World views and perspective are in two contexts: 1) The world that we are taught formally, and2) The world that we have historically inherited and we are born into.

Most children in developing countries have the two worlds to conform with, that is when in an urban setting you think and behave one way. When in a rural setting you behave and think another way. These two worlds signify the recognition of two authority systems of living, and in many instances most of them are devoid of the other. For example, if you are a recognized healer in the village, when you go to the city, more often you will not be accorded the same level of respect accorded to you in the rural s and vice versa. Because the indigenous lifestyles see life in another way as the modern non-indigenous see the world in another way. This is why indigenous communities see food as medicine, and not as calories.

Well, why assess the knowledge of a traditional healer? You want to be careful, tradiational healers often have very specific knowledge. This knowledge is often not meant or designed to be taken out of context. General remedies used by folks is often overlooked for what is known by traditional healers. Also, one group may have more then one healer that use very different means for healing. The spiritual aspects are more valued in the group and by the healer then by outsiders who overlook it because it can not be quantified. How does knowledge perform when it is assessed and extracted?

I agree with Mcclure, I am from a culture in which I believe in spiritual healer's and traditional healer, and each i their own right have such power's seeing what is wrong with individuals and being able to find the right conjunctures of plants to help cure peoples symptoms, and the spiritual healers, usually do a lot of praying of individual's and if that is their belief a do get healed. I may be due to the power of a person believing that they will be healed. My grandfather was a spiritual healer but knew what plants and mixtures to make for certain aliments, he was a herbalist and could look at plants and tell you what they healed and how to make it. I how ever do not have his knowledge, I can't even grow plant's in my house, but my son can grow anything. I do see problems with outsiders cataloging these conjuncture because of pharmaceuticals companies can find many ways of preventing people using these products only if they buy from them. It would be terrible if the art was lost to the culture only to be added to your some pharmacy profits. Such must be protected but in an capitalist society, even these simple things

There is no real way to asses such healer in today's technological world.

Unfortunately we have already been assessing and appropriating traditional healing models out of context, the entirety of alternative and complementary medicine can attest to that - so there are two threads which bear consideration.

The first is how to keep the traditiona internal to indigenous or place-based collective alive in situ, without constant comparison to conventional medical models and an assumption that 'western is better', which is simply neo-colonialist.

The second is how to assess these 'already migrated' and altered healing models in a way that is balanced and reasonable, and can create safety in scenarios where the appropriated models are incomplete or inadequate, whether it be because of bad training or an incomplete transfer of the ontological and epistemological requirements for transmission. Many mind-body medicines rely on an ability to connect or entrain with a particular worldview, healing modality indigenous to that worldview, and a client, simultaneously. They appear to 'fail' oftentimes not because they are inadequate, but because the practitioner has not achieved this. Our assessments rely entirely on a scientific premise (bias) that looks only at the manifest results of a practice, and uses a very narrow 'effectiveness' ledger, missing all the nuances of effective transmission and even client receptivity.

Today I have visited an old colleague from my KENGO days, from my eight years of work there while on leave of absence from the University of Nairobi's department of Biochemistry. Jael believed in my work of indigenous things, and that food is medicine. She runs a small but very prolific shop of things indigenous, which i sometimes supply. I say food is medicine and many East African's come to this tiny wee shop to get things they would get whilst in the village. She has brought the village to the city the by products and products of traditional healers and is doing good business which leaves many of us wondering why did we bother with research while healers knowledge works for the majority of Africans? The African healing molecule is so complex and diverse, that only traditional healers know what works best .

Indigenous knowledge historically scorned by the world of industrialized societies has now become intensely, commercially attractive (Greaves 1995). The very cultural heritage that gives Indigenous peoples their identity, now far more than in the past is under real or potential assault from those who would gather it up, strip away it’s honoured meanings, convert it to a product and sell it. Traditional healing is considered sacred by Aboriginal peoples and healers may not be willing to share this information due to the very real danger of cultural appropriation (Greaves). It is not owned by individuals, but by communities and cultures, and seeking permission and cooperation to participate in research may be problematic. Traditional medicine and healing are challenging concepts to define, as many Aboriginal peoples describe traditional medicine and practices within the localized geographical context of their community or nation (Martin-Hill). However, the WHO and the Royal Commission on Aboriginal Peoples (RCAP) provide the following working definitions. The term traditional medicine, as defined by WHO is the sum total of knowledge, skills, and practices based on the theories, beliefs, and experiences Indigenous to different cultures, whether explicable or not, used in the maintenance of health as well as in the prevention, diagnosis, improvement of treatment of physical and mental illness (WHO, 2001 as cited in Martin-Hill, 2009). The RCAP defines traditional healing as practices designed to promote mental, physical and spiritual well-being that are based on beliefs which go back to the time before the spread of western scientific bio-medicine. These include a wide range of activities, from physical cures using herbal medicines and other remedies, to the promotion of psychological and spiritual well-being using ceremony, counseling and the accumulated wisdom of elders (RCAP, 1996, as cited in Martin-Hill, 2009).

Duran & Duran (1995) state the assumption presented by Aboriginal traditional worldviews has been articulated as fundamental for framing a system of knowledge that is valid for healing and is based upon sound science. Duran & Duran; Martin-Hill state currently, there are emerging discourses that explain and define traditional thought as a part of an Indigenous knowledge framework that is a complete knowledge system with its own epistemology, philosophy and scientific and logical validity which can only be understood by means of a pedagogy traditionally employed produced by these people themselves (Smith 2012; Wilson, 2009). Unfortunately to many non-Aboriginal peoples such broad definitions of Aboriginal traditional healing seem to include everything and therefore seem to mean nothing.

Aboriginal leaders in Canada are calling for a different model of health that does not pathologize us as a population. One way that may provide an answers to this questions is using the Salutogenic model of health. Researching health is much different than researching disease, Aboriginal and indigenous traditional healing is focused on health, rather than disease. Salutogenesis is a stress coping framework.

Salutogenic Model of Health

The most complete treatise on salutogenic theory and model of health can be found in Antonovsky’s book Health, Stress and Coping (Antonovsky, 1979). Levin states it is also the most powerful counterpart to the concept of pathogenesis. Antonovsky stressed in salutogenic theory that the study of health is not the same as the study of disease (biomedical paradigm). Antonovsky did not disparage the concept of disease and the pathogenic orientation and mentioned its importance to medicine and public health work. Pathogenesis divides people into either one of two categories, either healthy or sick and has a tendency to blind us to the subjective understanding of the affairs of the person who is ill, to the human condition, as most of us are subjectively ill most of the time (Levin).

According to Antonovsky (1979) salutogenesis is not just the other side of the coin from pathogenesis, but is radically different and is based on different assumptions. There is a dynamic health ease/dis-ease (breakdown) continuum along which all living people fall, not a dichotomy of health vs disease and all people are to some extent healthy (Antonovsky, 1972). Antonovsky (1979) states epidemiologic research should focus on people’s story and not their disease in order to identify factors that help to maintain the health they possess or to move them in the healthy direction. Factors that initiate or enable salutogenesis are often not just the opposite categories of respective risk factors for pathogenesis, but rather entirely different factors altogether (Levin). Antonovsky (1979) states stressors are ubiquitous and just as likely salutary as pathological, in that they can make demands on an organism which can lead eventually to positive health consequences. Epidemiologic research should focus on factors that facilitate adaptation, rather than on factors that are etiologic and can be diagnosed and targeted with magic bullets, and studies as such, should examine the deviant cases, i.e., the smokers who do not develop lung cancer, the type A person who does not develop coronary heart disease, rather than ignoring them to focus on pathogenic cases (Levin).

Antonovsky (1979) states thinking salutogenically not only opens the way for, but compels us to devote our energies to, the formulation and advance of a theory of coping and operationally defined the theory of salutogenesis with the concept of sense of coherence (SOC). The SOC consists of three components, 1) comprehensibility, the extent to which internal psychological and external environmental stimuli make cognitive sense, 2) manageability, the extent to which available resources are adequate, and 3) meaningfulness, the extent to which challenging events are seen as worthy of emotional investment and engagement. Antonovsky (1979) states the SOC develops over the course of life and should be fully developed by the age of 30 and it is culturally universal and applicable to all cultures and peoples and defines it as:

… “a global orientation that expresses the extent to which one has a pervasive, enduring though dynamic feeling of confidence that ones’ internal and external environments are predictable and that there is a high probability that things will work out as well as can be reasonably expected” (Antonovsky, 1979, p. 10).

Antonovsky (1979) asks “how do we manage tension and prevent it from leading to stress?, what are the resources at our disposal that enable some of us or, rather, all of us, as long as we are alive, to resolve tension at least some of the time?” (p.99). The answer to these questions according to Antonovsky (1998) was another concept of importance in salutogenic theory, General Resistance Resources (GRR’s). GRRs are any characteristic of the person or group, or the environment that can facilitate effective tension management. GRR’s can be biological, material or psychosocial factors that make it easier for people to perceive their lives as consistent, structured and understandable (Horsburgh & Ferguson, 2012).

Antonovsky (1979) developed a mapping-sentence definition of GRR’s to be either “physical, biochemical, artifactual-material, cognitive, valuative-attitudinal, interpersonal-relational or macrosociocultural characteristic of an individual, primary group, subculture or society that is effective in avoiding or combating a wide variety of stressors” (p.103). For example, typical GRRs are money, knowledge, experience, social support, culture, intelligence, traditions, ideologies (Levin). If a person has these kinds of resources available to themselves, or in their immediate surroundings there is a better chance for them to deal with the challenges of life (Harrop, Addis, Elliot, & William, 2006). They help the person to construct coherent life experiences, but what is more important than the resources themselves is this ability to use them (Antonovsky, 1979). GRRs lead to life experiences that promote a strong sense of coherence – a way of perceiving life and an ability to successfully manage the infinite number of complex stressors encountered in the course of life (Antonovsky, 1979). The SOC is the capability to perceive that one can manage in any situation independent of whatever else is happening in life. The SOC is a resource that enables people to manage tension, to reflect on their external and internal resources, to identify and mobilize them, to promote effective coping by finding solutions, and resolve tension in a health promoting manner (Lindstrom & Eriksson, 2010; Horsburgh & Ferguson 2012). SOC is flexible and not constructed around a fixed set of mastering strategies, unlike the classic coping strategies (Antonovsky, 1979).

Your question is very relevant. To plan a study about sometimes very individual therapists in their work needs a specific theoretic approach. It must be done from a neutral point of, concerning both scientific and health care professional understanding. Medical doctors trained in Western universities are often bound to the values and knowledge of academic medicine. They should be specially trained to know and scientifically understand other groups in health care with different backgrounds. This problem of finding a scientifically competent theoretic and methodological frame is a key problem in the study of "alternative", "traditional", "ethnic", "folk" etc. therapists - what ever name we use of them. - Professor Lauri Honko (1931-2002) studied the theory and practice of cultural studies very profoundly. I think that the wisdom, he, a folklorist and scholar in religious studies, has presented in many of his works could be evaluated and used here in health care studies. His deep scientific understanding of the formal and transformal contents in communication could be shifted and used to various health practitioneer studies. - To answer your question: Yes, it can. But everything is up to the scientific level of the "formal system of assessment"? Big problems may arise too because of the professionally non-neutral background of the investigators.

- My background is that of a DrMedSci. I have personally studied these things in Finland especially concerning traditional indigenous therapists,mostly bonesetters, cuppers, blood stoppers and spiritual healers in 1981-2002. I studied them with many field work methods: e.g. personal interviews, queries, participant observation and co-work (esp. bonesetters). I photographed and video filmed their working tens of hours.

Some of my theoretic and methodological results are presented in :

Hernesniemi, Antti. "Presentation of bonesetter-patient collaboration through "positiographical cinemanalysis". Medical thesis. Oulu. 1999. Hernesniemi, A : Co-work between a medical doctor and a traditional healer. Odense. 1994. Hernesniemi, A. Do ”healers with healing hands ” emit thermal radiation to patients ? Helsinki 2001.

This is a great question which I am especially concerned about. Integrative Medicine has made some advances in this regard, but really very little. There is still a lot of skepticism regarding indigenous health systems and their capacities to treat sicknesses. Despite the abundant evidence which shows that local traditional health systems work perfectly well and much better than Western biomedicine in local situations because local sicknesses and their explanations pass through the purview of specialists in cosmology, the nature of the spirit world, specific religious experiences, and extensive knowledge of forest or local remedies. Knowledge which Western biomedicine does not have. On the other hand, biomedicine is more apt to be efficacious when the cases are defined as 'emergencies', life-and-death. In local communities, simply the strength and backing of the entire community to help pull a seriously sick person through a crisis sometimes works, sometimes is not enough. Then, Western biomedicine should serve as partners to local health systems. What cannot be maintained is the colonialist bias that Western biomedicine has the remedy for everything, which it does not, nor do huge pharmaceuticals have the right pill for every sickness there could be. That attitude has to be dropped, and a more congenial, collaborative, sharing of knowledge is the way of the future.

Traditional healers are known in many parts of world. These are path lines of old age medicine which are recently used for cure. They have no basic diagnostic data but a believe in society that nature has cure of all diseases. Only thing is right assessment to read the symptoms like Bat, Pitta, cough.  In local communities of India, and south east Asian nations, and   south Africa  practitioners of traditional  medicine  are well known. They fulfill different social and political roles in the community, including divination, healing physical, emotional and spiritual illnesses, directing birth or death rituals, finding lost cattle, protecting warriors, counteracting witches, and narrating the history, cosmology, and myths of their tradition. There are two main types of traditional healers within the Nguni, Sotho-Tswana and Tsonga societies of Southern Africa: the diviner (sangoma), and the herbalist (inyanga).

Indigenous knowledge  of healing is time-tested and tried. Indigenous knowledge and its products and by products require a different set of thinking which is in the indigenous traditional context of time-tested keepers whose healing know-how and powers are not in linear semantics but rather exist as an accruement of diversity of access to healing know-how which often include meals or foods to be taken during the healing process.

Some shamans in the amazon say when indigenous knowledge is assessed or rationalised it gets out of their cognitive system, so that knowledge is lost. I think it depends from which point of view you do the assessment, and what you interpret of that. What it makes me more sense is that indigenous knowledge find the way to be shared in new ways, because in many cases traditional ways are being forgotten, maybe it descontextualize indigenous knowledge or maybe is a way to spread out a knowledge that is useful for humanity beyond the burden in which indigenous knowledge has been defined. 

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