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South African traditional healers generally fulfill different social, cultural and political roles in South Africa. 2014 saw the passing of the Traditional Health Practitioners Act with the intent of standardizing and regulating the affairs of all Traditional healers. The proposed regulations would require a registration by traditional healers before they will be allowed to practice. Done properly, this move by the government is set to be an excellent one, safe guarding both lives and property and giving structure to even the traditional healers who may sometimes be viewed almost illegitimately. Traditional healers have many different social and political roles in the community: divination, healing physical, emotional and spiritual illnesses, directing rituals such as birth or death rituals, finding lost cattle, protecting warriors, counteracting witches, and narrating the history, cosmology, and myths of their tradition.
Traditional healers will often give their patients Muti, medications of plant, animal and sand origin imbued with spiritual significance, often with powerful symbolism - e.g.
In modern times however, due to a number of factors such as urbanisation, colonialism, apartheid, cross-cultural mixing etc.[8] the distinction has become increasingly blurred and traditional healers tend to practice both arts. A sangoma is a practitioner of ngoma, a form of traditional African medicine in Zulu culture. The goal in healing is to establish a balanced and harmless relationship between the afflicted patient and the spirits that are causing their illness or problem. Accessing the ancestors' advice through the bones is an alternative to the exhausting possession states.
Mutis are prepared, and depending on the afflicition a number of purification practices can be administered. Vomiting (Phalaza)- A large volume (up to 2 litres) of a weak, lukewarm herbal infusion is drunk and a process of self-induced vomiting occurs to cleanse and tone the system. Steaming (Futha) - Medicinal herbs are commonly inhaled by steaming them in a bucket of boiling water. Cuttings (umgaba) - Extracts or powders are directly applied to small cuts, made with a razor blade, in the patients skin.
An experienced inyanga will generally seek the guidance of an ancestral spirit before embarking to find and collect muti.
Initiate (Thwasa) being led towards the goat that will be sacrificed at her initiation into becoming a Sangoma.
A trainee sangoma (or ithwasa) trains formally under another sangoma, for a period of anywhere between 3 months and many years of learning humility to the ancestors, purification through steaming, washing in the blood of sacrificed animals, and the use of Muti, medicines with spiritual significance.
During this training period the ithwasa will share their ailments in the form of song and dance, a process that is nurtured by the analysis of dreams, anxieties, and with prayer. At the end of thwasa and during initiation, a goat is sacrificed to call to the ancestors and appease them.
Sangomas are legally recognized in South Africa as traditional health practitioners, under the Traditional Health Practitioners Act of 2007 (Act.
Ngoma is believed to have come to southern Africa during the Western Bantu migration that began around 2000 BCE and was further influenced by the eastern Bantu migration that occurred until 500 CE.[27] The practice has evolved along with the social problems of its users.
While there are recorded instances of white sangomas before 1994, since 1994 an increasing number of white people have openly trained as sangomas in South Africa.[32] The question of authenticity is still often an ongoing discussion.
The formal health sector has shown continued interest in the role of sangomas and the efficacy of their herbal remedies. A bill to regulate South Africa's 200,000 traditional healers has been adopted by parliament.Healers will have to be licensed before being allowed to work. This has led to a spate of child-rapes in South Africa, some of babies just a few months old.
Our South Africa project teaches HIV prevention to traditional health practitioners, who are often the first source of information and treatment for older people and their families.
Traditional health practitioners (also known as traditional healers) are an important source of health information for older people all over Africa. This is because they are often excluded from training sessions on HIV, putting themselves and their clients at risk. With our affiliate Muthande Society for the Aged (MUSA), we are working in Kwa-Zulu Natal province, where there are more than 1,000 traditional health practitioners. These health practitioners attend workshops where they learn how HIV is spread, how to prevent transmission between health practitioner and client, how to provide emotional support and when to refer clients to other health facilities.
To improve the availability of HIV and AIDS information and care services to older people in six communities in Kwa-Zulu Natal.
To develop a "code of conduct" with traditional health practitioners which they voluntarily adopt. John Mabasa is a 57-year-old traditional healer who receives regular training in HIV prevention.
What we're doing to alleviate the impact of HIV and AIDS in Ethiopia, Kenya, Uganda and Tanzania. They handle a range of duties from like divination, physical healing, directing birth and death rituals, finding missing cattle, protecting warriors and lots more. This would entail traditional healers providing R200 to apply to the council for a practicing certificate. For example the crab, could be invoked as a mediator between the human world and the world of spirits. This is generally performed through divination (Throwing the bones or Ancestral channeling) and a number of purification rituals.
A patient will come to the sangoma and the sangoma must determine what the affliction or reason why the patient has come to see the sangoma. Because the healing is not only physical but also social most problems a person could have could be determined to be twasa, spirit cause, and treated by a Sangoma.
They may be employed in healing either the body or spiritual conditions, as warranted in the opinion of the herbal specialist or inyanga.

Some are taken to induce sneezing which may traditionally be believed to aid the expulsion of disease. The enema is a preferred route of administration of certain plant extracts, as it is believed they are more effective when administered this way. The healer, through dreams, or during prayers, will be advised of an auspicious time for collecting the plants, and in some cases will be advised which particular plants to collect for a particular patient, and where these plants may be found.
A Sangoma is called to heal by an initiation illness, often psychosis, headache, intractable stomach pain, shoulder or neck complaints or illness that cannot be cured by conventional methods.[20] To become a Sangoma, these problems together must be seen by a Sangoma as twasa or the calling of the spirits. The story develops into a song which becomes a large part of the graduation type ceremony that marks the end of the ithwasa's training.[14] At times in the training, and for the graduation, a ritual sacrifice of an animal is performed (usually chickens and a goat or a cow). The local community, friends and family are all invited to the initiation in order to witness and celebrate the completion of training.
22 of 2007) as diviners alongside with herbalists, traditional birth attendants, and traditional surgeons.
Western-style scientists continue to study the ingredients of traditional medicines in use by sangomas. Charlatans who haven't undergone Thwasa charge exorbitant prices for fraudulent service, and not all countries in southern Africa have effective regulatory bodies to prevent this practice. Janzen "Self Presentation and Common Cultural Structures in Ngoma Rituals of Southern Africa" (1995) 154-157. Collaboration with traditional healers in Aids prevention and care in Sub-Saharan Africa: a literature review. South Africa has one of the highest numbers of HIV-positive people in the world - some 5.3m, or one in nine of the population. As a traditional healer, and a certified pastor, I see many patients who are scared to go to the clinics as they fear the public stigma. Since we move with the times, protecting myself, my family and my patients at a time where HIV knows no boundaries, it is important to inform my patients, guide them, as well as use preventative measures when treating them. I have learnt I must wash my hands before I attend to my patient, that I must always put gloves.
The healers have until recently operated quite independently from the government although some work under governing structures like the Traditional Healers Organization with over 29,000 members, a number which goes to show the sheer bulk of traditional healers in South Africa. After that, the government invited public reactions, with the act and proposed regulations receiving some heavy criticism by traditional healers who have deemed it in simple terminology, difficult to follow.
The certificate by the way will only be issued if the registrar who is appointed by the health minister after consulting with the council, determines that the said traditional healer has met the requirements. They have specific coloured cloths to wear to please each ancestor, and sometimes wear the gallbladder of the goat sacrificed at their graduation ceremony in their hair.
There are medicines for everything from physical and mental illness, social disharmony and spiritual difficulties to potions for protection, love and luck. They perform a holistic and symbolic form of healing, embedded in the beliefs of their culture that ancestors in the afterlife guide and protect the living. It can be very dramatic, with the Sangoma speaking in tongues, or foreign languages according to the specific ancestor, or dancing fervently beyond her normal ability. The crab is given this power because of its ability to move between the world of the land and the sea.[14] Helping and harming spirits are seen as using the human as a battle ground for their own conflicts.
In the Cape, Black patients tend to complain of vague pains, anxieties, and harm to their reputation presumed to be the result of sorcery. Muti is a term derived from a Zulu word for "tree," and African Traditional medicine makes extensive use of botanical products, but the medicine prescribed by an inyanga may also include other formulations, such as those which are zoological or mineral in composition. The spilling and drinking of this blood is meant to seal the bond between the ancestors and the sangoma. The ithwasa is also tested by the local elder sangomas to determine whether they have the skills & insight necessary to heal. The act calls for the establishment of a national council of traditional health practitioners to regulate and register a.o.
Over time the system adapted to include the introduction of guns, and later the racial and class struggles of practitioners under colonial rule.[27] In Zimbabwe, the civil war experience lead to a revival of ngoma practice with a new emphasis on the spirits of the victims of war. Some Sangomas have been known to abuse the charismatic power they have over their patients by sexually assaulting them, sometimes dressed up as ritual. I have also learned to sterilize my equipment and label my muthi bottles properly, to have separate coloured labels for drinking medicine and chatha (non drinking) medicine. Sangomas are called to heal, and through them ancestors from the spirit world can give instruction and advice to heal illness, social disharmony and spiritual difficulties.
By using ngoma, the sangoma can create harmony between the spirits which results in the alleviation of the patient's suffering. The patient or diviner throws bones on the floor, which may include animal vertebrae, dominoes, dice, coins, shells and stones, each with a specific significance to human life.
Others have illnesses that come from breaking social taboos, such as sleeping with a married woman, and they wish to remove the stigma. In South African English and Afrikaans the word muti is sometimes used as a slang term for medicine in general.
The climactic initiation test is to ensure the ithwasa has the ability to 'see' things hidden from view. The sangoma will fall into trance where the ancestors will be channeled (which is signified in Zulu traditions by episodes of convulsive fits) followed by the singing of ancestral songs.
The term sangoma is often used colloquially in South Africa for equivalent professions in other Bantu cultures in Southern Africa.[6] Forms of the ngoma ritual are practiced throughout southern and south-eastern Africa in countries such as South Africa, Swaziland, Zimbabwe, Mozambique, Lesotho, Kenya, and Batswana. In the past decade, the role of all types of traditional healers have become important in the fighting the impact of the virus and treating people infected with the virus before they advance to a point where they require (or can obtain) anti-retroviral drugs. Repeated use of the same razor blade to make incisions for Muti carries HIV transmission risks in regions where the disease is rife.

For example a hyena bone signifies a thief and will provide information about stolen objects. Young people also consult the Sangoma to learn ways to gain good fortune for their future careers and families.
These songs are echoed back to the ancestor via the audience in a process of call and response. National coordinator Phephsile Maseko said healers can play a positive role to play in the fight against Aids. The Sangoma or the patient throws the bones but the ancestors control how they lie, and the Sangoma then interprets this metaphor in relation to the patient's afflictions, what the patients ancestors require and how to resolve the disharmony.
The possessed sangoma will then change into their traditional ancestral clothing and dance vigorously while others drum and sing in celebration. It will create a framework for cooperation between mainstream health practice and traditional healing," she said. The South African Medical Association says the legislation will ensure safety standards, reports AFP news agency.
But Doctors for Life International, which represents some 600 medical practitioners says healers should not be given official recognition, as there was no proof that their remedies were effective. Before it becomes law it needs to be passed by the second chamber of parliament and the president. While you will be able to view the content of this page in your current browser, you will not be able to get the full visual experience.
Human sacrificeMany healers use herbs and some of these have been proven to be effective and have been used as the basis of medicines marketed by western pharmaceutical companies. Please consider upgrading your browser software or enabling style sheets (CSS) if you are able to do so. But some witchdoctors have been known to recommend the use of human body parts to make magic charms to bring luck or success. And some are blamed for helping spread Aids by advising patients that it can be cured by having sex with a virgin.
John, Nairobi, KenyaI wonder if this new legislation will go so far as to protect the knowledge of traditional healers. So often it happens that new medicines are discovered directly as a result of traditional healers knowledge. Needless to say the traditional healers seldom receive any of these profits, nor do they even receive acknowledgment of their enormous contribution.Andrew, Devon, EnglandAs a South African pharmacist I have witnessed first hand the damage that these people do, especially in the rural areas. Regulation is never going put an end to centuries of a practice based in superstition, urban legend and hearsay. Threats of fines and prison sentences will only drive it further underground adversely affecting even more lives every year.
Craig H, London, UKDefinitely recognise sangomas, they've been on our earth for longer than any 'western' pharmaceuticalsAdz, Rome, ItalyThe healers should most definitely be recognised and should have some sort of regulation in place. The healers are part of African culture and should therefore have the right to play a part in the new South Africa. However the healers should not be able to issue 'sick leave' or if so for a maximum of two days, if the illness requires further sick leave he should be advised to see a GP.
This may seem a contradiction in terms but I think both the healers and the medical practitioners need to come to some compromise and putting a limit on the sick leave is one way.
Also with having a register with all licensed healers the health services can easily contact the healers and send them information on Aids and other serious illnesses and so better educating them. Strict regulations are required to limit the number of these individuals to the bare minimum.Ali, Port Elizabeth, South AfricaThe root of traditional healing through so called 'sangomas' has it's foundations in witchcraft. I am disappointed at the fact that the South African government does not see how much harm this will do to the country in the long run.
If they legislate traditional healers - they will open the flood gates to more demonic forces, as if Africa needs more than it already has. Does the South African government know where sangomas get their so called 'divine' knowledge and power from? Why do you think Africa has not advanced since colonial rule - belief in Witchcraft powers is part of the problem. Phumla, USAI believe that the concept of African traditional healers is a double sided coin. It appears the South African government is taking the right step by making legislation to register traditional healers.
There is no doubt that many do have esoteric knowledge of herbs, roots etc and their application and usage in curing or preventing illness. Many are charlatans whilst others are offering a service which actually erodes African society and no doubt is effectively a criminal activity. By monitoring and controlling these healers a lot could be done to prevent this unsavoury aspect. Nana Kwansah, London, UKI have some experience in dealing with the so called traditional healers as I once consulted them and have interviewed many who have been involved in witchcraft as traditional healer. The truth is, it is from the devil, it is ugly, they tell nothing but lies, they divide people and there is nothing positive.
I would be dead had it not been for the local medicine man who correctly identified the sickness and gave me the right shrub and roots to chew.

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