The Shrine in the Dungeon: On Knowledge, Power, and the Right to Healing in the Asante Region

Abstract

This thesis examines medical pluralism in the Asante region of Ghana, asking what it reveals about the relationship between institutional power and indigenous knowledge in postcolonial societies. It draws on ethnographic fieldwork conducted primarily in Kumasi, Ghana from December 2025 to January 2026 – including healers, clergy, biomedical practitioners, community members, and traditional leaders. I argue that medical pluralism in the Asante region is neither neutral nor organic, but structured by a colonial hierarchy that relegated traditional medicine to the epistemological margins. Chapter One establishes this hierarchy as a colonial inheritance, tracing how traditional cosmology was subordinated to uphold the authority of Christianity and biomedicine as mutually reinforcing and institutionally dominant systems. This reveals a landscape in which all three systems share a claim to divine authority, yet only two are granted institutional legitimacy. Chapter Two asks whether the hierarchy is justified and finds that it is not: traditional herbal medicines have demonstrated pharmacological efficacy on biomedical terms, biomedical practitioners themselves expressed belief in spiritual causation when confronted with cases biomedicine cannot explain, and the incuriosity of biomedical institutions reflects institutional rigidity rather than epistemological necessity. Chapter Three follows the same hierarchy from institution into individuals, showing how it has become so thoroughly internalized that it now reproduces itself through the silences, concealments, and self-limiting choices of ordinary people. The thesis concludes that dismantling this structure requires both institutional restructuring – including licensing, research funding, epistemological recognition, and economic opportunity– and an attention to how hierarchies that begin as impositions become absorbed as common sense. What is ultimately at stake is not only which knowledge systems receive legitimacy, but who has the right to live well on their own terms.