Traditional healers in South Africa
by Stuart Hess
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Traditional Healers, (in South Africa known as
sangomas and inyangas) have been
administering health for centuries. Instead of using
medicines like penicillin, panado’s or other western
substances, they use the fruits of the earth, gathering
plants in the mountainous areas of KwaZulu Natal, the
Free State and the Eastern Cape.
Traditional healers play a crucial role in administering
health to the majority of South Africans. However their
role is still not concretely defined and there is much
disparity between western trained or allopathic doctors
and indigenous practitioners. Many from the sector and
outside it feel traditional healers should take up their
rightful place within an integrated medical and dental
council. Not everyone subscribes to this view,
however. The head of the Traditional Healers
Organisation, Nhlavana Maseko, does not believe the
two sectors should be integrated. “This traditional
system is an indigenous one which is totally different
from the modern system so the two cannot be
integrated,” said Maseko. “We want to establish the
traditional system parallel to the modern system.” He
says in South Africa the western health system is well
established and recognised, but similar recognition is
not afforded to traditional medical practice. “If one looks
at the current situation, Traditional healing is looked
down upon by the modern system which is housed in
these large [hospitals].” He believes traditional healing
needs to be upgraded to rank equally with modern
schemes. “[Traditional Healers] are the first contact and
front-line service provider (of health services) and they
also help by referring patients to the modern sector,”
explained Maseko.
Maseko established the THO in the wake of protests
in the 1970’s against the Witch Craft Act promulgated
by the British Colonists in 1818. After approaching the
former Swazi king - King Subuzo II – a council was
formed to address the problems faced by traditional
healers. In 1980 Maseko placed 150 associations
representing traditional healers in South Africa under
a single umbrella body and formed the Traditional
Healers’ Organisation. The organisation currently
represents more than 180 000 traditional healers from
South Africa and a number of neighbouring countries
including Swaziland, Zambia and Zimbabwe.
To qualify as a traditional healer one has to serve an
apprenticeship of between 1 and 5 years, and be well
known within the community and amongst other
traditional healers. Healers then register with the THO
and are given a book to certify that they are qualified
practitioners. The qualifications are valid in Africa, Asia,
Latin America, Europe and Australia. Members pay
an annual subscription fee of R60.
Maseko says the roles of traditional healers need to
be upgraded as they serve a far greater number of
clients than western doctors, especially in rural areas.
The self proclaimed international president of the THO
wants to see traditional healing and western practice
operating equally with both sectors referring patients
to one another.
This view is shared by the president of the National
Traditional Healers Association of South Africa
(NTHASA), Patience Koloko. However, although
NTHASA, which represents 5000 traditional healers,
is affiliated to the THO, Koloko wants to see traditional
healers incorporated into the South African Interim
Medical and Dental Council (SAIMDC) because this
would provide traditional healers with more benefits
such as recognition by hospitals and doctors.
Traditional healers would also be able to draw up
“official” medical reports when referring patients to an
allopathic doctor. “ Because we’re not incorporated into
the SAIMDC we can’t work in hospitals and our patients
can’t receive medical treatment from us there,” says
Koloko.
She believes students who want to become traditional
healers should go to a “traditional healer school” similar
to a medical school. She is currently negotiating with
Mangosuthu Technikon in Umlazi to provide NTHASA
with facilities to train traditional healers.
Besides her work as a traditional healer with the
community in Hammarsdale, Koloko also conducts
awareness programs on primary health care and AIDS/
HIV. The 51-year-old healer wants to use empty, newly
built clinics as “surgeries” for traditional healers. “The
department has built all these clinics in rural areas but
many are standing empty; we should use them,” says
Koloko.
The Department of Health wants traditional healers to
establish a formal council to conduct their affairs saying
this will make management of the sector much easier.
Situated east of South Africa’s biggest city, in the
Tsakane township outside Brakpan, Thoko Maseko is
busy re-arranging her house for an important
ceremony. Four women are to graduate and become
official traditional healers. The four, including a nurse
from the neighbouring suburb of Benoni are all covered
with red make up and after bathing in a nearby vlei,
they are taken to Maseko’s home where they are set
to complete the ritual.
Maseko started practicing as a traditional healer in 1978
and is well known within the community. She has a
very close working relationship with the nearby
Rockville clinic. Maseko says there is a regular referral
of patients between her and the clinic, especially with
the seven AIDS sufferers living in her neighbourhood.
“When I’ve got patients I send them to the clinic for
check ups, and the clinics always send them back,”
says the 47-year-old healer.
Maseko is a member of the Traditional Healers
Organisation. She not only administers medicinal
treatment but also specialises in providing
psychological aid, the treatment of diabetes, flu and
other common ailments. The Aids Treatment and
Information Centre granted her a certificate last year
for participation in an Aids workshop.
Grace Thuketane a senior nurse at the Rockville clinic
says they have a good relationship with Maseko and
trust her judgement. “If patients don’t get any better
after we treat them we have to refer them to a traditional
healer,” says Thuketane. She trusts Maseko because
she is very experienced and many of the clinic patients
speak highly of her work. Clinic administrators are very
happy with her work especially with AIDS patients.
While the allopathic and the traditional practices are
working closely together in Tsakane, Maseko believes
traditional healers should not be integrated into the
South African Interim Medical and Dental Council
(SAIMDC). Instead an independent traditional healers
council should be established with a similar status as
the SAIMDC.
The shelves of Maseko “surgery” are packed with
hundreds of bottles containing traditional medicines
many of them obtained from plants in Kwazulu Natal.
Medicines used by traditional healers belonging to the
THO are administered to the public with the blessing
of the clinic, even though these medicines have not
been formally tested and registered.
“The [Medicines Control Council] approves both
orthodox and unorthodox medicines for registration
on the basis of safety, quality and efficacy for the South
African market,” says the registrar of medicines,
Precious Matsoso. The terms of the Medicines and
Related Substances Control Act of 1965 stipulate that
no substances passed by the MCC can be sold by
persons other than doctors, dentists or pharmacists.
The current definition of the Act does not make
provision for Complementary Medicines. However, a
new Bill proposed by the department will make
provision for the listing of all Complimentary Medicines
and all medicines will be listed based on their safety,
quality and proven efficacy. This will only occur once
the act is passed. (see our article “The registration of
traditional medicines”).
The department of health says that medicines must
be made available to be tested by the MCC although
such tests are not yet underway. The chair of the MCC’s
Complementary medicines section, Peter Makhambeni
says medicines are tested and then registered before
they are allowed onto the market. “Those [traditional
healers] currently giving substances to people are not
using registered medicines,” says Makhambeni. The
committee is formulating a new bill that will see all
medicines sold on the market are properly registered
with the department. However despite the growing
number of people using traditional healers for their
medical ailments, neither the department of health nor
the MCC have come up with a definite policy regarding
the sector.
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