Traditional healers, new partners against HIV/AIDS

Swaziland's health ministry has begun enlisting traditional healers in efforts to contain HIV and assist patients with AIDS-related illnesses. The cooperation between modern and traditional medicine reverses decades of separation, and highlights the extent of the AIDS emergency in Swaziland. "We are a little behind the curve in getting the 'tinyanga' (traditional medicine men and women) on board, but by now the medical establishment agrees that these healers can be enormously helpful because they have such close ties with the community," Dr John Kunene, principal secretary at the Ministry of Health, told PlusNews. The Swaziland branch of the Traditional Healers Association of South Africa estimates that about 3,000 traditional healers are at work in the country. Exact figures are hard to establish, because customarily healers work independently, and do not belong to any professional group. "I trained under a healer in my community, and I never had any contact with the Western doctors until the health ministry held an AIDS seminar for us," Gogo Shongwe, a healer in Kwaluseni, in rural central Swaziland, told PlusNews. Organised by agencies like UNAIDS, the AIDS Support Centre of Manzini and the health ministry, the seminars seek to both enlist healers in anti-AIDS efforts, and inform them about the disease. "We respect traditional healers because they are knowledgeable in their own way about medicine, and they have a great following in the communities," AIDS activist Pholile Dlamini said. A World Health Organisation survey in the 1990s found that a majority of Swazis use traditional healers as their primary source of health care, despite a growing network of health clinics and private physicians. "At the clinics there are long queues, and there is often no medicine," said Stella Magongo from Manzini, the country's commercial centre. The main hospital in Manzini faces bankruptcy due to mismanagement. Understaffed and lacking in resources and medicines, health clinics cannot devote the time to individual patients that traditional healers, working from home, can provide. Supplies of traditional medicines, which are used to lessen everything from labour pains to treating gout, seem inexhaustible, because they are made from roots and barks extracted from the fields and forests of this largely rural nation. "My inyanga [healer] knows me and my family. Going for treatment is like a social visit," Magongo said. Health officials aim to tap into those bonds of trust, to pass on HIV/AIDS information in a country in which 38.6 percent of the adult population are HIV-positive. Health ministry field workers search urban townships and rural areas to locate healers, then arrange their transport to ministry seminars. The healers are taught how the HI virus infects and affects the body, and ways to prevent opportunistic infections. But the medical establishment has also had to tackle the claims made by some healers that they have a treatment that cures AIDS. Gladys Simelane, who conducts HIV/AIDS awareness workshops, explained: "We emphasise that there is no cure for AIDS, and it is cruel to give patients false hope. We see how desperate people try any new 'cure' that is proclaimed in the media. The healers are told that if they think they have a medicine that helps people with AIDS, they must bring it to us for testing." In the past, traditional healers were accused of contributing to the spread of AIDS by using the same razor blade to draw blood from a number of patients while performing "kugata", the making of incisions into which medicines are rubbed. "Traditional healers are poor, and we cannot afford a new razor blade for each patient," said healer Shongwe. "But we are returning to the traditional way of making punctures, using porcupine quills." The quills also have natural antiseptic chemicals that protect the cut from infection. Health ministry education officers also take the AIDS message to traditional healers at their workplaces. They bring with them a supply of condoms to distribute to patients. Ten years ago, a self-proclaimed head of Swaziland's traditional healers discouraged the use of condoms, which he said were opposed by Swazi custom. The healer was accused in the press of jeopardising lives, and traditional healers were blamed for furthering the spread of HIV. "There is no resistance at all now to accepting and distributing condoms," Dlamini said of her trips to traditional healers. "They complain that there are not enough condoms." Healers are told about clinics and AIDS prevention centres that conduct blood tests and counselling. Given Swaziland's high HIV-infection rate, everyone is encouraged to know his or her HIV status. "Some healers have asked if they could get involved in the HIV tests, but because this is a technical procedure, we have had to disappoint them. But the healers can be instructed to do counselling services, because they are already natural counsellors to their patients," said Dlamini. The enlistment of traditional healers in the AIDS containment effort has also helped local conservationists and educators to identify indigenous plants with medicinal properties. The need to catalogue these plants becomes more urgent as an expanding population reduces wilderness areas where traditional healers go for their herbs. The bonds that are being made between traditional and Western medicine in the response to AIDS are also bringing together two world views on curing, that in the past were separated by prejudice. Healers complained that they were not respected, while the medical establishment dismissed the healers' credentials and folk remedies. Now the two groups are working together against a national medical emergency.