The efficacy and self-efficacy of treatment: ethnomedical aspirations, biomedical inhibitions, and health outcomes.

This article argues for a shift from an evaluation of the efficacy of "traditional medicine" to an analysis of the influence of notions of efficacy on health seeking and health outcomes. Studies on the therapeutic value of traditional medicine tend to focus on countering or engaging with biomedical models to explain the process and efficacy of healing. Less examined is how efficacy is evaluated by traditional healers and patients themselves. Ethnographic research focused on health seeking and language use in Tonga reveals a diversity of claims of efficacy that relate to the social and epistemological positions of healers, health workers, and patients. Using the celebrated case of a man who was cured by a healer after the hospital could do no more for him facilitates greater epistemological dialogue and poses a challenge to the current efficacy consensuses in medical anthropology and Tonga.