The Role of Traditional Healers in the treatment of HIV and AIDS in 
Tsetse Village: The Case of Mahikeng in the North West Province 
Name & Surname: Tsietsi Piet Sebata 
Student Number: 17006929 
Date of Submission: August 2015 
Supervisor: Professor. M.A. Masoga 
Faculty: Human and Social Sciences 
Programme: Masters of Arts in Indigenous Knowledge System-MA 
{IKS) 
A mini-dissertation submitted in partial fulfilment of a Masters of 
Arts in Indigenous Knowledge Systems (IKS), in the faculty of 
Human and Social Sciences (HSS), at the North West University, 
Mahikeng Campus 
Declaration by candidate 
Acknowledgement 
Abstract 
Glossary 
Appendices 
List of figures 
Letter of Language Editing 
CHAPTER ONE 
TABLE OF CONTENTS 
ORIENTATION TO THE STUDY 
1.1 INTRODUCTION 
1.2 BACKGROUND OF THE STUDY 
1.3 DEFINIION OF CONCEPTS 
1.3.1 INDIGENOUS KNOWLEDGE SYSTEMS 
1.3.2 INDIGENOUS KNOWLEDGE 
1.3.3 BADIMO/ANCESTORS 
1.3.4 TRADITIONALKNOWLEDGE 
1.3.5 DIVINATION 
1.3.6 RITUALS 
1.3.7 SPIRITUALITY 
1.3.8 TRADITIONAL HEALTH PRACTITIONER 
1.3 .9 TRADITIONAL HEALER 
1.3.10 TRADITIONAL MEDICINE 
1.4 STATEMENT OF THE PROBLEM 
1.5 OBJECTIVES OF THE STUDY 
1.6 HYPOTHESIS 
1.7 JUSTIFICATION OF THE STUDY 
1.8 CHAPTERS OF THE STUDY 
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1.9SUMMARY 
1.10 A BRIEF PREVIEW OF THE FOLLOWING CHAPTER 
CHAPTER TWO 
LITERATURE REVIEW 
2.1 INTRODUCTION 
2.2 CORRESPONDENCES IN POLICIES 
2.2.1 THE TRADITIONAL MEDICINE STRATEGY-WORLD HEALTH 
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ORGANIZATION 2002 13 
2.2.2 TRADITIONAL HEALTH PRACTITIONER BILLOF 2003 13 
2.2.3 TRADITIONAL HEALTH PRACTITIONERS (South Africa, Act 22 of2007) 14 
2.2.4 DRAFT POLICY ON AFRICAN TRADITIONA MEDICINE FOR PUBLIC 
COMMENT, 21 JULY 2008- GOVERNMENT GAZETTEE (South Africa, Department of 
Health 2008) 15 
2.3 CO-EXISTENCE OF AFRICAN TRADITIONAL MEDICINE 15 
2.3.1 THE HIERARCHY WITHIN THE HEALTH CARE SYSTEM 16 
2.3.2 DIVINATION, DIAGONOSIS AND HEALING PRACTICES 16 
2.3.3. THWASAAND INITIATION 18 
2.3.4 PROMULGATION OF TRADITIONAL HEALTH PRACTITIONER 19 
2.3.5 TYPES OF AFRICANTRADITIONALHEALTHPRACTITIONERS 19 
a. Divinerlsangoma 22 
b. Herbalist/ngaka 22 
c. Prophets/faith healers 23 
d. Traditional birth attendants 23 
2.4 INDIGENOUS KNOWLEDGE SYSTEMS AND HEALING PRACTICES 23 
2.5 TRADITIONAL CONCEPTUALIZATION OF HEALTH AND ILLNESS IN-
AFRICA 24 
2.5.1 TRADITIONAL TREATMENTS 24 
2.6 CORRESPONDENCE OF WESTERN AND AFRICAN MEDICINE 26 
2.6.1 EXAMPLES OF HEALING THROUGH MOVEMENT AMONG THE KHOI 
COMMUNITY 26 
2.6.1.1 NDEUP 26 
2.6.2 ANCESTRAL WORSHIP AMONG THE CRISTIANS 27 
2.6.3 THE RELATIONSHIP BETWEEN ANCESTORS AND AFRICAN CRISTIANITY 28 
2.7SUMMARY 
2.8. A BRIEF PREVIEW OF THE FOLLOWING CHAPTER 
CHAPTER THREE 
RESEARCH APPROACH 
3.1 INTRODUCTION 
3.2 METHODOLOGY 
3.3 RESEARCH DESIGN 
3.4 RESEARCH PARADIGM 
3.4.1 QUALITATIVE RESEARCH 
3.4.2 SAMPLING TECHNIQUE 
3.4.3 RESPONDENTS 
3.4.4 STUDY SITES 
3.4.5 DATA COLLECTION TECHNIQUE/ RESEARCH METHOD 
3.4.6 QUALITATIVE RESEARCH INTERVIEWS- QUESIONNAIRES 
3.4.7 OPEN-ENDED QUESTIONS 
3.4.8 ETHICAL CONSIDERATION 
3.4.9 DATA ANALYSIS METHODS 
3.4.10 THEORISING 
3.5. SUMMARY 
3.6 A BRIEF PREVIEW OF THE FOLLOWING CHAPTER 
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C~TERFOUR 38 
SOCIO-ECONOMIC AND DEMOGRAPHICS 38 
4.1 INTRODUCTION 38 
4.2 THE SOCIO-ECONOMIC AND DEMOGRAPHIC CHARACTERISTICS OF 
RESPONDENTS 38 
4.3 QUESTIONNAIRES AND RESULTS OF RESPONDENTS 39 
4.4 SUMMARY 41 
C~TERFIVE 42 
TRENDS AND RESULTS 42 
5.1 OVERVIEW 42 
5.2.1 NOTED TRENDS IN QUESTION 1 42 
5.2.2 NOTED TRENDS IN QUESTION 2 43 
5.2.3 NOTED TRENDS IN QUESTION 3 43 
5.2.4 NOTED TRENDS IN QUESTION 4 43 
5.2.5 NOTED TRENDS IN QUESTION 5 43 
5.2.6 NOTED TRENDS IN QUESTION 6 43 
5.2. 7 NOTED TRENDS IN QUESTION 7 43 
5.2.8 NOTED TRENDS IN QUESTION 8 43 
5.3 SUMMARY 44 
C~TERSIX 45 
DISCUSSIONS AND RECOMMENDATIONS 45 
6.1 OVERVIEW 45 
6.2 RECOMMENDATIONS 45 
6.3 SUMMARY 48 
CONCLUSION 
BIBLIOGRAPHY 
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50 
DECLARATION 
By submitting this thesis electronically, I declare that the entirety of the work containing 
therein is my own, original work, that I am the owner of the copyright thereof (unless to the 
extent explicitly otherwise stated) and that I have not previously in its entirety or in part 
submitted it for obtaining any qualification. 
ACKNOWLEDGEMENT 
I want to thank Almighty for giving me the strength to complete the study. Thanks to my 
mother Sophia Selelo Sebata for the courage and support through the difficult times of my 
studies. I experienced a huge challenge during the times of my studies and my mother was 
always there for me. 
My deepest sincerity goes to Professor M.A. Masoga for the critique and perseverance during 
the course of my research. Ms H.S Schutte an excellent critique and assistance for editing my 
thesis is acknowledged and appreciated. Thanks to Professor Eno Ebenso and Lurnkile 
Lalendle for allowing an opportunity to redo my thesis. 
Lastly, thanks to all Traditional Healers who are residing Tsetse village for the knowledge 
and assistance. I could not have finished the study if it was not for you. 
ii 
ABSTRACT 
During the colonial era there was a huge disparity between modem sciences and indigenous 
knowledge systems. For instance, modem sciences have gained momentum while indigenous 
knowledge was labelled as primitive, out-dated and to certain extend as witchcraft. The 
disparity in health system created a parallel between modem sciences and indigenous 
knowledge system. 
WHO (2003) has recommended the collaboration between Western medicine and Traditional 
healers for treatment of HIV and AIDS. The latter are skilled in the treating secondary or 
opportunistic infections. Therefore, Traditional Healers have a hope that they can cure 
HIV/AIDS if they can be allowed to practice effectively in hospitals and if their medicines 
can be accessed. In Africa, traditional herbal medicines are often used as primary treatment 
for HIV and AIDS symptoms such as dermatological disorders, nausea, depression, botseno, 
letshollo le malwetsi a thobalano. Also, people living with HIV and AIDS resorts to 
traditional medicine to augment conventional therapeutic products. 
In this context, a descriptive research used qualitative interviews to investigate the role of 
traditional healers/ doctors in the treatment of opportunistic infections of HIV and AIDS in 
Mahikeng (Tsetse village) North West Province. The study utilised unstructured interviews 
which consisted of various interview questions that are developed in such a way that neither 
the exact questions the interviewer asks nor the responses of the subjects are predetermined. 
The units for the study were ten (1 0) Traditional Healers because they are the key participants 
for the study and ensured the researcher has knowledge of the topic. The study has found out 
that Traditional healers play a significant role in the treatment of opportunistic infections and 
is willing to work with Department of Health in treating people infected with HIV and AIDS. 
People who are living HIV and AIDS will firstly consult Traditional healers for assistance. 
The study has made the following recommendations. Traditional healers must be prohibited 
from certain procedures, for instance, drawing of blood from patients, rapid use of razors, 
claiming to cure HIV and AIDS. Traditional healers have knowledge in midwifery and 
government should give training on continuous basis. In Hospitals Traditional Healers with 
relevant certificate must work together with western doctors in the diagnosis of diseases and 
treatment of opportunistic infections. Drastic measures must be taken against bogus doctors 
who do street abortions and claim to cure more than thousands diseases. 
iii 
GLOSSARY 
Badimo: Ancestors are regarded as the living dead-responsible for misfortunes or calamity in 
the society. Sometimes, are regarded as gods who are worshipped and appear in dreams or 
visions. They are regarded as the guiders for healers during consultation (Donmoyer, 2006). 
Ceremony: A ceremony is way of expressing communication with ancestors and there is 
always a sacrifice of blood. It is a way of calling upon the ancestors. It has its own rituals, 
values and customs and does not have religious connotations (Pefile 2005:197). 
Culture: is a way of life within different society and culture helps people to identify who 
they are in terms of language, religion, cuisine, social habits, music and arts as contained in 
(Morris, 2005). 
Divination: is the prediction of the future or the ability to foresee the unknown through 
distinct talent or knowledge. The other word for divination is fortune tellers. Sangomas are 
also regarded as diviners because of the ability to foretell the future of individual (Bob, 
2004). 
Diviner: Diviners are predominantly female who act as mediators between humans and 
ancestors/the supernatural. These people are able to predict the future of the person or 
country either using water or bones. Diviners diagnose by means of listening, observation and 
experience as well as the aid of the ancestors in the case of an unexplainable condition, where 
the message of the ancestors is imparted through bone throwing. 
Herbalist/Ngaka: Herbalist can be regarded as a pharmacist who dispenses medicine made 
of natural ingredients comprising the bark of trees, roots, leaves, animal skin, blood or parts 
of animals, herbs and seawater. Their services do not include prediction (Latiff, 201 0). 
Indigenous Knowledge Systems: fudigenous Knowledge Systems (IKS) is a unique 
knowledge originates from a particular culture since time immemorial. The knowledge 
transcends from one generation to another and it has been used for survival over generations. 
Ethno- science might be defined as a local knowledge that is unique to a given culture or 
society. Africans used indigenous knowledge to survive the oppression of the colonists 
(Morris, 2005 and Freeman & Motsei, 2004). 
iv 
Rituals: Rituals are arrangement of events including signals, arguments and items executed 
in appropriated domicile, and executed according to set of arrangements. Rituals might 
remain as customs of a public, referring to Christians and they are symbolised by "formalism, 
traditionalism, invariance, rule-governance" (Hakim and Chishti, 2010). 
Traditional Birth Attendants (TBA): Traditional Birth Attendants possesses a unique 
knowledge of bringing new life to earth. Majority of Traditional Birth Attendants are older 
women and they have been practicing for a long time (Fontaine, 2004). 
Traditional healers (TH) are recognized in the communities due to their use of herbal 
medicines and therapies in healing. Many traditional medicinal practitioners are people 
without education, who have rather received knowledge of medicinal plants and their 
effects on the human body from their forebears. They have a deep and personal 
involvement in the healing process and protect the therapeutic knowledge by keeping it a 
secret (Bob, 2004). 
Traditional Medicine (TM): Traditional Treatment is the combination of information, 
expertise and practices created on ideas, opinions and views native to different values that are 
used to preserve health as well as to avert, identify, increase or treat physical and emotional 
well-being. Herbal medicines include herbs, herbal materials, herbal preparations and 
finished herbal products that contain parts of plants or other plant material, such as active 
ingredients (Rupert, 2001). 
Traditional Health Practitioner (THP): Traditional Health Practitioner is defined as a 
sangoma who is legally recognized in South Africa in terms of the Health Practitioners 
Health Bill Act (Act 22 of 2007) (Traditional Health Practitioner Bill of 2007). It also 
involves Sangomas, Prophets, Traditional Birth Attendants and Herbalists. Traditional Health 
Practitioner does not charge exorbitant fees before the consultation and does not use parts of 
human beings to make muti. 
Traditional: 'refer to knowledge systems embedded in the cultural traditions of regional, 
indigenous, or local communities. Traditional knowledge includes types of knowledge about 
traditional technologies of subsistence (e.g. tools and techniques for hunting or agriculture, 
midwifery ethno-botany and ecological knowledge (Latiff, 201 0). 
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Thwasa: The process is to prepare the healer for a life of commitment to healing. For 
instance, at the end of training a goat or cow will be slaughtered and the ithwasa will drink 
the blood as a way to show connection between the ancestors and traditional healer. 
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APPENDICES 
A. LETTER OF PERMISSION TO CONDUCT RESEARCH ........................... 56 
B. QUESTIONNAIRE ASKED TO THE TRADITIONAL HEALTH 
PRACTITIONERS ............................................................................ 57 
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LIST OF FIGURES 
Figure 2.3.1 Hierarchy within Department ofHealth .............................................. 16 
Figure 4.1.1 Socio-Economic and Demographic Characteristics of Respondents ............. 38 
viii 
RE: AN ASSESSMENT OF TRADITIONAL HEALERS/MEDICINE TOWARDS 
THE TREATMENT OF HIV/AIDS IN TSETSE VILLAGE: 
THE CASE OF MAHIKENG IN THE NORTH WEST PROVINCE 
BY T.P. SEBATA- Student No.: 17006929 
26 May 2014 
This letter serves to confirm that I language edited the above 
dissertation, as required. 
Please contact the writer should you require any further information. 
Regards 
CHAPTER ONE 
ORIENTATION TO THE STUDY 
1.1 INTRODUCTION 
Chapter one provides an orientation of the role of traditional health practitioners for treating a 
variety of diseases, such as human immunodeficiency virus/acquired immunodeficiency 
syndrome (HIV and AIDS), in hospitals and clinics in the North West Province (Tsetse village -
Mahikeng). It also explains the usages of traditional medicine among Africans. It sets out the 
definitions of concepts, the problem statement, and the significance of the study, the hypothesis 
and the intended aim of the study. The study will use the terms traditional health practitioners 
and traditional healers interchangeably, as synonyms for the same profession. 
1.2 BACKGROUND OF THE STUDY 
Since the colonial era, there has been a huge disparity between modem science and indigenous 
knowiedge systems. Modem science has prospered, while indigenous lu"lowlcdgc systems have 
been labelled primitive, outdated and witchcraft. The disparity in health practices created the 
parallel systems of modem science and indigenous knowledge. Western medicine has more often 
than not shunned traditional health practices, despite their role in primary healthcare in rural 
communities. The exorbitant cost of modem healthcare systems and technology established in 
developing countries led to a national healthcare system approach, which gave traditional health 
practitioners the opportunity to be recognised in modem healthcare in rural communities 
(Helwig, 2010:30). 
Hillenbrand (2006) and Kayombo (2007) state that during the colonial era in Africa modem 
healthcare was used and advocated among Africans to the extent that modem science came to 
dominate over indigenous knowledge. Africans, however, continued to use traditional medicine, 
due to its accessibility and affordability. The support of the World Health Organisation (2002) of 
the integration of indigenous healing in modem science led to a rise in active indigenous healers 
in South Africa of approximately 200 000 and an estimated 80% of Africans consult traditional 
healers on a daily basis. They do so not only because it is a longstanding part of traditional 
culture, but also due to the lower cost of traditional medicine. 
1 
Horton (1998), in Viriri and Mungwini (2009:183), explains that traditional health practitioners 
use a combination of healing methods, which include: pricking the skin with needs, to alleviate 
pain and disease; predicting the future or coming troubles; massaging the feet for relaxation and 
improved circulation; and healing disease, both emotional and physical. Throughout Africa, the 
sick or afflicted consult prophets to advise them whether the cause of their troubles is the 
displeasure of their ancestors and whether an individual is meant to become a sangoma 
(traditional healer). Then after thorough consultation with these ancestors, the patient is expected 
to thwasa. The Shona in Zimbabwe, for example, believe that disease within society is the result 
of disturbed social relations and misfortune. 
The prophets treat natural causes of diseases by means of water and visions. Upon pinpointing 
the causes of the medical condition, the diviner prescribes medicine to the patient. Should it fail 
to heal the condition, he refers the patient to an herbalist/inyanga (traditional healer who cures 
illness by means of herbs and bones) or a sangoma (performs simi'lar functions as the inyanga). 
The diviner may recommend a Western medicine regimen if the condition persists. 
The World Health Organisation (2002) furthermore advocates the use of herbal remedies in the 
primary healthcare sector.· In 2012, the Treatment Action Campaign launched a protest against 
the government's denials on HIV and AIDS and a television programme that brought to light 
how two people died after attending services of the Christ Embassy Healing School that claimed 
to be able to cure cancer, heart disease and arthritis and forced people to stop antiretroviral 
treatment. 
The late Minister of Health, Dr. Tshabalala-Msimang, was strongly opposed to the use of 
antiretroviral drugs to treat HIV and AIDS, calling the latter toxic and dangerous. She instead 
promoted a balanced diet with a combination of beetroot, garlic and African potatoes in response 
to which the media labelled her Dr. Beetroot. The former President of South Africa, Thabo 
Mbeki, also displayed some reluctance towards antiretroviral treatment in the public sector and 
expressed doubts about whether HIV causes HIV and AIDS (Cunningham, 1993). 
African traditional medicine is deeply entrenched in indigenous life across the continent, since 
indigenous communities favour such treatment over Western medicine. Indigenous medicine is 
also more accessible and affordable to many indigenous people around the world. Even the Bible 
cites the use of herbs and records of the use of traditional medicine go back as far as Ancient 
2 
Egypt. It is a broad concept that includes a diverse range of practices, like: acupuncture, 
Ayurveda, Islamic medicine, traditional Vietnamese medicine and African traditional medicine. 
Hakim and Chishti (2010) state that the media often cast African traditional health practitioners 
in a negative light, for example reports on the number of healers claiming to have found the cure 
HIV and AIDS and the unethical treatment of patients. These reports have tarnished the image of 
traditional healing in South Africa. One such news item by the South African Broadcast 
Corporation on 5 October 2013 featured Bishop Nala, who claimed to have found a remedy for 
HIV. He alleged that drinking holy water had cured a number of HIV-positive people of the 
virus, a claim that elicited great criticism from the Treatment Action Campaign and government, 
since no proven cure has yet been found for HIV and AIDS. 
Moral and knowledgeable indigenous health practitioners can indeed play a role in Africa's 
response to HIV and AIDS, but their entreaties for a viable healthcare structure have basically 
gone unheeded. Both Richter (2003:4) and Peters et al. (2010) indicate how media reports in 
South Africa usually only focus on the negative and sometimes inaccurate depiction oftraditional 
medicine and its practitioners. 
Tales of abhorrent acts and practitioners' intentional deception of the public, like the claim to 
have found a cure for HIV and AIDS, continue to cast all traditional health practitioners in a bad 
light. Another example of such deception is the false advertising by fraudsters in pamphlets of 
cures for a variety of diseases and the ability to bring about lottery riches or the return of a lost 
loved one. 
Western society continues to be dismissive of traditional, distrustful of any treatment that has 
undergone extensive testing. One example of this comes from an article in the South African 
Medical Journal (Onominya, 2013) that states: A study conducted by the Department of 
Pharmacology of the University of Cape Town (UCT) showed that herbs used by traditional 
health practitioners are effective for treating malaria, but remain unused in the public sector. The 
curative properties of herbs are scientifically sound, but none are close to mainstream medical 
adoption. Traditional medicine is furthermore experiencing an upward trend in developing 
countries, due to complementary and alternative medicine that applies natural science or formal 
science to develop knowledge or forms of medicine. The World Health Organisation on 
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Traditional Medicine Strategy (2005) calls for traditional medicine to be tested and evaluated for 
safety and efficacy, before it can be accepted into society/national healthcare policies. 
Despite the efficacy of traditional medicine in the treatment of diseases, there have been cases of 
toxicity among communities. Lack of knowledge, fraudulent practitioners and incorrect dosages 
have led to instances of death among children. The circumstances around death are not recorded, 
due to the African belief that the death of an infant is simply the will of the ancestors. Even when 
a death is recorded, it is not related to indigenous healing and a post-mortem is not always 
performed. 
Onominya (2013) explains, in the South African Medical Journal, indigenous healers are the first 
to be consulted when calamity strikes a rural community because people trust and believe in their 
ability to treat, diagnose and cure ailments. Although there are many traditional health 
practitioners who provide the necessary medical treatment, there are also charlatans who falsely 
claim to have undergone thwasa. They often require upfront payment of an exorbitant fee. 
It may be easy to be dismissive of traditional medicine, but its cultural values and healthcare 
practices are inherent to traditional society and pertinent to issues around HIV and AIDS (Munk, 
1997:10). Indigenous communities will continue to opt for traditional health practitioners over 
Western medicine. A choice justified by the problems encountered in accessing antiretroviral 
medication, the negative attitude ofhealthcare professionals and the toxicity of drugs. 
The World Health Organisation (2013) and Munk (1997) report that the majority of South 
Africans consult sangomas and inyangas for relief from symptoms related to HIV and AIDS. The 
World Health Organisation (2013) recommends the collaboration between Western doctors and 
traditional health practitioners to find a cure for HIV and AIDS in Southern Africa. A possible 
initiative could be to incorporate the expertise and skills traditional health practitioners possess in 
treating secondary or opportunistic infections. Furthermore, sangomas are able to spiritually 
connect with ancestral spirits for assistance in diagnosing and curing physical and spiritual 
ailments; while inyangas are primarily herbalists, who specifically employ the medicinal 
properties of indigenous flora toward patient treatment and cure. Most traditional healers consult 
with ancestral spirits to locate plant material, using plant material vultures and rare animal 
species to make muti. 
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Mander et al. (2007: 1) assert that in Africa it is believed that the fortunes of life such as "health, 
disease, success or misfortune" are in the hands of the ancestors and it is thus necessary to seek 
the assistance of a traditional healer, who is guided by "prayer, dreams and visions" (2007:1) to 
gather the relevant herbs and apply the knowledge and skills acquired during training (Mander et 
al., 2007:1). 
The majority of South Africans consult sangomas and inyangas for the relief of symptoms 
stemming from HIV and AIDS. Cultural values and healthcare are inherent to traditional society 
and within the context of HIV treatment in Africa. This cultural bond to a particular indigenous 
community is the reason for the preference of traditional medicine over Western medicine. 
Below is the definition of operational concepts, as set out below. 
1.3 DEFINITION OF CONCEPTS 
1.3.1 INDIGENOUS KNOWLEDGE SYSTEMS (IKS) 
Indigenous knowledge system is the unique and age-old knowledge of a particular culture. This 
knowledge is passed down from one generation to the next and has been the means of survival 
from the oppression of colonists since time immemorial. Ethno-science can be defined as the 
knowledge distinctive to a given culture or society (Morris, 2005; Freeman & Motsei, 2004). 
1.3.2 INDIGENOUS KNOWLEDGE (IK) 
Indigenous knowledge is local knowledge - it originates from a particular culture and is passed 
from one generation to another and serves as a means of survival. Indigenous knowledge and 
local knowledge are two different concepts. Local knowledge is generated in universities, 
research institutions and private firms and form the basis for local-level decision making in 
agriculture, healthcare, food preparation, education, natural-resource management and a host of 
other activities in rural communities. Indigenous knowledge is the information base of a society 
that facilitates communication and decision-making. It is a dynamic information source and 
continually influenced by internal creativity and experimentation (Freeman & Motsei, 2004). 
5 
1.3.3 BADIMO/ANCESTORS 
Ancestors are regarded as the forefathers of a family, who continue to live among the family in 
spirit. Traditional healers also consult with ancestors for healing a variety of diseases. Many 
cultures around the world worship the spirit of the departed, which in Biblical times consisted of 
prayers and offerings. This living spirit has the power to cause destruction or calamity in a 
person's life and the amadlozi acts as mediator between the living and God (Maila, 2001). 
1.3.4 TRADITIONAL KNOWLEGDE (TK) 
Indigenous knowledge is made up of different sub-disciplines, such as "traditional environmental 
knowledge" and "local knowledge" (Booth & Skelton, 2003), all falling under the umbrella of 
traditional knowledge and found in national, provincial and local structures. Examples of 
elements related to traditional knowledge are "tools and techniques for hunting or agriculture); 
midwifery; ethno-botany and ecological knowledge; celestial navigation; ethno-astronomy" 
(Booth & Skelton, 2003). Traditional knowledge has therefore played a major role in the lives of 
indigenous people and it has passed from one generation to the next (Booth & Skelton, 2003). 
1.3.5 DIVINATION 
Divination, also called fortune telling, is the prediction of the future or the ability to foresee the 
unknown through a distinct talent or knowledge. Sangomas are also regarded as diviners, because 
of their ability to foretell the future (Bob, 2004). 
1.3.6 RITUALS 
A ritual is a set arrangement of events including signals, arguments and objects executed in an 
appropriated domicile. It is often a longstanding customs of a community, which is characterised 
by "formalism, traditionalism, invariance and rule-governance" (Hakim & Chishti, 2010). 
1.3.7 SPIRITUALITY 
Spirituality is related to the substance of the soul. Mystical substance is to human beings, like 
nature is to flora and fauna, but is a connection that transcends time and tangible material 
(Kahakwa, 2004). 
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1.3.8 TRADITIONAL HEALTH PRACTITIONER (THP) 
Traditional health practitioner is a sangoma who is legally recognised in South Africa under the 
Health Practitioners Health Bill (Act 22 of 2007). Also included under this act are Prophets, 
traditional birth attendants and herbalists. A true traditional health practitioner does not charge 
exorbitant fees before the consultation and does not use human body parts to make muti. 
1.3.9 TRADITIONAL HEALER 
Traditional healers are recognised in communities, because they offer curative herbal remedies 
and therapies. Many traditional medicinal practitioners do not have a formal education, receiving 
their knowledge of medicinal plants and their effects on the human body from their forebears. 
They have a deep and personal involvement in the healing process and protect such therapeutic 
knowledge by keeping it confidential (Bob, 2004). 
1.3.10 TRADITIONAL MEDICINE 
Traditional treatment is the combination of information, expertise and practices created on ideas, 
opinions and views native to different values that are used to preserve health as well as to avert, 
identify, increase or treat physical and emotional well-being. Herbal medicines include herbs, 
herbal materials, herbal preparations and finished herbal products that contain parts of plants or 
other plant material, such as active ingredients (Rupert, 2001). 
Traditional African medicine is a frame of information established and accrued by Africans over 
tens of thousands of years and is connected with the investigation, analysis, cure, management, 
avoidance or elevation and recuperation of the physical, psychological, mystical or public 
welfare of individuals and creatures. Traditional medicine includes assorted methods and 
opinions integrating herb, animal- and/or crystal-based remedies, mystical cures, handbook 
practices and applications useful singularly or in arrangement to preserve well-being as well as to 
treat, identify or avert disorder (Lofman eta!., 2010). 
African forefathers have employed traditional medicine for the treatment of a range of diseases 
such diarrhoea, headache and skin conditions. It is in fact a concept that transcends physical 
health and socially based. This implies that people will continue to tum to traditional medicine, 
despite the availability ofWestem medicine. 
7 
The traditional medicine industry contributes immensely to the economy and can be regarded as 
a system for addressing misfortune (biological or otherwise), drawing on theories about the body, 
health, illness and remedies that are rooted in the histories of cultures and religions that have 
built and continue to build a country. 
Arguably there are practically as many forms of traditional medicine as there are cultures. The 
variety of traditional medicine found from one region to another, from country to country and 
even within a particular country is both an advantage and a challenge. For example, there is a 
strong oral tradition and no provision for formal training for practitioners in African or Latin 
American traditional medicine, whereas traditional Chinese medicine is much more structured 
and documented (Hillenbrand, 2006). 
1.4 STATEMENT OF THE PROBLEM 
Traditional medicine has in recent year's sparked increasing interest. The World Health 
Assembly, for example, puts emphasis on the practice of traditional remedy as well as the 
incorporation of traditional medical practices and labour support into healthcare systems. Herbal 
medicine is also gaining popularity worldwide as alternative and complementary therapies and 
yet despite traditional healers' impact on treating disease, they have not been formally recognised 
by governments. 
Herbal treatments are frequently a great aid in curing HN -related conditions in Africa, such as 
dermatological ailments, vomiting, sadness, sleeplessness and weakness. Individuals living with 
HN and AIDS regularly and increasingly tum to traditional medicine and natural health products 
to enhance orthodox therapeutic regimens, though little is known about such treatment. 
Regardless of rareness of proof on efficiency or possible harm, several countries strongly 
advocate the use of traditional medicine. The South African Department of Health recommends 
the practice of traditional medicine in conjunction with antiretroviral drugs (Mander et al., 
2007:15). 
Lack of training opportunities and support from government for traditional healers has led to 
them being isolated. 
The problem statement of the study is based on the following aspects: 
8 
Previous studies have characterised the combined use of antiretroviral treatment and traditional 
medicine as naive. 
Western medicine or biomedicine undermines the impact of traditional medicine for the 
management of HIV and AIDS, wherein it is alleged that traditional medicine cannot be taken in 
conjunction with antiretroviral drugs. 
The healthcare system in South Africa is exclusive in nature and only ascribes to Western 
medicine, to the exclusion of traditional healing. This is an unrealistic approach, since the 
majority of the population consults sangomas and inyangas for the alleviation of symptoms 
associated with HIV and AIDS. Traditional health practitioners are skilled in treating secondary 
or opportunistic infections, which raises the question why their services have not been 
incorporated into the management and treatment ofHIV and AIDS. 
1.5 OBJECTIVES OF THE STUDY 
The study investigates the prevalence, facilitators, predictors and types of traditional medicine for 
treatment and cure ofHIV and AIDS. 
It also examines the role of traditional healers in primary healthcare, particularly in the rural 
areas. 
The study outlines the connection among the Department of Health and traditional healers in the 
North West Province, particularly in the Mahikeng district. 
The study analyses the Traditional Health Practitioner Bill (2003) and the Traditional Health 
Practitioners Act (35 of 2004) to assess its incorporation of indigenous medicine into the South 
African healthcare system and to determine traditional healers' knowledge of it. 
1.6 HYPOTHESIS 
The knowledge and skills of traditional healers are being undermined in Africa in the treatment 
of the opportunistic infections that arise from HIV and AIDS. 
There is no enterprise of collaboration between the Department of Health and Sangomas in South 
Africa and conventional treatment does not allow for consultation with a traditional health 
9 
practitioner, prior to exploring Western medicine. Traditional medicine is, in fact, often 
summarily dismissed as treatment/cure for the physical as well as psychological or mental (i.e. a 
disturbance in the natural order of social contact with the soul world or, conditional on the 
precise belief, lack of a deep connection with God or the Supreme Being) symptoms related to 
HIV and AIDS. In a nutshell, conventional medicine continues to suppress all methods of 
traditional healing and their practitioners. 
Traditional medicine is the best treatment for HIV and AIDS-related illnesses, lebanta or Mollo 
wa Badimo, Makgoma and tuberculosis - particularly in developing countries. Yet, patients who 
take antiretroviral medication are prohibited from using traditional medicine. 
1.7. JUSTIFICATION FOR THE RESEARCH 
The study provides insight into the treatment modalities in South Africa selected by HIV and 
AIDS sufferers receiving antiretroviral drugs. The findings of the study reveal the significance of 
traditional medicine and traditional health practitioners in healing diseases related to HIV and 
AIDS as well as information on the relationship between traditional health practitioners and 
general physicians on matters related to healing and diagnosing of diseases. The study also sets 
out knowledge that will inform the formulation of policy and practical solutions to address 
problems between bio-medicine and traditional healing in South Africa. 
1.8 CHAPTERS OF THE STUDY 
1.8.1 Chapter 1 provides introduction and background ofthe study 
1.8.2 Chapter 2 discusses literature review in detail and provides views of other countries 
1.8.3 Chapter 3 provides methods for data collection 
1.8.4 Chapter 4 summarises demographic characteristics of the respondents 
1.8.5 Chapter 5 provides the findings ofthe study 
1.8.6 Chapter 6 is the conclusion and recommendation of the study 
10 
1.9 SUMMARY 
Chapter one provides an overview of the research and delineates the problem under investigation, 
the formulation of the aims, definitions of concepts and organisation of the study. The main 
argument of the study is that traditional medicine for the treatment of HIV and AIDS has been 
increasing, yet insufficiently documented. Chapter two presents the relevant policies and scholarly 
literature related to the topic. 
1.10 A BRIEF PREVIEW OF THE FOLLOWING CHAPTER 
Chapter two of this study focuses on the views of other researchers of traditional medicine and 
HIV and AIDS, also relating the relevant sources of the study 
The preceding chapter shed light on the current situation in South Africa; the following chapter 
provides global views and analysis of policy itself in relation to the vision of national 
government on the application of traditional medicine and the role of traditional health 
practitioners in the future of South Africa. 
11 
2.1 INTRODUCTION 
CHAPTER TWO 
LITERATURE REVIEW 
This chapter discusses the appropriate approaches and theoretical literature impacting on the 
topic and scrutinises procedures in the guidelines of traditional healing. Furthermore, traditional 
medicine and the African Renaissance are based on the principle of UBUNTU: Umuntu 
ngumuntu ngabantu/motho ke motho ka batho/a human being is a human being through other 
human beings. There is a connection between the living and the departed and traditional 
medicine relates to a range of approaches and beliefs, the environment and the human being. It is 
also vital to study traditional medicine in conjunction with the views of others scholars on the 
treatment and cure of diseases (Rupert, 2001). 
Traditional medicine not only focuses on the treatment of diseases, but also on other aspects of 
life that have an impact on the individual such as the environment and ancestral spirits. Societal 
discord is often the result of an imbalance in the relationship between the environment and the 
community, which is why African traditional medicine possesses in-depth k_nowledge on all 
elements of this balance (mental equilibrium). Western researchers have shown a real interest in 
traditional medicine and the government is also endeavouring to integrate traditional medicine 
into the primary healthcare system. It remains a challenge, however, because of traditional 
healers' preference to work in isolation (NWU, 2013). 
2.2 CORRESPONDENCES IN POLICIES 
A. Interest in traditional and alternative medicine is on the rise within the recognised sector of 
African countries and abroad. 
B. Policy advocates the provision of training, guidelines, regulation and issuing of licence to 
traditional healers. 
C. Scientific research, intellectual property rights for traditional medicine and quality assurance 
must be addressed in the manufacture of traditional medicine. 
D. Policy needs to conform to international standards. 
Policy comprises the rules of practise for indigenous medicine within a national healthcare system. 
The objective is to ensure that the code of conduct and legal imperatives for upholding sound 
12 
practises, guaranteeing protection and efficiency as well as providing access to healthcare 
resources. The National Development Plan envisages eradicating poverty and improving on the 
healthcare system, particularly given the influence of history on this field. Policy is drafted and is 
currently in the monitoring and appraisal stage awaiting execution (Maila, 2001). 
The White Paper for the Transformation of the Health System in South Africa advocates for the 
inclusion and recognition of traditional birth attendants and traditional doctors in primary 
healthcare. In addition, there must also be regularisation and registration of traditional doctors so 
that they can be recognised and able to practice in hospitals and clinics (PHILA, 1997). 
2.2.1 THE TRADITIONAL MEDICINE STRATEGY - THE WORLD HEALTH 
ORGANISATION (2002) 
A conference held in Geneva in 2002 recommended the inclusion of traditional health 
practitioners in the primary healthcare system, especially in developing countries that have a 
policy on their national healthcare. The World Health Organisation emphasised that intellectual 
property rights and policy must be put in place to protect traditional health practitioners and 
traditional medicine in developing countries (WHO, 2002; WHO, 2000; Hakim & Chishti, 2010). 
2.2.2 TRADITIONAL HEALTH PRACTITIONER BILLOF 2003 
The Traditional Health Practitioners Bill of 2003 allows traditional health practitioners to prescribe 
medication and sick leave to patients, similar to Western doctors. The Bill inhibits charlatans 
(fraudulent healers who use human body parts to make muti and claim to cure a variety of ailments) 
from practicing. Government implemented the Traditional Health Practitioners Act (22 of 2007) to 
ensure that traditional doctors enjoy the same rights as other healthcare practitioners in South 
Africa and also that all healthcare practitioners are operating legally, meeting all standards of 
healthcare set out by the Department of Health. The Traditional Health Practitioner Bill (2003) was 
passed in 2003 by parliament. The objective of the Bill is to recognise the traditional healthcare 
system in South Africa as well as to provide a framework for ensuring efficacy and quality of 
traditional healthcare services and give patients recourse in instances of malpractice (Sagan, 2013). 
The Bill (2003) also established temporary Traditional Health Practitioners Council of South 
Africa. The Council is tasked with delivering a regulatory framework to safeguard the 
productivity, well-being and excellence of traditional healthcare amenities for the regulator and 
13 
detailing the recording, preparation, expansion and behaviour of specialists as well as define the 
classes of the traditional medicine profession. 
The Bill (2003) relates the formation, goals, roles and structure of the Council that promotes 
excellence in healthcare inside the traditional health sector. It guards the benefits of the public 
and preserves specialised ethics for traditional health practitioners, offering a code of conduct 
that conforms to generally accepted standards and norms. 
The Traditional Health Practitioners Bill (2003) was appraised by the late Ms. Manto Tshabalala-
Msimang who emphasised that the plan will bring dignity and respect of traditional medicine to 
the public sector. During the public consultation seminars of 15 September 2004, she asserted 
that the Bill will bring traditional healers such as diviners (sangomas), herbalists (izinyangas), 
traditional birth attendants and traditional surgeons (iingcibi) closer to the primary healthcare 
system and the Bill will benefit more than 200 000 traditional health practitioners (Matomela, 
2013): 
2.2.3 THE TRADITIONAL HEALTH PRACTITIONERS ACT (22 OF 2007) 
The Traditional Health Practitioners Act (22 of 2007) indicates that all traditional health 
practitioners in South Africa must register with the Health Professional Council. The Act also 
established a legal framework known as the Board of Traditional Health Practitioners. The 
mandate of the Council is to provide support for traditional health practitioners and identify 
fraudulent practitioners who financially exploit the public (Traditional Health Practitioners Act 
(22 of2007). 
The purpose of the Council is to: 
• promote health awareness to safeguard the quality of health services within the traditional 
health system; 
encourage and preserve moral and proficient health standards required ·from traditional 
health practitioners; 
• improve interest and encourage research and training; 
• set and preserve the code of conduct; and 
• ensure that traditional practice conforms to universal healthcare standards. 
14 
2.2.4 DRAFT POLICY ON AFRICAN TRADITIONAL MEDICINE FOR PUBLIC 
COMMENT, 21 JULY 2008- (Department of Health, 2008) 
Chapter Two Section 27 of the Constitution (1996) and Bill of Rights set out a draft policy on 
traditional medicine with the objective to integrate traditional medicine into the primary 
healthcare system that all citizens may have the right to quality healthcare and the type of 
healthcare (i.e. traditional medicine or Western medicine) they wish. The draft policy reflects the 
diversity of health disciplines available to citizens in South Africa within the public healthcare 
system. 
The Alma-Ata declaration emphasises the transformational process of protecting traditional 
medicine, acknowledging the heritage of the country and its knowledge to strengthen the national 
healthcare system by ensuring effective progress through legislative policy (Kale, 1995). 
2.3 CO-EXISTENCE OF AFRICAN TRADITIONAL MEDICINE AND BIOMEDICINE 
Although conventional medicine (art of healing by diagnosis, treatment and prevention of 
disease) is embraced in developing countries, it has its limitations in undeveloped countries. 
Western practices have an impact on areas, such as managing the spread of disease, but has failed 
to integrate into the culture of indigenous people. This is why the African healer is an important 
part of society, since many rural communities prefer traditional medicine and also struggle to 
access treatment facilities due to poor infrastructure and an inadequate transport system. 
Obtaining such services entails travelling long distances and waiting long hours to receive 
medical attention (up to eight hours at times). 
Hospitals in urban areas are overcrowded and often lack the necessary medication, neither are 
patients properly informed of the cause and scope of their illness (Mander et al., 2007). 
Treatment is then also at times sub-standard due to the lack of proper technology and the expense 
of obtaining proper care. The approach taken in Western medicine has alienated indigenous 
people from their culture and tradition, distancing them from their families and society, whereby 
many Africans no longer practice spiritual healing in accordance with their culture. 
The interest in the properties and benefits of medicinal plants is on the increase and Western 
pharmaceutical companies have come to consider herbal medicine as a source of reference for the 
preparation of synthetic medicine. Some of these companies are, however, using traditional 
medicine without the permission of traditional healers. This is the result of the lack of recognition 
15 
afforded traditional healers and intellectual property rights remaining taboo in the traditional 
healthcare sector. 
2.3.1 THE HIERARCHY WITHIN THE HEALTHCARE SYSTEM 
National Department of Health 
Health Dental Nursing Pharmacy Allied Health Traditional Healers 
Professional Technicians Council Council Professions Council* 
Council 
*Interim Council 
Source: Caldis eta!. (2001) 
2.3.2 DIVINATION, DIAGNOSIS AND HEALING PRACTICES 
A Sangoma plays the vital role in society of ensuring that the community is protected from evil 
spirits that bring illness, in which the healer mediates the relationship between the patient and the 
ancestors. A patient visits the sangoma, who determines the nature of the affliction or the reason 
for the patient seeking their assistance. The diviner throws bones (ditaola) on the floor that may 
include animal vertebrae, dominoes, dice, coins, shells and stones to ascertain the cause of the 
ailment and the appropriate treatment. Such treatment may be a purification ritual or animal 
sacrifice to appease the spirits through atonement. Each bone has a different meaning, which only 
the healer can interpret. Ditaola has certain implications for human life, like a hyena bone 
identifies a thief and will provide information about stolen property. The sangoma or the patient 
throws the bones, but the ancestors control how they are interpreted in terms of the patient's 
ailment (Mawere, 2011). 
The National Health Plan for South Africa (ANC, 1994) and Mathonsi (2013) urge that the 
benefits of collaboration and cooperation between modern and traditional health practitioners 
need to be fostered, given that traditional practitioners are often more accessible and satisfactory 
than the modern healthcare sector and can thus aid in promoting good health. 
16 
On 12 February 2013 an Interim Traditional Health Practitioners' Council (ITHPC) officially 
integrated traditional healers into the National Health Insurance (NHD landscape (Mathonsi, 
2013). This council advocates mutual education between healthcare systems that all specialists, 
including traditional healers, may enriched their practices. 
The Interim Traditional Health Practitioners Council operates under the leadership of Abram 
Conrad Tsiane and consists of twenty members from a variety of disciplines such as herbalists, 
diviners, traditional surgeons, traditional birth attendants, academics and researchers from the 
Department of Health (Mathonsi, 2003). The objective of this council is to register traditional 
health practitioners with the Health Professional Council of South Africa and to protect the 
public against fraudulent healers who exploit the public. It is also responsible for protecting the 
intellectual property rights of traditional healers, to keep any company or individual from 
acquiring such medicine without acknowledging or compensating traditional healers. Research 
into traditional medicine must benefit the community and the creators of knowledge (Mathonsi, 
2013). 
Mathonsi (2013) argues that the 1978 Alma Ata Declaration, endorsed by the World Health 
Organisation, provided for the incorporation of traditional medicine into the primary healthcare 
system. There has been a degree of collaboration between Western and traditional systems. Many 
primary healthcare facilities and hospitals have been working hand in hand with traditional health 
practitioners to treat childhood diseases such as diarrhoea, vomiting, HIV and AIDS, tuberculosis 
and mental illness (Mathonsi, 2013). 
Maw ere (20 11) asserts that African countries need to recognise the importance role that traditional 
and faith healers play in healthcare, since so many people prefer traditional medicine to Western 
medicine. A study conducted in the Northern Cape among hospital patients and staff; church 
members; and university students revealed that most diseases are cured with traditional healing. 
These diseases include witchcraft- (like Sejeso and Sefolane) and ancestor- (badimo) related 
problems; traditional diseases, like hlogwana (pulsating fontanel - lit. "little head"); makgoma 
(assortment of ailments, the result of the violation of particular taboos); infertility and sexually 
transmitted diseases; asthma; mental disorders; epilepsy; and diarrhoea. Biomedicine was found 
successful in diseases such as tuberculosis, chicken pox, AIDS, hypertension, diabetes, malaria, 
measles, cancer, anaemia, mental retardation and ulcers. It must also be mentioned that Western 
medicine is unable to treat the above conditions. 
17 
Sagan (2013) states that understanding traditional medicine requires a thorough investigation of the 
lives and views of Africans. The opinions of Africans differ and form a multifaceted organisation in 
which opinions about inherited spirits, magic, sorcery, witches and pollution co-exist. This loose 
connotation offers a normal way of understanding bad luck and provides straightforward answers to 
the puzzling questions of the purpose of life. 
Health to the traditional African is being in harmony with cosmic vitality/energy, i.e. honouring 
ancestors to prevent misfortune in life. Traditional healers heals both physical and spiritual/social 
ailments by diagnosing common illnesses; selling and dispensing remedies for medical complaints; 
and divining the cause and providing solutions to spiritual or social complaints. It is furthermore 
believed that diseases relate to the mental, spiritual and physical requiring holistic treatment. 
2.3.3 THWASA AND INITIATION 
Sangomas have the ability to heal a variety of ailments, such as spiritual troubles and social 
disharmony as well as act as mediators between the living and the ancestors. It is believed that 
ancestors provide the instructions and advice to heal illness and that communication between the 
ancestors and the living occurs in a secret hea1ing hut or ndumba (a sacred place for healing), 
where the ancestors are believed to reside. Sangomas communicate and seek guidance from the 
ancestors through interpreting dreams and throwing bones. Drums, songs and dancing all form 
part of the interaction with ancestors, where the traditional health practitioner enters into a trance 
that enables him to communicate directly with the ancestors (Peters, 2010). 
The ancestors play a definite role in the "calling" (thwasa) of a health practitioner, which consist 
of certain processes and rituals. A sangoma is believed to be "called" to heal through an initiation 
of illness that is characterised by psychosis, headache, intractable stomach pain, shoulder or neck 
complaints or illness that cannot be cured by conventional means. The simultaneous emergence 
of such symptoms is deemed to be twasa or the calling of the ancestors. It is also the belief that 
failure to respond to the calling will result in further illness, until the person relents and obtains 
training. The word twas a is derived from thwasa, which means "the light of the new moon", or 
from ku mu thwasisa meaning "to lead to the light" (Richter 2010). 
The training of a healer could take several years, just like a medical student who has to undergo 
seven years of medical school. A trainee sangoma (ithwasa) receives formal instruction from 
elderly sangoma, for a period ranging from a few months to many years. The training involves 
18 
learning humility towards the ancestors, purification through steaming, washing in the blood of 
sacrificed animals and the use ofmuti, medicine with spiritual significance (Richter, 2010). 
It is a process aimed at preparing the healer for a life of commitment to healing. Upon 
completion of the training, a goat or cow will be slaughtered and the ithwasa will drink the blood 
as a way to demonstrate the connection between the ancestors and traditional healers. Local 
community, friends and family will be invited to observe and rejoice upon the conclusion of the 
exercise. The transcended healer will be tested by the elder sangoma to ensure he has acquired 
the skills and insight to heal. This is signified and proved when other sangomas hide the 
ithwasa's sacred objects, including the gall bladder of the goat that was sacrificed, and the 
ithwasa must call upon their ancestors, find the hidden objects and return them back to the 
sangomas that hid them in front of the community, thus proving their ability to "see" beyond the 
physical world (Matomela, 2013; Verhelst & Tyndale, 2010). 
2.3.4 PROMULGATION OF TRADITIONAL HEALTH PRACTITIONER ACT (22 OF 
2007) 
The Traditional Health Practitioners Act (22 of 2007) recognises and acknowledges the foliowing 
traditional healers: herbalist, traditional birth attendants and traditional surgeons. The Act also 
established the Traditional Health Practitioners Council on 12 February 2013, after Parliament had 
already approved the Traditional Health Practitioners Act (35 of 2004). Doctors for Life 
International however ruled the Act unconstitutional, because the public was not consulted at 
provincial level during the promulgation of the Act. 
2.3.5 TYPES OF TRADITIONAL HEALTH PRACTITIONERS 
Motsei and Freeman (1992:118) and the NWU (2013) identify four categories of traditional 
healer: inyanga, sangoma, traditional surgeon and traditional birth attendants. A traditional 
doctor specialises in using herbs for the cure of ailments. The dingaka (Sotho) or isangoma 
(Zulu) is usually a woman (±90%) who operates within a traditional religious supernatural 
context and acts as a medium to the ancestral shades/spirits. Only those who are called by the 
ancestors can become diviners. Then there is the faith healer, called umprofethi or umthandazi, 
who integrates traditional practice into Christian rituals. Faith healers are predominantly 
Christians who use holy water or mirrors for treatment or to predict the future and belongs to the 
Independent African Churches. 
19 
Kale (1995:1) states that traditional birth attendants are mostly elderly women who assist during 
labour to ensure that the baby and mother safely make it through the birth. Traditional birth 
attendants are respected within the community for their skills and work in partnership with an 
inyanga, especially when complications arise during birth. Aside from these traditional birth 
attendants, there are also traditional surgeons (rathipana) who are responsible for circumcision 
and taking boys to the mountain for initiation. There they teach initiates about culture and their 
roles in society. Despite the existence of these traditional practitioners, lack of collaboration 
remains a challenge. 
Traditional healers possess the knowledge and skills to treat sexually transmitted diseases and 
children's diseases (tlhogwana, letshollo le khujwana le amangwe), whereas faith healers focus 
on substance abuse and chronic conditions as well as social problems. Most traditional health 
practitioners would be interested in assisting the government in the treatment of diseases arising 
from HN and AIDS, but they would have to work out of sight of the community to avoid 
possibly angering the ancestors (Rhodes & Rhodes, 2004). 
The ingredients of traditional medicine include plants and animals, aimed at maintaining the 
wellbeing of Africans. Mapara (2009) sets out the approximate number of people who consult 
Western doctors and those who choose traditional healers. In South Africa there are approximately 
thirty to forty thousand traditional health practitioners, but a mere six thousand Western doctors. 
Marapa (2009) further provides the geographical areas where traditional medicine features strongly 
(the percentage of traditional health practitioners to university-trained physicians in relation to 
population size is covered in the next session). In the Kwahu district of Ghana, for instance, more 
people go to traditional healers than to Western doctors and in Swaziland there are hundred and ten 
thousand people for every traditional healer, but only ten thousand for the university-trained doctor. 
This is a clear demonstration of the preference for traditional medicine over its Western 
counterpart. 
The tendency to resort to traditional healing can be ascribed to the high cost of Western 
medicines and the inaccessibility of Western services, making traditional health practitioners the 
only source of medical treatment for many Africans. Traditional healers offer valuable 
experience as well as affordable and effective treatment (even in relation to HN and AIDS), 
according to a traditional healer and trained dentist in Uganda (Mapara, 2009). 
20 
Rhodes and Rhodes (2004) indicate the clear distinction among traditional healers according to the 
particular functions they perform and in South Africa each culture has its own term for a diviner. 
Among the Xhosa traditional healers are known as amagqira, in South Sotho they are called ngaka 
and in Northern Sotho Selaoli and Mungome in Venda and Tsonga. Generally, traditional healers 
are referred as sangomas (from the Zulu word izangoma) in South Africa. 
Recently Western society has expressed an interest in the efficacy and efficiency of herbal 
remedies and greater research is being undertaken into the ingredients (such as aloe, buchu and 
devil's claw) of the traditional medicine of traditional healers. Public health specialists 
acknowledge the role of traditional health practitioners in the treatment of diseases, such as: HIV 
and AIDS, diarrhoea and pneumonia, which are major causes of death in rural areas (especially in 
children). Traditional health practitioners have continued to assist in the fight against the scourge 
ofHIV and AIDS in Africa. 
Claude El Fox 2010:3 Healthy People 2010 states that traditional healers in Africa fall under the 
umbrella of herbalists. Their practices centre on treating ailments by means of herbal medicine, 
while diviners use prayer, prediction and spirit channelling. Traditional African healing focuses 
on the body, spirit and social well-being of individuals. Any disturbance on these levels 
manifests in ill health, healing will thus address the patient in relation to the environment, society 
and universe. Expertise, techniques and methods of diagnoses vary among the traditional healers 
(izangoma) in South Africa and their practices overlap, making the distinction between diviners 
and herbalists virtually impossible. Another practice recently added to the framework of 
traditional medicine is Christian prophesying and there has also been talk about including 
traditional surgeons (ingcibi) and traditional midwives/birth attendants (ababelithisi) in the 
category of traditional healers. 
The remuneration traditional health practitioners receive depends on the effectiveness of their 
services. A traditional health practitioner who has undergone initiation or thwasa will only request 
payment once the relevant condition has been treated successfully, reflecting that the care of 
patients are uppermost and not financial gain. Western physicians however expect payment prior to 
consultation, especially in urban areas. The following categories of traditional healer can be 
distinguished: 
21 
a. Diviner!sangoma 
According to Kayombo (2007), diviners must undergo a ceremony of spirit possession that 
primarily features music, dancing, community participation and interpretation of dreams. Diviners 
are predominantly female who act as mediators between humans and ancestors/the supernatural. 
This traditional practice is a calling and not a choice. Such calling may occur through visions, 
prophecy and dreams or sometimes the individual called this service will suddenly fall ill for a 
period of time and will then, upon consulting a traditional healer, learn of the calling to this 
profession. 
Diviners diagnose by means of listening, observation and experience as well as the aid of the 
ancestors in the case of an unexplainable condition, where the message of the ancestors is imparted 
through bone throwing. Prediction is another method a diviner employs to interact with badimo 
(ancestors), to determine the impact of illness and curative ceremonies or mechanics. This practice 
entails the reading of palms, water and mirrors; dancing; trance; throwing bones or shells; and 
prayers (Hakim, 2010). 
Becoming a traditional healer/go thwasa can occur in a different ways. Witchdoctors learn of this 
skill when receiving this kind of treatment and then resolve to become healers upon recovery 
(mental disarray might be a sign of spiritual calling). There are also instances that involve spiritual 
calling and diagnosis and treatment will thus be supernatural in nature. 
Passing down knowledge and skills informally from a close family member, such as a father or 
uncle or even mother or aunt (in the case of midwives), is another way it may occur. It is a kind of 
apprenticeship in which a traditional health practitioner conveys the skills and knowledge to the 
younger generation (Ramokgopa, 2013). 
b. Herbalists/ngaka 
Herbalists possess extensive knowledge of supernatural techniques. They also employ empirical 
knowledge to diagnose certain illnesses and prescribe the proper curative herbs; prevent calamity 
within a village; provide defence against bewitchment and hardship; and bringing wealth and 
contentment. 
Traditional health practitioners use traditional medicine, such as crocodile skin for fever, to treat a 
variety of illness. Becoming an herbalist requires seven years of strict training, under a qualified 
22 
herbalist, whereafter the trainee is tested during ceremonial ritual on his/her knowledge of herbal 
remedies. 
Herbalist can be regarded as a pharmacist who dispenses medicine made of natural ingredients 
comprising the bark of trees, roots, leaves, animal skin, blood or parts of animals, herbs and 
seawater. Their services do not include prediction (Latiff, 2010). 
c. Prophets/faith healers 
Faith healers diagnose and treat disease by means of prayer, candlelight or water. Upon healing, 
patients normally join the church where the healer is a member. 
d. Traditional Birth Attendants (TBA) 
Fontaine (2004) indicates that a traditional birth attendant assists a community far from hospitals or 
Western medicine, which is only widely available in urban areas, and is a valuable asset. Despite 
the vital role that a traditional birth attendant plays, particularly in rural areas, practices have not 
been documented. 
2.4 INDIGENOUS KNOWLEDGE SYSTEMS AND TRADITIONAL HEALING 
PRACTICES 
Struthers and Eschiti (2004) indicate that indigenous knowledge originates from the relationship 
between human beings, the earth and animals. This knowledge is employed for farming, without 
the aid of modern technology; healing the ailments of animals and humans; and for making rain. 
Indigenous knowledge systems include traditional knowledge, indigenous technical knowledge and 
rural knowledge and arose from the struggle of indigenous people against colonialism. The 
importance of bringing this knowledge to the fore becomes clear from native communities' 
testimony of success, across the world, in fields like health and medicine (Helwig, 201 0:43). 
Westerners may have introduced advanced medical knowledge to Africa, but they also caused their 
own share of problems for the local population. Floyed et al. (2009) explain how indigenous 
communities have contributed significantly to the medical field, through the treatment of the 
sexually transmitted diseases of gonorrhoea and syphilis that were brought by colonisation. 
Traditional health practitioners have the skills and knowledge to treat a range of ailments, which 
has been recognised by the World Health Organisation and the United Nations Conference on 
23 
Environment and Development (UNCED). For example, traditional health practitioners use herbs 
such as the African willow (South Africa), the hoodia plant (Namibia) and "iboga" (Gabon and 
Cameroon) (Floyed, 2009) to treat conditions like cancer, obesity and drug addiction. Western 
pharmaceutical companies have become aware of the potential of the herbs used in traditional 
medicine and have at times stolen these plants to sell them to indigenous people at greatly inflated 
prices. 
2.5 TRADITIONAL CONCEPTUALISATION OF HEALTH AND ILLNESS IN AFRICA 
Wilkson (201 0) explains the great social and political role that traditional healers play in the 
community through their healing of spiritual and emotional illness; assistance in childbearing; 
location of property and interpretation of the past and future. Traditional health practitioners are 
highly respected in the community, because of their ability to cure illness associated to witchcraft 
and the displeasure of ancestors that results in misfortune being visited on a family or community. 
Traditional health practitioners appease these ancestors by means of certain rituals that include 
burning imphepho (Helichrysum petiolare) or play drums and chanting. They also prescribe muti 
(medication), prepared from floras and faunae, and infused with spiritual importance. Muti is often 
significantly representative of the goal it aims to achieve, such as giving lion fat to children to 
promote bravery. There are treatments for all forms of physical and mental illness, social 
disagreement and spiritual difficulties as well as potions for protection, love and luck (Padayachee, 
2004). 
2.5.1 TRADITIONAL TREATMENTS 
Healing is defined as the correcting of disorders affecting the body, mind and soul for which 
traditional health practitioners have a diverse range of traditional healing methods. Examples of 
such treatments include taking green tea orally (herbal remedies), mixture of hot water and herbs 
where the vapour enhances relaxation and washes off bad luck (steaming); traditional medicines 
that improve blood circulation (blood cleansing and incision) and others that bring about good 
fortune (charms); and communication with ancestors, through drums and music (dancing) 
(Campbell, 2008). 
African society ascribes ill health to a troubled relationship with the community and the ancestors 
or disobedience to elders and ancestors, breaking social norms and infuriating God. An example of 
this is when a widow fails to mourn her husband's death a full year and enters into marriage before 
24 
that period has passed. The variables are multi-faceted, with complex implications on how people 
understand their world and their place in it. Culturally prescribed interpersonal rules regulate 
behaviour among members of the family, social groups and the broader community (Hakim & 
Chishti, 2010). 
Healing and illness are interconnected and cannot be separated. The theory of illness is complex 
and does not only relate to pain or malfunctioning of the cells, but cuts across the whole of the 
human being and the community. Healing is, therefore, restoring wholeness in human relationships 
including the psychological, social, moral, economic, political and spiritual. fu order to bring about 
such restoration, the ancestors are consulted for solutions to illness (Hakim & Chishti, 2010). 
Manner of greeting, interaction with members of the community; specific duties and social 
obligations are instilled from childhood. Duty to family and society is crucial in traditional life and 
respect for the important members of society such as community leaders, older people, professors 
and doctors is heavily emphasised. It believed that lack of respect for social norms and standards 
leads to headaches, mental illness and bad luck (Brodnicka, 2003). 
Traditional health practitioners use ditaola!bones to treat variety of illnesses. For instance, we have 
different types of ditaola/bones and each has its own name. Tne following is a list of names of 
ditaola/bones: "Moremogolo ", "Sejaro/ tlhako ya kgomo ", "Maboni a ga Ratsatsi ", 
"Pubagadi/tlhako ya kgomo ", "Kgoloko-kgoloko/ pelo ya tshilwana ", "Thakadul seepela tse 
dingwe matsatsa ", "Ditlhakwana tsa podi tse pedi" and "Mosarwa o losika o a rongwa" 
(Padayachee, 2004). 
Further examples oftraditional medicine are as follows: 
);> Diarrhoea (letshollo) is treated with a combination of boiled water and the roots of the 
mosokelo tree, which must be drunk three times a day. 
);> A patient who has a stomach pains would be given hot water mixed with roots of a tree 
known as sekatapohwana. A traditional health practitioner may also mix warm water with 
the barks of the leshogwa tree. 
);> A diviner uses holy water and dried chicken breast to treat heartburn and vomiting. 
);> A women who has given birth will be given makwati a mosetlha and phate ya ngaka to 
clean the womb (Padayachee, 2004). 
25 
2.6 CORRESPONDENCE OF WESTERN AND AFRICAN MEDICINE 
The Journal of Pan African Studies (2009) states that among the Y oruba tribe holistic healing 
encompasses the body, mind and the spiritual world. This holistic approach is ultimately the 
distinction between traditional healing and Western modes of treatment. Traditional healing in 
Africa employs herbal medicine as well as incarnation and invocation of spirits for whole-body 
healing. African traditional medicine is, as indicated above, strongly connected with the cultural 
belief in the supernatural. 
Conventional medicine is allopathic, while African Traditional medicine is homeopathic in nature. 
The Journal of Pan African Studies (2009) explains that allopathic medicine is based on the 
principle: prevention is better than cure. Orthodox medicinal principles promote concentrated doses 
of medicine to treat illness, which often have severe side-effects, focussed on the alleviation of 
symptoms (Campbell, 2008). 
2.6.1 EXAMPLES OF HEALING THROUGH MOVEMENTS/DANCE AMONG KHOI 
2.6.1.1 NDEUP 
According to Brodnicka (2003), Ndeup is a type of therapeutic ritual that heals a person possessed 
by spirits by addressing the relationship of the ancestors with the community and reconciling the 
afflicted individual with the ancestors. Ndeup is also necessary when a family has failed to show 
the ancestors the proper respect by strictly adhering to the prescriptions for an ancestral offering. 
This ceremony generally lasts four to eight days, (Pefile, 2005) relate, which is arranged by the 
traditional healer and attended by the community. 
Once the ceremony has been completed, a trainee or lethwasana is tested on the skills he 
acquired during training. The trainee must slaughter a goat or sheep and pour the blood onto the 
patient, during which the trainee communicates with the ancestors in different languages and beat 
drums to which the patient then starts to dance. The drums are played from the morning until the 
evening to revive the spirit of the ancestors (Pefile, 2005). 
The traditional health practitioners of the Bushmen heal by means of trances (a complete 
relaxation of the mind, body and soul), during which the patient has visions of animals or flying 
in the sky and is in a state of hypnotism. The patient then dances like chicken or a cow and this 
process can heal a variety of ailments such as chest pains or stomach cancer. Trances also serve 
26 
to call for rain and expel evil spirits from the community, whereby members of the community 
would also entered into a trance. The process/healing is characterised by the beating of drums 
and patients dancing like a snake (Rupert, 2001). 
Struther et al. (2012) and Floyed et al. (2009) furthermore indicate that women with babies tied 
on their back sing and clap, while the men dance with bangles made from cocoons clung together 
with cords tied to their legs. The dancing lasts all night (an age-old tradition) and, Dowson 
(2013) explains, during the night songs can be heard from far away as it travels on the cool night 
air that warms with the coming of dawn. Children are taught how to go into a trance at an early 
age, but this practice can be dangerous - for example should the person who is in a trance point a 
finger, especially among children, it could lead to death. 
Yet this trance state energises the traditional healer with a powerful spirit, enabling him to 
undergo a process of transformation and connect the healer with the ancestors and community. 
The traditional healer can then identify the illness in the patient and, as Richter (2010) explains, 
treatment entails the healer putting his feet inside the fire (healers often walk on fire to see inside 
of the human body), one hand on the person's chest and the other on their back to suddenly suck 
the evil out. Healers do not just focus on healing physical illness, they also expel what they call 
"star sicknesses" (a force that takes over a group of people that causes jealousy, anger and 
failure) and is the evil that causes havoc, division and a break in unity. Bushmen thus continue to 
use this method of healing to ensure unity and peace in their community. 
Dowson (2013) calls becoming a traditional health practitioner a long and painful, but necessary, 
process. The motivation behind the wish to become a healer, despite it being an arduous process, is 
a passion to serve the community by bringing the dead back to his family or diagnosing illness or 
foretelling the future. 
2.6.2 ANCESTRAL WORSHIP AMONG THE CRISTIANS 
Donmoyer (2006) states that to the African badimo are close family like parents, grandparents or 
clan who look after the living. Ancestors have endless capabilities, in terms of the living, and have 
the talent to intervene among human beings as well as the Creator. It is believed that badimo 
represent the Creator of earth. Many African Christians worship both the ancestors and God, 
believing that the ancestors have reached divine status. African languages are filled with beliefs and 
principles referring to ancestors. 
27 
Death is the transition from earthly to spiritual life. The deceased may not be physically there any 
longer, but they remain in and around the living and maintain a parental role. It is such a deep-
seated connection that many continue to worship the departed regardless of their Christian beliefs. 
The ancestors communicate with the community through visions; dreams; noises; diviners; priests; 
the incarnation of a dead person; and even through manifestation of animals such a snake, butterfly 
and lion. Ancestors serve to unify families and other members of the community, to care for each 
other; empower; bless; reward and inspire and protect families against demons. Traditional health 
practitioners similarly strive to unite families with the divine and facilitate holistic healing. Any 
member of the community that's has been cursed by the ancestors is to admit to his troubles, upon 
which the elders intervene to bring about reconciliation with the ancestors (Richter 2003). 
2.6.3 THE RELATIONSHIP BETWEEN ANCESTORS AND AFRICAN CRISTIANITY 
It is believed that most African Christians also worship their ancestors, a practice that precedes the 
introduction of Christianity to the continent. While incense is burned to communicate with 
ancestors, Christians communicate with the Creator through prayer and immersion in the Holy 
Bible. Many academics, preachers and theologians characterised the ancestors and spirits as 
instruments of the devil, in previous times, considering it imperative to eradicate this belief in 
ancestors as soon as possible - despite the worship of ancestors also being a feature of monotheistic 
religions like Judaism, Islam and Christianity (Kale, 1995). 
There are thus many who are both devoted members of a church and continue to communicate with 
their ancestors, who they deem to be the living dead or resting and able to communicate with the 
living. Christians do not, however, consider the ancestors to be gods and such a claim would be a 
distortion of their culture, nor do they associate the ancestors with Christian saints, which would be 
a dangerous and confusing comparison (Kale, 1995). 
2.7 SUMMARY 
This chapter describes the relationship between nature and human beings, in which the literature 
explains nature as part of life and a living force in African philosophy. Any disruption in nature 
may lead to imbalances in the social, physical and mental well-being of society. African 
traditional medicine revolves around the relationship between the environment, ancestors and 
people. 
28 
The chapter also defines the clear distinctive types of traditional healer, according to the specific 
functions each performs, preventing any generalisation. The diviner, for example, diagnoses 
illness by throwing bones and the herbalist applies the extensive knowledge of supernatural 
techniques. Then there is also the traditional birth attendant essential to a village located great 
distances from Western medical facilities. The next chapter presents the methods of data 
collections of the study. 
2.8 A BRIEF PREVIEW OF THE FOLLOWING CHAPTER 
The following chapter details the methodological aspect of the research study. Areas of focus are 
the physical structure and the functions of the selected population. It also describes the type of 
research methods and data-collection tools employed as well as the rationale behind their use. 
29 
CHAPTER THREE 
RESEARCH APPROACH 
3.1 INTRODUCTION 
Chapter three outlines the research methods, data-collection tools, population, sampling 
technique and data-analysis technique. It also explains the rationale behind the methodology 
employed, instruments of collecting data, also the manner in which the study was conducted and 
the possible limitations of the study. 
3.2 METHODOLOGY 
Research methodology is the manner selected to obtain information for a study and describe the 
approach to the work. This methodology encompasses the approaches, processes and methods 
used to gather and examine material. Investigation of the study entails the assumptions, 
hypothesises, guidelines and approaches the researcher employs to render their work open to 
examination and and/or adaptation for selection of research methods. 
Secondary sources consist of journal articles and textbooks on traditional healing and medicine. 
Mouton (2002:30) refers to methodology of study as an analysis of those principles and 
procedures that describe how an investigation should be carried out. This research follows a 
qualitative approach that does not involve measuring variables in a quantifiable way, but 
represent data collected for its numerical value. Given that a qualitative comparison cannot be 
drawn from the data collected, the reseacher focuses on the situation to ensure the results remain 
objective (Gerbach, 2009). 
3.3 RESEARCH DESIGN 
The research design is understood to be a systematic process of research that entails intensive 
planning of events, prior to conducting the actual study. The objective of the research design of 
every study is to provide solutions to an existing problem. The qualitative research design is 
deemed to be the most suitable to accomplish this and thus the researcher has observed, 
discovered, compared and analysed the technique, methods of healing and facial expressions of 
traditional healers. 
30 
This qualitative research follows a design that seeks and describes new observations, where no 
prior information existed (Seaman & Baxter, 2008) and the investigation strategy guides the 
achievement of the objectives of the study. It also directs the researcher in the selection of 
relevant study material, respondents and the examination of material collected (Mouton & 
Babbie, 2001 ). 
Seaman and Baxter (2009) indicate that research design connects research questions with the 
implementation of the study, in other words how the research is structure and the methods of data 
collection used. It aids the researcher in collecting material relevant to the research (Lofman et 
al., 2010:137). 
This implies that the research design must guide the respondents in articulating the answers to the 
research questions and thus the survey strategy has to be appropriate to the study. Marczyk et al. 
(2005) further explains that survey design normally includes qualitative data, from unstructured 
questions, in qualitative interviews. This questioning technique allows the respondents to express 
their answers in their own words. The research design of this descriptive research has used 
qualitative interviews to investigate traditional healers/doctors in Mahikeng, North West 
Province, who are contributing to the search for a cure for HIV and AIDS. 
3.4 RESEARCH PARADIGM 
The study's qualitative research approach incorporates the core tenants of African-centred 
psychology. This approach was selected due its appropriateness for examining different facets of 
the phenomena explored, for triangulation as well as for adding breadth and depth to the 
examination of the issues. The objective of qualitative research is, furthermore, to gain an 
understanding of a particular phenomenon to create new ideas and patterns of behaviour (Hoy, 
2010). The purpose of the research is to render guidelines and recommendations for primary 
healthcare to the peripheral society. 
The objective of the research is furthermore to obtain a true experience of the social aspects of 
society and offer a solution, by rendering an account of the roles and responsibilities of traditional 
healers and medicine in the treatment of HIV and AIDS. The phenomenological methodology 
creates the opportunity for a holistic understanding of the diseases related to HIV and AIDS. This is 
then also the reason for the socio-cultural approach (defined as lives and stories narrated as 
meaning, coherent entities). 
31 
fudividual stories tend to be fairly succinct and narrate the exact events witnessed. Wimpenny and 
Gass (2000) assert that research that narrates the life history of elders tends to provide a clearer 
image of life experiences and thus the researcher selected the unstructured interview (i.e. the 
respondents is allowed to elaborate on the questions) to acquire the relevant information (Watkins 
& Shulman, 2008; Gerbich, 2009). 
3.4.1 QUALITATIVE RESEARCH 
Mouton & Babbie (2001) indicate that qualitative research is based more on narrative events than 
on numbers since it is not possible to count phenomena like opinions, views, thoughts and symbols. 
The goal is thus to form a holistic view of events to gain a deeper understanding of the cultural or 
social aspects of society. Data is acquired by means of interviews, observation and document 
analysis as well as narrative analysis that include case studies, focus groups and historical research. 
The research approach taken improves the validity of the findings and increases the capacity to 
cross-check one data set against another (Mouton & Babbbie, 2001). 
The researcher must avoid enforcing his/her expectations on emerging data, since the primary goal 
is to acquire the relevant information from the respondents in a natural setting without bias or 
preconceived assumptions. Qualitative research questions are usually framed as behaviours, factors 
accounting for behaviours, the meaning associated with behaviours and the context in which 
meanings, behaviour and other factors occur. Questions may also address changes over time. The 
choice of qualitative interviews thus enables the researcher to direct the respondents in answering 
probing questions. Qualitative interviews ensure that the researcher either comes to reject or accept 
the hypotheses set out in chapter one (Wiersma, 1995; Given, 2008:518). 
3.4.2 SAMPLING TECHNIQUE 
Sampling is a process of selecting a portion of the main population for study, Seaman and Baxter 
(2009) explain. The sampling process assists in the collection of specific information from the 
respondents, the chosen sample of the study. The sample population determines the method of data 
analysis of a study. ill this case the selected sample of the population might be traditional health 
practitioners who are registered and certified with the Traditional Health Council. This researcher 
elected convenience sampling, due to the limited number of traditional health practitioners in the 
particular community (i.e. Tsetse village) and their availability during the research (Maila & 
Loubser, 2003). 
32 
Convenience sampling is not only a user-friendly method, but also possesses certain other research 
advantages. It permits the investigator to acquire simple documents, without the difficulties 
inherent to a randomised sample. The sampling technique also facilitates recording a specific 
quality of a material or phenomenon occurring within an agreed sample (Seaman & Baxter, 2009). 
3.4.3 RESPONDENTS 
Lofman et al. (2004) explain that understanding social behaviour rests heavily on the participation 
of the study's respondents. Respondents are the subjects, participants and interviewees who aid the 
researcher to gather relevant data by means of questionnaires, tests and personal health records. 
The population is the complete number of people within a particular location selected for the study 
from which the researcher can draw a sample. Another way to define population is the entire 
collection of observations to which study results can be generalised (Makgoba, 1999). 
Ten to twelve respondents are sufficient for the study, particularly for understanding the views and 
perceptions of respondents. The proportion of the population selected depends on the actual number 
of respondents and the required sample size should be determined through a power analysis, which 
employs the alpha level and the size of the population (Hoy, 2010:23). 
The researcher obtained a letter of permission to conduct research from the Faculty of Human and 
Social Sciences/Indigenous Knowledge Systems Centre of Excellence at the North-West 
University. The researcher visited the tribal office of Tsetse village and requested permission from 
the chief to conduct research in the village. Assistance was also requested with allocating available 
traditional healers, well-known in the village, and was given a list of a mere ten traditional healers. 
The researcher was allocated an assistant to aid in the interviewing of the traditional healers. 
The units for the study comprise ten traditional healers (the key respondents of the study), because 
of the detailed insight they possess on the subject. Tsetse village has less than twenty (20) 
traditional healers of which only ten agreed to participate in the study. A sample size of ten is 
manageable and time efficient. 
3.4.4 . STUDY SITE 
Given (2008:518) defines the study site as the location/place chosen to conduct the study. It 
could be the homes of respondents, university library or community library in the relevant 
city/town. The research site of this study is Tsetse village, twenty kilometres from Mahikeng. 
33 
3.4.5 DATA-COLLECTION TECHNIQUE/RESEARCH METHODS 
The research methods are the ways in which the researcher collects data, whether by questioning, 
measuring or observation. The chosen method of data collection, the problem being studied and 
the research design are all related. Qualitative interviews provide a detailed account of the 
problem under study, protect the anonymity of respondents and enable the researcher to clarify 
any uncertainty with the interviewees (Marczyk et al., 2005). 
According to Conelly et al. (2009), a research interview can be either structured or unstructured. 
The structured interview allows respondents to elaborate in detail and the researcher to probe for 
further information from the respondents, providing an in-depth understanding of the topic. The 
unstructured method, followed in this study, entails an assortment of interviews. Structured 
interviews follow a precise set of questions, in which the respondents' answers are succinct, while 
the open-ended questions of the unstructured interview give respondents (i.e. traditional health 
practitioners) the opportunity to elaborate. 
3.4.6 QUALITATIVE RESEARCH INTERVIEWS- QUESTIONNAIRES 
Questionnaires were administered to the sample population for the purpose of collecting data on the 
research problem. A questionnaire constitutes a method of data capturing through written response 
to questions posed by the researcher. Human behaviour becomes accessible by means of indirect 
observation found in the questionnaire. The investigator elucidated the objectives of the study to the 
respondents and requested permission to conduct interviews. The researcher ensured that 
respondents felt at ease by establishing a rapport with the respondents, by means of a short 
conversation that created a bond with the interviewee and instilled a sense of freedom to share. The 
collaboration between respondents and interviewer is guaranteed if there is understanding between 
the two (Mouton, 2001). 
The researcher was present for each interview and took detailed process and observation notes, with 
the purpose to enhance the partnership with the respondents. Before the start of the interviews, 
permission was obtained from the traditional health practitioners to conduct the research and 
questions were asked in the local language Setswana. 
Respondents were also allowed time to pose questions. Interviews of approximately fifteen to 
twenty five minutes were held at the respondents' homes, ensuring a familiar and comfortable 
interviewing environment as well as a sense of safety to participate in the process. Particular 
34 
attention was paid to recording the respondents' facial expression, not only the information they 
communicated. The notes taken during the interviews aided the analysis of the results and to 
determine if their relevance to the study (Watkins & Shulman, 2008). The researcher did encounter 
challenges, like the refusal to disclose the types of medicines used to treat certain ailments. It did 
not, however, affect the quality of the data acquired and sufficient data were obtained for analysis. 
Given (2008:520) states that investigation in qualitative research relate to the respondents of the 
study. The researcher plays a vital role in the gathering of data, which involves the key aspects of 
introspection and reflection on possible bias. The objective of qualitative research methods for 
collecting data is based on social phenomena and the personal experiences of respondents. 
3.4.7 OPEN-ENDED QUESTIONS 
Siedman (2006:582) defines open-ended questioning as a set of questions posed to the respondents 
in which the researcher always probes for further elaboration. The type of questions posed indicates 
the respondents and researcher knowledge on the topic under discussion. The study presented open-
ended questions to traditional healers, with the purpose to gather information on the topic and they 
were allmved to elaborate in detail with greater flexibility. 
Since the study is based on the metaphysics of traditional healers and traditional medicine, open-
ended questions are hugely beneficial. It enables in-depth understanding of the topic, revealing 
much information on traditional healing and especially on the dynamics of African healing. It 
revealed the benefits of African healing over conventional medicine, in that traditional medicine is 
affordable and easily available; does not only focus on the individual, but also extends to the 
community; and aims to ascertain the main cause of illness to ensure that the traditional healer, with 
the assistance of the ancestors, provides an accurate diagnosis. 
Some of the disadvantages of the open-ended questioning is that is time consuming and the 
researcher might record information that is not relevant to the study. It also requires skill to analyse 
and record the data. The researcher found it difficult to pose questions to the respondents and record 
information at the same time. Most of them refused the use of a tape recorder, fearing that the 
researcher might pass the information on to other healers and the media (Given, 2008). 
35 
3.4.8 ETHICAL CONSIDERATIONS 
Ethical principles must always be taken into account during the interview. The research presented 
no risk to respondents relating to experimental treatment or exposure to physical or psychological 
harm. Ethical concerns are important in reference to planning, conducting and evaluating research. 
Care was taken to ensure that the respondents understand the objective of the research and that the 
study is completely voluntary. The researcher also explained that data collected from the study 
would be treated as completely confidential and would at no stage be transferred to any third 
person. 
3.4.9 DATA-ANALYSIS METHODS 
According to Mouton (2002:108), the choice of data-analysis methodology for a study is influenced 
by certain factors. Data analysis entails organising information into segments to form meaning and 
establish trends, for interpreting the data and relating the findings to existing theory to show 
whether they support or refute interpretation. 
The data in this study were collected by means of a research design posing unstructured questions. 
The researcher chose a combination of content and narrative analysis to understand the perceptions, 
roles and views of traditional healers. 
Conelly et al. (2009) argue that narrative analysis implies using raw data gathered during 
interviews, fieldwork and archival documents arranged in order to form meaning. People are 
collectively the centre of knowledge in their diverse experience of life, narrative study is thus the 
life experiences of society. The methodology is about investigating, collecting and understanding 
the life experiences of people under study. 
Gerbach (2009) defines content analysis as an orderly coding and classifying method that enables 
the inconspicuous discovery of great quantities of written information in order to determine the 
styles and forms of words used. The researcher furthermore applied the basic process of qualitative 
data analysis: observing, gathering and noting interesting facts. Jorgensen (1989), as contained in 
Seidel (2009), states that the aim of this process is to assemble or reconstruct the data in a 
meaningful or comprehensive fashion. 
36 
3.4.10 THEORISING 
The process of theorising involves the researcher taking the collected results and looking at them 
again through the lens or frames of one or several theoretical or conceptual positions, in order to 
make further sense of information and to lift the analytical discussion to a more abstract level. The 
method allows the researcher to call upon a huge variety of conceptual methods and theoretical 
ideas that exist across all available disciplines in order to provide a more abstract explanation of the 
findings. Once the data has been assembled into groupings, the researcher can begin recording. The 
first step is to see if it is possible to develop a more abstract explanation of the results gathered 
(Gerbach, 2009). 
3.5 SUMMARY 
Chapter three lays down the structure of the research for collecting and methods employed to 
analyse data. The selected method of convenience sampling was the result of the availability of 
respondents during the research and data was collected by means of interviews and questionnaires. 
The chapter also highlights the questions administered to respondents that include: treatment 
methods, diseases treated, type of referral system, relationship with Department of Health and 
process of curing diseases. The next chapter presents the empirical research conducted as well as 
the interpretation of the findings. 
3.6 A BRIEF PREVIEW OF THE FOLLOWING CHAPTER 
The next chapter deals with data analysis. The gathered data serves to substantiate or refute the 
hypothesis, confirmed by relevant literature. The appropriate narrative analysis and tests are also 
explored to calculate the findings and help make sense of the data. 
37 
CHAPTER FOUR 
SOCIO-ECONOMIC AND DEMOGRAPHIC OF THE RESPONDENTS 
4.1 INTRODUCTION 
This section of the mini-dissertation deals with arranging raw data into patterns and trends to 
make meaning of the data. The qualitative interview was the primary data-collection tool, 
administered to a representative sample of ten. The findings of the research presented in this 
chapter reflect the life experiences of traditional health practitioners. 
The information obtained from the respondents was the cross-referenced with the literature on the 
topic to confirm important features that would enable identifying solutions toward advancing 
fruitful execution. The innovative investigation enquiries offered in the study are reviewed and 
the appropriate results presented, with the determination of classifying styles. 
4.2 THE SOCIO-ECONOMIC AND DEMOGRAPHIC CHARACTERISTICS OF 
RESPONDENTS 
No Age Gender Religion Level of Type of healer Methods of healing 
experience 
1. 70 Female N/A Satisfactory Diviner/herbalist Specialises in herbs, with 
ancestral guidance 
2. 65 Female N/A Satisfactory, Diviner/herbalist Specialises in herbs, with 
with certificate ancestral guidance 
3. 55 Male Apostle Zion Fair Faith Holy water and prayer 
healer/prophet 
4. 48 Female N/A Satisfactory Diviner Mutilherbs 
5. 76 Female N/A Satisfactory Diviner/herbalist Specialises in herbs, with 
ancestral guidance 
6. 33 Male N/A Satisfactory, Diviner/herbalist Traditional bones/ditaola 
with certificate 
7. 58 Female N/A Fair Herbalists/ diviner Specialises in herbs, with 
ancestral guidance 
8. 45 Female Church member Satisfactory, Herbalists/ diviner Holy water, prayer, 
with certificate traditional bones 
9. 55 Female Anglican Church Satisfactory, Herbalists/ diviner Traditional boneslditaola 
with certificate 
10. 33 Male Anglican Church Satisfactory, Herbalists/ diviner Traditional bones/ditaola 
with certificate 
38 
4.3 QUESTIONNAIRES AND RESULTS OF RESPONDENTS -ANNEXURE A 
The researcher interviewed ten traditional health practitioners who are well recognised in the 
community (Tsetse village) and are registered with the Board of Traditional Healers, with the 
intent to ascertain their views on the treatment of HIV and AIDS and whether they would be 
amenable to have it integrated into the healthcare system. A secondary aim was to identify some 
of the traditional medicine used to treat HIV and AIDS. The following set of questions was posed 
to the traditional health practitioners: 
In which area of traditional medicine do you specialise? 
The majority of the respondents indicated that they specialise in a combination of spiritual and 
traditional healing. All employ ancestral guidance to heal patients, together with prescribing a range 
of self-made herbal remedies. 
What are your views on traditional health practitioners working in government hospitals and 
clinics? 
Five traditional health practitioners stated that they would gladly offer their services in government 
hospitals, while the remaining five respondents would not support such an initiative. They prefer to 
work independently and fear that the presence of ancestral sprits would not be as clear or effective 
in a medical facility. 
Regardless of their personal preference, these healers would first have to consult with the ancestors 
before taking such a step. Traditional medicine is unique and could not co-exist with Western 
medicine, given the difference in belief and approach between the traditional and scientific. The 
traditional health practitioner, for example, bums imphepho to request the assistance of the 
ancestors. 
How do you distinguish between spiritual healers and traditional healers? How does their 
method of treatment differ? 
The majority of respondents related that spiritual healers use holy water and prayer to treat disease 
and traditional healers throw bones/diataola to identify the cause of ailments. Some conditions may 
require a combination of herbal and spiritual healing (holistic treatment). The different types of 
traditional health practitioners are outlined in the literature review. 
39 
Do Western physicians or facilities ever refer patients to you? 
None of the respondents have ever received patients from clinics or hospitals. Traditional health 
practitioners do however refer patients to hospitals/clinics when the illness necessitates Western 
medicine or when blood samples need to be drawn, due to a lack of resources. 
Have you, as traditional healer, ever treated the opportunistic infections of HIV and AIDS? 
Half of the respondents have diagnosed such infections by means of consultation with the 
ancestors, through throwing of bones, and offered treated with traditional medicine. The ancestors 
may at times require the patient to performing cleansing ritual to ward off misfortune. Five of the 
respondents indicated that they normally refer patients to Western medical facilities for treatment. 
One respondent explained that he is able to treat mental illness and supernatural diseases because of 
his knowledge of which traditional medicine ingredients to gather from the mountain and the 
assistance of the ancestors. Another traditional health practitioner is able to cure high blood 
pressure, lymphadenopathy and tuberculosis. It is however important that patients seek treatment 
early. A fourth respondent has cured infertility and womb conditions. 
The remaining respondent is an expert on marriage, fertility, relationships, reversal of luck and 
witchcraft. He also combats the tokoloshe and, like the above respondent, treats early-stage HIV 
and AIDS and tuberculosis. All the ingredients for his treatment are gathered from the mountain, a 
very expensive enterprise. 
How long does it take traditional medicine to cure the opportunistic diseases related to HIV 
and AIDS? 
The majority of the traditional health practitioners indicated the necessity of early treatment in the 
curing of such opportunistic diseases. One traditional healer indicated that within three weeks of 
giving a patient muti the patient showed improvement and increased strength. The treatment is 
however holistic- i.e. the body, soul and spirit- and not only focussed on the particular condition. 
Do you work with hospitals and clinics? 
None of the respondents have ever collaborated with any medical facilities, but have recommended 
extremely weak patients to seek Western medical treatment. 
40 
What kind of treatment do you provide to patients who show symptoms of HIV and AIDS? 
All the respondents refused to divulge the kind of treatment they provide to patients. One traditional 
healer explained that they are not supposed to divulge certain information to the public, due to a 
number of factors. Traditional medicine philosophy is never to be revealed to the public and certain 
information was kept from the researcher, to ensure that communication with the ancestors remains 
a sacred. 
4.4 SUMMARY 
This chapter presents the socio-economic information and demographics of the respondents as well 
as the interpretation of the findings. It focuses on the ten traditional health practitioners, duly 
recognised in their community (Tsetse village). Most of the respondents indicated that they would 
welcome being integrated into the healthcare system, particularly in clinics and hospitals. 
41 
5.1 OVERVIEW 
CHAPTER FIVE 
TRENDS AND RESULTS 
Chapter five presents the results and outcomes of the study as well as the general views of 
sangomas on the treatment of the opportunistic diseases of HIV and AIDS and the integration 
of traditional medicine into primary healthcare. Most of the respondents of the study asserted 
that they are able to cure a variety of ailments ranging from diarrhoea, lethopa, shingles, 
lebanta and sexually transmitted infections (STis). 
5.2 TRENDS 
5.2.1 Question 1: Why do you think you are side-lined in the treatment of opportunistic 
infections arising from HIV and AIDS? 
The majority of the respondents would like to be integrated into the national healthcare sector. 
The research also shows the following: 
• There is no collaboration between clinics and hospitals. 
• Patients are encouraged to continue taking antiretroviral medication, while undergoing 
traditional treatment. 
• Traditional healers are unable to assist patients who seek treatment too late. 
• Traditional healers offer medicinal mixtures to cure illness. 
• The following diseases are treated: diarrhoea, lethopa, shingles, lebanta and sexually 
transmitted infections. 
The majority of the respondents under study indicated that: 
• the government and research institutions, like the Council for fudustrial Research, 
should test traditional medication in laboratories; 
• there must be sharing of skills between traditional health practitioners and Western 
physicians, particularly for treating disease; 
consultation fees must be regulated, i.e. standardisation of rates; and 
• the sites of traditional herbs should be protected. 
42 
5.2.2 Question 2: Would you like to be integrated into government medical facilities? 
All of the respondents are somewhat reluctant to have their services integrated into government 
facilities. Traditional medicine, communicating with ancestors and bone throwing must never 
be made public. They would only consider such a move if they were provided with an isolated 
and safe environment within these medical facilities. 
5.2.3 Question 4: Do you treat all diseases arising from HIV and AIDS? 
The respondents explained that they are able to treat a variety of ailments, by means of a range 
of remedies, which include: diarrhoea, shingles, lebanta and sexually transmitted infections, 
HIV and tuberculosis. 
5.2.4 Question 5: Have you ever treated patients suffering from the opportunistic diseases 
related to HIV and AIDS (referred by a clinic or hospital)? 
The respondents indicated that hospitals/clinics have not to date referred patients to them and it 
is rather they who refer patients to these facilities for treatment. 
5.2.5 Question 6: Do you collaborate with clinics and hospitals for treating of 
opportunistic diseases? 
One of the respondents summed up the general finding in this regard as follows: "We work 
separately, clinics prohibit HIV positive people to use traditional medicine. Hospitals and 
Clinics undermine our traditional medicine. Clinics prohibit patients from coming to us 
(THPs)." 
5.2.6 Question 7: How long does it take for a person being treated with traditional 
medicine to be cured from the opportunistic diseases of HIV and AIDS? 
A respondent explained that if the patient takes the traditional medicine properly, it usually 
takes a week to see some improvement. God also plays a major role and early treatment is 
crucial for healing and the immune system. 
5.2.7 Question 8: What kind of treatment do you provide to patients who show 
symptoms of HIV and AIDS? 
Most of the respondents were unwilling to answer this question, citing concern over misuse of 
information if divulged. 
43 
5.3 SUMMARY 
Chapter five relates how traditional healers would only practice in medical facilities if they 
could do so in a confined environment, to facilitate contact with ancestral spirits. Traditional 
Health Practitioners furthermore expressed the wish to have traditional medicine be tested and 
regulation of consultation fees. The following chapter presents the recommendation of the 
study. 
44 
CHAPTER SIX 
DISCUSSIONS AND RECOMMENDATIONS 
6.1 OVERVIEW 
Chapter six details the outcomes derived from the data obtained from the respondents, the 
conclusions drawn and the resultant recommendations for the integration of traditional 
medicine into the primary healthcare system. Here the mini-dissertation renders new insights 
concerning the problems faced by traditional healers in the North West Province. It also 
examines models that policymakers might use in the drafting of national health policy, in 
reference to the input of a number of scholars. The chapter concludes with a review of the input 
and suggestions for the future of traditional medicine. 
Traditional medicine is progressively losing ground around the world. Research to determine 
the quality and efficacy of traditional medicine remains a challenge and fraudulent practices 
are escalating at an alarming rate. This decline can be ascribed to the lack of support 
provided to traditional health practitioners. Legislation, like the Traditional Health 
Practitioners Act (22 of 2007), is not enforced and the results of research on traditional 
medicine are not always communicated to traditional health practitioners and remains 
unpublished. The World Health Organisation (2001) has placed great emphasis on traditional 
medicines and urged further research in support of quality medicine. Although the 
Traditional Health Practitioners Act (22 of 2007) stipulates stringent measures on research 
into traditional medicine to ensure safety and quality, it remains a challenge especially 
among the developing countries. 
6.2 RECOMMENDATIONS 
6.2.1 RECOMMENDATION 1: 
Would you like to be integrated into government medical facilities? Do you think 
traditional medicines should be regulated by the Board of Traditional Healers? 
Richter (2003) states that despite the use of traditional medicine in developing countries HN 
and AIDS remains a challenge. Many HN -positive patients take both traditional and Western 
medicine, reflecting the conflict between these two systems. It would thus be necessary for the 
government to support and educate traditional health practitioners in the formal healthcare 
45 
system and also enlist their aid in expanding the research on traditional medicine. This research 
will enable the production of tested and quality traditional medicine for the treatment of HIV 
and AIDS. 
Ensuring the protection, effectiveness and excellence of traditional medicine would imply 
registering traditional health practitioners with the Board of Traditional Healers and instituting 
measures to monitor practice. A range of traditional herbs needs to be introduced and rigorous 
investigation/research on traditional medicine is vital, which would bolster further research that 
would in tum produce quality medication that could be recommended in public healthcare 
facilities. This would require structuring the traditional medicine profession within the primary 
healthcare policy. 
6.2.2 RECOMMENDATION 2: 
Question 2: Why do you think you are side-lined in the treatment of the opportunistic 
infections related to HIV and AIDS? 
The community trusts traditional healers and consults them before seeking Western medicine. 
fudigenous healing forms part of their ethnic principles and traditional health practitioners are 
often suggested by families and friends. Traditional health practitioners are furthermore a great 
deal more accessible and affordable to rural communities, making government regulation of 
traditional medicine essential. The Western health care system has oppressed and dismissed 
traditional healing and medicine as outdated, ineffective in the treatment of disease, and 
existing legislation, as contained in the Traditional Health Practitioners Bill (2003), is not 
adequate or effective. Hospitals and other facilities could collaborate with traditional health 
practitioners in the treatment of the opportunistic diseases of HIV and AIDS, in which 
traditional health practitioners are allowed to establish traditional pharmacies and receive the 
authority to prescribe sick leave. De Conning (2007) asserts that a scheme to control, record 
and issue licences to traditional health practitioners and training is vital. 
6.2.3 RECOMMENDATION 3: 
Question 3: Do you treat all diseases arising from HIV and AIDS? 
The respondents indicated that they have the ability to treat a variety of ailments such as 
diarrhoea, shingles, lebanta and sexually transmitted infections, HIV and tuberculosis. The 
46 
study, therefore, recommends that a cooperative relationship among Western and traditional 
medicine must be developed at all levels. 
Practitioners can however not be permitted to draw blood or treat cancers, diabetes and HIV 
and AIDS because of the lack of resources. 
6.2.4 RECOMMENDATION 4: 
Have you ever received patients who suffered from opportunistic diseases due to HIV and 
AIDS (who came from a clinic or hospital)? 
Traditional healers and their medicine have been suppressed for a long time by colonialists and 
are even now not recognised for their knowledge and skills in curing a variety of ailments. 
One example of this is the prohibition against traditional medicine, citing it as untested and 
potentially dangerous, for patients taking antiretroviral drugs. 
Traditional healers work independently and although they have referred patients to 
clinics/hospitals, these medical facilities have never suggested traditional medicine to their 
patients. 
The literature on traditional medicine reveals a variety of specialities such as the use of holy 
water and mirrors; ditaola; and the traditional muti. Unfortunately, patients often only seek 
treatment once it is too late and certain ailments, like high blood and diabetes, require intensive 
care. 
6.2.5 RECOMMENDATION 5: 
How long does it take for traditional medicine to cure opportunistic diseases related to 
HIV and AIDS? 
The respondents claimed the ability to cure symptoms associated with HIV and AIDS, should 
the disease still be in its early stages and one respondent recounted a case in which the patient 
was healed of all symptoms of HIV and AIDS. The overall findings indicate a significant 
improvement in these patients after consultation with a traditional healer. Traditional healers 
make a real contribution in the treatment of disease, but receive little recognition from the 
government. The Southern Africa Development Community introduced an action plan, entitled 
Decade for African Traditional Medicine (2001-2010), in June 2006. Its objective was for all 
47 
member states to formalise traditional medicine as part of their public healthcare system by 
2010. Yet traditional medicine continues to be marginalised in South Africa. 
All the respondents were adamant that the Department of Health should take action against 
"charlatans" misleading the public, by claiming to cure more than a thousand diseases. 
Traditional health practitioners are not supposed to advertise their specific services and easily 
be located through enquiries in the community. 
The study recommends the following: 
• Traditional health practitioners must be thoroughly trained in procedures such as 
drawing blood from patients, the rapid use of razors and the treatment of conditions 
related to HIV and AIDS. 
• The government should provide continuous training on midwifery. 
• Traditional healers must be certified to practice in hospitals/clinics to enable them to 
collaborate with Western doctors in the diagnosis of disease and treatment of 
opportunistic infections. 
• Drastic measures must be taken against fraudulent doctors who perform street abortions 
and falsely claim to cure innumerable diseases. 
The objective of traditional healing is to diagnose, prevent, promote and rehabilitate physical, 
mental and emotional illness as well as address issues within the family and the society. 
6.3 SUMMARY 
Having studied the relevant documents, extracted the purposes of the investigation, provided 
recommendations and a projected structure it remains reasonable to both lawfully and 
practically acknowledge and promote traditional medicine in South Africa. Regardless of all 
the impact and adversities brought about by Apartheid, South Africa has demonstrated that it is 
capable of the reform and progress that will unlock the gates to an accomplished, successful 
and progressive nation. 
48 
CONCLUSION 
This study is an inquiry for the role of traditional healers in the treatment of HIV and AIDS 
in Mahikeng, North West Province (Tsetse Village) as research site. The research uncovered 
the facts on the discipline of traditional medicine and assessed its efficacy. Although the 
findings are based on a somewhat small sample of traditional health specialists, it is expected 
that the results could create insight into the field of traditional healing. Investigations on 
Traditional Medicine need to be understood from the perspective of the nature and scope of 
the schoolwork, which assert that the research will serve to enlighten traditional healers and 
add value to policy. 
The purpose of the study is to determine how traditional medicine can be incorporated into 
the national healthcare system and contribute to a possible strategy. In order to do so greater 
understanding of traditional medicine, which is quietly practiced to variable degrees 
throughout South Africa, was sought. Traditional healing remains the dominant form of 
healthcare in rural areas. It needs to be analytically investigated to protect its practitioners 
and recipients against negligence as well as institute safety measures and regulation to 
protect its benefits, while still retaining the scope for its survival and growth. 
It was found that rural communities are increasingly accessing national healthcare services 
(i.e. Western medicine), but continue to consult traditional practitioners due to the cost and 
arduousness of travelling to medical institutions. Much of traditional medicine, both in rural 
and urban areas, is for benevolent purposes and not healthcare - for example, the 
administering of a cleansing ritual (in consultation with the ancestors) to counteract 
misfortune. 
The study thereby concludes that African traditional medicine is an important part of the 
South African healthcare structure. South Africa has an abundance of plant life that is used 
every day both as nourishment and in traditional medicine. It is an intrinsic part of the 
services offered by traditional healers who are regularly consulted throughout African for the 
relief of symptoms or prevention of illness. 
49 
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55 
Research Interviews - Questionnaire 
I am Tsietsi Sebata, currently doing Masters Degree studies in Indigenous Knowledge 
Systems (IKS) at the North West University (Mahikeng Campus). 
The research is about traditional medicines/traditional health practitioners towards the 
treatment of HIV/AIDS in the North West Province, with a specific focus on the Ngaka 
Modiri Molema District Municipality in Tsetse Village. 
I would therefore, ask for your assistance to answer the following questions to the best of 
your ability. You are therefore, asked not to mention your name and you are also assured that 
all data and information supplied will be treated with outmost confidentiality and but will 
only be used solely for research/study purposes. 
1. What type of traditional healer are you? 
0 ngaka ya mofuta mang? 
2. Would you like to be integrated into government hospitals? 
A o ka itumelela go dira ko dipetlele tsa puso 
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3. Why do you think you are sidelined in treatment of opportunistic infections which 
arises from HIV/AIDS?Seabe salona le le dingaka ke sefeng go thusa mo go lwantsheng 
kokwana tlhoko ya AIDS? 
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56 
4. Do you treat all diseases arising from HIV/AIDS? 
A kgona go alafa malwetsi a kokwana-tlhoko ya phamokate? 
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5. Have you ever received patients who suffered from opportunistic diseases due to 
HIV/AIDS (who have been send from a clinic or hospital)? 
A o tlile wa alafa balwetsi baba tshwatsegileng ke mogare wa AIDS go tswa ko sepetle? 
...................................................................................................................................................... 
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57 
6. Do you work with clinics and hospitals, in terms of treating opportunistic diseases? 
A le le dingaka le dirisana le dipetle mo thusa batho ba ba tshwaetsitsweng ke kokwana 
tlhoko ya AIDS? 
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7. How long does it take for a person if a person uses traditional medicine to be cured 
from opportunistic diseases of HIV I AIDS? 
Molwetsi yo o dirisang melemo ya setso go mo tsaya sebaka sese kae gore a fole? 
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58 
1 . 
8. What ldnd of treatment do you provide to a person who is suffering from 
opportunistic infections? 
0 dirisa melemo e feng ya setso go alafa molwetsi yo o nang le kokwana tlhoko ya 
AIDS? 
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9. What is the difference between spiritual healers and traditional healers? Do they have 
different treatments? 
Pharologanyo magareng ga Mosebeletsi le Ngaka Ya Setso? 
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10. How do you distinguish between spiritual healers and traditional healers? How does 
their method of treatment differ? 
A o kgona go farologanya Mosebeletsi le Ngaka ya Setso 
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59 
To: Whom it May Concern 
24 January 2013 
Dear Sir I Madam 
1 
NORTH-WEST UNIVERSITY 
YUNIBESITI YA BOKONE-BOPHIRIMA 
NOORDWES-UNIYERSITEIT 
MAFIKENG CAMPUS 
Private Bag X2046, Mmabatho 
South Africa 2735 
INDIGENOUS KNOWLEDGE 
SYSTEMS PROGRAMME 
Tel: 018 389 2157 
Fax: 0866975797 
e-mail: 
motheo.koitsiwe@nwu.ac.za 
SUBJECT: PERMISSION TO CONDUCT RESEARCH 
This serves to inform you that the l:ltudent: Sebata, T. P (Student # 17006929) is a registered 
student for the Master Degree in Indigenous Knowledge Sy_§tems, F[tc_!tlty of Hum_an and Social 
Sciences, North West University. Mr Sebata is conducting research on the following topic: An 
Assessment of Traditional Medicine Towards Treatment of HIV/AIDS in Tsetse Village, North 
West province. This study aims to investigate the prevalence, facilitators, predictors, and types of 
Traditional Medicine used among persons living with HIV/AIDS on antiretroviral treatment. 
Furthermore, this study will also investigate the role of Traditional Healers in finding the cure for 
HIV/AIDS. Moreover, the study will also investigate the relationship between Department of 
Health and Traditional Healers in North West Province, particularly in Mahikeng district, to 
assess if that relationship might lead to reduction of HIV I AIDS in our province. 
It is against this backdrop that were hereby request your permission to allow Mr Sebata to 
conduct research as indicated above and this is not for profit making but for academic and 
educational purposes. Your cooperation and assistance will be highly appreciated. 
~ 
Motheo Koitsiwe 
.·.-' -. ~ . 
Head: Indigenous Knowledge Systems Programme 
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