The quest for wholeness: health care strategies among the residents of council-built hostels in Cape Town

The 1980s in South Africa have witnessed an extraordinary interest by health care professionals in the relevance of health care and healing systems outside the dominant biomedical system. The debate centres around the most effective way of incorporating "these other forms" of healing into the dominant system in the best interest of the patient. It is essentially a debate amongst professionals based on their perceptions of "the best interest" without any significant input from the "patients" who are the object of their concern. This paper attempts to bring into focus "patients" perceptions of different health care systems, their access to them and the rationale behind their choice of therapy. The experience of acute symptoms, especially pain, identifies an illness episode and initiates therapeutic action. Biomedical services are, most often, the first choice of the hostel dwellers. Hostel dwellers, although poor, are often prepared to pay for the services of the private biomedical practitioner. In some cases they have no other biomedical option, the lengthy delays encountered at the local government hospitals and clinics are costly for poorly paid unskilled labourers. The local government services, unlike the private practitioner, are not available at times convenient to working people.