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MY FRIEND THE WITCHDOCTOR
Role of Traditional Healers in South African Society
Christa Rautenbach1
My friend the witch doctor
I told the witch doctor I was in love with you
I told the witch doctor you didn’t love me too
And then the witch doctor, he told me what to do
He said that … Ooo eee, ooo ah ah ting tang …
[Lyrics by David Seville - 1958]
1. Introduction
It is estimated that South Africa has 200 000 traditional healers who are consulted by
almost 70-80% of South Africans.2 Currently they operate unofficially and without
licenses as traditional healers,3 some under the auspices of the Traditional Healers
Organisation4 and other unofficial organisations.5 Over the years traditional healers and traditional
healing have been unjustly and in some instances rightly criticised by the popular media of South Africa
and elsewhere.6 The media often carries horror stories of traditional healing gone wrong, while the victims of
their malpractices have to live with the consequences.7 On the other hand, there are also positive reports8 and it is clear that traditional healers have played and continue to play a vital role in creating a just society based on human dignity, equality and freedom.9
Although traditional and western health systems have operated side-by-side since
early times,10 western healing has enjoyed greater official acceptance by successive
governments because it was seen to be based on “scientific and rational knowledge,
whilst traditional healing was seen to be based on “mystical religious beliefs”.11
As a result, by far the greater part of state and private funding has been poured into
western healing at the expense of its traditional counterpart. This leads to a
segregated health system where those who can afford it enjoy amongst the best
medical services one can find while those who cannot afford it, particularly those
people in rural areas,12 are serviced by health institutions characterised by poor
facilities and insufficient resources. Currently western healing is unattainable for the
majority of the South African population.13
The inaccessibility of western healing, the high cost attributed to it and the more
holistic approach14 followed by traditional healers are some of the reasons attributed
to the popularity of traditional healing.15 The government has realised this and has
put forward legislation aspiring to integrate traditional healing into existing western
healing practises.16
In this paper the lexical confusion regarding the terminology surrounding traditional
healing will firstly receive attention.17 Secondly, the paper will focus on the current
and future role of traditional healers in the health sector.18 Thirdly, the most important
provisions of the Traditional Health Practitioners Act19 will be discussed critically and
finally an outline of an interview with a local traditional healer will be given before a
conclusion is reached.20
2. What’s in a name?
There is an overwhelming lexical confusion concerning the correct terminology for a
traditional healer.21 Some of the confusion is created by the accounts of academic
writers and others by the difference between the various culture groups in South
Africa. In Zulu culture, for example, there are different classes of traditional healers,
which are sometimes collectively labelled as “witchdoctors”,22 a term traditional
healers earned because of their function to counter curses put on people by
witches.23
The classes of traditional healers that can be distinguished in the Zulu culture include
the nyanga,24 sangoma,25 sanusi26 and thwasa.27 Another distinction28 is between a
sangoma (diviner-mediums)29 and inyanga (herbalists).30 Other writers use the terms
“diviners” and “traditional healers” interchangeably without distinguishing between the
two terms.31 So-called abathandazi or Christian diviners developed as a result of antiwitchcraft
legislation. They found it easier to infuse traditional healing practices with
Christian values and rituals, whilst enjoying the protection of the church.32
Research indicates that the difference between the various classes of traditional
healers have been blurred as a result of colonial powers and structures which played
a role in changing the setting of traditional healing.33 Legislation, such as the
Witchcraft Suppression Act,34 distorted the difference between diviners and herbalists
even more by prohibiting diviners to practice their trade.
Research also indicates that most traditional healers prefer the more generic term
“traditional healer”, because the word “sangoma” also refers to someone who does
harm to others.35 In some of the literature it is suggested that the categorisation of
traditional healers is a mere academic exercise and that the profession itself does not
distinguish in the same manner between the various categories of healers.36
The Traditional Health Practitioners Act37 distinguishes between the following
persons who engage in traditional health practice,38 provided that they are
registered39 as such under the Act:
(a) Traditional health practitioner.40
(b) Diviner.41
(c) Herbalist.42
(d) Student.43
(e) Traditional birth attendant.44
(f) Traditional tutor.45
(g) Traditional surgeon.46
Since only traditional healers engaged in traditional health practices may be
registered as a traditional healer under one of the relevant categories, the terms
“traditional health practice” warrants further explanation. In terms of the Act it
means:47
… the performance of a function, activity, process or service based on a
traditional philosophy that includes the utilisation of traditional medicine
or traditional practice and which has as its object-48
(a) the maintenance or restoration of physical or mental health or
function; or
(b) the diagnosis, treatment or prevention of a physical or mental
illness; or
(c) the rehabilitation of a person to enable that person to resume
normal functioning within the family or community; or
(d) the physical or mental preparation of an individual for puberty,
adulthood,49 pregnancy, childbirth and death, but excludes the
professional activities of a person practising any of the
professions contemplated in the Pharmacy Act,50 … the Health
Professions Act,51 … the Nursing Act,52 … the Allied Health
Professions Act,53 … or the Dental Technicians Act54 … and any
other activity not based on traditional philosophy.55
The Act affords quite a wide meaning to the concept of traditional philosophy. It
includes:
… indigenous African techniques, principles, theories, ideologies, beliefs,
opinions and customs and uses of traditional medicines communicated
from ancestors to descendants or from generations to generations, with
or without written documentation, whether supported by science or not,
and which are generally used in traditional health practice.56
The broad meaning afforded to the concept of traditional philosophy might create
difficulties when it needs to be proven, especially when the concepts are based on
unwritten and unscientific customs and usages.
3. Role of traditional healers
Although the younger generation traditional healers engage in an increasing amount
of political activities, it is commonly accepted that the older generation traditional
healers are apolitical.57 Although most people from the traditional communities
believe that a good traditional healer must have inherited his or her skills from one’s
ancestors, research has shown that most traditional healers have high school and
tertiary education qualifications. The same research has revealed that people from
the traditional communities still consult traditional healers on a daily basis.58
Accounts of people with a western background consulting traditional healers are also
on the increase.59
The common viewpoint is that traditional healers have played and still play a major
role in witchcraft violence.60 In some instances they are instrumental in the “sniffing”
out of “witches.”61 However, the Witchcraft Suppression Act62 discourages the
naming or indicating of persons as witches and also criminalises the employment or
solicitation of a witchdoctor to name or indicate any person as a witch.63 Although
there is variance of opinion, it is generally accepted that a belief in witchcraft is
indeed a factor to be taken into account in assessing an appropriate sentence in
criminal law, if genuinely held by an accused and directly associated with the crime
which he has committed.64
In one case65 the court held that the fact that the offender believed he killed “a bad
and dangerous” traditional healer, is an extenuating circumstance, even if the
traditional healer did nothing to the offender or his family. In S v Malaza66 the
accused consulted a traditional healer about his unemployment and inability to find a
wife. Acting on the advice of the traditional healer to drink the blood of a strong
person and to bury certain of his organs, he killed his victim and was consequently
brought to trial for murder. He was convicted by the trial court67 and, since no
extenuating circumstances could be found, sentenced to death.68 On appeal the
Appellate Division confirmed the judgement of the trial court and held that the
accused’s belief in witchcraft in this situation did not amount to extenuating
circumstances.
In Phama v S69 a cousin of the accused sustained fatal injuries in a motor collision.
The family of the accused consulted a traditional healer who informed them that the
victims were responsible for their cousin’s death. In a response to this
announcement, the accused went to the victims’ home and executed them. The court
considered the belief that witchcraft was the motive for killing, but found that it was
not an extenuating circumstance in this case, because the accused was “not a
tribesman from some remote district completely cut off from the influences of modern
civilisation”.70 The court emphasised the need to show the accused and potential
offenders that the price they must pay for resorting to murder in order to eliminate an
alleged witch or wizard was not worth it.71
The role of traditional healers extends far beyond the criminal law. From time to time
an employer tries to submit a medical certificate issued by a traditional healer to
justify his absence from work.72
The Basic Conditions of Employment Act73 requires that a medical certificate must be
issued and signed by a medical practitioner or any other person who is certified to
diagnose or treat patients and who is registered with a professional council
established in terms of an act.
Although some traditional healers belong to a voluntary unofficial association, such
as the Traditional Healers Organisation, they do not qualify as medical practitioners
or any other persons who are certified to diagnose and, therefore, they will not be in
a position to issue a valid certificate.74 Aphane75 points out that this situation could
have serious repercussions for an employee. It would mean that the employee was
absent without leave and this could result in the dismissal or non-payment of the
employee. This was indeed the situation in Numsa obo M Seemane and Kromberg
and Schubert76 where the Commissioner held that a medical certificate issued by a
traditional healer did not conform to the requirements as set out in the Act and as a
result, the employee was absent without leave.77 The envisaged registration of
traditional healers should alleviate the problems employees currently experience
when their medical certificates obtained from traditional healers are not acceptable to
their employees.78
The occurrence of traditional healers can also manifest itself in conflict situations in
the workplace. One such example can be found in Chevron Engineering (Pty) Ltd v
Nkambule79 where the appellant dismissed his entire workforce after they embarked
on an illegal strike. Although the case dealt with the unfair dismissal of the appellant’s
employees and not with the role or status of traditional healers, the facts of the case
reveal that the reason for the strike was the appellant’s failure to allow his employees
to bring a traditional healer to the appellant’s premises to cleanse some of the “muti”
which was causing illnesses among the employees.80 After the differences between
the appellant and his employers were resolved by the former allowing a Christian
traditional healer to perform his rituals on the premise, the appellant re-instated only
some of the dismissed employees.
The rest of the employees contested the fairness of their dismissal in the Labour
Court who held that the dismissal was indeed unfair labour practice. The appellant
then commenced with litigation which lasted almost nine years81 before it reached its
end in the Supreme Court of Appeal who ordered the appellant to reinstate the
dismissed employees retrospective for a period of six months as from 2 December
2003.82
Traditional healers have a huge role to play in the HIV/AIDS epidemic in South
Africa.83 The negative publicity generated by the notorious conduct of some
traditional healers added to the negative sentiment held toward the role that ethical
and learned traditional healers can play with regard to South Africa’s fight against
HIV/AIDS.84 Some traditional healers claim to have found the cure for HIV/AIDS85
and some have been accused of unethical and unsavoury behaviour towards
HIV/AIDS patients.86 However, research has shown that traditional healers can play a
major role in the prevention or control of HIV/AIDS.87 They should be included in
HIV/AIDS prevention programmes, they could serve as sources of condoms and they
could be involved in HIV/AIDS counselling programmes. Traditional healers have the
trust of the communities they serve and have considerable influence amongst their
patients. Sometimes they are the only alternative to western medicine in remote rural
areas where the formal health sector is either poorly developed or non existent.
These attributes of traditional healers should be used to prevent and control
HIV/AIDS.88
Although the new Act89 prohibits traditional healers to make a diagnosis regarding
HIV/AIDS or to treat it, they still have an important role to play in the prevention or
control of HIV/AIDS. It would, therefore, be imperative to educate traditional healers
regarding important aspects HIV/AIDS and to encourage them to participate in
government structures involved in the HIV/AIDS programmes.
Tuberculosis has reached, besides HIV/AIDS, pandemic proportions in South Africa.
In many instances issues related to tuberculosis can not be separated from issues
relating to HIV/AIDS. Often tuberculosis patients are also infected with HIV/AIDS.90
One of the problems in the treatment of tuberculosis concerns the patient’s
unwillingness or carelessness to complete their treatment.
As a result community based DOTs (directly observed treatment) were introduced in
some areas with a certain rate of success.91 Since traditional healers are widely
spread over remote rural area, a study was implemented to assess the possibility of
including traditional healers as supervisors. The study showed that patients were
highly satisfied with most of the supervision provided by the traditional healers who
participated in the study and as a result the authors recommend that the expertise,
including aspects such as easy accessibility and shorter waiting times, of traditional
healers be used to control tuberculosis.92 Others share the viewpoint that there is
real scope for including open-minded and keen traditional healers in the control and
treatment of tuberculosis.93
Traditional healers, especially herbalists, have a very important role to play as
conservationists.94 A research project has been initiated to investigate the extent of
the traditional medicinal trade in areas bordering the Kruger National Park, as well as
assessing the availability of medicinal species, in order to determine conservation
priorities.95 The project included the assistance of traditional healers in order to make
them aware of the importance and problems regarding conservation.
Although problems were experienced as a result of cultural and socio-political issues,
the general feeling was that there was a mutual understanding of the problems being
experienced by conservationists and traditional healers and that both groups could
work together in obtaining a common goal of protecting and conserving the
environment.96
The role of traditional leaders is not limited to the situations already discussed above.
Traditional leaders claim to be part of the medical profession and they demand the
recognition and respect of the health care sector as a whole. They share the
responsibility to operate in an ethical manner. They can be utilised to deal with
mental health care problems97 and they can fulfil a core role in paediatric care.98 The
list of co-operation between traditional healers and western doctors is endless. The
time has come to bridge the gap between the two professions in order to fulfil the
social, ethical and professional responsibility the health care sector has towards the
community it serves.
4. Licence to heal
In recognising that the first point of medical contact for almost 80% of the South
African population is traditional healers,99 the government has undertaken to
establish a Traditional Health Practitioners Council to formulate work ethics for such
healers. Earlier this year the President gave his blessing to the Traditional Health
Practitioners Act.100 The purpose of the Act is to establish an interim Traditional
Health Practitioners Council of South Africa;101 to provide for the registration, training
and practices of traditional healers; and to serve and protect the interest of members
of the public who use the services of these healers.102 The Act will create a
framework for cooperation between mainstream health practice and traditional
healing, which could, it is hoped, lead to integration and co-operation between
traditional and western healing.103
Registration of a person is required in order for that person to be classified as a
traditional healer.104 The registrar must register a healer only if he is satisfied that the
applicant is suitably qualified to be a traditional healer.105 The Minister of Education106
is the responsible person to determine the suitable qualifications for registration.107
However, to date the Minister has not published what the suitable qualification would
be. One can only hope that it will be suitably skilled healers only which will be
registered.
Any person, who is dissatisfied with the treatment of a registered traditional healer or
a student, may lay a complaint with the Council.108 The Council has comprehensive
competencies regarding the investigation of complaints and if a traditional healer is
found guilty of improper or disgraceful conduct, his or her penalties may include a
caution or reprimand; suspension for a specific period; removal of his or her name
from the registry; fine; compulsory community service; payment of costs or restitution
to the complainant.109 It is important that the communities be informed of their rights
to complain about improper and disgraceful conduct of traditional healers. It will be of
no use if there are the necessary structures to lodge a complaint, but nobody knows
how or where it could be done. There should also be sufficient protection for a
complainant against the vengeance of the healer that he reported.
The disciplinary procedure described in the previous paragraph can only be instituted
against a registered practitioner. An unregistered practitioner or student is criminally
liable if he or she practices as a traditional health practitioner for gain, including110
rendering services normally associated with traditional or any other kind of healing.111
The inclusion or integration of traditional healing into the official health sector of
South Africa is seen as a relatively inexpensive method of expanding health
services.112 The provisions of the Act should ensure that registered traditional healers
do not charge exorbitantly high fees for their services. A registered practitioner must,
before rendering any traditional health service to a person, inform such a person of
the fee he or she intends to charge for such a service.113 The Act prescribes that a
practitioner must supply his patient with a detailed account within a reasonable
period of time114 and which must comply with the provisions of the Medical Schemes
Act.115
The Council may determine and publish fees from time to time116 and the patient may
approach the Council for advice if he or she is not satisfied with the fees charged.117
In terms of the new legislation, a practitioner’s account may be charged against one’s
medical aid. It is, however, uncertain at this stage whether existing medical aids will
be able to cope with these new demands.
Another drawback is the implementation and monitoring of licences, and the testing
and certifying of traditional remedies, which could prove to be expensive and time
consuming in an already tight health budget.118
Although the Act has been subject to criticism,119 the general feeling is that it would
ensure some standards of safety and certainty which will benefit the medical
profession in general and the patients of traditional healers in particular.120
5. My friend the witchdoctor121
May Mongdi Seithati has been a traditional healer for the last eighteen years. He
practices in the small town of Rammolutsi at Viljoenskroon,122 approximately 40
kilometres from Potchefstroom. He claims that he is both a herbalist and a diviner
and that it is also his function to identify witchcraft and then report it to the local
police. On an average, he sees six patients per day. Depending on the financial
means of his patients, he either charges cash or receives goods in kind as payment
for his services. Sometimes a patient is bedridden or unable to come to his house
and he then makes a house-call.
He received his calling to become a traditional healer from his ancestral spirits. Their
calls manifested themselves in dreams, hearing them speak to him and even
moments of insanity. He received his training in Lesotho where he used to live before
he became a South African citizen.123
He makes traditional medicine from the environment and claims that he has even
used his medicine to treat HIV/AIDS, with some success. However, he did not
elaborate on his level of success. He has referred some of his patients to a medical
doctor, but admits that it has not happened often.
He is a member of the Traditional Healers Association and had to pay a once-off
membership fee of R160,00. After mentioning the Traditional Health Practitioners
Act, he responded by saying that he has never heard about it. However, he will
register as a traditional healer in terms of the Act if it is explained to him and if it does
not prohibit him from practicing as a traditional healer. He was, nonetheless,
adamant that he would continue his traditional healing practice even if the Act does
not allow him to do so.
Although it could not be said that the views of one traditional healer reflect the views
of the majority, it clearly illustrates that there is indeed a need to educate traditional
healers with regard to the consequences and requirements of the Act. Ignoring the
issues would not make them go away. It is important that government interacts with
everyone involved in traditional healing and the modern health sector in order to
ensure mutual understanding and co-operation.
6. Conclusion
One of the hurdles preventing a closer working relationship between traditional
healers and western healers (or the modern health sector) is the level of distrust that
still exists between some members of both professions.124 Traditional healing is a
well known phenomena that most people fear and do not understand. Therefore, it is
imperative that there should be discussions, education programmes and more indepth
studies to bridge the gap between traditional and formal health practices.125
For example, in stead of condoning circumcision during the initiation of young boys, a
western surgeon could assist or train traditional surgeons to do the operation under
more hygienic circumstances.
Medical doctors are considered to be good with physical healing, such as surgery
and provision of powerful drugs, but their communication skills are sometimes poor
and they often treat the patient in isolation, without considering the social context of
the patient. On the other hand, traditional healers follow a holistic approach, they are
available in all areas, especially remote rural areas, and they treat the patient within
his social context.126
The potential benefits of including, rather than excluding traditional healers,
outweighs the possibility of malpractices and maltreatment of patients. Besides, the
same occurs in the formal health sector. The Act should address these issues in
future and should ensure a rise in the general standard of traditional healers, as well
as the protection of the patients of a traditional healer.
This might be a naïve viewpoint. Some traditional healers may feed on the
superstitious beliefs of their patients who may be scared to report maltreatment to the
Council, but having half an egg instead of an empty shell, may be one step in the
right direction to eradicate incompetent traditional healers in South Africa.
The inclusion or integration of traditional healing into the official health sector of
South Africa is seen as a relatively inexpensive method of expanding health
services.127 The provisions of the Act should ensure that registered traditional healers
do not charge exorbitantly high consultation fees and it would also give traditional
healers the necessary leverage to demand payment for their services.
However, the Act may have a totally opposite effect than envisaged above.
According to Xaba,128 the socio-economic conditions of African people and the lack of
support from the official health sector were some of the reasons why traditional
healing flourished. If the regulating of traditional healers would mean that the
traditional communities’ access to traditional healers is being hampered, it might
become mere paper law.129
1 Christa Rautenbach, Professor in Law, North-West University (Potchefstroom Campus),
South Africa I am extremely aware of the complexities and sensitivity of the issues
associated with some aspects of traditional healing in South Africa. Despite not being
someone who is confronted on a daily basis with issues of African traditional healing and
traditional healers, I have spent many hours reading material about it, as well as conducted
an interview with a local healer, May Mongdi Seithati – see par 5 for an summary of the
interview.
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