Traditional Healers Straddle Two Worlds in South Africa’s Fight Against HIV

BULUNGULA, SOUTH AFRICA — 
This is Part Four of a five-part series Continue to Parts: 1 / 2 / 3 / 4 / 5
Nozolile Zintoyinto’s 82-year-old eyes widened when she looked up at the corrugated iron ceiling of her mud hut. “I hope it does not collapse!” she exclaimed. A thunderstorm, accompanied by pounding rain, was lashing the Bulungula district in South Africa’s Eastern Cape province.

Zintoyinto fingered the mass of white beads around her neck and her wrinkled face became even more furrowed when she told VOA, “I am suspicious of you. If I tell you wrong things then the spirits of my ancestors will be furious with me….”

Zintoyinto’s been a sangoma, or traditional healer, in the heartland of the country’s Xhosa ethnic group for more than 60 years.

Through interacting with ancestral spirits and giving concoctions of herbs, plants and roots, called muti, to patients, sangomas traditionally heal physical and emotional sicknesses. In Xhosa culture some of their services include brewing potions to protect people from harm and to ensure good luck, prosperous business and a faithful husband or wife. They’re also often called upon to find lost livestock.

Perhaps a sangoma’s greatest role is to save people from various afflictions, primarily serious illnesses, believed to be caused by witches and evil spirits.

“When I’m talking of serious illnesses here, I am mostly talking about when people are being bewitched, or cursed, by their enemies. Such people usually experience terrible pain in the waist or the back, and also vomiting,” said Zintoyinto. “This is caused by evil spirits. Then I wash them with a mixture of herbs and roots. I stand on their back to straighten them and I rub their legs with the muti. This makes the evil spirits leave them alone and they get better.”

​But she acknowledged that there’s one illness that even she cannot heal.

“This thing called HIV is very powerful, very horrible,” said Zintoyinto, whispering.

Her words were punctuated with sudden, hoarse bellows – indications that the spirits of her deceased ancestors were making their presence felt to her.




In Bulungula, where South Africa’s health department estimates one in every four adults is infected with HIV, the prevalence and severity of the virus is radically changing the sangoma’s role...and resulting in a dramatic merging of tradition with modern medicine.

Muti fails HIV test

Zintoyinto insisted evil spirits are infecting some people in Bulungula with HIV. “I’ve heard that you get HIV through sex. But I also know that there are witches busy mixing muti to poison people so that they get HIV,” she said.

Then the sangoma added, “But no matter how you get this terrible disease – whether it’s through sex or it is visited upon you by evil spirits and curses from your enemies – it remains only ARVs that can treat HIV.”

Zintoyinto’s unwavering support of life-prolonging antiretroviral [ARV] medication sets her apart from other traditional healers – many of whom continue to maintain that only traditional muti can treat, and even cure, HIV. Zintoyinto disagrees.

“I encourage people to be tested for HIV because sangomas like me cannot heal it. I was told this by the ancestor spirits. So it’s better to send the infected people for ARVs at the hospital than to give muti to them that won’t work,” she said.

Personal experience, said the sangoma, has also informed her decision to back modern science over tradition. “I’ve seen people with serious illnesses, like non-stop diarrhea and incurable vomiting, who get so weak that they’re close to death. But when they start taking ARVs, they improve remarkably. That’s why I trust ARVs,” said Zintoyinto.

In South Africa, where UNAIDS estimates 5.6 million people are living with HIV and where recent academic research shows that about 60 percent of the population consult traditional healers, sangomas like Zintoyinto are important weapons in the battle to stem HIV.

“In many South African cultures traditional healers, especially the old ones, are the most respected members of society. What they say, people listen to. So for sangomas to promote ARVs, instead of traditional medication, will result in many, many lives being saved,” said Nomzingisi Hopisi, health manager at the Bulungula Incubator NGO.

Sangoma with HIV

In a village about 15 miles from Zintoyinto’s hilltop hut, a slight young woman’s eyes flashed as she steeled herself to speak to a crowd. Old men and women and boys and girls fell silent as she grabbed a loudspeaker and shouted, “Molweni abantu! [Hello people!] My name is Veliswa Manundu. I am 32 years old, and I am HIV-positive!”

Some in the audience murmured; others giggled uncomfortably; most simply stared at her.

Manundu is living openly with HIV in a part of the world where those known to have the virus are discriminated against and shunned. Most infected people in Bulungula go to great lengths to keep their HIV status a secret. Some choose not to take ARVs for fear that hospital visits to collect the drugs will reveal them to be infected with HIV. In effect, they choose serious illness and eventual death over public exposure as HIV-positive individuals.

“I’m living with HIV and my heart told me to tell everyone about this, so that I could give hope to others, to help them to cope with it when they are diagnosed with HIV,” Manundu said after her speech to the village community.

She’s a rarity on another front in the district – Manundu is a traditional healer who’s living publicly with HIV.

She vividly remembered being “called by the spirits” as a teenager. “When you are about to become a sangoma, there are some illnesses that you start experiencing. Also, you start having visions. These are signs from the ancestors that you about to become a sangoma,” she explained.

Then, Manundu became emotional and exhaled deeply. “Yoo!” she exclaimed. “In the dreams I saw my ancestors, the old people who had lived before me. They told me I must be a sangoma. They told me I must always wear white clothing and these beads around my neck.”

HIV ‘changed everything’

Manundu’s status as a traditional healer has placed her in a unique position to influence the response to HIV in the Bulungula area. Like Zintoyinto, she’s a fervent advocate of ARVs, not traditional medicines, to treat the disease.

“I know that if I give a patient muti, and that person is infected with HIV, the muti will make that patient even sicker,” stated Manundu. “I have seen it happen.”

She’s adamant that HIV is transforming the role of sangomas in South Africa.

“Long ago, there was no such thing as HIV. Long ago, it was okay to treat most diseases with traditional medicine, but those times are gone. HIV has changed everything and it is forcing us to change our culture and traditional practices,” said Manundu.

“If a patient comes to you as a sangoma and you suspect the person is infected with HIV, you have a responsibility to that person and to the broader community to get that person tested and onto ARV treatment if he or she tests positive. That is your responsibility; your responsibility is not to uphold tradition at the cost of peoples’ lives.”

Manundu said the fact that she is personally taking ARVs, and is a sangoma, accords her immense credibility in Bulungula.

“Because I have the experience of living with HIV, and also the experience of taking ARVs and feeling how they work for me, I am able to advise others that it is good to take them,” she commented.

“I know that many sangomas themselves are not having HIV, or they are not living openly with HIV. They are not taking ARVs and therefore they are ignorant about the medicines. That’s when they tell people not to take ARVs and to carry on taking muti.”

Nurses and sangoma cooperate

Manundu goes much further than merely encouraging people to get tested for HIV; she accompanies them to the nearest hospital and guides them through what is often a traumatic experience.

“If they test positive, I encourage them to go onto ARVs. If a person cannot collect the medicine themselves, I get their clinic file and I go and collect ARVs on their behalf and I deliver the pills to them.”

She and the hospital nurses cooperate in what is an example of tradition and modern medical science melding together to combat HIV.

“If people test positive, the nurses refer them immediately to me. I give them advice in detail. I explain to them where they can get ARVs and I also teach them how to take the pills properly and how to prevent spreading HIV,” said Manundu.

She continued, “What also really helps is the fact that I am infected with HIV myself, unlike the testers at the hospital and clinic. This means that the people see me as very credible and they tend to listen to me and to immediately go on to ARVs. I don’t lecture them.”

No HIV patients

But the revolution in the ranks of traditional healers in Bulungula isn’t complete.

In a dark hut on a hill overlooking the mouth of a swollen river, a man seated on a plastic beer crate swung a cattle whip. His bloodshot eyes blinked incessantly as he drank from a polystyrene cup filled with gin.

He was dressed in khaki pants tucked into mud-flecked black gumboots, his torso swallowed up by a silver-grey suit jacket that was several sizes too large for his featherweight frame.

His name was Melidinga Machi [60], and he was the local ixwele, or traditional Xhosa herbalist.

Between sips of gin, he explained that he mostly treats “mentally ill” people “who just cry for no reason. Others become violent. I help them by giving them herbs crushed into powder to snort, and a drink made from the bark of a tree.”

But, said Machi, it’s more difficult to cure other patients…those who are “bewitched” and have “insects inside their brains.”

“I give such a person some medicine to drink,” he explained. “After a while he starts to vomit these insects out. They look like big crickets. There are usually three or four of them. The creatures are alive when they come out but they cannot move, because they are poisoned. Then I kill them.”

Machi said some of his business comes from people who want protection from evil spirits. “I make a mixture of traditional plants. Then I cut the person with a razor blade, into the flesh. Then I rub the concoction into the wound. This muti makes a person very strong.”

But Machi remained adamant that in his many years as a herbalist, he has never seen a single patient infected with HIV, or even one he suspects had HIV.

“I’ve only heard about this AIDS thing on the radio,” he insisted.

Machi acknowledged that he doesn’t pay much attention to HIV – even though he’s “scared” of it as he’s heard – again from the radio – that “it’s a killer.”

Machi said he sees “no reason” to ask his patients to get tested for HIV.
“I’ve never been tested for HIV, because I’m very afraid of that needle that takes the blood. How can I encourage others to get tested if I myself am not willing?” he asked, smiling, and swigging gin.

Machi’s apparent willful ignorance of HIV irked Manundu.

“The time of denial is over,” she said firmly. “The time for us traditional healers to hide behind culture and to hide from HIV is past. It is now time to confront this disease that has killed and is still killing so many of our people.”

Slowly but surely, a creeping presence is manifesting itself in this most isolated and superstitious of communities – in the form of an acceptance by sangomas that HIV is the greatest evil spirit they’ve yet encountered…and that only by embracing modern medicine can they exorcise the demon.