The significance of the traditional healer in contemporary society

The World Health Organisation (WHO) estimates that 80% of people in Africa regularly consult traditional healers, and advocates incorporating safe and effective traditional medicine into primary healthcare systems¹.

South Africa was one of the first countries to recognise the significance of collaboration. In 2005, parliament approved a law to recognise the country’s estimated 200 000 healers as healthcare providers in an attempt to bring traditional healers into a legal framework². Recent meetings, held in Pretoria, have strengthened relationships and possibilities for collaboration between the Department of Health and the recognised traditional medicine organisations.

Credo Mutwa – renowned Zulu sangoma and author – experienced both Western Christianity and traditional African folklore as a child. In his view, traditional and modern medicine both serve the well-being of their patients and contribute to a healthy community. However, traditional healing encompasses body, spirit, the personality and ancestors of a patient, and the prescription of traditional medicine, whereas the formal health sector tends to focus on specific symptoms, treating the disease rather than the individual situation³.

Dr Velaphi Mkhize, an initiate regarded as an authority on African traditions, culture, ancestral wisdom and African healing, pleads for recognition of both disciplines in his comprehensive article: ‘Africa’s two worlds of healing: their challenges’. As the origin of both is Ancient Egypt, Western medicine should acknowledge the African uniqueness of being able to heal both the physical body and the soul, which allopathic medicine does not claim to do. Some conditions cannot be cured by Western medicine and others cannot be cured by African medicine so the two systems need each other in service of all South Africans. He posed the question: How can we marry the two for the betterment of our communities and for humanity?⁴

Can training in diabetes management emulate the success of the HIV/AIDS model in KwaZulu-Natal?

The South Africa prevalence (> 7%), increasing and risk factors (BMI, obesity and cholesterol levels) for diabetes make a case for urgent intervention and cooperation of health practitioners in all our communities⁵. Dr James Hartzell, a professor at South Africa’s University of KwaZulu/Natal medical school, initiated a project to improve collaboration between doctors and 350 healers trained in caring for people with HIV/AIDS.

In his experience, people take their traditional healers seriously, and when the healers are willing to be trained, they recognise symptoms and refer to the health facilities. When referring patients to the clinics, they wish to be regarded as part of the team. According to Dr Hartzell, “They are just asking for at least basic information back from the biomedical team, which is often hostile to them, such as what were patients given in terms of treatment.”

The training of 350 healers included prevention, voluntary counselling and testing, home-based care and antiretroviral therapy. The healers are empowered to make an impact on patient compliance and management when there is collaboration with the biomedical team. Traditional healers can assist with advice on good nutrition, lifestyle changes, a positive attitude, and many good herbal remedies strengthen the immune system⁶. Together with the formal healthcare sector, they could ensure improvement in diabetes awareness, prevention and management.

Why are they sidelined?

For the most part, healers, according to Itai Madamombe, a United Nations staffer, are not officially recognised by governments. Not including them in the formal structures could have serious consequences. Patients, putting their trust in the healer, may disregard their medical doctor’s advice or take herbal medicines without regard for possible dangerous interactions with pharmaceuticals. By working with these healers, doctors would find colleagues in the patient’s own community⁷.

Collaboration with all stakeholders

As an outreach project of Diabetes South Africa (DSA) – Agents for Change – seeks to empower all those living with (i.e. patients and families) and working with (i.e. health providers) diabetes-related conditions with knowledge and skills, so they can collaborate as a team.

Traditional doctor and community leader, Joseph Makhubu, recently heard about the project and, with great enthusiasm, booked 30 traditional healers and invited us to Duduza Township in Ekurhuleni to offer the first module of the Agents for Change training. This module focuses on the pathophysiology of diabetes, signs and symptoms, risk factors, and the significance of lifestyle changes of the participants themselves.

He explained that the formal health sector has shown continued interest in the role of sangomas and the efficacy of their herbal remedies. Some of which are being researched include buchu, aloe and Sutherlandia frutescens. On the other hand, traditional healers were most willing to be a part of the diabetes team and to learn more about diabetes and how the two disciplines can collaborate for the benefit and health in the communities.

Dr Henning Morr – a medical doctor supporting departmental programmes, training and research, including community health and community development – works with traditional doctor Joseph Makhubu. Their research found that traditional healers empowered with basic medical knowledge feel safer in their decisions and have more patients. ‘Co-educational’ training is requested, role plays, dialogues, not aiming at shifting traditional healers to the modern system, but rather to understand and find ways of collaboration⁸.

A role play between Dr Ethel Ndlovo Phillips and traditional doctor Joseph Makhubu during the Agents for Change project.

How, when and where can we meet?  

In the South African medical Journal, J P de V van Niekerk, posed the question: how is it possible for such a diverse and often conflicting range of systems and views to be accommodated sensibly, peacefully and to the benefit of South Africa’s people? He concludes in his editorial, that establishing a council for traditional healers could face insurmountable problems. However, acceptance and respect for their respective domains of truth has enabled health professionals to collaborate successfully with traditional healers to address some of South Africa’s major health challenges⁹.