Professor Robert Thornton, Anthropology, Wits University

1. Professor Robert Thornton, Anthropology, Wits University ‘Traditional Healers , Bio-medical Practice and Sexuality: Prospects and Barriers toCo-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 modelof the body Enduring Transient Substance Non- substance presence fluid

14. Thank you for your attention