1. Introduction

In different societies around the world, knowledge regarding potential threats associated with external forces often creates situations where people give priority to ways and means of ensuring that their communities enjoy good health, prosperity and goodwill. In this regard, it has been indicated by [25] that good health, prosperity and goodwill is achieved in some communities through the promotion of good interpersonal relations between human beings, on the one hand, and between human and the spiritual entities on the other. It is also worth noting that because the attainment of good health is intrinsically desirable; people in different parts of the world have adopted ways and means of achieving and maintaining optimum health. Interestingly, efforts towards achieving optimum health are as diverse as the social, cultural, economic, mental, spiritual, physical, and even political circumstances of the particular individual at any point in time.

In parts of Africa, especially in indigenous Ghanaian communities, some diseases and misfortunes are often handled with suspicion and uncertainty, clouded by questions such as: ‘Why is this happening to me?’, ‘Why this time?’, and ‘Why me?’ [27]. Attempting answers to these questions creates situations where blame is often placed on the shoulders of alleged witches and sorcerers [7, 20]. As indicated by [23], these beliefs are usually imbedded in religions which tend to influence individual worldviews. As a concept, worldview as used in this paper refers to how people perceive and explain the world around them; the sources of the explanations as well as the ways things are or change in their environment [17].

It is important to note that the different ways people conceptualize the social environments reflects their basic assumption about, and view of, the universe that gives orientation and value to their lives. Put differently, worldview represents the source of explanation for the ways things are in the world, including theories of illness, death and misfortunes and how human afflictions and problems are approached and handled [17]. In view of the diversities in human orientation across societies and cultures, thoughts, reasoning and ways of knowing of people within these societies also differ in many ways, especially from the dominant Western thought and reasoning [27]. It is important to note that decisions about health and wellbeing and the possible interventions during illness episodes are often managed in accordance with the people’s belief structures [6]. In this regard, individual and collective response to illness and disease varies and reflects relevant knowledge, culture and knowledge of etiology, including the availability of treatment options.

In some of the indigenous societies, knowledge and ideas on issues pertaining to health are sustained in view of healing practitioners’ ability to construct and reconstruct culture with the passage of time [26]. As indicated by [24], since illness is socio-culturally constructed, the ways people express their sicknesses gives insight into how they view the world as well as sourcing possible interventions. As the practice continues, the worldview remains real in a subjective plausibility as it is confirmed and reconfirmed by oneself in relation to the social others [6]. This paper examines some of the beliefs and practices associated with the supernatural and how this is expressed in divination in the attainment of good health and prosperity among people in the Talensi district in the Upper East Region of Ghana.

2. Contextualizing Religion and Health

One important observation about Africans is the fact that they are notoriously religious. Depending on which religion one is associated with, the individual religious philosophies permeates into all aspects of their lives so fully that, it is not easy to separate religion from their daily activities [12]. In this regard, some of the experts in indigenous African studies have re-echoed this fact, defining religion as “beliefs and practices associated with the supernatural” [16]. This conviction presupposes that religion plays a key role in people’s understanding of any phenomenon including disease and ill-health [27]. It is worth noting that a typical indigenous Ghanaian view of the cause of any given disease stems mostly from his or her cosmology or worldview. As a consequence, ailments where causes are not known are often attributed to supernatural forces. This attribution however can only be understood through supernatural means [16, 4]. This way of life is sustained because many people are socialized into these cosmologies and as such, any explanation provided for disease causation has to reflect these cosmologies to make it meaningful. Not only must it reflects the cosmology, but must be acceptable to all parties – sufferers, supporters and healers [7]. In some of the indigenous communities, strange events are often interpreted as emanating from gods as a result of their displeasure about certain practices. Be that as it may, some of these allegations are sometimes confirmed when diviner who serve as intermediary between the seen and the unseen, reveals that the gods or guardian spirits have indeed been wronged. The diviner or intermediary will then prescribe what ought to be done to appease the gods [25]. It is important to understand that though individuals in charge of the gods may sometimes double as diviners as well as medicine men, not all of them can treat or appease the gods [15]. As Laurenti Magesa (1998) has asserted:

African religion recognizes various ways to deal with afflictions and has different religious experts whose task is to discover the reasons for disharmony in the universe. These experts are generally expected not only to know the causes of calamities, but to prescribe antidotes or cures for these problems. Their responsibility is to advise on measures to be taken to restore the force of life. [cf 19]

Some diviners are exceptional people in their areas of operation and have the capabilities to mediate between the seen and unseen worlds, and to uncover the alleged agents responsible for afflictions. According to [3], the reason why people consult these experts is that they think these people can best serve their interest in terms of problem solving. This way of thinking has permeated deep into society that [25] has opined that an orthodox health care provider can function well if he or she understands the culture and worldview of the local people. It has been noted that when the local people consult physicians to determine the cause and treatment of an illness, they also seek answers to existential questions that medical science rarely answer (eg, “Why is this illness happening to me?”). This second consultation is often done through diviners who investigate matters in the ‘spiritual laboratory’ to try to uncover the unknown. Thus, many patients rely on a spiritual framework by calling spiritual care providers to help answer these existential questions.

It has also been illustrated that through innovation, African indigenous churches continue to attract many seekers of spiritual healing in Ghana due to their ability in integrate ‘Christian ideals, perspectives and practices of healing’ into the people’s own traditional understanding of healing [2; 28]. In parts of Ghana and Africa at large, medical doctors who either failed in their efforts to cure their patients of certain diseases or have genuine belief in the cultural competence of healing often refer patients to spiritual experts for further investigation and treatment [11, 22; 5].

3. Diviners as Spiritual Laboratory Technicians

Divination as a concept is an effort to gain an understanding or vision into a question or situation. It is a systematic process of organizing what appear to be disconnected facets of existence such that they provide insight into a problem at hand [23]. Divination refers to a set of procedures involving the art of using a ritual or ceremony to acquire information from the spirit world in order to predict the future. In some indigenous communities, this practice is the main means of spotting allegedly spiritual problems and prescribing remedies (5). Diviners who are thought to possess spiritual powers are able to detect the ills affecting people and society and suggest remedies from the deities and invisible world.

In situations where afflictions manifest individually, functional differentiation becomes difficult as a result of the categorization of causal spirits according to the outward manifestation of afflictions. Thus, depending on the society and the existing culture, different interpretations may be attached to the same affliction. As a consequence, diagnosis and course of action in such situations is often decided through divination. The diviners enter the ‘spiritual laboratory’ by using diviner’s-stick, cowries, or river sand to uncover the unknown. Whereas medical doctors use machines to determine the cause of illness, diviners use the above mentioned items to determine the cause of afflictions. In the cosmology of the local people, divination plays a central role in lay consultations to determine the right treatment or referral for therapy (5).

Managing illnesses of this nature on the part of healers and the afflicted brings to light two important observations drawn from the healing practices. The first issue involves reliance on diviners to determine which spirit is responsible for a particular problem. Under this circumstance, a variety of spiritual entities may be addressed in turn through the use of the spiritual laboratory to determine the spirit responsible for the affliction [3]. Per the cosmological set up of the people, this is the only way they can provide the right antidote. The second observation involves the act of identification of the cause of the illness and the interventions to be undertaken. Though people would often argue that the practice constitutes a post hoc assessment in that it is only after an improvement in the condition of the patient that a relation between what was initially speculated can be corroborated, one has to bear in mind that the practice is part of their plausibility structure and its continued practice makes it real.

4. Methodology

From July and September 2013, 15 diviners, drawn from the four communities in the Talensi district were selected and engaged in an in-depth interview concerning their role in the health seeking behaviour of the local people. The selection was done at the time the researchers were undertaking participant observation in these communities. Although the research participants were purposively selected, it is important to note that only those who agreed to be interviewed were interviewed. There were other 32 community members who were also engaged in focus group discussion to elicit more information on divination and health. The criterion for selecting the research participants was such that diviners should have been in the practice of divination for at least five years whereas community members should have lived in the community for at least two years to abreast themselves with the socio-cultural practices of their communities. Five years was considered enough time to practice as a diviner and to know the history and background of the vocation. Since some of the residents in the study area could speak English, Talansi and Frafra, all languages the researchers speak; the research was conducted in these languages. An interview guide with questions was used to elicit detailed information from diviners, and a focus group discussion guide question guide used to elicit information from members of the communities. Each interview lasted between 40 to 45 minutes, and was recorded and later transcribed, while observations and field notes were also taken for analysis.

5. The Art of Consulting Diviners

One important observation about these diviners or soothsayers with regard to their consultation and what aids them in uncovering the unknown is that all the diviners who were interviewed used generally very similar items for their art [5]. Thus, the common items that were in use by these diviners consisted of a goatskin bag with its content, a stick, a musical instrument, and two or more vertebral bones of an animal. Others also used cowries mixed with pebbles, coins, and small metallic objects. Yet still others relied on river sand as a medium to uncover the unknown. The diviner’s stick for instance is about a meter long. It is called bakolug-dore, which literally means the diviner’s-stick. During a divination session it is this stick (usually held at its lower end by the diviner and supported loosely at its upper end by the client) that points to the objects or makes certain signs that are interpreted by the diviner [5]. For those who use cowries and other mixed items, what usually happens is that these items are thrown on the floor and the interpretation given based on the position of each item. With regard to those who use river sand, they write on the sand (writing an ordinary person cannot read) and get the messages through the writing for their clients.

In all these, testimonies that came from clients of the diviners were to the effect that the diviners stick, cowries or sand, depending on which medium one is using, indeed are not manipulated in any way in unearthing the unknown. The divine stick moves and points to the objects and makes other kinds of movements without the control of both the diviner and the client. In a testimony to prove a point, a member of a focus group discussion had this to say:

‘..When I finished consulting him (diviner) and he told me what I needed to do, he added that before I got to my room, I was going to encounter a stranger in the house waiting to see me, or meet a woman preparing fresh meat. This was just to prove that his words were real. True to his word, I saw this woman preparing fresh meat in our house, and all the other things he told me came like a video.

Testimonies like this attract more people to consult these diviners. In the same vein, another respondent also gave a narration of his experience consulting a diviner: ‘

I went to consult a diviner to see if it was safe for me to travel, before the man could even tell me what I needed to know, he told me that someone had just died in our village and that the ghost of the dead man has just passed by. On the substantive issue, he told me the road was rough and so it was not safe to travel. When I got home, someone had actually died. The people I wanted to travel with that week were also involved in an accident and all of them perished. This means I would have also died if I had not enquired.

In view of these revelations, the local people do not take diviner consultation kindly. This goes to explain why many of them consult diviners before undertaking any activity. As regard the working of the stick and the other devices, one of the diviners had this to say:

The movement of the stick is controlled by the gods and not me. The only thing you have to do is to hold this stick and it will direct you to whatever you came purposely for.... and whatever you came here to ask for, the gods will tell you and not me because everything here has a meaning. Another diviner added that:

It is the Bakolug-dore (divine-stick) that will point out the items for you. But it is better you learn the art so that you will be able to ask the necessary questions to the Bakolug for clarification.

Still on the movement of the stick, a third diviner postulated:

I have absolutely nothing to do with the movement of the stick. The Bakolug controls the movement because it is only the Bakolug that knows why you came and the necessary interventions you should put in place to solve your problem. Only the Bakolug can see and tell by pointing at the items.

Stressing on the same point differently, another diviner indicated:

If someone comes, he/she does not tell you what is wrong with him/her; you collect whatever the person brings and tell the gods to collect it, and try to diagnose the problem. You ask the gods and not the person. It’s only the gods that can tell the problem with the person.

What this suggests is that all what they say is divine and they only relay the messages to the people concerned. In view these testimonies, it is clear that the diviners believed that they have been chosen by the gods, ancestors or other spirit mediums to perform these functions in society [27]. As is often claimed by many religious leaders, the individual diviners have no influence whatsoever on the outcomes of divination consultations even though some of them have been accused of been quack diviners. The claim is that it is God, gods, or spirits that reveals whatever is required of men through the diviners or bakoluk-dore and this is interpreted to the understanding of the client. In a way, they serve as intermediaries between the God or gods and the people in need of solutions to their problems. This corroborates [21] explanation that those who divine by mechanical means such as coscinomancy normally explain that the movements of the instruments are caused by some spirit which controls the instruments. The diviners also revealed that every diviner is chosen through divination and subsequently initiated into the vocation. One of the clients even indicated how a diviner asked him questions that ‘shocked’ him because the diviner did not know him or his village:

When I entered the diviner’s room, he mentioned my name and welcomes me, them he told me I had a quarrel with my father before setting off, and many other private issues…. When he told me this, I just realized that something was aiding the man because he could not just have known all these things.

These are some of the pronouncements the diviners make to their clients so that they will not doubt whatever information that will come their way later. These issues, it must be stated, are very much appreciated by the local people because they structure their world and knowledge scheme around uncovering the unknown through diviner consultation.

6. Management of Life-crises through Divination

In the study communities, it was observed that diviners were consulted upon every conceivable occasion; at birth to find which ancestor is returning; in misfortune to find the cause and sacrificial remedy; at marriage; at death; after dreams; at succession to office, or undertaking a new enterprise [17]. In the opinion of [13], divinatory process performs a connective function in that it permits willful individuals to negotiate and to recreate their social order as they attempt to explain misfortune, cure illness and redress impaired social relations. Divination deals with life crises. It is a set of institutionalized procedures and plays a role of dealing with calamities of different sorts. As [12] has indicated, it is a system of symbolic beliefs and practices that can be used to diagnose, explain and ameliorate misfortunes. One of the respondents indicated how he was helped to escape an issue that kept recurring every year:

….. I used to have accidents every September for three consecutive times, I did not know what was causing that until I went to a diviner who disclosed to me that I was had a quarrel with my father and if not until I apologize to him, the problem will continue to recur. When I apologized, the accidents stopped.

Issues like this makes divination diagnostic because it reveals the hidden components of misfortunes which give directions to the resolution of the misfortune.

It is important to indicate here that though diviners may find it easier identifying the causal agents, there are times they also encounter difficulty in identifying the exact causes. These often generate a feeling of fear and uncertainty at the inception of the affliction as the people struggle to make sense of the problem at hand (27). During these periods of uncertainty, the ‘therapy managing group’ [9] or family members and close friends are often tasked to identify a competent diviner. What these people often struggle to make sense of is whether the affliction is natural, or caused by ancestors, the community deities, machination of witches or combinations of two or more spirits. This uncertainty is usually overcome after the ‘therapy management group’ is able to successively invoke all the spirits thought to be potentially responsible for the affliction through the consultation of powerful diviners.

It is in this regard that [16] has argued that divination in Ghana is often employed to find the cause of sickness or misfortune. In view of the general feeling that supernatural forces are often alleged to be behind their successes and misfortunes; divination has become a very popular if not lucrative venture as people constantly consult them directly or indirectly in the management of their life crises including diseases and illnesses. On this note, it would be reasonable to argue that because diviners act in line with the belief or plausibility structure of the people they serve, the operation and success of their acts lie in the notion that a supernatural phenomenon can only be understood through supernatural means.

A common feature of diviners is the fact that as agents that link the living and the spiritual world, they are very active members of the society, take interest in daily events and are accommodating to all their clients [12]. Diviner per the role they play, fulfils an intermediary function between the physical and the non-psychical, between human and the spiritual, for the sake of his own community.

Experts have stressed the importance of the Right to Culture in innovative participatory approaches to endogenous development. For many people in the world today, culture, faith and values are very important because they provide the moral and practical basis for decision making in daily life [14]. However, local cultures are often ignored or even outlawed from formal development programs; especially those cultural aspects such as spiritual or ancestral consultations – which are hard to understand for people from other cultural backgrounds or even locals who are removed from the cultural setting physically, mentally and/or spiritually. To illuminate this point more clearly, let’s consider the following conversation between a researcher and a farmer:

On another occasion I was in Nandom, Northern Ghana, the home of the Dagaaba. I asked a farmer I was interviewing to imagine that I had brought him a millet variety that yielded three times that of the variety he used, and asked him to plant it straight away on his farm. Thereafter when he goes to work on that plot some misfortune befalls him, like being stung by a scorpion. What would he do? He told me that he would consult the soothsayer and if the soothsayer said that his ancestors are unhappy with the introduction of that variety, he would abandon it immediately. He would not even go back there to destroy the crops but would avoid the farm completely. In no way would he compromise his ancestors for any increases in productivity, no matter how great the increase.

Perhaps a more appropriate approach of the development worker could have been first to explore tracing lost property; what to do to ensure success; and in fact anything for which information may be needed for the benefit of the client. From all indications, these desires have bearing on the health of the individuals. The contention is that these things happen because of the general conviction that these beliefs and values guide their decision regarding their agricultural practices. Thus, the farmer together with the researcher, divination could have been conducted to find out the ancestors views on the introduction of the new variety. Indeed, this suggested approach has been shown to be feasible in a study in which ancestors were interviewed to find out their opinions on certain decisions about to be taken by people in Kassena-Nankana District in the Upper East Region of Ghana. As [1] have indicated, interviews were conducted (through divination) with lineage heads who were diviners to solicit the ancestor’s views about their reproductive preference. Comparing pairs of lineage heads and corresponding ancestral spirit responses to determine the role of traditional religion in influencing reproductive preferences, they found a shared preference for sons, and large family size. However some ancestral spirits preferred small family size. This suggested that some ancestral spirits can be open to modern ideas.

7. Discussion

The above data illustrates those beliefs about illness and how illness causation influence people in the way they respond to afflictions. What has been observed is that decision on the course of action regarding therapy seeking and management are usually collective rather than individual, where therapy managing group [9] plays a very important role in the process. What need to be noted here is that the truth, efficacy or otherwise of the outcome of divination is not the focus of this paper. What the paper sought to establish was to provide an account of how the practice of divination influences the health outcome of the local people. Within the local cosmological set up, non-serious illnesses such as headaches and coughs are often attributed to natural causes whereas very serious illnesses are often associated with supernatural entities such as sorcerers, witches/wizards, and ancestral spirits [23, 27]. Though these categorizations are established, there are times the perceived natural illnesses tend up to become supernatural especially when it takes a longer period to treat.

Another important revelation is the fact that peoples with western mindset especially the health professionals need to be sensitive to the beliefs and worldview of the communities they intend to serve. This demands that they respect the local people’s perception, needs and demands. Beliefs about afflictions, their causes and suitable treatments through the consultation of diviners suggest a need for re-contextualization of education about diagnosis and treatment of common ailments.

The continuous practice of these beliefs makes it imperative for the integration of traditional and indigenous methods of dealing with ill health into the mainstream medical care practice. This is because the current modern health care system is deficient in offering comprehensive care to patients and this is due to the tendency to narrow health within the biomedical model. Perhaps a psychosocial-spiritual biomedical model is needed. Divination is just one of the many indigenous healthcare resources that can be utilized to augment the rather scarce modern healthcare resources, and it is in the light of this that [8] has suggested that in the face of increasing scarce medical resources in a given locality, the greatest challenge is to help people to exploit the positive elements of indigenous health resources. One good lesson learned out of the experiment by [10] was that treatment begins with the people’s beliefs and worldview, which underlie psychological functioning and provide the basis for healing. Religious values that give meaning and coherence to life can be the most acceptable route for many people. Many therapists recognize the need to place the sick person in a social context; a therapist cannot heal a patient without attending to his beliefs, family, work and environment [25].

8. Conclusions

The modern healthcare system as we have it has often failed to take care of indigenous social, psychological and spiritual needs which are essential in the quest for optimum health. This has been largely due to an overconcentration on curative measures and the failure to recognize that health delivery cannot be divorced from the socio-cultural milieu in which it is delivered. If the creation and provision of good health is to be an essential component of cultural developmental process using endogenous development as a participatory approach, then the spiritual matters bordering health must be taken much more seriously. Understanding, appreciating and consequently integrating some of our indigenous medical practices into the modern healthcare system could go a long way to provide better healthcare for the people. But we must first overcome some of these Western biases regarding health and begin to make indigenous peoples’ worldviews and livelihood strategies the starting point for our development.