The patient relationship and therapeutic techniques of the South Sotho traditional healer

Abstract

The practice of traditional healers up to 1996 was outlawed in South Africa and not afforded a legal position in the community of health care providers. In 197 4 the Health Act forbade healers not registered with the South African Medical and Dental Council (SAMDC) from practising or performing any act pertaining to the medical profession. In 1978 the World Health Organization (WHO) identified traditional healers as those people forming an essential core of the primary health workers for rural people in the Third World Countries. They offered this recognition through a mandate so as to ensure that, in countries where traditional medicine is widely practised, and is within the existing system of medicine, its uses should be availed as part of health services. During 1994, with the change in the South African Government, this trend of identifying traditional healers as forming an essential core of primary health care workers was followed . This recognition was confirmed by the passing of the Act of Chiropractors, Homeopaths and Allied Health Service Professionals in 1996. In South Africa traditional healers number of the African population. are the health care choice of a large number of the African population. It is estimated that 80% of the black I population uses traditional medicine as it deeply rooted in their culture as part of their cultural heritage linked to their religion. Therapeutic techniques typically used in traditional healing sometimes conflict with the therapeutic techniques used in biomedicine. Biomedical therapeutic techniques are based on a scientific approach while those of traditional healing are unscientific, therefore, perceived as being strange in the view of biomedical personnel's understanding of healing. Therefore, the patients' perceptions of traditional healing, their needs and expectations, may be the driving force behind their continuous strife to consult a traditional healer, even though the former may have sought the therapeutic techniques of biomedical personnel. This creates conflict, which I as a black

nurse, trained within the biomedical context, identifies the existence of both systems, operating with the same society. These simultaneous consultations create a problem to both providers and recipients of health care. Confusion then arises and the consumer chooses the services closer to her. The research was therefore aimed at investigating the characteristics of the relationship between the traditional healers and the patients, explore the therapeutic techniques that are used in South Sotho traditional healing process, as well as investigate the views of both the traditional healers and the patients about the South Sotho traditional healing process so as to facilitate incorporation of the traditional healers in the National Health care delivery system. A qualitative research design was followed. Participants were identified by means of a non-probable, purposeful voluntary sampling. Data collection was achieved by means of video recordings of the six traditional healers and six patients as well as conducting semi-structured interviews with the six traditional healers and twelve patients. This was followed by taking down field notes. An independent co-coder and the researcher analysed the data independently after which three consensus discussions took place to finalise the analysed data. For the video recordings a checklist was used and for the interviews content analysis was done. From the results of the research, it appears that the traditional healer views himself as the only person able to treat the patient's culturally perceived illnesses and not biomedical personnel. The traditional healer and the patient seem to have a relationship which evolves around the patient's cultural illness, strengthened by the shared worldview. The traditional therapeutic techniques used were various but all were used after the process of divination which is a procedure carried out to determine the cause of the problem and the solution thereof. Further the conclusions confirm that the traditional

healer is seen to have the ability to cure culture bound diseases by giving the patient medicines suitable for these diseases. The conclusions confirm that the traditional healer is not used as part of the health care system and functions in isolation. It is for this reason that the guidelines were formulated on the basis of which the traditional healers can be incorporated in the National Health care delivery system so as to enrich health care resources. The guidelines involve the facilitation of the change in perceptions and attitudes of both the biomedical personnel and the traditional healers, development of a more committed relationship, establishing negotiations for the process of incorporation as well as for facilitation of a comprehensive community based health care delivery service.