1. Professor Robert Thornton, Anthropology, Wits University
‘Traditional Healers , Bio-medical Practice and Sexuality: Prospects and Barriers to Co-operation’

2. Ma Lubisi, sangoma, Acornhoek

3. The Project: Traditional healers’ and Medical doctors’ responses to HIV/AIDS and potential for co-operation
Supported by Margaret Sanger Institute, Boston, USA
Administered by Medical Care Development International
Principle Investigators: Edward Green, Harvard University School of Public Health and Professor Robert Thornton, Anthropology, Wits Univeristy.

4. Project Details
Conducted in Mpumalanga, Gauteng and KwaZulu-Natal, April to August 2002.
Interviews with Traditional Healers (‘Diviners’ or sangomas, Faith Healers, Herbalists) and Medical Doctors who practice in similar areas (rural, small towns and townships).
24 Traditional healers in KwaZulu-Natal, 11 in Mpumalanga, 21 in Gauteng
21 medical personnel in KwaZulu-Natal, 6 in Gauteng, and 8 in Mpumalanga (doctors and nurses).

5. Project aims: To investigage
The nature of traditional healers’ responses to HIV/AIDS
The extent and nature of tradtional healers’ contact with each other and with bio-medical practitioners
The attitudes held by traditional healers and medical personnel about each other.

6. Who are Traditional healers?
There are three ‘types’, none of them exclusive to each other, with some people claiming status as one, two or all types
‘Diviners’ (sangoma): possessed or possessors of ‘spirits’ (amadlozi); initiated; belong to mutual support groups (mpande, or ‘roots’) where they are trained and initiated;
Faith healers (amaprofeti): Generally Christian, heal by prayer and ritual; belong to churches; practice alone;
‘Herbalists’: Practice as business; not possessed; learn trade from parents or other kin;

7. Principle findings
Distinction must be made between ‘cure’ and ‘treatment’
Considerable confusion about this in traditional healing
Some methods and herbs appear to be effective in treatment of symptoms
Healers and MD express interest in co-operation

8. Obstacles to co-operation
Poor organisation of healers; no system of registration or qualification
Healers themselves are dissatisfied with their organisations
Many traditional healers are resistant to further organisation of licensing
Nurses, especially, are hostile to Tr. healers

9. Conclusions and recommendations
Some traditional healing methods and herbs are effective in treatment of AIDS symptoms
Closer direct or directed co-operation between MD and Traditional healers is not advisable since it is likely to decrease legitimacy of both
Process of working in parallel is appropriate, but formal methods for cross-referral are likely to be effective
Government intervention unlikely and probably undesirable, but education of medical personnel in traditional healing practices is appropriate and do-able

10. Traditional concepts of sexuality
Tradtional concepts of sexuality and sexual practice are poorly understood
Further knowledge of this is essential in interventions aimed at limiting HIV and STI transmission
There is a set of concepts about sexuality that is shared by many healers and their clients

11. The flows of sexual substance in social time and space
Ancestors, the past
time
Lovers, wives and husbands
Lovers, wives and husbands
space & society
Children, the future

12. The flows of blood and gifts
Ancestors, the past
Sacrifices, ukuphahla
Lovers, wives and husbands
Gifts
Lovers, wives and husbands
Sexual fluids
Blood
Children, the future

13. A Sangoma’s model of the body
Enduring
Transient
Blood
(Madzi)
Body
(Mmele)
‘Spirit’
(Moya)
‘Shadow’
(Seriti)
Substance
Non-
substance
fluid
presence

14. Thank you for your attention