Using semi-structured interviews, this study explored the perceptions of traumatic brain injury (TBI) held by a group of 22 brain-injured individuals and their caregivers living in rural African communities. While there are similarities between these findings and those in other parts of the world regarding the cognitive, emotional, personality and behavioural changes experienced by brain-injured individuals, the perceived aetiology of brain injury differed according to the individuals' worldview. Most of the participants believed that the accidents considered in this study as well as the injuries they gave rise to were the result of witchcraft, ancestral anger, God's will or thwasa. The reactions of family members to caring for, and living with, a brain-injured person appeared to be influenced by specific social practices and local cultural beliefs. It is important to incorporate these beliefs into the rehabilitation process. Suggestions for rehabilitation are discussed.
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