/ 21 November 2003

Sangomas and spirits must answer to Manto

South Africa’s estimated 200 000 traditional healers will soon be regulated under the Traditional Health Practitioners Bill, to be enacted by Parliament next year. But many traditional healers are unaware of its contents and critics have raised various problems with its implementation.

Traditional healers will be required to register with the Traditional Health Practitioners Council of South Africa, a Department of Health spokesperson told the Mail & Guardian. Unregistered healers will be liable for prosecution. The council will oversee the healers and help protect the public.

Traditional practitioners include herbalists, diviners, birth attendants and traditional surgeons. Under the new Bill, they will be able to issue medical certificates for sick leave.

Dr Irwin Friedman, who has worked with traditional healers in KwaZulu-Natal, said: ”We need to recognise the value in collaborating with traditional healers. Most people from traditional black communities will visit traditional healers before they visit doctors.”

Traditional healers, he said, could help alleviate the mental health-care load. ”So much of what people feel is about psychological and spiritual stress, and traditional healers deal with that.” Nonetheless, he said, regulation is essential.

The Bill faces opposition from Doctors for Life (DFL). Traditional healers cannot be regulated, said DFL spokesperson on traditional healing Dr Moses Thindisa. ”They get their instructions from the spirits. There is no way to get spirits around a table to account for their instructions.”

Moreover, ”when spirits give medicine, it’s usually a secret that is not supposed to be divulged. [But] the medicines need to be subject to laboratory tests.”

DFL is also sceptical about giving healers the right to issue medical certificates. ”We foresee situations where a person will stay away from work for six months or a year because the ancestors said they should stay away.”

There is also some opposition from traditional healers. The Traditional Healers Organisation, which has 15 000 members, says the department is excluding existing organisations and failing to recognise their work.

There is also conflict between traditional customs and the provisions of the Bill. In its submission to the department, the organisation raised questions about the proposed minimum age for practitioners. ”If the spirit of your ancestors needs you to [be a healer], you will be without a choice. You can be a traditional healer at the age of 10.”

The Bill also excludes mentally ill people from practising. But, said the organisation, ”some people first go ‘mad’ … as a sign [from the ancestors] that they must be healers”.

The submission asks how healers will be assessed for registration, since many are functionally illiterate.

There is also the issue of medical aid cover. Dr Maurice Goodman, head of clinical communication and marketing at Discovery Health, said his company welcomed the inclusion of traditional healers, provided the proper checks and balances are in place.

The Council for Medical Schemes was not consulted, said spokesperson Pat Sidley, but cover would depend on the trustees of individual schemes.

Gilbert Matsabisa of the Medical Research Council said the quality, safety and effectiveness of traditional remedies had to be determined.

The health department failed to respond to requests for comment.