United Press International - April 13, 2004
Steve Mitchell, United Press International

These "medicine men," known as sangomas, are found in many tribes in South Africa, including the Pondos and Xhosas. Just as with traditional healers found in other cultures, the sangomas use native herbs, roots and tree bark to make medicinal concoctions for everything from headaches to AIDS.

They still are active in modern day villages, but as the government builds schools in these rural areas and more children receive a Western education, the sangomas no longer may be used and ultimately may fall by the wayside.

"The young people, they know nothing of sangomas," Zukile Khambi, an independent tour guide and a Xhosa (pronounced KO-sa) living in East London, told United Press International.

"It is only my generation" that still believes in them, added Khambi, who is in his 50s.

Already, many people are turning away from these healers because they now have access to modern medicine and no longer find any benefit from the sangomas, which can charge $400 or more, a relatively large sum that some village residents cannot afford.

"I don't believe in sangomas," Khambi said. "What they do does not mean anything to me. I am too Westernized."

Clemmy Mbatani, who also is a Xhosa and works with the Eastern Cape Tourism Board, offered a similar perspective. "Educated people think of (sangoma medicine) as witchcraft," she said.

The sangoma concoctions offer no real benefit other than the placebo effect, Mbatani added. "If you believe, it works," she added.

At least some of the sangoma medicines may have something to offer, however.

Scientists are studying the compounds used by sangomas for treating AIDS to see if they are effective. Khambi said a concoction comprised of African potato, garlic and other materials is often employed by these traditional healers to treat AIDS patients, and he knows of a man infected with the deadly disease who appears to have gotten much better after taking the compound.

Mbatani said her friend suffered from asthma for years until she went to a sangoma and the concoction prescribed by the healer markedly improved the condition.

Despite these anecdotal suggestions of effectiveness, Mbatani still doubts sangoma medicine and said she would never go to one.

Khambi offered another reason to avoid sangomas, saying he thinks the modern ones are more interested in profiting from the traditional cures rather than actually treating illness.

"The sangomas today don't know what they are doing," Khambi said. "They are just there to make money. It's just business."

Mbatani said a typical scenario is the patient will describe their symptoms and the sangoma will then say the problem is due to conflict with a neighbor or an in-law. If the medication they prescribe does not alleviate the illness, the sangoma will say that is because it was not used properly, she said.

At present, however, the traditional healers are still employed to a wide degree in the rural areas, so much so Phelophepa, a train that provides healthcare to these remote regions, has developed outreach programs to teach them modern medical concepts.

The Ministry of Health also has begun working with them to inform them which of their traditional medicines are appropriate and which are ineffective and could even be dangerous. The health department has advised sangomas to refer AIDS patients to local clinics and hospitals because they will not be able to cure them.

The programs seem to be having an impact. Nonzwakanzi Mabhida, 25, a sangoma belonging to a Pondo tribe in Mbotyi, told UPI via a translator her medicine works "very good in many kinds of illness," except AIDS.

She sends those patients to the clinic, Mabhida said. She claimed she can treat a variety of diseases, including headaches, tuberculosis, strokes, cancer and sexually transmitted diseases.

She added she often works together with the local health center because she "can see that sometimes the person has to go to a clinic." Her rationale for this is that occasionally her medicine is "too strong so she can see maybe the patient needs to be injected (with modern medicines) and then come back to the bush medicines."

Mbatani said Mabhida's willingness to work with modern physicians is characteristic of younger sangomas. They often are open to working with medical doctors and clinics, but the older sangomas are not.

Lennox Mkanywa, 27, a Pondo in Mbotyi, told UPI that people in the villages usually only use sangomas for more serious, chronic diseases because the treatment can be so expensive.

The sangoma generally will charge about $50 just to open their medicine cabinet and diagnose the condition, Mkanywa said. Then, after one year, "if you feel strong, that you have the power back, you will pay another ($350) maybe," he said. This may represent a princely sum for many of the villagers because few have jobs or a significant source of income.

Despite the growing skepticism about sangomas, Khambi said he would fight to keep them from disappearing because they represent an important part of the culture of his people -- a culture he loves. He said he would encourage the sangoma tradition to be taught in schools so students at the very least would gain an appreciation of their history.

Steve Mitchell is UPI's Medical Correspondent. He has been on assignment in South Africa. E-mail sciencemail@upi.com

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