Involving traditional healers in the AIDS battle

IT has been exactly 20 years since health minister Dr. Fanny Friedman paid a call on the Traditional Healers Organisations headquarters in Siteki in an effort to bridge the gap between tinyanga and the Western medical establishment her ministry oversaw.
Two decades on, the bridge remains unbuilt, and the gap between the two styles of medicines unfilled.
The frustration of traditional healers was on vivid display this week when they stormed the health ministry in Pretoria and reportedly committed acts of vandalism. The purpose of the demonstration was simply that they wanted attention, to be taken seriously and to be given portions of the state budget for their use.
Some Swazis traditional medical practitioners were reportedly involved in the demonstration.
The impact of the protest however, was largely lost in the ongoing labour strife besetting South Africa. It was seen as just another special interest group seeking more money and concessions from government, on top of so many other groups besieging urban centres from Cape Town to Jo’burg.
However, to some observers the protest did signal a need to finally and seriously look into the integration of traditional healers and public healthcare systems.
For some time there have been Western practitioners (a great majority I suspect) who rather hope that the tinyanga will simple go away; that their ways of medicine will disappear like traditional African life itself as modernization continues its relentless advance.
Well, after 20 years it hasn’t happen, and 20 years from now it won’t have happened. The reason: the people of this region are very poor, and for them the only affordable healthcare is traditional healers.
The factor of culture also weighs heavily in tinyanga’s favour; people believe in them and what they do.
“My inyanga is my neighbour. I trust her. She knows the herbs. She does not make us travel long distances to see her and wait all day when in the end I might not even see a doctor at a clinic or get the proper medicine at a hospital,” one woman said.
Her comments are widely echoed amongst Swazis and a majority of residents of Southern Africa, if surveys on the subject are accurate.
If you look at her comments closely, you see that what it will require to wean her from the services of an inyanga would be a better Western-style health system – clinics that are nearby, where you can see a doctor sooner rather than later, and where medicines are readily available.
If that happens, the days of the tinyanga may indeed be numbered. But does anyone anticipate such a complete upgrade in the medical system here and regionally, given the expense and other factors involved?
Meanwhile, the reality of AIDS is here. People are dying, and all players, both conventional an unorthodox, who are in a position to be of assistance are solicited.
That is why traditional healers are incorporated into AIDS conferences and policy meetings.
But to what end, however? Tinyanga face the same obstacles now as they did when Dr. Friedman visited Siteki 20 years ago – obstacles from without but also obstacles of tinyanga’s own making. In 1989, the issue was simply how to involve tinyanga in the formal healthcare set-up.
AIDS was not recognised as a threat to Swaziland, and methods that would have stopped the disease before it started were discouraged by traditional healers. A prominent official amongst traditional healers told the press that he discouraged men from using condoms. “We are Swazis.
What do we know of condoms?” he said. At the time a white South African woman allegedly had sex with several young Swazi men and then told each that she had AIDS. They went to the traditional healer for advice.
At the time there were no HIV testing centres, counsellors or organisations dedicated to HIV and AIDS.
Now there are several, and the use of condoms is promoted as the surest and easiest way to prevent HIV contagion.
Traditional healers have been brought to conferences to educate them, so they would not spread false information and put people’s lives in danger.
In 1990, the wife of Prime Minister Obed Dlamini reached out to tinyanga and urged them not to use the same razor blade for kugata (slitting of skin so medicines might be inserted) or at least sterilise the razor blade between patients.
In 1989, an inyanga from South Africa told me, “AIDS has been misdiagnosed. It is really a form of cancer.” Through years of training, such ignorance has hopefully been replaced with facts. What do traditional healers want? At the Pretoria protest and at submissions made at last month’s National Dialogue in Manzini, they made clear what they want: money.
They want money “to prove that our herbs work.”
The irony is that such proof can only come from universities and hospitals, which are scientific research facilities, and not the inyanga’s indumba (healing hut), which is not.
So if there is money to be spent to prove the tinyanga’s herbs and practices are legitimate, it won’t go to the tinyanga but to the scientists and researchers, whom the tinyanga say ignore them.
One solution is to involve tinyanga in the research, and give them grant money to locate, catalogue and even cultivate herbs. This also is important fieldwork to preserve ecological diversity. But the true value of tinyanga is their omnipresence in communities. Many are trusted and liked by their patients. Therefore, they are in a valuable position to be communicators, to spread correct AIDS information and best preventive practices.
By James Hall

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