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South Africa's traditional healers help fight HIV

By Rebecca Harrison

MTUBATUBA, South Africa (Reuters) - Tryphina Ngwenya slides a pink condom over the magic wooden stick normally used to conjure up ancestral spirits, unleashing a ripple of laughter among her audience of traditional South African healers.

"You see it's easy -- there's nothing poisonous or dangerous about condoms," she told the group of some 80 sangomas -- as traditional healers are locally known -- draped in brightly colored wraps, animal hides and beads.

Ngwenya has recruited the sangomas -- sometimes called witchdoctors -- as foot soldiers in the fight against HIV, which has infected about one in three adults in this deeply traditional corner of rural South Africa.

She is teaching them basic AIDS awareness and prevention.

Many of the healers once believed HIV was a curse from the spirit world and patients had been bewitched. Some claimed they could cure AIDS -- and many who have not been trained continue to claim this.

But while they still prescribe roots and herbs for ailments and mutter incantations to dispel evil spirits, these sangomas now also issue condoms, refer patients to clinics for HIV tests and urge them to take life-prolonging anti-retroviral drugs.

"Before, I didn't even know what this HIV animal was, but the training has brought sophistication to my work," said Miriam Tembe, who has been consulting the spirits for tips on treating patients for 25 years.

The training helped her with the practice of scarring a patient then rubbing herbs or powder into the wound: "I used to use one razor for five people -- I used to kill people," she added. "Now I teach them how to protect themselves."

BEWITCHED

The project linking traditional practioners with modern health systems is being run by African Medical and Research Foundation (AMREF), which says more than two-thirds of people in rural Africa consult sangomas before attending a clinic.

Sangomas are revered and trusted in rural communities and play multiple roles as spiritual guide, healer and counselor. Mostly but not always woman, they might offer tips to a young couple on their sex life, advise on proper burial rites, or concoct a treatment for toothache -- all in a day.

AMREF wants sangomas to keep providing spiritual succor and basic healthcare, and also to use their influence and authority to promote HIV-testing and modern medicine in areas where many people are distrustful of hospitals, clinics and ARV drugs.

"Traditional healers are so important in these communities. People trust them more than they trust us nurses," said Ivy Mdletshe, a nurse who works in AMREF's HIV testing centre.

Zandile Bukhosini has benefited from the system. When her feet swelled up and she developed a hacking cough she assumed she had been bewitched and went straight to see Tembe -- her local sangoma.

Fortunately, Tembe knew how to spot the symptoms of tuberculosis, which often accompanies HIV infection. She consulted the spirit world as usual, then sent Bukhosini for an HIV test. The results were positive.

"When Miriam sent me for a test I was skeptical, but her medicine had helped me before so I decided to trust her," said the 25-year-old, hunched inside a mud and straw hut, the bitter aroma of burning incense wafting from the corner.

Now, with Tembe's support, Bukhosini is taking anti-retroviral drugs and looks happy and healthy.

"Miriam encouraged me to take the medicine the doctors gave me," she said. "But she also gives me her own treatment and tells me if I need to slaughter a chicken to appease the ancestors."

TOXIC DRUGS

The AMREF project has particular resonance in South Africa, where Health Minister Manto Tshabalala-Msimang has angered AIDS activists by appearing to question accepted science and emphasizing treatments such as lemon, garlic and the African potato.

Ngwenya insists the two approaches are not mutually exclusive, and argues sangomas can help treat some of the side effects of HIV -- such as skin problems or coughs and colds -- and break down the stigma attached to it.

"Obviously there is not a traditional healer who can cure AIDS but they can help treat the symptoms and help support patients by giving them what they want to believe," she said.

But she also says much more must be done. An estimated 200,000 traditional healers are practicing in South Africa -- there are almost 900 in this small district of some 200,000 people -- and organizations like AMREF have trained just a handful.

Many healers still tell patients anti-retroviral drugs are toxic, condoms are infested with disease-carrying worms and killing a goat will appease ancestral spirits and cure the sick.

And while a few weeks of basic training can halt dangerous practices like razor-sharing, healers may continue to promote traditional methods over modern medicine.

But most sangomas see little conflict between the two approaches, and say learning about orthodox healthcare has helped improve their traditional practice.

"How can the ancestors be angry with me?" said sangoma Philile Gumbi when asked what the spirits thought when she encouraged patients to turn to modern medicine: "Both me and the hospitals are doing the same thing -- we are saving lives."

(Additional reporting by Spokes Mashiyane)

HIV/AIDS
HIV AIDS is a serious problem. It is becoming more and more prevalent in the Muslim community. In light of the serious threat that it poses the lives of all South Africans including Muslims, the Jamiatul Ulama, together with the Islamic Careline (the Jamiatul Ulama, Islamic Careline and the IMA are founder members of MAP – Muslim Aids Awareness Program) are focusing on HIV/AIDS in the Online Newsletter.

Names in the case histories are not actual names (to protect the identity of the persons), but permission to print the case histories has been obtained from the respective persons.

Muslim AIDS Programme / Islamic Careline
We have provided personal testimonies of people living with AIDS (PLWAs) for the last few weeks in order to highlight the realities around this devastating pandemic. As Muslims, we are not immune to HIV and AIDS as many infected and affected people will know.

In conclusion, it is apparent that HIV and AIDS is a major problem in the community at large. The solution is therefore to treat the root of the problem i.e. sexual promiscuity and drug abuse which are the two primary modes of transmission. Prevention should include discouraging sex outside of the marriage, chastity should be vigorously promoted and fidelity within marriage should be upheld at all costs. It is the Muslim AIDS Programmes firm belief,
that this is the only solution to stem if not eradicate the onslaught of the HIV/AIDS pandemic.

As far as drug abuse is concerned, young people should remember to have clean fun with friends, not with destructive substances like drugs and alcohol. Sporting activities are a great way to socialize and enjoy yourself. You cannot get away from your problems but you can learn to deal with them and succeed – so get help if you are in need of it. Your future is too valuable to lose.

We at MAP are confident that we are making a positive contribution to the Faith Based Initiative in the partnership with the National Government in the fight against a disease that is destroying our community and our nation.

MAP: 011 373 8083/5 ~ ISLAMIC CARELINE: 011 373 8080
FAX: 011 373 8089 ~ E-MAIL: careline@islamsa.org.za