Mama Laura is the mother of seven children, including Shukarani who is eight and a half months old. When Shakurani was born he refused to breastfeed and his body was shaking, requiring intensive care. Mama Laura traveled with Shukarani to several hospitals over the course of two weeks until she found the care he needed and his condition improved. But three months later his condition worsened, and all that she could find to help Shukarani was physical therapy -- an intervention she finds meaningless without more intensive interventions to address and remedy the underlying cause -- which she had originally attributed to an argument with her husband, but when he unbound his curse there was still no improvement. Visiting vernacular healers, Laura was given two other explanations (spirits and witches), both of which she did not agree with, and a variety of medicines and charms, none of which improved Shukarani’s condition. She is left with little hope for a cure, and leaves everything in God’s hands.

Available data indicate that border-crossing to access social services (like health and education) is common in the region that straddles Malawi and Mozambique, and that many providers accept this fact and do not request identification or payment from foreign nationals. Others accept cross-border transfers, so long as they arrive with a referral letter from their doctor.

In seeking remedy to their misfortunes, people around the world utilize care from a variety of healthcare sectors and providers, sometimes simultaneously or sequentially. Anthropologists have, in the past, sought to find culture-based logics in medical decision-making. However, numerous studies have now demonstrated that individual decisions are not predictably patterned. Rather, they are influenced by a variety of personal factors that include previous experiences with a practitioner or healing technique, or their reputation through word of mouth from others, distance (whether desiring a practitioner that is nearby for convenience or far away for privacy), specific symptoms/conditions or the context in which a person became ill, the opinions of social relations, preference for particular procedures, anticipated costs, available resources, and response to treatments procured.

Mama Laura alludes to the ways in which words have power to curse, or to heal. This reflects a broader theme of incredible power attributed to that which is spoken aloud, enabling forces that would otherwise lie dormant and calling them to action. More broadly, across the African sub-continent words, and sometimes even thoughts, are conceived as actions in and of themselves that can have life enhancing but also life negating effects (words of warning and words spoken in anger are especially suspect). Great care thus must be taken with words, and some forms of speech are restricted.