Lahiya vitesse and the quest for relief : A study of medical pluralism in Saga, Niamey, Niger

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This paper focuses on what people in Saga, a village on the periphery of Niamey, the capital of Niger, do in the face of illness. With limited economic assets and in a context of medicalpluralism, to which therapeutic alternatives do they turn? And what factors are determinant in the choice that they make? Saga is an old village, which has become increasingly integrated into the expanding urban community of Niamey. It can be described as a semi-urban area inwhich elements of both rural and urban Niger are present. The therapeutic field in Saga is, as in all of Niger, characterised by medical pluralism. A number of therapeutic alternatives exist side by side. They range from ‘western’ or hospital medicine provided by the local public dispensary, the private confessional dispensary and by the unlicensed sale of medicine by ambulant vendors to ‘traditional’ treatments, such as Islamic medicine practised by marabouts and ‘traditional’ healing using herbal remedies and spirit possession rituals. This paper is about the various institutions and actors of ‘modern’ medicine in Saga, namely on the public dispensary, on the confessional dispensary and on the informal sale of pharmaceuticals. To better understand the quest for therapy in Saga this paper focuses on everyday practices oftherapy seeking, on the actual and everyday choices people make in the face of illness.Special attention is paid to the therapeutic alternatives and to the relation between therapy seeker and therapy provider in what may be called the therapeutic encounter. It is argued that socio-economic factors as well as social relations, personal experie...