/ 4 October 2003

Tradition is not ‘witchcraft’

Traditional healers have a crucial role to play in the implementation of a national anti-retroviral (ARV) treatment plan, especially in rural areas where there is a shortage of doctors.

This was the major resolution reached at a forum hosted by the Traditional Healers Organisation (THO), which represents 25 000 members. It met with the Treatment Action Campaign (TAC) this week in Johannesburg.

The forum was held to inform the TAC on the benefits of traditional healers’ involvement in treating people with HIV and Aids. ”The TAC holds a very powerful position in our community,” said THO national coordinator Phephisile Masebo, ”and it is important for the TAC to be fully informed when they are making statements about traditional healing and medicines.”

The forum was held on Tuesday, the same day the Minister of Health, Manto Tshabalala-Msimang, was handed the completed draft Aids plan that paves the way for the roll-out of anti-retroviral treatment.

The plan details logistical issues, with a focus on staff capacity, distribution of the drugs and testing facilities. One of the major challenges facing the roll-out is the shortage of health-care workers — which is precisely where the traditional healer can step in.

The World Health Organisation (WHO) estimates that about 80% of Africans rely on traditional medicines for their health-care needs. ”In many parts of Africa, the numbers of traditional health practitioners far outnumber that of medical doctors,” wrote Ebrahim M Samba, the WHO’s regional director for Africa, in the WHO publication African Health Monitor in June 2003.

The WHO acknowledges that traditional remedies are cheaper than modern medicines, are more widely available in communities, and are integrated in the communities. Samba wrote: ”The question therefore arises: Why don’t we promote what is accessible and acceptable to us, and institute measures to nurture and manage it?”

About 30 traditional healers attended the forum to share their experiences of treating people with HIV and Aids. Many complained of a negative image that equates traditional healing with witchcraft.

The forum discussed ways of improving perceptions of healers through devices such as the registration of healers and conducting research into their treatments. Jafta Semenya, a traditional healer in Shonshonguve, said he administers care to many clients who have HIV or Aids and tuberculosis. ”I have cures for diarrhoea, fertility and sexually transmitted diseases.”

Many traditional healers work within the community as counsellors. This role could be enhanced to include treatment literacy. The TAC said traditional healers have a key role in ensuring the adherence of Aids patients to ARV regimes, and by referring patients to treatment centres when necessary.

TAC treasurer Mark Heywood said at the forum that traditional healers are already filling a gap. If effective roll-out in rural areas is to take place, he said, such healers will have to be part of a communication system referring patients to clinics and getting feedback from clinics on patients’ health. ”It is not difficult if the district sets up a forum where traditional healers, doctors, nurses and community activists work together in monitoring roll-out.”

According to Masebo, the aim of the forum was to create a partner- ship with the TAC to raise the profile of traditional healers and facilitate the involvement of the THO in the national treatment plan. ”We can play a role in educating clinic staff and their patients in relation to anti-retroviral treatment roll-out and compliance issues,” said Masebo.

Heywood said the partnership will be built on common principles: all must agree that traditional medicine be safe, efficacious and of good quality. He said: ”There must be a plan by the government to evaluate and register traditional medicine and do more to educate the population around these treatments.”

The Medical Research Council’s traditional medicines research unit, founded in 1997, engages in such research.