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South Africa mulls regulating traditional healers for the modern age

March 19, 2016 at 1:55 PM EDT
In South Africa, practitioners of traditional medicine, including herbalists, midwives, and faith healers who claim to speak to ancestors, have historically practiced openly and freely. But the government now aims to formally register and regulate the estimated 250,000 self-described healers, who are pushing back. NewsHour Special Correspondent Martin Seemungal reports.


For the estimated 250,000 practitioners of traditional medicine in South Africa, healing, they say, is a calling.

Sangomas, as they’re are known in the Zulu language, carry forward a long history of healing in the Zulu, Swazi, Xhosa and Ndebele traditions of the country, acting as herbalists, midwives, and traditional faith healers who claim to communicate with ancestors.

Historically, healers have practiced openly and freely with little oversight over how they administer medicine, but proposals by the South African Department of Health, introduced last year, aim to regulate the practitioners.

Under proposed regulations, sangomas would be required to obtain certification, submit details of their sessions for review, pay annual fees to the government, and only be allowed to practice after age 18 — a marked shift from the current arrangement.

The proposal has been widely criticized by the community of healers, many of whom feel the regulations would stifle their ability to practice traditional medicine.

“Who’s to say who’s a qualified traditional healer or not?” said Khauki Maada, who has been practicing traditional medicine for 15 years. “By virtue of me being a traditional healer nobody can give me a certificate.”

Supporters of the regulations contend there is a need to standardize the industry.

“I have to accept that they are a part of the fabric of South African health care at some level, for a certain percentage of the population,” said Dr. Daniel Nciyana, a former editor of the South African Medical Journal. “But there are good ones and there are harmful ones.”

South African lawmakers plan on reviewing public opinion on the proposals until April, before finalizing regulations by the end of the year.  

Read the full transcript of this segment below:

MARTIN SEEMUNGAL:  A voice from an ancestor is speaking through a sangoma —  a traditional faith healer, in South Africa.

It is a widely held belief, especially in the rural areas of this country, that sangomas communicate with the dead to help the living.

Zandile Nkosi is a 41-year-old sangoma who says she’s had the gift since she was 10-years-old but started practicing only 7 years ago.  She says her ancestors’ voices guide her sessions with patients who see her for physical ailments and counseling.

A sangoma’s main tool is “throwing the bones” – animal bones, shells and sometimes other articles. The healers and their patients believe how the bones land is influenced by ancestors who “speak” through the bones.

ZANDILE NKOSI: If you would have gone to a Western doctor, the doctor would take an x-ray. This is my tool to ascertain what’s wrong with her.

MARTIN SEEMUNGAL: Patient Thembi Maluleke says these beliefs are an important part of her African culture.

THEMBI MALULEKE: When people believe in archangels and angel Gabriel, as Africans before Christianity there was us and our ancestors. For them those are our archangels and it’s our direct link to God.

ZANDILE NKOSI: This is the bone that identifies Thembi and Thembi has a serious relationship with somebody. The bone is saying she is in a happy relationship, she is content, they are both content. If they were not happy, Thembi’s bone would have sat like this, it means “I am not happy,” now Thembi’s bone is like this. She is happy.

MARTIN SEEMUNGAL: Western medicine is readily available in South Africa, and health care here is among the best on the continent. Still, an enormous number of people seek out traditional healers.

Sangoma Khauki Maada has been throwing the bones for 15 years in a village near South Africa’s border with Zimbabwe.

KHAUKI MAADA: A lot of times it’s bad news, like you get a premonition of something bad will happen. But you have to be very tactful as to not blur the lines of truth and really trying to hurt people but do it in a manner that sort of takes care of their spirit as well.

MARTIN SEEMUNGAL: To treat patients, a sangoma will often prescribe traditional medicine known as muti, like these herbs and animal bones ground into powder.

ZANDILE NKOSI: This has been coming from our forefathers. You know, they didn’t have hospitals, then and they didn’t have doctors, but they used traditional healers to administer health problems, so, yes, this comes a long way and is still effective today.

MARTIN SEEMUNGAL: Malusi is a new sangoma. This ceremony marks the end of his six week initiation process.

It’s estimated that there may be as many as 250,000 traditional healers in South Africa, and every week more and more initiates join their ranks. It’s gone on like this for generations and generations. And now the South African government wants to bring traditional medicine into the modern era.

South Africa is now pushing new regulations for traditional healers recommended by the World Health Organization including a certification process for all new healers.  They will have to submit details related to their sessions with patients, a minimum age of 18 years old and paying an annual licensing fee to the government.

Bruce Mbedzi is the acting director responsible for traditional medicine in South Africa’s health department.

BRUCE MBEDZI: It’s a matter of moving it from an informal sector to a formal sector. If we are formalizing the sector we need to regulate the sector.

MARTIN SEEMUNGAL: After the government proposed the regulations last year, sangomas took to the streets in protest.

KHAUKI MAADA: They tell you about having a log book, for instance, where you disclose certain aspects of your healing, and I find that very funny, because I don’t think any doctor in any practice across the world would disclose his log book. It’s a breach of confidentiality between the client and the patient.

ZANDILE NKOSI: One of the things we are not happy about as traditional healers is they are putting an age for being an initiate. It says you cannot initiate prior to 18 years. Now, I know a lot of people that are good traditional healers between the ages of 12 and 16.

MARTIN SEEMUNGAL: Dr. Daniel Nciyana, the former editor of the South African Journal for Medicine, supports the regulations for healers.

DANIEL NCIYANA: I don’t sympathize with them, and I know that they are really motivated by commercial — by greed, basically, by commercial interests. They just don’t want to be subjected to the scrutiny that comes with regulation.

MARTIN SEEMUNGAL: Nciyana believes in the idea of certification but worries his country currently has little means to enforce it.

DANIEL NCIYANA: That sounds very reasonable, but there are no training places, there are no colleges for traditional healing, so where do you start?

MARTIN SEEMUNGAL: Complicating matters is the trend of traditional healers, many from other countries, who South Africans consider to be impostors overcharging for their services.

DANIEL NCIYANA: They take advantage of the trust that people invest in the healers, in the community, and they exploit that. You know, in the old days when I was growing up, payment was not a major issue.

MARTIN SEEMUNGAL: Traditional healers say the bogus traditional healers hurt their credibility and are the ones the South African government should crack down on.

KHAUKI MAADA: Because it’s so widespread, and it’s so damning for us, and it gives us a bad name. Because all sorts of things are happening. People are dying.

MARTIN SEEMUNGAL: Marlin McKay is a family doctor with 20 years of experience working in South Africa’s black townships that were established during the apartheid era. He says the sangomas’ practices go against everything he has ever been taught. Proper diagnosis he says involves a physical examination and detailed blood tests.

MARLIN MCKAY: I am very very skeptical, and I don’t see any way that someone can make a true scientific diagnosis based on throwing a few bones around.

MARTIN SEEMUNGAL: Dr. Mckay also says the recent rise of bogus traditional healers has made things even worse.

MARLIN MCKAY: It’s difficult for the communities out there to ascertain or to know who is better who is good, who can be trusted, and who isn’t worthy to be trusted, and I think there’s the financial incentive, it’s an easy way of making money.  People are desperate people are gullible and a lot of people at the end of the day will believe anything that they feel will help them to get better.

MARTIN SEEMUNGAL: Bruce Mbedzi at the department of health says that is a key factor driving these initiatives.

BRUCE MBEDZI: So there’s a need for the sector to be regulated, and then we know who are the real traditional health practitioners and take out all the charlatans and fly-by-nighters.

MARTIN SEEMUNGAL: The protests by mainstream sangomas pressured South Africa’s government to to allow more time for comments on the proposed regulations,  regulations that younger sangomas like Zandile Nkosi accept are inevitable.

ZANDILE NKOSI: But we are saying, “talk to us, and we will help you write the regulations,” not the other way around.

MARTIN SEEMUNGAL: Still, there may be a generation gap. Older sangomas like Mberegene Maada, a traditional healer for 25 years, believe his practices should not be regulated.  

MBEREGENE MAADA: Because I know what it is in me. Government does not know what I do and how I do it. So how do you regulate that? How do you regulate a thing that you don’t know?

MARTIN SEEMUNGAL: But the government intends to push forward. It will continue to hear recommendations until April; after that; it will begin to work to finalize the regulations before the end of the year.