Traditional bone setting and trauma care in South-Eastern Chad

BACKGROUND: Traditional bonesetters are the main providers of fracture treatment and trauma care in much of Africa. However, there is a paucity of literature on bonesetters in Chad. OBJECTIVES: Our study sought to investigate Chadian bonesetter practices, their relationship to the community, and the complex local perspectives on trauma care in Am Timan, Chad. METHODS: Thirty-three semi-structured interviews were conducted with community members, traditional bonesetters, and physicians in Am Timan using a constructivist grounded theory approach. Responses were coded, categorized, and compared within and across study populations to identify themes. RESULTS: Most community members (n=25) interviewed preferred bonesetters for trauma care due to their affordability, continuity and convenience of care, and the community's fear of Western medical practices. Although the Chadian bonesetters' fracture management mirrored bonesetters in neighboring African countries, the Chadian bonesetters have a much wider scope of practice, including treatment for both medical and spiritual ailments. Both Jabari (n=6) and physicians (n=2) emphasized the need for more training and collaboration. CONCLUSION: As in much of Africa, bonesetters perform a major role in providing trauma care in Chad. Our research identifies an opportunity to maximize trauma care in Chad through dialogue, training, and collaboration between bonesetters and physicians.