DIALOGUE ECOURAGED BETWEEN TRADITIONAL HEALERS
AND DOCTORS IN SOUTH AFRICA
With a population of over 40-million and 12 national languages, South Africa is home to a very diverse culture in terms of beliefs, norms and traditions. As a result of this diversity, several very different approaches to the treatment of illness (particularly mental illness) exist, often in tension with each other. In addition to the more generally accepted western approaches to the treatment of illness, traditional healers employing more unconventional methods are often the first contact many rural South Africans will have with any form of treatment. Having long been ignored as providing any recognisable form of treatment from a western perspective, traditional healers were considered to be “untrained” healers making use of ancestral spirituality and various herbal remedies which do not fall within the realm of Western medicine.
Realising the importance and integral role of the traditional healers in their communities, the Depression and Anxiety Support Group recently convened a meeting in Johannesburg, aimed at breaking down cross-cultural barriers in the areas of healthcare. Attended by over 90 traditional healers (called “sangomas” and “inyangas”), many of whom were clad in traditional clothing, the meeting provided a forum for discussion between doctors, psychiatrists and traditional healers and established the grounding for further co-operation. Traditional healers appear to be the key to greater understanding of anxiety and depression sufferers in the rural communities, and are thus influential in providing information to communities regarding treatment options available for these and other mental illnesses.
Addressing the talk, Dr. Frans Korb explained that western practitioners and traditional healers view the concept of illness from two very different perspectives. A very fundamental difference exists between the two ideologies: traditional healers view illness as being located externally to the patient (in the form of spirits or ancestors) whilst western doctors regard illness as being located within the patient (in the neurotransmitters and brain function). The healers explained that since many of the causes for illnesses present from outside the individuals : They throw bones to predict whether the ancestors or gods are influencing the person and thus determine whether the patient has been bewitched or is actually suffering from a physical ailment. Dr. Korb proceeded to talk on aspects of diagnosis and treatment from a Western perspective, and mentioned the use of specialist physicians for where any uncertainty exists – specialists too exist in the traditional healer hierarchy, with referrals being made when diagnosis is uncertain. The topic was then changed to depression and anxiety disorders as viewed from a western perspective, with explanation of the basic symptoms and diagnoses.
The discussion also focussed on the topic of referrals and the involvement of the government in the work of the healers. The traditional healers voiced dissatisfaction at the lack of co-operation they have received from the medical sector thus far, and stressed their eagerness to work with medical doctors in order to combat mental illness in a mutually respectful environment. The healers emphasised that, unlike western doctors, they do not choose their profession but are instead chosen by the ancestors. Dr. Korb acknowledged that it was very important for Western doctors be sensitive to this concept of the ancestors selecting future sangomas through mysterious illnesses.
On a collective level, a compromise was reached in that both groups agreed to refer treatment-resistant patients to the alternative mode of treatment, where culturally appropriate. Talking about the outcome of the meeting, Sarah Mashele, chairman of the Sangoma Association, said “The meeting was very beneficial. The traditional healer knows that if [the patient] is not of their line, and has the symptoms that we have learnt, we can refer them [to the support group].”