1Women have adopted the role of taking care of each other’s health and assisting with birth long before the roles became formalized in biomedicine as gynecology and midwifery. Previous iterations of “midwife” as a term in global health literature include ‘traditional’ midwife or ‘traditional’ health worker. In the context of the Indian subcontinent women providing care to the community during birthing were called ‘Dais’. Today dais do not exist in the same context, but the healthcare workforce remains highly gendered, specifically through the Lady Health Workers (LHWs) program. Drawing on archival research and anthropological scholarship, this paper examines how women health workers from dais to LHWs shape the landscape of care available to Pakistani women and reflect state and global priorities in managing population health in Pakistan. The institutionally trained ‘lady workers’ programs have contributed to the devaluation of dais through the prioritization of biomedical practices. The landscape of women care providers in Pakistan today is deeply shaped by processes of colonization and biomedicalization and ignores the lived realities and credibility of traditional healing practices employed by traditional healers like dais.
2Due to numerous taboos, women’s health topics, from menstruation to menopause, are often silenced in everyday conversations in Pakistan. This silencing has been addressed by South Asian scholars who have written on the impact of patriarchal and cultural gender divisions (Kabeer 2011) and the importance of redefining autonomy and its influence on reproductive decisions (Mumtaz, Salway 2005). South Asian scholars also strive to acknowledge the socioeconomic and cultural barriers women encounter when discussing their health, accessing healthcare, and making informed decisions about their bodies (Jafree 2020). Barriers include a lack of health literacy, caused by a large percentage of women lacking access to basic education, combined with cultural norms which discourage discussion around sexual and reproductive health (Unterhalter 2006). Economic barriers include severe class based disparities in healthcare, in which upper-class women have greater access to care as opposed to women in lower economic classes (Fikree, Pasha 2004). Significantly, traditional women health workers play a crucial role in overcoming these barriers by making healthcare accessible to women outside of the upper class and educated groups. Women health workers also help break down the taboos surrounding the body by creating safe spaces for women to ask questions and have open discussions (Mangay-Maglacas, Simmons 1986). Thus, understanding the landscape of care accessible to Pakistani women, especially the context of women health workers, helps to understand how women perceive ideas about their own body and health and how to bridge the gaps in care.
3Traditional women health workers, known as ‘dais,’ have a long history on the Indian subcontinent. Dais are known within rural communities to possess healing abilities. They have been subjected to repeated attempts of modernization through the synergistic processes of British colonialism and the global rise of biomedicalization. Due to their expertise with women’s bodies, they often assist at the time of birth (Towghi 2024: 33). Traditional women healers were and continue to be an integral part of local caregiving. However, following the effects of colonialism and subsequent state-making processes, dais began to be replaced by biomedically-trained health workers. These new women health workers and training were created in an effort by the state to improve maternal health and child health (ibidem: 107). Through the implementation of various national and global healthcare initiatives, a large landscape of women healthcare workers emerged, including Certified Midwives (CMWs), Lady Health Visitors (LHVs), and Lady Health Workers (LHWs).
4This article traces the transformation of women health workers in Pakistan, beginning with the intentional marginalization of dais by British colonial biomedicine, as evidenced through archival sources. It then discusses the history of this gendered workforce through subsequent World Health Organization policies that further transformed the landscape of traditional care, culminating in the professionalization of Traditional Birth Attendants (TBAs) into Skilled Birth Attendants (SBAs) and the current iteration of Lady Health Workers (LHWs). This paper argues that the deeply gendered nature of Pakistan's frontline reproductive healthcare workforce, spanning from traditional dais to contemporary Lady Health Workers (LHWs), is a product of historical colonial and global state-making projects. This history has led to the current landscape of care for women that simultaneously relies upon and undervalues this essential female labor.
5I used both archival and ethnographic methods to conduct my research. I consulted two archival sources. First, I went through digitized newspaper archives in online British databases of The Times of India for instances discussing midwifery, dais, or birthing. Through these archives, I intended to get a first-hand account of the goals of colonial medicine agendas. Secondly, to get a more geographically local perspective, I contacted the archives of the Aga Khan University, a long-standing medical teaching institution in Pakistan. They generously granted digital access and provided online publications, institutional handbooks, and newsletters concerning lady health workers. I use these sources to comparatively understand how LHWs developed and how they contributed to the delegitimization of traditional birth attendants.
6Ethnographically, I lean on secondary literature of ethnographies about traditional birth attendants and birthing practices in South Asia. More personally, I conducted participant observations and interviews in the gynecological waiting rooms of different institutions in Karachi, Pakistan, in the summer of 2025, from which I pulled insights. For the sake of this paper, I use the archival sources to start my argument about the historical importance and place of dais and how it was transformed through colonial medicine. Following this historical foundation, I draw from more recent ethnographies and my own work to bring my argument to the present-day practice of dais and landscapes of care.
7British colonial rule over India started with the East India Company which lasted until 1874 and then the British Raj which lasted until 1947, when India gained independence from British rule (Talbot, Singh 2009). Along with independence, the 1947 partition split the land into two countries along religious and geographic lines. Pakistan (including West and East Pakistan) was formed as a Muslim-majority country, and India was formed as a Hindu-majority country (ibidem). During British rule, colonial medicine played a significant role in exerting control over the 300 million people within the subcontinent (Arnold 1993). Colonial medicine initially focused on maintaining the health of the British army, but by the 1900s it involved a much broader scope including the delegitimization of local medical practices to prioritize western biomedical systems (ibidem). Arnold asserts that British rule in India relied heavily on medicine and the corporeal control of bodies. Their strategy involved initially persuading local elites to favor Western medical practices over traditional ones and then implementing large public health measures in response to various outbreaks from smallpox to cholera (ibidem). They sought to establish Western medicine as hegemonic by discrediting and marginalizing traditional healers, portraying them as unhygienic or antiquated (ibidem). While complete hegemonic control, both geographically and through medical practice, proved elusive, the impact of this colonial medicine endured. This process of delegitimization continued beyond colonialism and parallels today’s modernization practices.
8The first foray into women’s health by the colonial medical apparatus was through the appointment of Vicereine Dufferin and the establishment of the Dufferin fund in the late 1800s (Lal 1994: 30). This fund aimed to relieve the suffering of women in India by providing women healthcare workers. The fund supported three main areas,
medical tuition, including the teaching and training of women as physicians, hospital assistants, nurses, and midwives, the education to be supplied first by England and America but then by India; (2) medical relief, which included establishing dispensaries […] founding hospitals for women where funds were forthcoming; and (3) provision of trained female nurses and midwives to care for women and children in hospitals and private houses (Lal 1994: 35).
9The goal of the colonial medical officers was to take birthing out of the home and bring it to the colonial state-established hospital, where women would be aided by European-trained midwives, and later by Indian midwives and women doctors also trained by western biomedical standards. The underlying assumption of these goals was that women’s lack of access to medical care was largely due to not having western-trained women providers (ibidem). The colonial government, on the topic of women's healthcare, expected that an increase in the supply of Western-trained female biomedical officers and separate hospital wings for women would result in improved health conditions. A consequence of these aims and underlying assumptions was that dais (the traditional health care workers) were intentionally devalued and portrayed as dangerous to push women towards western-trained midwives (Towghi 2024: 206). However, dais could not completely be discarded as they were needed for the trust and access they had with their communities. Especially communities that were remote or lower class and could not access the colonial medical apparatus.
10In an opinion piece published in a 1933 edition of the The Times of India, Dr. Miss Jerbanoo, an Indian physician who was trained in western biomedical practice, criticized dais and home births as the greatest threat to maternal mortality in India. The Times of India was a renowned daily newspaper printed in the English language. The article, Facts About the Indian Midwife: Need to Educate Public Opinion, called on women doctors to inform the public about the dangers of dais as unhygienic while also telling them to befriend dais to have greater access to patients and a larger likelihood of sending women to the hospital (Jerbanoo 1933). The intended audience for this piece was an English-speaking audience on the Indian subcontinent, which would mean an educated class. The piece gives evidence of how dais were perceived by physicians from the biomedical world and how they were intentionally being construed as uneducated and dangerous for the sake of promoting the biomedical apparatus over any traditional forms of healing by Indian local elites. The local elites shared, «[…] with the colonial state the notions of hygiene, cleanliness and the propagation of science, but also transformed these to the disadvantage of those who provided them with customary services, including the dai» (Malhotra 2003: 255). Local elites who had used traditional healers like dais for generations began to turn to western-trained medical practitioners. A combination of colonial officers and later local elites focused their efforts on encouraging the public to utilize hospitals, clinics, and western-trained physicians (Arnold 1993). The need for these continued efforts throughout the twentieth century shows that, even as women were being pushed towards biomedicine, they still utilized dais and local healers to a significant extent.
11The decision to seek out local dais versus clinical biomedical care involves a lot of factors, including relations of trust, gender norms, mobility, clinical accessibility, urban or rural geographies, and economic accessibility. During my fieldwork, I spoke with a group of women while they were sitting in the waiting room of a gynaecological ward in Karachi, three of whom sought care for abnormal or excessive bleeding in their 50s. When I asked what made them choose to come to this particular office, they explained that they first consulted their dai regarding their gynecological concerns and once they felt as if the issue was persistent, they decided to come to the hospital. However, that choice involved having someone accompany them, arranging transport and having funds to do so. Alternatively, I spoke with a multigenerational group of women, all part of one family kinship unit that lived in a district on the eastern outskirts of Karachi, to understand their decision-making to seek care at hospitals/biomedical institutions versus locally. They talked about how LHWs were very active in their community and they were the first point of contact. Then as instructed by LHWs they would go elsewhere to seek care as needed. So the preference for dais, LHWs, or hospital care is contextually specific. However, both LHWs and dais are frontline contacts for women that mediate access to further care.
12In the South Asian context, this category of traditional healers or dais exists in both colonial and postcolonial India. Dai is a broad term that describes the role of traditional midwives across the entire subcontinent, including Pakistan, Bangladesh, and India (Towghi 2024). Their knowledge and expertise are passed down generationally and learned through apprenticeship and experience (Towghi 2024). However, the most prominent ethnographic accounts of dais in Pakistan is through the work of Faouziyheh Towghi. Medical anthropologists like Towghi push back against the term ‘dai’ because it homogenizes the many different names and roles traditional midwives took up in different regions. For example, in Towghi’s fieldwork in Balochistan, Pakistan, a tribal and rural community, dais were seen as state implants and the traditional healers were called dhīnabogs, kawwās, and balluks (Towghi 2024: 32). For the purposes of this paper and understanding how traditional South Asian healers were positioned in the broader context of state and global policies, I will continue to use the term ‘dai’ to refer to a broad group of traditional healers that existed prior to the colonial encounter and continue to exist in many places today.
13The effort to move women away from traditional healing and home births towards the clinic and hospital setting continued from the colonial period to the modernizing efforts of the late twentieth century through the World Health Organization’s (WHO) global development initiatives and state-sanctioned employment of women as healthcare providers (Maciocco, Stefanini 2007). However, the continued use of dais, despite the numerous pushes towards western biomedicine, shifted policy from eradicating dais to training them in biomedical practices. In the 1970s, the WHO designated the category of ‘traditional birth attendants’ (TBAs) to bring ‘indigenous women’ who provided healthcare into the biomedical system of primary care (Mangay-Maglacas 1986). The creation of the TBA category was an effort to provide biomedical training to traditional midwives to combat infant and maternal mortality worldwide (ibidem). In the 1986 report on the progress of TBA programs, the WHO describes, Daunting problems encountered in attempts to change long-established customs among the poor in developing countries. The typical traditional birth attendant is illiterate, believes in folk models of the human reproductive process, does other work besides midwifery, and has limited opportunities to attend training sessions. Yet […] traditional birth attendants constitute an important resource that could be mobilized to help achieve the social goal of health for all (ivi: 6).
14Here, we see the discrediting of dais and traditional healers as having inadequate knowledge about the body and therefore causing harm; while also acknowledging they are a necessary resource in terms of manpower and community access to get healthcare to all. We also see that while global initiatives only focus on traditional healers’ practices during the reproductive process, they are known to provide a larger scope of care for their communities. The description also fails to acknowledge that health practices carried out by traditional midwives are learned from decades of hands-on experience and instead homogenizes all they do into ‘long-established customs’ (Towghi 2007).
15Through these policies, biomedicine ascends to the level of “authoritative knowledge,” a concept introduced by Brigitte Jordan (1997). Jordan posits that when people are using different knowledge systems in one area, one type of knowledge frequently becomes dominant and accepted as the standard (Rapp, 1997). When one way of knowing is deemed authoritative, it often leads to the dismissal or devaluation of all other forms of knowledge (Jordan, Rapp 1997). It is important to understand that the authoritative knowledge is not given its authority based on its correctness, but rather it is based on which knowledge is given the power to impact action (Jordan, Rapp 1997). With this concept in mind, dais and community health workers have equally valid knowledge systems around women's care and birthing but are not given authority. Global policy initiatives grant authoritative power to biomedicine and biomedical caregivers over all other forms of reproductive care. This effectively delegitimizes the knowledge held by dais.
16Global and national initiatives in Pakistan have attempted to integrate dais into the modern biomedical system through medical training workshops and partnerships with clinics. In a study conducted in Pakistan in 2005 researchers found that dais still attend to 80% of all rural births (Chesney, Davies 2007). Training dais and employing local women health workers has been a popular policy enacted by global health projects for improving health in the global south, especially in regards to maternal mortality. These projects recognize that communities trust their local healers and birth attendants more than the biomedical apparatus. However, targeting dais to become part of the apparatus is still part of a larger push to eventually get citizens to depend on the biomedical system over traditional healing. To this end, both colonial and later independent government and healthcare establishments depict dais as dangerous in similar ways (Towghi 2024: 105). During the British colonial period, to cement the authoritative power of biomedicine, the dai was uneducated and dangerous and was to be replaced by western-trained midwives (Arnold 1993: 259). In the post-independence period, dais were targeted as unhygienic and as adding risk during the birthing process to encourage the normalization of hospital births (Towghi 2007). Dais and the care they provide communities give us an important site for understanding how western biomedical ideas about health were being pushed to women and how much of these ideas were being absorbed or rejected.
17The term ‘lady’ was introduced by the British in colonial India and persisted in Pakistan’s healthcare system through lady health workers (LHWs), lady health visitors (LHVs), and lady medical officers (LMOs) (Towghi 2024: 232). LMOs have existed since the Dufferin Fund and are Indian/Pakistani biomedically-trained physicians who hold an MBBS degree, equivalent to a bachelor’s degree in medicine and surgery (Towghi 2024: 233). LHVs or Lady Health Visitors, on the other hand, were first introduced in Pakistan in 1951 to supplement LMOs. These workers were not physicians but rather paramedics who expanded the LMOs’ reach by working in remote settings outside of hospitals. LHVs are auxiliary biomedical workers who receive two years of training in midwifery and basic public healthcare. They often head primary care clinics in remote areas (Towghi 2024: 233). The women recruited to become LHVs come from rural areas all over Pakistan and travel to Karachi to receive training, after which they are deployed back into under-resourced areas that lack primary healthcare (“Shamim Hussain- Taking Health Care to the Mountains”, Aga Khan University Archives). The training and refresher courses were often sponsored by international organizations. One organization that has done and continues to do this work is the Aga Khan Health Services and the Aga Khan University, located in Karachi, Pakistan. The Aga Khan Health Services Board collaborated with international universities in Canada and the United States, as well as UNICEF and the WHO, to develop training manuals and workshops for LHV training (“UNICEF joins Aga Khan Foundation”). LHVs were intended to deliver maternity services in both urban and rural areas to encourage hospital births, but are allowed to attend births at home. However, ethnographically it was found that while LMOs and trained LHVs are available, they assist with births exclusively in the hospital setting (Towghi 2024: 233).
18In May 1981, the first edition of a manual for Lady Health Visitors was created and published in collaboration with UNICEF and Aga Khan Health Services to establish what LHVs would need to know as mid-level health workers (“Handbook for Lady Health”). The preface states that the handbook was created to fulfill the goal of “healthcare for everyone by the year 2000,” established by the WHO in 1978 (“Handbook for Lady Health”) (Alma-Ata Declaration 1978). In accordance with this initiative, the Aga Khan University held a seminar to understand issues faced by LHVs and concluded that a manual was needed to establish important basic health information (“Handbook for Lady Health”). In the manual, the topics LHVs were expected to know included obstetrics, from antenatal to postpartum care, infectious diseases, deficiency diseases, pediatrics, and tropical ailments (“Handbook for Lady Health”). The scope of the LHVs included women’s reproductive care and common diseases faced by people living in the region such as, bronchial asthma, diarrhea, cataracts, glaucoma, and ringworm. However, it did not address a broader lifespan of health for women, such as perimenopause or menopause.
19Despite the efforts made to maintain LHV programming, new roles continued to be created for additional women healthcare workers. Global health directives in the twenty-first century introduced a new category to move away from the ‘traditional’ by creating the ‘skilled birth attendant’ (SBA), also referred to as the community midwife (CMW) (Towghi 2024: 207). This created the opposing categories of ‘skilled’ versus ‘traditional’ within policies and in practice between SBAs and TBAs. Towghi writes:
The ‘midwife’ designation from this point onwards is for schooled women trained in biomedical forms of healthcare. Only she can be formed into a ‘skilled midwife.’ Her expertise is gauged by a minimum of two years of training. The trained, so-called skilled birth attendant (SBA) will be registered with the government and can become licensed to run her own private practice” (ivi: 161).
20This demonstrates the underlying anxieties of the state surrounding ‘unregistered’ health workers rather than a push towards empowering more women to become educated healthcare practitioners. These varying designations of health workers and numerous titles also reflect a global push for improving women’s health without an informed understanding of how these practices will play out on the ground.
21The global maternal health movement remains deeply divided over the policy shift from training and integrating Traditional Birth Attendants (TBAs) to prioritizing Skilled Birth Attendants (SBAs). As a result, TBAs are viewed with skepticism by numerous health professionals, researchers, and policymakers globally (MacDonald 2022). MacDonald (2022) critiques this global policy and argues that the evidence supporting the move away from TBAs was weak. Adding to this critique, the editors of Traditional Midwives Cross-Cultural Perspectives (2025), suggest, in many respects, that the practices of TBAs worldwide are often more effective and evidence-based than contemporary obstetric practices (Davis-Floyd, Daviss, Ali). They note an exception only for the relatively rare complications that some Traditional Midwives (TMs) are not equipped to handle (ibidem). Furthermore, these scholars assert that the global policies promoting the switch from TBAs to SBAs and contemporary biomedical healthcare have failed to develop effective strategies for ensuring the quality and long-term sustainability of the new services (ibidem). The editors also emphasize that, for the foreseeable future, fully replacing TBAs is simply impractical in many rural areas across the Global South, including various countries in South Asia (ibidem).
22Finally, the most recent iteration of gendered healthcare workers in Pakistan are the Lady Health Workers or LHWs. LHWs were introduced by Benazir Bhutto, Pakistan’s first female Prime Minister, under the Prime Minister’s Population Welfare Program in 1993 (Soch Video 2020). The program was created to empower women economically and improve national health indicators, including maternal and infant mortality rates (Towghi 2024: 248). The LHW program employs approximately 100,000 women from rural and underdeveloped communities. LHWs initially had the mission of providing primary care and family planning services to medically underserved areas through door-to-door work in local communities and keeping up to date with immunizations. However, the government now uses LHWs for various public works beyond just family planning and primary healthcare, including polio vaccine implementation, election volunteering, and population census (Soch Video 2020). Each LHW has a designated catchment area that she is responsible for, which typically encompasses approximately 200 families. LHWs are recruited from both rural and urban areas to work in and near their communities after completing training that occurs over a period of three to five months. 97% of LHWs come from the communities they are assigned to serve (Towghi 2024: 245). LHWs can also work exclusively in hospitals in more medically under-resourced northern regions in Pakistan. The LHWs who work in hospital settings in Pakistan are specifically trained in two- to three-year diplomas to address emergency gynecological issues (Varley 2023). The Federal Ministry of Health is responsible for their training, supplies, and salaries. All LHWs must report to their assigned LHV supervisors (Towghi 2024: 248).
23LHWs are usually appointed via a contract, but are currently advocating to become full governmental employees with government benefits and retirement plans (Soch Video 2020). LHWs provide a wide range of services, including maternal and infant care, nutrition, treatment of diarrhea, medication for acute respiratory infections, immunization, community hygiene, sanitation, and family planning (Towghi 2024: 246). Additionally, LHWs are encouraged to partner with dais to transport birthing women to the hospital more quickly when needed (Towghi 2024: 248). In her ethnography, The Stigma Matrix, Husain observed that LHWs often use traditional herbalist and homeopathic medicinal practices along with their biomedical training to gain trust and better serve their communities (Husain 2024: 125).
24Dais, CMWs, LHVs, and LHWs are highly gendered professions with exclusively women trained and holding these positions. As such, they are also the frontline workers in addressing women’s gynecological issues and far more accessible to women than doctors for clinical care (Husain 2024: 18). Gender norms play a major role in their lives and work. Both the state and the citizens agree on the premise that women are more likely to seek and accept care regarding their reproductive health if it is delivered by another woman. However, these lady workers still face severe stigma for being in the workforce, even when they are the preferred personnel for the job. Husain discusses how LHWs are stigmatized by their families and communities due to patriarchal standards where being visible in public spaces and speaking about family planning is considered dishonorable (Husain 2024: 135). Lady workers are also stigmatized by the biomedical apparatus, as doctors, hospitals, and other clinical institutions often do not recognize them as credible healthcare workers. Despite all these obstacles, they remain an integral part of the healthcare delivery system in Pakistan today. For example, without LHWs, there would not be a workforce large enough to adequately carry out immunization campaigns like the polio eradication campaign.
25These lady workers, from Dais to LHWs, are negotiating gender norms daily while also providing an important network of social service support to their communities. Ethnographic interviews with LHWs revealed that families are more likely to trust and consult their local community health worker than to go to a clinic or hospital (Husain 2024: 145). Additionally, women are often able to unload mental stressors and precarious circumstances on LHWs that they would not bring up in front of clinicians (ivi: 146). Inversely, LHWs are also able to provide home remedies and emotional support that is not available through the strict protocols of the biomedical apparatus. Similarly, dais are community-embedded workers whose knowledge of the community, the women, their environment, and their social positioning allows them to provide more specific and attuned care than any purely biomedical practice can offer. In this way, both dais and LHWs provide crucial gendered social support and care outside of their health related duties.
26Even with the large number of lady caregivers that have proliferated since the colonial period, their constant fight for credibility from the local biomedical system, the state, and within global policies is ongoing. The LHW, LHV, and CMW programs are largely supported by funding from organizations such as the WHO and UNICEF, which are only able to address issues with measurable outcomes and metrics like maternal morbidity and infant mortality. In serving programs driven by metrics, CMWs, LHVs, and LHWs focus most of their efforts on the birthing process. What about women’s longer lifespan issues, one such example being menopause? Additionally, the innate prioritization of all these programs to the biomedical apparatus severely undervalues the important knowledge and contribution of dais that have provided care to women long before these initiatives.
27The persistent effort over decades to try to solve women’s health issues simply by giving women more ‘lady workers’ has proven ineffectual. In the current landscape of care in Pakistan, there is a plethora of ‘local’ and ‘traditional’ women healers for everyday citizens to choose from, and yet a lack of access to care still exists (Ijaz 2024). Creating a gendered workforce as a solution to women’s healthcare issues only addresses one aspect of the larger deficiencies in care available to women. This is not to say that local women should not be empowered within these programs to support and heal their communities. It is to point out that the main goals of these programs were to encourage women, particularly those from rural and underserved areas, to turn to the western biomedical apparatus. Many post-colonial scholars have pointed out that often the underlying goal of the state for moving away from traditional to skilled healing is to have more surveillance and control over the population (Baron 2008; Kanaaneh 2002).
28While programs that empower women within local communities should persist, they should not be predicated on ideas of legitimacy based on western biomedical authority models. Instead, the depth of dais’ experience and knowledge as legitimate sources of practical understanding should be recognized as valuable resources. Additionally, what all these women, from dais to LHWs, provide is not simply access to a healer, they are important pillars of the community that provide a social welfare net. They help support and uplift women through transitional periods like pregnancy, postpartum, and menopause in a way that the biomedical apparatus simply cannot do. Further research needs to be done to understand how, despite the existence of numerous women’s healthcare workers and programs, women still encounter gaps in accessing information about their bodies, health, and well-being.
29Colonial medicine, driven by the desire for control by colonizers and modern state-making projects, has historically framed women’s health primarily through a reproductive lens. Medical anthropology can help us move beyond this narrow focus towards a more holistic understanding of women's health across their entire lifespan. Medical anthropologists have a vital role in challenging biomedicine’s dominance as the sole legitimate healing practice, particularly in regions like the Global South where traditional healers and practices thrive. A historical ethnographic approach is crucial for this work. While the widespread presence of biomedicine cannot be undone, understanding its historical context can offer valuable ethnographic insights into how non-biomedical practitioners establish their space within the current healthcare landscape.