Table 1 Features of the folk system

Religious healing involves individuals or groups praying or reciting religious texts to seek cure. Individuals may drink holy water, fast or undertake pilgrimages to seek forgiveness of sins and alleviation of illness

Faith healers (gurus – for Sikhs and Hindus, pirs – for Muslims) may be consulted for a number of illnesses/problems perceived to have a spiritual element (including epilepsy and mental illness). Some Muslims refer to such healers as pirs. The pir's special spiritual power, acquired through birthright (lineage) or a lifetime of devotional acts, allows him to communicate directly with God and thus act as a mediator between God and the people.

Pirs offer a number of treatments. Amulets (tawiz), containing verses from the Koran are usually worn around the neck or on the arm, act as a defence against evil spirits or the evil eye (buri nazaar). Other types of amulets are dipped in water and then the blessed water is drunk. When the problem is thought to be spiritual, the pir may diagnose possession by evil spirits (jinns) which must be exorcised. However, only specialist pirs have the specific knowledge to perform exorcisms. While most pirs do not levy a charge for their services, they expect some type of payment in kind, often cash or jewellery. Others ask for donations to a mosque or other places in India and Pakistan that may be in need of charity.

There is a widespread belief amongst Muslims that jinns are spiritual beings – created from smokeless fire rather than the spirit of dead people – that live on earth in a world parallel to mankind. Jinns have the ability to possess and take over the minds and bodies of other creatures, including humans, and to behave in either a good or evil manner. Jinns possess people for different reasons. Most of the time possession occurs because the jinn is simply malicious and wicked.

The word hakim is derived from hikmat, the traditional system of medicine practised mainly among Muslim countries in South Asia. The practice, which involves use of a variety of herbs and minerals, has its basis in Greek medicine and Hippocrates' theory of the four humours (blood, phlegm, black and yellow bile). Humoural imbalance is thought to be the cause of ill health and it is the hakim's role to help regain the body's original state through a combination of medication (dawaa) and abstinence (parhez). In Pakistan, hakims often come from a well-established lineage of healers and are generally trained through a process of apprenticeship, although there are also a number of well-established institutions which offer training.