A qualitative exploration of cultural illness perceptions and barriers to modern healthcare: the case of Ikirimi and traditional uvulectomy in Rwanda

Bibliographic Details
Title: A qualitative exploration of cultural illness perceptions and barriers to modern healthcare: the case of Ikirimi and traditional uvulectomy in Rwanda
Authors: Sadallah Bahizi, Michael Schriver, Francois Xavier Sunday, Kathryn Beck, Maaike Flinkenflögel, Vincent K. Cubaka
Source: Journal of Ethnobiology and Ethnomedicine, Vol 21, Iss 1, Pp 1-10 (2025)
Publisher Information: BMC, 2025.
Publication Year: 2025
Collection: LCC:Other systems of medicine
LCC:Botany
Subject Terms: Traditional medicine, Cultural illness perceptions, Indigenous knowledge, Healthcare-seeking behavior, Biopsychosocial impacts, Patient–provider communication, Other systems of medicine, RZ201-999, Botany, QK1-989
More Details: Abstract Background Understanding cultural perceptions of illness is crucial for effective healthcare delivery. This study examines the ethnomedical concept of ikirimi, a culturally recognized illness in Rwanda characterized by perceived uvula abnormalities, and its traditional management through uvulectomy. This study explores the cultural understanding of ikirimi, its perceived causes, symptoms, and treatments, as well as barriers to integrating modern healthcare. Methods An exploratory qualitative approach was employed, involving in-depth semi-structured interviews with eight participants: traditional healers, individuals who underwent traditional uvulectomy, and healthcare providers. A grounded theory approach which analyzes data in systematic manner to generate new theories was applied, with coding conducted in English after initial transcription and analysis in Ikinyarwanda to preserve Indigenous concepts. Results Participants described ikirimi as an illness affecting the uvula (named as akamironko or akamirabugari or agashondabugari in Ikinyarwanda), characterized by swelling, elongation, and pus-like discoloration. Reported symptoms included fever, difficulty swallowing, coughing, and weakness, with children identified as the most affected group. Traditional healers diagnosed ikirimi through visual inspection of uvular morphology and movement and treated it by cutting the affected part of uvula and is known as guca Ikirimi ‘traditional uvulectomy’. Barriers to integrating modern healthcare included skepticism about biomedical care, judgmental attitudes from providers, and communication gaps. Despite the prevalence of ikirimi, its biomedical correlates remain unclear, though participants associated it with severe throat illnesses such as tonsillopharyngitis. Conclusion The findings highlight ikirimi as a socially constructed illness with deep cultural roots, significant health implications, and persistent barriers to modern healthcare. Addressing these barriers requires culturally sensitive approaches that integrate Indigenous knowledge with biomedical practices. Future research should explore the biomedical correlates of ikirimi and foster collaboration between traditional and modern healthcare systems to improve patient outcomes.
Document Type: article
File Description: electronic resource
Language: English
ISSN: 1746-4269
Relation: https://doaj.org/toc/1746-4269
DOI: 10.1186/s13002-025-00771-7
Access URL: https://doaj.org/article/1abb18f9e6be4b1381ae1201583613c7
Accession Number: edsdoj.1abb18f9e6be4b1381ae1201583613c7
Database: Directory of Open Access Journals
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More Details
ISSN:17464269
DOI:10.1186/s13002-025-00771-7
Published in:Journal of Ethnobiology and Ethnomedicine
Language:English