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Webster dictionary gave a number of definitions of ‘Ritual': "a system of rites, a Ceremonial act or action, a customarily repeated often formal act or series of acts". In our everyday dealings there are different forms of actions taken that are repetitive but cannot be classified as symbolic eg, bathing, sleeping, and eating.

However, if we kneel, and say a particular word of prayer and make the sign of the cross before doing any one of the above routinely, then that can be considered a ritual because it can be decoded as symbolic to the Catholic religion, and to other observers as a way of devotion.

There are some symbolic rituals associated with health practiced by various cultures. In the Catholic Church the sprinkling of Holy water by the priest and burning of incense during Eucharistic prayers is believed to ward off evil spirit, and promote good health and everything progressive for the congregation. The vestment of the priest, the setup of the altar and the arrangement of the pews are symbols of a place of worship. The prayers said at every mass are rituals and members believe attending mass keeps them in good health, and good standing in life.

So it is with other religious practices. As stated by Wintz, S., and Cooper, E. (2009), Islamic religious beliefs are based on five principles: "shahadatain (declaration of faith), Salat (prayer/worship), zakat (charitable contribution), sawn (fasting), hajj (pilgrimage to mecca)", are all the five principles that require some degree of rituals to perform them. In health matters, doctors are seen as helpers of God's will, so they are not restricted in the course of treatment, (p.21-22).

As a child I remember my maternal grandmother had a large clay pot with water in it at a corner of her living room; decorated with white/red colored cloths, and figurines like a shrine, where every morning as traditional worshipper, she said her prayers. We were never allowed to play close to the area. But the water from the pot which she drank she gave us to drink too when we visited. She believed it promoted good health and good luck in life. I cannot say for sure if those deeds worked, but she lived to be 103years before she died in 1978.

In the hospitals as described by Helman, C., (2007), the white coat worn by the doctors and other health professionals are symbolic, and the stethoscope used for checking blood pressure and other vitals are the rituals, performed to diagnose illness or certify clean bill of health. So many instruments, computers, hi-technology machines, the arrangement of the doctor's consulting room, are all symbolic rituals associated to health and illness (p.227).

For a patient who is certified ill; all these could symbolize healing, or may signify death, especially for the elderly. The process of getting admitted as illustrated by (Helman), is how a sick person goes through some rituals, such as being stripped of their social statuses, by exchanging personal clothing to hospital garments, name turned to case file number, regular monitoring by nurses and medicines administered routinely (p.236&237).

There are also cases where illness among children defies biomedical treatment; Abubakar A., et al. (2013) in their work described the "abikus", ie, children who are tagged as coming from the spirit world because they fall ill all the time despite all manner of treatment. Finally, the child is taken to the traditional healers to perform some ceremonies and marks are inscribed with sharp instruments on the body of the child; so if the child dies, he/she would not reincarnate. This practice is very common among the Yoruba tribe of Nigeria, West Africa (p.1-2). In some cases, the child survives and is always identified through these inscriptions on them by those from the same tribe as the "abikus".

There are other instances in some cultures where conversion to Christianity has changed the method they consult by combining both the Christian and traditional practices to carry out healing. In a study of Mapuche tradidtional medicine in Temuco, Chile by Torri, M. C., (2013), described how the machi (traditional healer) uses the picture of God and the Virgin Mary as symbols to remove the devil (evil spirit). The machi prays in the name of Jesus Christ over the herbs before consultations, diagnosis, and dispensing of medicine (p.1235).

In Sub- Saharan Africa, and South American cultures; illness, and death are classified as misfortunes. Therefore, the need to find the cause always drives the people to consult traditionalists for answers. In Nigeria, the Pentecostal church's mode of operation is similar to the study by Torri, (2013) explained above. There is a combination of Christianity and traditional practice to interpret misfortune as being caused by the devil in place of the evil spirit. Symbolic items like white handkerchiefs, olive oil, and water are used to caste away the devil. Death is never seen as a natural phenomenon except it occurs at old age.

I conclude that the practices of today are ways to retain membership in the religious settings (Christianity, Islam, Judaism, traditionalism, etc.), with the trend of cultural beliefs; instead of totally abandoning them altogether. Instead the symbolic items used during the primitive era, skulls of human/animals, shrine, blood etc., were exchanged for things like; altar, rosary, crucifix, candle, holy water, incense, misbaha etc. These ideas are corroborated by Harvey, M., (2015) in his work that described the Akan, Ghana urban and rural mixture of traditional mode of worship/consultation with priest/faith religious practices to fulfill the ideology of the people. It is meant to ward off evil spirit when misfortune happens, and give reasons why it happened (p.401-402).

Why is ritualism central in all forms of religious worship, spiritual, and medical consultations?

REFERENCE

Helman, C. G., (2007), CULTURE, HEALTH AND ILLNESS (5thedition). Boca Raton, FL. Taylor Francis Group.

Wintz, S., & Cooper, E., (September, 2009). A DICTIONARY OF PATIENTS' SPIRITUAL & CULTURAL VALUES FOR HEALTH CARE PROFESSIONALS.

Source: Pastoral care leadership & practice group of health care chaplaincy, New York, NY.

Harvey, M., (2015), MEDIAL DEITIES & RELATIONAL MEANINGS TRACING ELEMENTS OF AN AKAN GRAMMAR OF KNOWING.

Source: Journal of Africana religions, Vol. 3 No. 4 p.397-441

Published by: Penn State University Press.

Torri, M. C., (2013). THE INFLUENCE OF CHRISTIAN CONVERSION IN MAPUCHE TRADITIONAL MEDICINE IN TEMUCO, CHILE: TOWARD A CULTURAL SYNCRETISM OR A FORM OF IDEOLOGICAL ASSIMILATION?

Source: Journal of religion of health, Vol. 52, No. 4, P. 1228-1239

Published by: Springer.

Abubakar, A., Baar, A. V., Fischer, R., Bomu, G., Gona, J. K., Newton, C. R., (2013), SOCIO-CULTURAL DETERMINANTS OF HEALTH-SEEKING BEHAVIOR ON THE KENYAN COAST: A QUALITATIVE STUDY.

Pols One B(11); e71998, Doi: 10.1371/journal.pone.0071998