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Change the world

22/08/2023

With up to 80% of South Africans choosing indigenous healers and plants over mainstream medicine, local health knowledge is a rich resource that fills a critical gap in the country’s overstretched healthcare system.

 

The role of Traditional Health Practitioners (THPs) and Traditional Herbal Medicine (THM) in the lives of Western and Eastern Cape citizens is the focus of groundbreaking research by Mandela University anthropologist Professor Luvuyo Ntombana and medical anthropologist Dr Denver Davids, Acting HOD: Department of Sociology and Anthropology.

They are investigating and documenting the use of THM among THPs, bossiesdokters, Rastafari healers and local people.

Knowledge and use of THM is very common in rural and semi-rural areas throughout South Africa, says Dr Davids, but remains poorly documented and subjugated in the past.

“South Africa has a plural, but strained healthcare system, and the use of medicinal plants – and consultations with indigenous healers and doctors – is not only widespread, but also the primary source of healthcare for a large part of the population.

“Indigenous healers are widely consulted for common and more serious conditions, and are perceived as more easily accessible, culturally sensitive and to offer holistic treatment, which counters some barriers sick people experience in accessing Western allopathic medicine.”

The power of plants

Most plant species in Africa have medicinal characteristics and are utilised in indigenous medicine, says Professor Ntombana.

“In most southern African countries’ basic healthcare systems, indigenous medicine remains the most economical viable and easily available source of therapy. It is used by about 80% of underdeveloped nations, who cannot afford the high cost of western medications, and because indigenous remedies are  more desirable culturally and spiritually.

“If the vast amount of knowledge about the usage of medicinal plants is not actively explored and collected, it is likely to be lost to future generations.”

Compiling a record of the plants will ensure that knowledge is kept safe, and the plants are used sustainably, he says.

Dr Davids explains that there is scant knowledge about the healing systems of indigenous African people – nothing was well-recorded before, or even after, European exploration.

Investigations into THPs focus on two areas: comprehending THP understanding of communicable and non-communicable conditions and identifying, understanding and better documenting South African medicinal plants for future conservation and research.

The pandemic’s silver lining

The outbreak of COVID-19 motivated the academics’ study, which explores knowledge of medicinal plants used to treat coronavirus-related symptoms in rural villages far from city centres, with limited health care access.

At the outset, there was no specific medication for treating pandemic symptoms, says Prof Ntombana, and rural African people visited their indigenous healers or herbalists when confronted by, what was then, an unknown or apparently incurable illness, he says.

These healers and herbalists see more patients than conventional doctors, owing to healthcare system limitations; the belief in a spiritual aspect to illness; and readily available, more affordable remedies.

During COVID-19, several indigenous healing plants were prescribed to patients for coronavirus symptoms, and researchers are actively investigating these as part of their general research.

The proven value of THM

Indigenous plants are being utilised to manage and treat a variety of illnesses, demonstrating that food may act as medication, says Dr Davids.

THM is also receiving a lot of attention from global health players, cementing the importance of building an inventory and documenting the many medicinal plants and herbs in use.

Every prescription or supplement is shown to help prevent disease and small illnesses, including headaches, stomach aches, fractures and sprains, while herbal vitamins, natural medications, baths and massages are ingested or applied to avoid all types of illnesses and maladies.

Sustainable practices

“When I collected plants with indigenous healers, they were attentive to harvesting samples from multiple mature specimens and did not harvest young plants,” says Dr Davids. “They were careful not to disturb the growth of the plant by uprooting it, except when the roots and bulbs were needed for specific remedies and symptoms.

“Specific species, which are known to be scarce, were often substituted with other species which are believed to possess similar properties.”

Several studies have shown the impact of over-harvesting on the trade of medicinal plants, with some threatened or already extinct, he says.

Many medicinal plants used and traded throughout South Africa have been evaluated by the South African National Biodiversity Institute’s (SANBI) threatened species programme (Red Data List), focusing on monitoring species at high risk of extinction.

Biodiversity and conservation strategies are important for monitoring threatened species and should be advocated in rural areas, he says.

Indigenous vs global: a place in the sun for both

THPs and mainstream medicine can work together, and often do.

Dr Davids says that indigenous healers, for example, don’t claim to diagnose or cure HIV or TB; instead, they work closely with local clinics, developing professional relationships with allopathic doctors.

A way to truly preserve medicinal knowledge is to recognise the role played by THPs, says Prof Ntombana. This way, everybody wins.

The government is accused of sidelining THPs during the medication regulation process. One concern raised was a fear that, once indigenous medicines are regulated, THPs will lose their right to intellectual property, with only conventional pharmaceutical properties benefiting from this.

It is therefore crucial to put THPs at the forefront of dialogue about their own knowledge, and to protect their rights, he says.

Xhosa indigenous medicine

Before colonisation, South Africa’s indigenous people relied on their deep knowledge of medicine plants and healing methodology, says Prof Ntombana.

Women dominated the healing community and were particularly knowledgeable about pregnancy, childbirth and parenting.

“As the Eastern Cape is rural, natural forests are found – and in them, most medicinal plants. The elderly, who respect the ecosystem, teach the young how to find medicines without destroying them for the future.”

Medicines are found across diverse geographical areas, such as mountains, grasslands, rocky areas or near rivers.

Some examples of the many plants being studied include: Umnonono, Intlungunyembe, Umhlonyana, Isivumbampunzi and Impepho.

FACTS

  • An estimated 200 000 practising indigenous healers across South Africa.
  • Around 50 000 of these are in the Eastern Cape.

Study a group effort

The academics’ study is funded by the South African Medical Research Council, and research is conducted in partnership with Walter Sisulu University, the University of Kwazulu-Natal, Great Zimbabwe University and the National University of Lesotho.

The researchers are committed to advancing the educational revolution through decolonisation, and these studies are a first step in the right direction, says Dr Davids.

“I agree with scholars such as Joshua Cohen, when he argues that it is difficult to emphasise and comprehend the extent to which science has subjugated indigenous medicine in South Africa.”

Contact information
Mrs Debbie Derry
Deputy Director: Communication
Tel: 041 504 3057
debbie.derry@mandela.ac.za