are multiple management forms utilised by the prophets, prophetess and church elders in reducing and eliminating epilepsy condition. The use of prayer, baptism in water, sprinkling blessed water in houses is seen as powerful in driving the evil spirits away and restoring health. This is corroborated by findings from (Modiko, 2011) in a study in Vaal Triangle in South Africa. The study findings also concur with findings from Mugumbate and Gray (2021) who argue that faith in God, praying, and seek help from prophets, who use anointing oils, water, and touch for healing are prevalent among Christian churches.
The use of holy water and oil (Wilson & Hallard 2021) is in contrast with the findings from this study as blessed water could be used with either salt or cooking oil. In the use of sacrificial animals demons are believed to be transferrable to the animals then the client is redeemed and delivered is in line with the findings by Wilson & Hallard (2021) who also found out that sacrifices with chicken and sheep, the blood from these was placed on the head as a way of cleansing the client from the evil and ancestral spirits.
The results from the study did not mention any form of locking up the patient and beating the patient with epilepsy to drive away ancestral and evil spirits as noted by Wilson & Hallard, (2021). From a social work perspective this is violation of human rights and religious leaders should be educated through advocacy.
Implications for social work practice
For multi-disciplinary practitioners, it should be noted that the management of epilepsy come in a package from Western, African Religion, Christianity, natural and herbal medicine thereby it should be noted that there is no single path for treatment. Partnership and collaboration is needed to avoid further polarisation of Afrocentric options which are also acceptable, affordable and accessible. Efforts to integrate the spirituality and western interventions should be sought to ensure that no-one is left behind.
Research on religious aspects should be studied and researched with regard to caregiver perceptions, attitudes and practices in the management of epilepsy as this might reduce the treatment gap and for clients to make informed decisions. Furthermore, research should be carried out by social work researchers to find out how the two extremes of Afrocentric and Eurocentric interventions can be integrated without any conflict.
Social workers should also advocate for collaboration and interaction of religious (including African religion) and western professionals to enable exchange and sharing of ideas as the problem of epilepsy uses the multi-disciplinary approach.
Conclusion
It can be concluded that even in African Independent churches, there is no single path of management of epilepsy however there are a basket of treatment options including use of prayers, blessed water and salt, cooking oil and salt, sacrificial animals, steaming use fatty oils from the sheep, use of milk. The management is not a once off but a gradual process.
References
Ademilokun, T. F., & Agunbiade, O. M. (2022). Approaches to epilepsy treatment among Yoruba traditional healers in southwest Nigeria. International Journal of Modern Anthropology, 2(18), 924-958.
Ali Arazeem, A., Tahirah Adedolapo, I., & Joseph Alabi, O. (2022). Shame, stigma, and social exclusion: The lived experiences of epileptic patients in a health facility in Ilorin, Nigeria. Global Public Health, 17(12), 3839-3852.
Beghi, E. (2020). The epidemiology of epilepsy. Neuroepidemiology, 54(2), 185-191.
Chabangu, Q., Maputle, M. S., Lebese, R. T., & Makhado, L. (2022). Indigenous practices for management of epilepsy by traditional healers in South Africa. Epilepsy and paroxysmal conditions, 14(3), 267-275.Daneel, M. L., (1970). Zionism and Faith-Healing in Rhodesia: Aspects of Independent Churches (Hague and Paris: Mouton) Ashforth, 40; 144-156.
Dastile, N. P. (2013). Beyond Euro-Western dominance: An African-centred decolonial paradigm. Africanus, 43(2), 93-104.
Dewa, W., (2012). Non-attendance of treatment review visits among epileptic patients in Gokwe South Disrtict, Midlands Province. College of Health Sciences, Department Of Community Medicine, University of Zimbabwe.
Esterhuizen, A. I., Carvill, G. L., Fieggen, K., McIntosh, C., Ramesar, R. S., & Wilmshurst, J. M. (2021). Importance of genetic diagnosis in the management of early-onset epilepsies. South African Medical Journal, 111(1), 8-9.
Gelfand, M. (1973). The African’s concept of the causes and treatment of epilepsy and convulsions. South African Medical Journal, 47(3).
Igboin, B. O. (2016). Afrocentrism: Recalling the will of the past for the future. Cameroon Journal of Studies in the Commonwealth (CJSC), 3(2), 44-60.
Mabvurira, V. (2016). Influence of African traditional religion and spirituality in understanding chronic illnesses and its implications for social work practice: A case of Chiweshe communal lands in Zimbabwe (Doctoral dissertation, University of Limpopo).
Mabvurira, V., & Makhubele, J. C. (2018). Influence of Shona beliefs in understanding illness: Implications for indigenous social work practice in Zimbabwe.
Magazi, D. S., Nkohla, S., Mmako, M.T., (2018). Epilepsy seizure types, classification and treatment. South African Family Practice, 60(4):22-27.
Makhado, T. G., Lebese, R. T., & Maputle, M. S. (2022). Perceptions of teachers regarding the inclusion of epilepsy education in life skills for primary learners and teachers in Limpopo and Mpumalanga provinces (South Africa). Эпилепсия и пароксизмальные состояния, 14(4), 334-343.
Modiko, B. V. (2011). The concept of healing power in the African Initiated Churches (AICs) with special reference to the Vaal Triangle (Doctoral dissertation, North-West University).
Mugumbate, J. R., & Gray, M. (2021). Misrecognition of the Rights of People with Epilepsy in Zimbabwe: A Social Justice Perspective. The Tensions between Culture and Human Rights, 85.
Mugumbate, J., & Zimba, A. M. (2018). Epilepsy in Africa: past, present, and future. Epilepsy & Behavior, 79, 239-241.
Mugumbate, J., & Mushonga, J. (2013). Myths, perceptions, and incorrect knowledge surrounding epilepsy in rural Zimbabwe: A study of the villagers in Buhera District. Epilepsy & Behavior, 27(1), 144-147.
Munthali, A. C., Mannan, H., MacLachlan, M., & Swartz, L. (2016). Seeking biomedical and traditional treatment is a spiritual lapse among Zionists: a case study of the Zion Church in Malawi. Ufahamu: A Journal of African Studies, 39(2).
Mutanana, N. (2019). Challenges associated with anti-epilepsy medication and use of complementary or alternative medicines among people with epilepsy in rural communities of Zimbabwe. Malaysian Journal of Medical and Biological Research, 6(2), 77-84.
Nwani, P. O., Nwosu, M. C., Enwereji, K. O., Asomugha, A. L., Arinzechi, E. O., & Ogunniyi, A. O. (2013). Epilepsy treatment gap: prevalence and associated factors in Southeast Nigeria. Acta Neurologica Scandinavica, 128(2), 83-90.
Olinga, M. A. (2021). Factors Affecting Management of Epilepsy Amongest Epileptic Clients Receiving Services at Serere Health Centre IV Serere District. Student’s Journal of Health Research Africa, 2(9), 14-14.
Prokopaki, K. (2017). Epilepsy in children and adolescents: what a psychiatrist should keep in mind. Hospital Chronicles, 12(1-4), 15-22.
Riney, K., Bogacz, A., Somerville, E., Hirsch, E., Nabbout, R., Scheffer, I. E., … & Tinuper, P. (2022). International League Against Epilepsy classification and definition of epilepsy syndromes with onset at a variable age: position statement by the ILAE Task Force on Nosology and Definitions. Epilepsia, 63(6), 1443-1474.
Tsvere, M., Chiweshe, M. K., & Mutanana, N. (2020). General side effects and challenges associated with anti-epilepsy medication: A review of related literature. African Journal of Primary Health Care and Family Medicine, 12(1), 1-5.
Watila, M. M., Xiao, F., Keezer, M. R., Miserocchi, A., Winkler, A. S., McEvoy, A. W., & Sander, J. W. (2019). Epilepsy surgery in low-and middle-income countries: A scoping review. Epilepsy & Behavior, 92, 311-326.
Watila, M. M. (2019). Standard of Care for People with Epilepsy in Sub-Saharan Africa: the Case of Nigeria. A thesis submitted in fulfilment of the requirements for the degree of Doctor of Philosophy in Clinical Neurology.
Wilson, R., & Hallard, J. (2021). “God is first, MSF second, and my husband second too” Mental health conditions and epilepsy in Liberia: Understanding and healing pathways within a community-based and patient-centered care approach.
World Health Organization (2019). Epilepsy. Retrieved August 19, 2022, from Fact Sheet website: https://www.who.int/en/news-room/fact-sheets/detail/epilepsy