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SOUTH AFRICA: Linking traditional and formal HIV/AIDS treatment

[This report does not necessarily reflect the views of the United Nations]

WATERFALL, 4 June (PLUSNEWS) - With an estimated 80 percent of rural South Africans in KwaZulu-Natal province seeking treatment from traditional healers, cooperation between Western and traditional medicine is essential in tackling HIV/AIDS, say analysts.

Sangomas (traditional healers) enjoy a tremendous amount of respect in the community and can be instrumental in promoting HIV-testing, antiretroviral treatment, safe sex, and positive living.

The Kundalila Foundation is a rare initiative in the eastern coastal province that bridges the gap between the formal health sector and traditional healers. It is run by Yvonne Sliep, a psychologist and expert in traditional healers, and Adri van der Maas, a medical doctor who gained experience in the combination of traditional and Western healing methods during three decades of medical work in Malawi.

In 1999, South Africa-born Sliep moved back to South Africa from the Netherlands and settled in Waterfall, a village in southern KwaZulu-Natal, where she made contact with a number of sangomas from the Ngcolosi district, a rural area bordering Waterfall.

According to Sliep, the healers clearly indicated their need for HIV/AIDS training. They had seen many in their communities die of AIDS-related conditions and felt powerless in front of an epidemic they knew little about and could not cure with herbal medication.

In 2000, Sliep and van der Maas decided to create a project that would educate sangomas about HIV/AIDS, strengthen their role in the fight against the epidemic and spark collaboration between traditional healers and the formal health sector. In June of that year, they set up the Kundalila Foundation, mainly funded through private Dutch donors.

The foundation offered monthly workshops for traditional healers, in which they taught them about the virus, prevention and safe sex. Later, the two women started to train the sangomas as HIV/AIDS counsellors. About 40 healers from the surrounding rural areas now receive HIV/AIDS education through the Kundalila Foundation.

They have found that while it was easy to involve traditional healers in HIV/AIDS training, the intended knowledge exchange and cooperation between the formal health sector and the sangomas has proved difficult. Van der Maas said that Western physicians are sceptical about traditional healing, even though they know little about the methods.

The healers, on the other hand, appear to be more willing to combine forces with the formal health sector, according to van der Maas’ experience, but generally refuse to reveal the ingredients and formulas of their cures out of fear they might be appropriated.

The sangomas motivation is not necessarily altruistic, however. Many anticipate gaining public recognition and status through cooperation with the clinics, which they trust will generate more income.

“They hope to get government subventions or a place to practice in hospital,” explained van der Maas.

“It has been very tricky to develop a relationship between traditional healers and the formal health sector. There has been very little cooperation,” van der Maas noted.

She said that until the role of traditional healers was recognised, they would remain excluded from the country’s HIV/AIDS and other health debates.

Nokusho Bhengu, one of the most reputable sangomas of the Ngcolosi area, says that her group of 20 sangomas is keen to exchange knowledge with doctors from the formal sector, but the two local clinics they approached were unenthusiastic about the idea.

Their has been only one western physician who ever came to work together with her group of sangomas and that is van der Maas, Bhengu noted. Whenever health workers and doctors from surrounding hospices visit the district, they solely come to see patients, and purposefully avoid contact with the healers, she said.

Bhengu and her group are pleased about the HIV/AIDS education they have received from the Kundalila Foundation.

“We feel we have more control now [over the virus],” she said. While their only point of reference used to be traditional medicine to treat opportunistic diseases, the healers are now able to recognise early signs of the virus and often send people straight to the clinic if they suspect them to be HIV-positive. Before, they treated patients with herbal medications until they had developed full-blown AIDS.

The foundation also offers voluntary counselling and testing (VCT) with the help of a rapid test, which shows reliable results in only 15 minutes. Initially, Sliep and van der Maas planned to provide sangomas with testing equipment but then found out that only registered medical personnel are legally permitted to supervise such tests.

Now, Sliep, a registered nurse, does the testing herself and explained the advantages of early testing to the 40 healers the foundation works with. The sangomas, in turn, spread the message throughout the community, and since then, the number of people who have come to Sliep for testing has risen noticeably. If more people find out about their HIV-status at an earlier stage of the disease, more lives can be prolonged.

The Kundalila Foundation also provides training around the growth and usage of medicinal plants to teach healers how to treat basic opportunistic diseases caused by HIV. One of the plants it recommends is Sutherlandia frutescens, commonly called cancer bush, a herb that is said to boost the immune system. Van der Maas says the plant gave their patients good results in combination with promoting a healthy lifestyle.

Apart from medical education and support, the Kundalila Foundation empowers local women and children through income generating and capacity building projects, such as beadwork and sewing, and gives financial support for crèches in rural areas, amongst others.

[ENDS]