Customised healthcare

The number of white South Africans becoming traditional healers or availing of their expertise has increased dramatically, writes BILL CORCORANin Cape Town

LAST MONTH at a graduation ceremony in a small village in the Transkei, a former homeland for blacks in the Eastern Cape Province during apartheid, Claire Shields (Vangethongo) completed her traditional healer apprenticeship.

The white mother of two from Cape Town’s wealthy Constantia suburb was trained for her new profession by one of the Amaponda tribe’s most respected healers, Malikwa Jonga, a man revealed to her in a dream by her ancestors, she says.

Visiting one of the estimated 180,000 traditional healers in South Africa is not like an ordinary visit to the doctor in Ireland. According to Shields, after divulging the symptoms of your illness, a healer – or sangoma as they are known locally – will pray to the ancestors for guidance to unearth the nature of your illness and how to treat it.

If they respond, the sangoma will prepare herbal remedies to treat the physical manifestation of what ails you, while special ceremonies may also be performed to appease your ancestors.

"A Sangoma is a healer, therapist, teacher and priest all rolled into one in African culture. They are the overseer of the community and perform ceremonies to ensure their people are kept in touch with the ancestors," she told The Irish Times.

“While western medicine treats the physical causes and symptoms of an illness, we take a more holistic approach, and try to tackle the problem at every level. I have studied under two different teachers to get to this point. But saying that, if I don’t know what is wrong after a consultation I will refer you to a medical doctor for diagnosis.”

As strange as this sort of healthcare system may sound to people in the western world, it has been reported that at least 80 per cent of South Africa’s 49.3 million citizens have visited a sangoma, or taken traditional medicines for an illness.

This reliance on sangomas is partly due to the massive shortage of western trained health professionals in South Africa, which like many other countries in the region is suffering from a brain drain to more developed countries where salaries are higher.

However, just as influential is the fact many South Africans have more faith in traditional healing than western medicine, as it is intrinsic to their culture and they believe in it. For better or worse, this means sangomas are usually the first line of care many people encounter when seeking treatment.

Shields’ story is not an isolated one. The number of white South Africans either becoming sangomas or availing of their expertise has increased beyond measure in post-apartheid South Africa, an unforeseeable development given the country’s racist past.

According to Prof Marius Harold, the chairman of the Natural Healers’ Association, an umbrella group for alternative medicines, an increasing number of whites are accepting the importance of the spiritual and emotional aspects sangomas bring to treating illnesses.

“In some respects, western medicine has a limited focus, as it treats the human body, whereas we look at the total picture, which includes emotional and spiritual with physical wellness. People who buy into this way of thinking are finding an outlet for it in traditional African healing,” he explains.

In a country where fatal diseases such as Aids, TB and malaria are omnipresent, the dangers associated with trusting an unscientific approach to treatment, even if it is popular, have been well flagged and debated.

Recently, local investigative journalists won a major award for revealing how some traditional healers prey on desperate people infected with the Aids virus. The conmen relieve their patients of hundreds of euros for treatments and herbal remedies they claim cure the virus, but which were proven fake, and sometimes even dangerous.

Nevertheless, Phillip Mokoena, a spokesman for Treatment Action Campaign, a lobby group for people with Aids, explains that many sick people are left with no choice but to seek out their local sangoma because access to the public health system, which has low staffing levels and poor infrastructure, is limited.

“There are no waiting lists to see a sangoma and traditional medicines are easy to get. The sangomas are very important in the fight against Aids as they are far more accessible than the public healthcare system.

“What we are trying to push the government to do is integrate sangomas into the public healthcare system, because many continue to practice without taking into account western medicines,” she explains.

Creating a healthcare system that draws on western medicine and traditional healing for the benefit of the patients has proved generally elusive to date.

The majority of doctors remain sceptical about sangomas’ methods and cures when it comes to treating ailments, both serious and minor, which has led to rising mistrust between the parties, and poor working relationships.

According to Dr Motlalepula Matsabisa of the Medical Research Council (MRC), sangomas want a genuine open working relationship with modern doctors.

“They wish for a three-way referral system for patients and they need recognition of their expertise, but this rarely occurs because of doctors scepticism,” he says.

As a means to investigate the veracity of the healing properties attributed to the many different plants used in traditional remedies, the MRC through its Indigenous Knowledge Systems (IKS) programme has established a drug discovery initiative.

As well as training sangomas about scientific approaches to illness and disease, and trying to make traditional medicine a valued health model in South Africa, the IKS-led programme carries out research to discover lead compounds from medicinal plant extracts that are said to have healing properties.

The current collaborative research aims to establish whether traditional remedies can have a positive impact on TB, malaria, hypertension, diabetes, cancer, HIV and Aids.

The programme relies on sangomas to voluntarily submit for testing to the MRC IKS-led programme, products and plants they use to treat various ailments.

If their claims prove correct, their intellectual property is protected and they can share in the profits of whatever commercial developments arise from the discovery.

One of the most famous examples of a success story in this area in recent times involves the Khoisan bushmen of southern Africa and their use of the Hoodia cactus plant as an appetite suppressant, extracts of which are now used in diet products.

The IKS-led programme has also experienced some success, according to Matsabisa, who is responsible for the research and the development of any discoveries into new pharmaceutical drugs.

“Through our continuous research collaboration with indigenous knowledge holders, we have identified several molecules, from a medicinal plant, that have been very effective against plasmodium falciparum, the malaria-causing parasite.

“The compounds have shown their effectiveness in an in vitro testing for both the drug-resistant and drug-sensitive strains of the parasite.

“Current research is under way to test these compounds in an in vivo system for their effectiveness against the parasites, and safety in a living system, and the preliminary results in a living test model are very promising.

“These compounds and their derivatives have been patented and the patent applications have been applied globally. This work is at an advanced stage of in vivo research and we are hoping that very soon these results will enable us to prove the usefulness of these molecules in patients infected with malaria parasites.”

To try to legitimise the traditional medicine industry as a whole the government has begun the process of regulating and monitoring it, and a number of laws that cover all aspects of the profession have either been introduced or are in the pipeline.

In 2007, parliament adopted the Traditional Health Practitioners (THP) Bill to provide for the establishment of the Interim Traditional Health Practitioners Council of South Africa, a body which will be tasked with ensuring the efficacy, safety and quality of traditional healthcare services.

The THP Bill provides for control over the registration, training and practice of traditional health practitioners, and every healer has to be registered with the council, which has yet to be established, or they will face stiff penalties or jail sentences.

The recent announcement that one of South Africa’s most prestigious universities is launching a medical degree for sangomas was also a significant moment for advocates of integrating the profession into mainstream healthcare.

During the summer Profburg’s Witwatersrand University said it would start training the first 100 sangomas who signed up for the course.