Bringing traditional healers into the health care system
by Dr Leslie Pitt, the Valley Trust.
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Should traditional healers be recognised as part of the
health care delivery system? This controversy rages
on and is a long way from being answered.
The Valley Trust has considerable experience in the
field. In the first 30 years of the organisation’s existence
up to 1980, a stance of non-interference in the affairs
of traditional practitioners was taken. In 1980 a number
of these practitioners volunteered to be part of the new
Community Health Worker (CHW) or Community Based
Health Education (CBHE) programme. This was the
start of a much closer association between the Valley
Trust and Traditional Healers.
All volunteer Community Health Workers completed a
community based, experiential training curriculum for
a period of approximately three years after which
successful candidates received certification as
qualified Community Health Workers.
Our approach to traditional healers therefore changed
from 1980 onwards to actively involve them in the
health delivery system. Apart from their involvement
in the Community Health Worker programme, meetings
were held with traditional healers to exchange views
and to share knowledge and experiences in a nonjudgmental
way in an attempt to change harmful
practices into safe practices. Healers were encouraged
to bring their patients to our clinic when biomedical
treatment was needed. We in turn reported back to
the traditional healers and in some instances referred
cases with “Zulu” diseases back to them.
Thus through constructive engagement, a good
relationship between the two systems of practice was
fostered in our area of operation, where access to
health care was a problem, not only due to lack of
services, but due to the physical terrain which gave
the area the name “the Valley of 1000 Hills”. It is
estimated that in our operational areas there would
be between 200 and 300 traditional healers. Through
collaboration we therefore have that many more “health
workers” at no extra cost to the health system and
who would have been consulted in any event by 80%
or more of our patients.
We therefore actively involve traditional healers in all
our activities. Some are Community Health Workers.
They are part of our TB control programme. They
dispense oral rehydration fluid. They don’t re-use razor
blades. They help to run our health posts. They are
involved in our social plant use programmes. They
are involved in our nutritional programmes. They
dispense condoms. They are part of our student
training programmes.
Yes, there are the harmful practises which are delivered
by some uninformed or unscrupulous practitioners,
as happens in all professions. However, the gains of
bringing traditional healers into the health care system
far outweigh the negative impact of excluding them.
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