Integration of African traditional health practitioners and medicine into the health care management system in the province of Limpopo

[摘要] ENGLISH ABSTRACT:The Department of Health estimates that 80 percent of South Africans consult traditionalhealers before consulting modern medicine. The aim of this study is to investigate theextent of the use of traditional medicine in local communities in the Limpopo Province, andadd value to a draft policy that was introduced by the Minister of Health. (South Africa,Department of Health 2007a)Traditional healers are regarded as an important national health resource. They share thesame cultural beliefs and values as their patients. They are respected in theircommunities. In South Africa, traditional healers have no formal recognition as health careprofessionals.Despite the advantages of modern medicine, there is a dramatic evolution in traditionalmedicine developing and developed countries. In recognition of the value that traditionalmedicine has added to people's health needs, government organisations have realised thegap and needed to embark on public participation to bring to light the solution, byimplementing a relevant policy (Matomela 2004).According to research done by Pefile (2005), positive outcomes that resulted from the useof traditional medicine include a more holistic treatment, a wider choice of health care thatsuits people's needs, and scientific advancement, this paves a way forward for a policy tobe put into place for the legal recognition of traditional medicine. New legislations havebeen brought about in regulating traditional medicine and practitioners.This paper provides a synopsis of government initiatives to close the gap and address theconcerns of integrating traditional and modern medicine. The thesis addresses thechallenges involved in incorporating the two disciplines for the best possible impact oflocal communities in accessing their rights as vested in the constitution.The study is a qualitative study where relevant practicing traditional healers, users,Western doctors, nurses, managers and government policy makers were interviewedregarding the draft policy on traditional medicine. This was to obtain information on thechallenges, gaps and possible solutions regarding the integration of African traditionalmedicine into the health care system of Southern Africa. Findings show the following: a majority of traditional healers do not agree to scientific trialling and testing on the herbsthat they prescribe, and Western doctors feel that traditional healers should only treatpatients spiritually unless they have a scientifically tested scope and limitations on theirfield. The study also found that traditional healers want to be registered and integratedinto the health care system, but do not agree to have regulated price fixing. Otherconclusions included that the communities seek traditional help for cultural reasons andmore benevolent purposes, but are changing their focus towards seeking medical helpfrom clinics where it is provided for them. However, people within the communities arestill confused whether to seek traditional or western medicine and therefore seek both. Itwas found that medications are not readily available in district clinics and hospital waitingtimes force people into seeking traditional help. Nurses, doctors and caregiversacknowledge that traditional healers are hampering the health care of patients by delayinghospital treatment of patients hence progressing illnesses. However, they also state thattraditional healers help people spiritually and mentally. Therefore policy makers havefound solutions to educate healers and create regulatory boards to limit and create ascope of practice for traditional healers.Recommendations and solutions for the relevant policy are as follows:It is recommended that traditional health practitioners should only be allowed to practiceand train over the age of 21. They must be prohibited from certain procedures, forexample: drawing blood, treating cancers, and treating AIDS/HIV. They should only beallowed to practice midwifery if they have had training. They should be prohibited fromadministering injections and supervised drugs, unless trained at a tertiary level traditionalhealers can be used as home caregivers, spiritual healers, and traditional advicecounselling entities in the communities. Traditional healers must be prevented fromreferring to themselves as a 'doctor' or 'professor'. This misleads people into believing thatthey are allopathic doctors. 'Traditional health practitioners' must realise that they areholistic healers, and must be addressed as such. A strong recommendation is to rename'traditional health practitioners' as 'spiritual practitioners'.With regards to regulations, it must be imperative that every practicing traditional healthpractitioner be registered annually with the relevant board. A good suggestion is fortraditional health practitioners (THP) to attend formal training courses, under an experienced herbalist, and it should be documented on paper. A written record of thelocation of practice, and specialty must also be documented. There must be policies onhealth and safety, hygiene and sterility that need to be in place. It is suggested thattraining on patient confidentially must be taught and implemented. A code of conduct anda standard of professional ethics must also be implemented. Health and safety regulationspertaining to the profession and the citizens must be listed. Efforts towards dispellingmyths and making people aware, thereby filtering out the positive side of the traditionalmedicine (e.g. medical benefits with some herbs), and rooting out the 'quack' practices(e.g. the use of amulets around a patient's body to cure diseases) should be practiced.Pertaining to co-operative relationships between modern medical doctors and traditionalpractitioners, it is recommended that the use of exchange workshops between the twoprofessionals needs to be developed. Also scientific information and technology must beavailable to traditional healers. A continued professional development (CPD) programmeshould be a mandatory requirement, as for all other health care professionals. It seemsthe development of traditional hospitals, in which a scope of practice is defined, can beused as a recovery ward and a spiritual guidance centre.The above recommendations will encourage a healthier, safer and transparent health caresystem in South Africa, where all disciplines of medicine co-exist in one National HealthCare System.

[发布机构] Stellenbosch University