Africa is gifted with a wide variety of flora, and more than 4 000 plant species are being used for medicinal purposes.
Read: SA a natural pharmacy?
With so many forms, colours and effects, it has been considered an art form to be able to correctly identify and use South African traditional herbal medicines.
In an interview with traditional healers in Africa, Asher, a 21-year-old Rastafarian bush doctor told Health24 “We give up everything for [this] way of life. We even give up clothes.”
To many people, the art of prescribing traditional herbal medicines is not a hobby, but a way of life.
Read: The future of traditional healing
How do traditional healers find their 'calling'?
“You are born in this way of life. When you are born, if you are having coughs the [grandmothers and the mothers] just go into the forest and dig for medicines. So you learn from that, ” said Dr. Nokuzola Mndende, author, diviner and former lecturer at the University of Cape Town.
At any age, a person can be called to work with traditional medicines through visions.
“I couldn’t sleep. I got heavy visions, dreams. [During these visions,] I was crying,” said Asher.
Read: The Encyclopaedia of Medicinal Plants
Medicinal plants are used in the treatments of many diseases
South African traditional medicine uses animal, mineral and plant products to induce physiological or psychological healing effects. In short, all of nature can be used as medicine, even poisonous plants in very small doses.
“We just grind the leaves and put [them] in water. We let [them] settle and give [them] to people to drink,” says Mndende.
At Icamagu Heritage, medicine is prescribed depending on symptoms, and Mndende always recommends the prescribed medicine to be taken fresh.
Read: SA medicinal plants under threat
“We believe that once you take medicine and there is no relief after three days, it’s not that particular disease, it’s something else. So that is why we prefer that the person comes and stays with [us] so that [we] can monitor the person and change the medicine if [the one we prescribed] is not working,” says Mndende.
Image: Dr. Mndende shows where she picks the herbs she uses at Icamagu Heritage. Photo by Janelle Cabuco
Plants: cure more than just 'physical symptoms'
Ingredients are not only picked and used for their healing abilities, but oftentimes, they have corresponding symbolic and spiritual significances.
“The wisdom [to use traditional medicine] comes from my forefathers, from elders. That’s why I study,” said Asher.
“[However,] you can’t keep it for yourself. You can’t die with the secret; the people must know. You must pass it on from generation to generation.”
Traditional medicine practices are often very secretive and localised, causing practitioners to seldomly write down their trade. Instead, their knowledge is passed on orally.
Traditional herbal medicines may be gathered in the wild for self-medication, or they may be purchased from herb sellers or traditional healers.
However, as herbs can vary - depending on season, geography and genetics – and as a poor batch of medicine with variable potency can be very dangerous, many consumers shy towards buying their medicines from specialists.
Read: Herbs A-Z
“[People] would travel about 60 km, 100 km to come and look for [this specific medicine],” said Mndende.
There are about 200 000 traditional healers in South Africa alone, and about 133 000 households make a living off of collecting medicinal plants. Rural women, who would otherwise be unemployed, collect most of these herbs in the wild.
As a result, a number of indigenous plants have become endangered. Table Mountain currently has one of the highest concentrations of threatened and endangered plant species in the world because of medicinal plant poaching.
Image: A selection of medicinal plants that traditional healer Asher sells. Photo by Janelle Cabuco
How legal is this practice?
One of the biggest problems that have lead to the endangerment of numerous plants is an uncontrolled and unregulated market for traditional herbal medicines.
The Medicines Control Council is in charge of overseeing the sale of medicine products in South Africa. Though the Council is mandated to ensure the safety, effectiveness and quality of all medicinal products, it is currently failing to protect the cultivation and preservation of traditional herbal medicines, and is also failing to deal with complaints of malpractice.
Read: Triumph for traditional healers
Is it safe to use plants for medicinal purposes?
According to Bevan Gogwana, Parliament’s Health Committee’s chairman, the majority of Eastern Cape patients admitted into a hospital with renal failure have one thing in common: They have been prescribed with traditional medicines.
Since traditional South African herbal medicines are not under the same classification as Chinese medicines or complementary medicines, they do not have to be processed and certified.
Read: The dangers of herbs
Three years ago, the government initiated a process to regulate alternative medicines, but did not follow through with the system.
Additionally, in 2004, the council asked alternative medicine manufacturers to submit their medicines in for an audit, but the audit never materialized.
As a result, about 155 000 alternative medicines are being sold South Africa without proper testing.
“One of the problems we have in our country is [that] … there’s no major distinction between African traditional medicine and say a Chinese herbal, or Western herbal or combination product … They are in the main source from nature; they’re leaves, roots, fruits, and animal bits and pieces.
So the big question is how is it that they are not regulated?” says Norman Fels, an executive council member of Health Products Association of Southern Africa.
“It’s a constitutional right to choose your health modality, and because it doesn't fit into an orthodox paradigm this is no excuse to deprive people of that right.”
Image: A selection of plants, bark and roots used in traditional African medicine. Photo by Janelle Cabuco
Due to this lack of regulation, many people have begun to sell fraudulent products.
“People should worry about the fly by nights. Those people sell fake traditional medicines,” said Mndende. “I don’t encourage people to buy those medicines that are sold on the streets because who is going to be held accountable? You don’t know how it is mixed and you don’t know the person.”
Adverts claiming to bring back lost lovers, cure diabetes and enlarge penises can be found all throughout major cities. Since it is so hard to distinguish genuine medicines from fakes, marketers often tell consumers whatever they want to hear.
“There are doctors on the street with no qualifications. So be careful of those because they have just seen there is money here. When you buy medicine from me you must know which school of though I am coming from. Where is my home?” said Mndende.
“You find in town people are passing papers [that say,] ‘Win the lotto.’ If I am able to make people win the lotto, why am I selling on the streets? If I am able to do that [then why am I] not rich? That means those people are fake.”
Watch: 80% of South Africans use traditional medicine and the industry supports thousands of households. Documentary for Health24 by Jannelle Cabuco and Jenna Pittaway
Read: Why we need to embrace traditional medicine
Dangers linked to traditional medicines
One of the biggest issues that comes with using traditional herbal medicines is the possibility of being diagnosed inaccurately. An inaccurate diagnosis often leads to a delay in treatment, which can be detrimental to a person’s health.
However, many others have found relief in traditional medicine and are strong believers of its healing qualities.
Read: Health24 puts a traditional healer to the test
“I have been taking traditional medicines since I was in my early 20s; my mother exposed me to [them] … I was very skeptical about it first and I didn’t want to [take them]. I preferred going to a doctor, but after using [traditional medicines] I became quite accustomed to [them], and [they] helped me a lot,” said 66-year-old Elizabeth Gertse.
“I don’t like taking tablets, so I prefer to cook the medicine in a pot and drink it over a period of seven days. Buchu is the one thing I have trusted over the years, and ever since I started using it I have never looked back.”
“African wormwood also works well for stomach complaints,” said Callan Karamitas on Health24’s Facebook page. “I made a tea out of it and had it with raw honey when I contracted bad food poisoning. It cleared up completely in a couple of days without me having to go to the doctor or get antibiotics.”
HIV+ Health24 user Vic says "I've been using Sutherlandia & Moducare for 3 years, together with other vitamins. My CD4 count is still looking good, still going up - so I don' t have to go on ARVs yet."
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Though traditional healers are often the first ones to be called for help when sickness strikes in most of South Africa, there are still many misconceptions about the practice of traditional South African medicine.
For instance, some people still believe that traditional medicinal practices involve witchcraft or human sacrifices.
In fact, under colonial rule, traditional diviners and healers were outlawed because they were considered to be illegal practitioners of witchcraft.
In 1975, diviners and healers were sent to re-education camps in an attempt to control traditional medicine.
Image: Sangoma (Traditional Healer) students pose for a photo in front of their school
On his website ethnobotany.co.za Jean-Francois Sobiecki, a natural medicines healer, ethnobotanist and research associate with the Centre for Anthropological Research (CfAR) at the University of Johannesburg describes how traditional healer Letty Maponya (who passed away in 2013) treated her patients:
Headaches with snuffing or inhaling burning medicines, inflammation with anti-inflammatory drinking medicines, bitter tonics for increasing appetite, sedative medicines for depression, vomiting medicines to clean the digestive system and to open the mind (open intuition and increase sensitivity), and antibiotic or immune boosting medicines for weakness or infection.
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Image: A traditional healer's consulting room in Lulekani in Limpopo province
“If you look at the terminology first of all, even [other ethnicities have] shops selling traditional medicine. Those shops are called natural medicine.
But if it’s me, it’s called a muti shop, something negative. My medicine is regarded as unclean. Others, they’re all natural medicines.
If I’m a spirit medium, I’m regarded as somebody who is wrong – full of superstitions; somebody who is a witch doctor. That term is still applied today,” says Mndende.
“These are all the misconceptions about traditional medicine, but the very same people who are calling us witch doctors are the very same people who come here and steal out medicine.”
Read: How your medicine is made
Muti a word derived from medicinal plant and refers to traditionally sourced plant, mineral and animal based medicines, but in these instances, it is used negatively.
“I always make an example of an aloe plant for you to see the difference. If I take an aloe plant and cut the leaves, squeeze the juice out, the juice will turn black once it’s dried. That is called traditional medicine or muti,” says Mndende.
“But if someone from the West takes the same aloe leaf, puts it in a machine in the laboratory, squeezes the juice out, and it turns black when it’s dried, that is called western medicine or modern medicine. It’s the same thing, but the difference is that I took it and squeezed it myself.”
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Image credit: Janelle Cabuco, Jenna Pittaway