Tryphina Ngwenya slides a pink condom over a wooden stick normally used to conjure up ancestral spirits, unleashing a ripple of laughter among her audience of traditional South African healers.
”You see it’s easy — there’s nothing poisonous or dangerous about condoms,” she told the group of some 80 sangomas — as traditional healers are locally known — draped in brightly coloured wraps, animal hides and beads.
Ngwenya has recruited the sangomas as foot soldiers in the fight against HIV/Aids, which has infected about one in three adults in this deeply traditional corner of rural South Africa.
She is teaching them basic HIV/Aids awareness and prevention.
Many of the healers once believed HIV/Aids was a curse from the spirit world and patients had been bewitched. Some claimed they could cure Aids — and many who have not been trained continue to claim this.
But while they still prescribe roots and herbs for ailments and mutter incantations to dispel evil spirits, these sangomas now also issue condoms, refer patients to clinics for HIV tests and urge them to take life-prolonging antiretroviral drugs.
”Before, I didn’t even know what this HIV animal was, but the training has brought sophistication to my work,” said Miriam Tembe, who has been consulting the spirits for tips on treating patients for 25 years.
The training helped her with the practice of scarring a patient then rubbing herbs or powder into the wound: ”I used to use one razor for five people — I used to kill people,” she added. ”Now I teach them how to protect themselves.”
Bewitched
The project linking traditional practitioners with modern health systems is being run by African Medical and Research Foundation (Amref), which says more than two-thirds of people in rural Africa consult sangomas before attending a clinic.
Sangomas are revered and trusted in rural communities and play multiple roles as spiritual guide, healer and counsellor. Mostly but not always woman, they might offer tips to a young couple on their sex life, advise on proper burial rites, or concoct a treatment for toothache — all in a day.
Amref wants sangomas to keep providing spiritual succour and basic healthcare, and also to use their influence and authority to promote HIV-testing and modern medicine in areas where many people are distrustful of hospitals, clinics and antiretroviral drugs.
”Traditional healers are so important in these communities. People trust them more than they trust us nurses,” said Ivy Mdletshe, a nurse who works in Amref’s HIV testing centre.
Zandile Bukhosini has benefited from the system. When her feet swelled up and she developed a hacking cough she assumed she had been bewitched and went straight to see Tembe — her local sangoma.
Fortunately, Tembe knew how to spot the symptoms of tuberculosis, which often accompanies HIV infection. She consulted the spirit world as usual, then sent Bukhosini for an HIV test. The results were positive.
”When Miriam sent me for a test I was skeptical, but her medicine had helped me before so I decided to trust her,” said the 25-year-old, hunched inside a mud and straw hut, the bitter aroma of burning incense wafting from the corner.
Now, with Tembe’s support, Bukhosini is taking antiretroviral drugs and looks happy and healthy.
”Miriam encouraged me to take the medicine the doctors gave me,” she said. ”But she also gives me her own treatment and tells me if I need to slaughter a chicken to appease the ancestors.”
Toxic drugs
The Amref project has particular resonance in South Africa, where Health Minister Manto Tshabalala-Msimang has angered Aids activists by appearing to question accepted science and emphasising treatments such as lemon, garlic and the African potato.
Ngwenya insists the two approaches are not mutually exclusive, and argues sangomas can help treat some of the side effects of HIV — such as skin problems or coughs and colds — and break down the stigma attached to it.
”Obviously there is not a traditional healer who can cure Aids but they can help treat the symptoms and help support patients by giving them what they want to believe,” she said.
But she also says much more must be done. An estimated 200 000 traditional healers are practising in South Africa — there are almost 900 in this small district of about 200 000 people — and organisations like Amref have trained just a handful.
Many healers still tell patients antiretroviral drugs are toxic, condoms are infested with disease-carrying worms and killing a goat will appease ancestral spirits and cure the sick.
And while a few weeks of basic training can halt dangerous practices like razor-sharing, healers may continue to promote traditional methods over modern medicine.
But most sangomas see little conflict between the two approaches, and say learning about orthodox healthcare has helped improve their traditional practice.
”How can the ancestors be angry with me?” said sangoma Philile Gumbi when asked what the spirits thought when she encouraged patients to turn to modern medicine: ”Both me and the hospitals are doing the same thing — we are saving lives.” – Reuters