African Traditional Medicine at the Cross Roads in South Africa Challenges faced by its institutionalisation
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About this ebook
This book explores the views of a cross-section of the KwaZulu-Natal Traditional Health Practitioner (THP) community regarding the transformation of the traditional medicine sector necessitated by legislation: the Constitution, the Health Act and the Traditional Health Practitioners (THP) Act. The changes have implications for the Basic Conditions of Employment Act and Human Resource Officials.
Research findings of this study found that 84 per cent of the participating Traditional Health Practitioners did not know the existence of the THP Act, how it is being implemented and how it will affect them. Furthermore, the study indicates that there has been a reduction in the duration of training for THPs from an average of five years to one year while about 20 per cent of participating THPs have not actually had any training. This has serious implications for ethical patient care. As a result of findings of the study, several recommendations are made to improve this situation as well as inform the public of these developments.
“I am certain it will prove to be of great interest to those who work and/or study in this field or who are currently researching their own dissertations or theses and are looking for relevant literature.”
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African Traditional Medicine at the Cross Roads in South Africa Challenges faced by its institutionalisation - Nceba Gqaleniand and Nompumelelo Mbatha
AFRICAN TRADITIONAL MEDICINE AT THE
CROSS-ROADS IN SOUTH AFRICA
Challenges faced by its institutionalisation
Nompumelelo Mbatha and Nceba Gqaleni
AFRICAN TRADITIONAL MEDICINE AT THE
CROSS-ROADS IN SOUTH AFRICA
Challenges faced by its institutionalisation
Nompumelelo Mbatha and Nceba Gqaleni
Copyright © 2017 Nompumelelo Mbatha and Nceba Gqaleni
Published by Nompumelelo Mbatha and Nceba Gqaleni Publishing at Smashwords
First edition 2017
All rights reserved. No part of this book may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopying, recording or any information storage or retrieval system without permission from the copyright holder.
The Author has made every effort to trace and acknowledge sources/resources/individuals. In the event that any images/information have been incorrectly attributed or credited, the Author will be pleased to rectify these omissions at the earliest opportunity.
Published by Author using Reach Publishers’ services,
P O Box 1384, Wandsbeck, South Africa, 3631
Printed and bound by Novus Print Solutions
Edited by Cathy Eberle for Reach Publishers
Cover designed by Reach Publishers
Contents
About The Authors
Preface
Chapter 1 Introduction
Chapter 2 Review of Legislation
Chapter 3 Evolution of Traditional Medicine Occupations and Related Challenges
Chapter 4 Traditional Medicine Training Methods, Systems and Practices
Chapter 5 Traditional Health Practitioners’ Understanding and Perception of the Process of Insitutionalisation in South Africa
Chapter 6 Challenges Faced by the Traditional Health System
Bibliography
About the authors
Makhosi Nompumelelo Mbatha
A Traditional Health Practitioner, she obtained her Master’s in Medical Sciences at the University of KwaZulu-Natal Durban. She is currently studying towards her PHD in Medical Sciences. Her area of specialty is Traditional Health systems, focusing on the accreditation and institutionalisation of African Traditional Medicine in South Africa.
Professor Nceba Gqaleni
Executive Director: Aim-Hetep Institute.
Prof Nceba Gqaleni obtained a Master’s degree at the former University of Natal and a doctorate at the University of Strathclyde in Scotland. He is an Adjunct Professor at the Durban University of Technology and a Visiting Professor at the Vaal University of Technology. He is a member of the Interim Traditional Health Practitioners’ Council of South Africa. He previously served as leader of the Traditional Medicine programme, Director of the Centre for Occupational and Environmental Health, Operations Director of the Doric Duke Medical Research Institute and Deputy Dean of the Nelson R Mandela School of Medicine, University of KwaZulu-Natal. In 2007 he was appointed the DST/NRF Research Chair in Indigenous Health Care systems. He has been a member of the Presidential Task Team on African Traditional Medicine, Deputy Chairperson of the KwaZulu-Natal Provincial Council on AIDS and the WHO’s (African Regional Office) expert committee on Traditional Medicine. He is among the 20 best authors globally on integration of traditional medical practices into ‘mainstream’ medical care selected by an international committee of experts from the Inter-Academy Medical Panel and other renowned international scholars.
Preface
The research reported in this book was part of the Master’s degree component of Ms Nompumelelo Mbatha, supervised by Professor Nceba Gqaleni. The study came about through contemplating changes brought about by the new-found freedom of choice resulting from constitutional developments in South Africa, and the growing popularity and controversies surrounding Traditional Medicine (TM). At the same time, the development of the Traditional Health Practitioners Act (THPA) (No.22 of 2007) and the Draft National Policy on African Traditional Medicine (2008) took place. We set out with the premise to contribute to the paucity of information around TM and to find working solutions for the institutionalisation of TM in South Africa. We reviewed the efficacy of the legislative process against the contextual realities and virtual meanings apparent in the TM system. The aim was to identify the key areas necessary for the formation of institutions of TM and to further deliberate on the challenges facing institutionalisation. The work focused mainly on the principles of systems, processes and the operational relevance of TM, rather than the mystical underpinnings of the healing process. The idea was to determine the feasibility of the institutional development of TM and to identify the extent of the nature of institutionalisation possible for the TM system. The work presented in this writing, in its modest form, does not attempt to deliberate, nor does it seek to provide in-depth analyses of the philosophical and mystical world of TM systems. In pre-empting the various debates which could ensue, particularly regarding which direction and role TM should take in the health systems in South Africa; it should be noted that this work does not seek to alter, eradicate or mystify TM within the conventional health systems; but rather to document prevailing TM systems, to validate and emphasise its important contribution to the health and wellbeing of the South African community.
The study that informed this writing was conducted in KwaZulu-Natal in the eThekwini and Umgungundlovu District Municipalities. These locations were chosen for their representative characters, for example, combined, they have the largest number of THPs in KwaZulu-Natal and have a fair combination of urban and rural areas within accessible distances.
The study enrolled a total of 320 participants and, included in this number, are 211 THPs, 49 amathwasa (trainees), 40 officials and 20 medical doctors. Interviews and focus group discussions were used. The choice of design was informed by the authors’ understanding of the extensive literature review undertaken which detected a need for the inclusion of different categories of participants. These participants included practising Traditional Health Practitioners, legislative stake-holders, i.e. government officials, Employee Assistant Practitioners and senior members of the THP organisations; Health Practitioners and Trainee Traditional Health Practitioners (TTHP). Data collection methods varied, depending on the form of the data to be collected and the types of participants. Semi-structured questionnaires; using closed-ended and open-ended questions were utilised for THPs, THPTs and officials, while a standardised, open-ended question protocol was utilised to facilitate focus group discussions. The focus groups were important in order to gain an in-depth level of understanding of institutionalisation, to explore participants’ feelings and to identify potential factors that might hinder or advance the process of institutionalisation. These focus groups were facilitated by the researchers with the assistance of experienced research assistants. Each session was scheduled for two hours and the average time spent on all sessions was at least 1 hour 30 minutes.
The results determined that the Traditional Health Practitioners’ Act is based on preconceived historical interpretations instead of the contextual realities existing within the current TM system. For the first time in South Africa, this study identified, firstly, that there are multilateral practices in TM, thus determining that the TM occupations evolved from unilateral practices to multilateral practices over a period of time. Secondly, that the THP registration, as stipulated by the Act, is biased towards the registration of a small proportion of THPs. Thirdly, that outcome-based virtual training systems exist within TM and that these training systems are equitable with recognised conventional methods of learning. Fourthly, that the majority of the THPs are ignorant of the Act and the obligations it brings. Finally, that the TM sector is faced with a number of challenges. It therefore becomes debatable whether the THP Act will be able to achieve optimum levels of efficacy, and whether the preparatory process of public hearings formed sufficient empirical bases to inform the contextually relevant legislative process necessary to institutionalise TM.
The authors wish to acknowledge the financial support of the National Research Foundation and the Department of Science and Technology. We express gratitude to those who took the time to participate in this study. Sithi ukwanda kwaliwa ngumthakathi.
CHAPTER 1
INTRODUCTION
Traditional Medicine systems
Traditional Medicine, inherently known as ethno-medicine, folk medicine, native healing, or complementary and alternative medicine (CAM), is an ancient, culture-bound healing system that has been used by indigenous communities to manage diseases detrimental to their existence and survival (Kayombo et al., 2013; Abdullahi, 2011; Rukangira, n.d). It used to be the only dominant health system during the primeval era and provided health care to generations of African natives. According to the World Health Organisation (WHO), Traditional Medicine (TM) refers to systems of health practices, approaches, knowledge and beliefs incorporating plant-, animal- and mineral-based medicines, spiritual therapies, manual techniques and