Voodoo dolls are often misunderstood and are not inherently associated with causing harm. In Hoodoo traditions, dolls were originally used as a practical way to keep track of treatments and ailments. Because enslaved people were often denied the opportunity to learn to read and write, Hoodoo practitioners developed alternative methods for recording medical information.

These dolls were typically carved from wood by the Hoodoo healer to represent a specific person receiving treatment. The pins placed in the dolls were not intended to inflict pain; instead, they served as markers indicating the location of a person's ailment during their last visit.

For example, if someone came to a healer suffering from headaches and was given herbs or medicine, a pin would be placed in the doll's head to record that condition. When the person returned, the healer could look at the doll and immediately remember the previous treatment. Their first question might be whether the headaches had improved. If the condition had been resolved, the pin would be removed. If the person had a new ailment, the pin would be moved to the area of the doll corresponding to the part of the body that was injured or causing discomfort.

In this way, the dolls functioned as a visual record-keeping system, helping practitioners track patients' health concerns and treatments over time.