Traditional healers are one among professionals that are viewed as the most significant people in African Society. They are accorded the highest esteem because of the role they play in saving people’s lives and promoting cultural aspects such as ukuhlonipha amasiko in isiZulu. It should be remembered that this word ukuhlonipha which means to respect, is used across cultures to maintain peace within family and society. It all depends on which culture promotes it more than others. It is sociolinguistic truism that ukuhlonipha is essentially linked to the ubuntu philosophy of African people. However, traditional healers more than other people follow ukuhlonipha culture in numerous ways, especially when they meet, being consulted and during traditional ceremonies. They serve and promote what in IsiZulu is known as ukuhlonipha, which to the uninitiated and sometimes even to the scholars of this philosophy is a mystery. It is for this reason and others that people view them as the soul of society. This study looks at relevant sociolinguistic theories especially the politeness theory to analyze most of the hlonipha features shown by traditional healers, apprentice and people during consultation. / African Languages / M.A. (African Languages)

Thesis (MTech (Information Technology))--Cape Peninsula University of Technology, 2016. / The delivery of healthcare services should be of a high standard for everyone. For people in the location of Mantunzeleni this is not the case as there are still challenges that they go through in order to gain access to sufficient healthcare services. The location consists of four villages and the other nine which surround the four, in total this makes thirteen villages that are served by one clinic. These villages are divided by forest, rivers and mountains, people have to cross these and walk long distances to get to the clinic. Gaining access to basic healthcare services in rural areas has never been easy, hence this study seeks to understand the role telehealth could play to help improve the situation. It has been reported in the literature that telehealth has potential to address some of the problems experienced by healthcare service providers located in the rural areas. Research questions were posed to address the problem of limited access to healthcare services of under-served communities in rural areas. The study adopted an interpretive approach to understand how the people using healthcare services in the setting attach meaning to their experiences of the healthcare service. The study therefore seeks to understand how telehealth could improve healthcare service delivery through the participants’ views, perceptions and experiences. The research strategy for this study is a single case study without attempting to generalise the findings. Qualitative data was gathered using unstructured interviews, observations and co-design methods. The current state of telehealth and challenges of healthcare services in rural under-served communities was established through a review of relevant literature. It was important to actively involve the respondents in the research process for them to feel a sense of ownership. Data was analysed using a thematic analysis. The findings revealed the challenges currently hampering the delivery of healthcare in the research setting include poor infrastructure, high cost, the shortage of medical professionals, travelling distance, time management and lack of communication about the services. It was also revealed the role telehealth could play a role to improve access to healthcare and the findings indicate that the nurses feel that extending the healthcare service to include alternative access methods to health information, education and expertise could lead to a sense of appreciation, knowledge gain, dealing with distance problems and improved referrals, cost saving to improve healthcare service delivery.

South Africa, many plants which are used in traditional medicines are collected from wild populations. The high demand for trade and use of these medicinal plants place an enormous pressure on their natural populations, especially because they are indiscriminately harvested. The most affected of these plant species are those harvested from their underground parts, among which is Gunnera perpensa L. Gunnera perpensa is of considerable ethnobotanical interest in traditional medicine because of its wide usage. The rhizomes are widely used and indiscriminately collected in large quantities from the wild to meet the ever increasing demand in traditional medicine markets. As a result, this valuable medicinal plant species is being endangered. According to the Red List of South African Plants, the conservation status of G. perpensa has been listed as ‘declining’. The ethnobotanical survey conducted as part of this research confirms the plant species as threatened. It is, therefore, important to develop propagation and conservation strategies for this medicinal plant. Clonal propagation of G. perpensa was conducted using varying lengths of the rhizome (1, 2, 3, 4 and 5 cm) segments as propagules. While regeneration was possible with all the rhizome lengths, most of the growth parameters were significantly higher in the 5 cm rhizomes than the other rhizome segments. The appropriate planting depth for the rhizomes was also determined and 4 or 5 cm planting depths were found appropriate. No significant difference was observed in the growth parameters amongst the planting depths; nevertheless, 4 cm depth gave higher growth and yield. The results of this study show that regenerating G. perpensa.

South Africa has an estimated 920 000 patients on antiretrovirals (ARVs), the largest number of patients in any country. ARV therapy demands adherence levels in excess of 95% to avoid development of drug resistance, but adherence to ARV therapy is estimated to be only between 50% and 70%. Poor medication adherence is acknowledged as a major public health problem, reducing the effectiveness of therapy and promoting resistance to ARVs. More than two thirds of the South African population have marginal reading skills and this significantly influences a patient’s ability to read and understand health-related information. Patient education materials tailored for the South African population could be a useful aid in facilitating communication with patients and perhaps impact positively on their medicine-taking behaviour. This behaviour is influenced by patient knowledge, beliefs, attitudes and expectations and includes self-management, self-efficacy and adherence. Self-efficacy, which refers to patient confidence in the ability to self-manage medicine taking, is a key factor influencing adherence. This study aimed to develop illustrated patient information leaflets (PILs) and medicine labels for all first-line ARV regimens used in the public health sector in South Africa and, using a randomised control study design, to investigate the impact of these illustrated information materials on knowledge, medication-taking behaviours and health outcomes in HIV/AIDS patients taking ARVs. To achieve this aim, the objectives were to assess HIV/AIDS and ARV-related knowledge, as well as self-efficacy and adherence to ARV therapy; to assess the influence of demographic variables on knowledge, adherence and self-efficacy; to assess the influence of the information materials on knowledge, self-efficacy and adherence and to assess the association of knowledge with health outcomes. Medicine labels and PILs, both English and isiXhosa, were developed for ARV regimens 1a, 1b, 1c and 1d. The 8-item Morisky Medication Adherence Scale (MMAS-8) and HIV Treatment Adherence Self Efficacy Scale (HIV-ASES) instruments for measuring respectively adherence and self-efficacy, were modified to optimize clarity, simplicity and cultural acceptability and were translated into isiXhosa using a multi-stage translation-back translation. The questions and the rating scales, for both the MMAS and HIV-ASES, underwent preliminary qualitative evaluation in focus group discussions. Patients were recruited from local Grahamstown clinics. A pilot study to evaluate applicability of the instruments was conducted in 16 isiXhosa AIDS patients on ARVs and the results from this study informed further modifications to the instruments. One hundred and seventeen patients were recruited for the randomised control trial and were randomly allocated to either control group (who received standard care) or experimental group (who received standard care as well as pictogram medicine labels and the illustrated PIL). Interviews were conducted at baseline and at one, three and six months. Data were analysed statistically using the t-test, chi-squared test and ANOVA (Analysis of Variance) at a 5% level of significance. Correlations were determined using Pearson and Spearman rho correlations. Approval was obtained from Rhodes University Ethical Standards Committee, Settlers Hospital Ethics Committee and the Eastern Cape Department of Health. The results of this research showed that illustrated PILs and medicine labels enhanced understanding of HIV/AIDS and ARV information, resulting in a mean overall knowledge score in the experimental group of 96%, which was significantly higher than the 75% measured in the control group. Variable knowledge scores were measured in three areas: baseline knowledge of general HIV/AIDS-related information was good at 87%, whereas knowledge scores relating to ARV-related information (60%) and side-effects (52%) were lower. These scores improved significantly in the experimental group over the 4 interviews during the 6 month trial duration, whereas in the control group, they fluctuated only slightly around the original baseline score. There was no significant influence of gender on knowledge score, whereas health literacy, education level and age tested (at one and three months) had a significant influence on knowledge. Self-efficacy and adherence results were high, indicating that the patients have confidence in their ability to adhere to the ARV therapy and to practice optimal self-care. Age, gender and education, in most cases, significantly influenced self-efficacy, but were found to have no effect on adherence. The CD4 count improved over the trial duration which may have been influenced by a number of factors, including better knowledge of ARVs and improved adherence. No significant parametric correlation was found between knowledge score and change in CD4 count, however, Spearman's rho showed significance (rs=0.498; p=0.022). Both patients and healthcare providers were highly enthusiastic about the illustrated labels and PILs, and indicated their desire for such materials to be routinely available to public sector HIV/AIDS patients. The isiXhosa version of the PIL was preferred by all the patients. These simple, easy-to-read leaflets and illustrated medication labels were shown to increase understanding and knowledge of ARVs and HIV/AIDS in low-literate patients, and their availability in the first-language of the patients was central to making them a highly useful information source.

This study of 449 newspaper articles from South Africa from 1997 provides an analysis of the representations of obesity evinced in the corpus. The research argues that obesity is overwhelmingly framed as being diseased and that there are four main refrains within this frame, namely, statistics on obesity, the naturalisation of negative assumptions about fat, the social dysfunction of fat and the use of crisis metaphors to describe fatness. This framing lends itself to representations of obesity which are raced, gendered and classed. Fat bodies are portrayed as being in deficit and fat people as lacking agency. The disproportional focus on black bodies in the corpus can be attributed to assumptions of ‘incivility’ which are premised on racial stereotypes which construct black people as being unintelligent, irrational, lacking agency and being largely dependent on others to survive. This disproportional focus on black bodies can also be understood in the context of emerging markets. This study argues that the medicalisation of obesity has contributed to many oversimplifications and contradictions in the representation of obesity in the corpus, which seem to go unquestioned, such as the conflation of weight and health, something I argue is one of the main contributors to the negative consequences of the dominant framing of obesity. Framing obesity as medicalised also promotes fat shaming and acts as a form of social control which maintains existing power relations through the use of discursive practices for the identification and control of deviants. These representations are problematic chiefly because they promote the dehumanisation of fat people, but also because that they do not promote good health as they claim to do.

In South Africa, the quality of health care is directly related to the concept of patient-centred care and the enactment of the Batho Pele Principles and the Patients’ Rights Charter. The quality of health care delivery has dropped drastically, and reports in the media indicate that public hospitals in the Eastern Cape Province are on the brink of collapse, with thousands of patients being treated in condemned hospitals. Receiving and rendering health care in the face of such challenges, the question arose: “Are patients receiving patient-centred care in public hospitals?” The answer to this rhetorical inquiry appeared to be obvious, but this research study explored and described professional nurses’ perceptions of patient-centred care in public hospitals and their understanding of evidence-based practice and best practice guidelines. The proposed study followed a qualitative, exploratory, descriptive and contextual design. The research population included professional nurses who are employed in public hospitals in Nelson Mandela Bay, and consisted of nurse managers and nurses who work in the wards. The research study consisted of three phases. In Phase 1, semi-structured interviews and focus groups were conducted with nurse managers and professional nurses working in the wards in order to collect data about their perceptions of patient-centred care and their understanding of evidence-based practice and best practice guidelines. The interviews were transcribed and Tesch’s eight steps of data analysis were followed to create meaning from the data collected. Themes were identified and grouped together to form new categories. The researcher ensured the validity of the study by conforming to Lincoln and Guba’s model of trustworthiness, which consists of the following four constructs: credibility, transferability, dependability and confirmability. An independent coder assisted with the coding process. In Phase 2, an integrative literature review was conducted in order to identify previous guidelines regarding best practice for patient-centred care. Relevant guidelines were selected, critically appraised, data was extracted and synthesised for the development of a best practice guideline for patient-centred care. An independent appraiser critically appraised the guidelines, thereby ensuring trustworthiness. In Phase 3, the data in Phase 1 and Phase 2 were integrated to formulate a draft best practice guideline for patient-centred care. The guideline was submitted to an expert panel for review and was modified according to the recommendations of the panel, whereby the best practice guideline for patient-centred care in public hospitals in Nelson Mandela Bay was finalized.

Herbal remedies are commonly used in developing countries for the treatment of various diseases, including constipation. The rationale for utilizing medicinal plants for the treatment of diseases rested largely on the belief that they are safe and free of side effects. However, there is limited scientific evidence on the safety and efficacy of these herbal medicines to back up their continued therapeutic application. Aloe ferox Mill. (Aspodelaceae), known as Cape aloe, locally called ikhala is a medicinal plant used by the people of the Eastern Cape Province for the treatment of gastrointestinal problems and constipation. The plant is a perennial shrub with thick succulent leaves bearing brown thorns on the margin and bright orange flowers arranged in oval lanceolate. It occurs in all weather in bush veld, road side, gardens and undisturbed places. According to the ethnomedicinal information, A. ferox is used as purgative. This research project was therefore designed to evaluate its ability in the treatment of constipation and to investigate its possible toxicological property. At the beginning of this programme, a survey of plants used for the treatment of constipation in Nkonkobe Municipality of the Eastern Cape Province was carried out using a questionnaire, which was administered to herbalists, traditional healers and rural dwellers. The study revealed 10 plant species from 8 families that are used for the treatment of constipation in the province. Four plants, Aloe ferox Mill, Boophone distischa L.f Herb, Alepidea amatybica Eckl and Artemisia afra Jacq, were repeatedly mentioned. Based on the frequency of usage, perceived efficacy and availability to the rural dwellers and the traditional healers, Aloe ferox was the most commonly used of the plants for the treatment of constipation. The plant was thus, chosen for the study. The invivo laxative effect of the aqueous extract of Aloe ferox in the treatment of loperamide-induced constipation in Wistar rats was investigated at varying concentrations. The leaf extract at all the dosages investigated (50, 100 and 200 mg/kg body weight) improved intestinal motility, increased fecal volume and normalized body weight in the constipated rats. This was an indication of its laxative properties. However, the laxative property of the herb at 200 mg/kg body weight of the extract showed best efficacy and compares favourably well with senokot, a standard laxative drug. These findings have therefore, lent scientific credence to the folkloric use of the herb by the people of the Eastern Cape of South Africa as a laxative agent. Toxicological evaluation of aqueous leaf extract of Aloe ferox in loperamide-induced constipation was studied at 50, 100, and 200 mg/kg body weight. The oral administration of the extracts did not show any significant effect on the liver and kidney body weight ratios as well as the kidney and liver function indices. The extracts, at all the dosages investigated, did not alter the levels of creatinine, uric acid, urea, calcium and potassium ions. Similarly, the levels of total protein, albumin, bilirubin and gamma glutamyl transferase (GGT) were not significantly different from the control. The plant extract appreciably normalized the elevated activities of alkaline phosphatase (ALP), alanine transaminase (ALT) and aspartate transaminase (AST) in the untreated constipated rats following treatment with the extract. The extract did not show a significant effect on the hematological parameters except for the increase in the lymphocyte count in the untreated constipated rats, which was attenuated after administering the herb. ThThe available evidence in this study suggests that A. ferox may be safe as an oral remedy for constipation. Generally, the effect of the extract compared favourably well with senokot, a recommended drug for the treatment of constipation. The antioxidant activities against 1, 1 diphenyl- 2 picrylhydrazl (DPPH), 2,2’ – azinobis [3- ethylbenzothiazoline -6- sulfonic acid] diammonium salt (ABTS), hydrogen peroxide (H2O2), Nitric oxide (NO), lipid peroxidation and the ferric reducing agents were investigated spectrophotometrically. Alkaloids, saponins, tannins, total phenols, flavonoids, flavonols and proanthocyanidin were also determined to assess their effects on the antioxidants activity of this plant. The phytochemical content of the ethanol and acetone extracts were consistently high compared to other solvents extracts. The level of tannins was not significant (P > 0.05) as compared with other solvent extracts. The free radical scavenging activity of the extracts was high even at lower concentrations (0.025 mg/ml) except in DPPH and lipid peroxidation. The ferric reducing potential of the extracts was concentration dependent and significantly different from Vitamin C and butylated hydroxytoluene (BHT) that were used as standard drugs. The present study showed a high level of scavenging activity of the leaf extracts of Aloe ferox in all the solvent extracts. Both ethanol and methanolic extract showed potent antioxidant activities than acetone and aqueous extracts. The study indicated that the leaf extracts of Aloe ferox might be a valuable source of natural antioxidant for both medicine and food industries. A. ferox leaf consists of the gel, latex and mesophyll layer; however, the main active constituents of the latex and the leaf exudate of Aloe ferox are anthraquinones which are believed to be responsible for the laxative property. The laxative compound in Aloe ferox leaf extract was isolated and characterized by extracting the plant material in methanol and extract suspended in distilled water. Partitioning was done with n-hexane, ethyl acetate and butanol respectively and was co-spotted with the over-the-counter (OTC) laxative drugs. This led to the successive column chromatography and thin layer chromatography (TLC) of the most active ethyl acetate fraction on silica gel with benzene/ethanol/ammonia hydroxide (BEA: 90:10:1), ethyl acetate/methanol/water (EMW: 40:5.4:5) and chloroform/ethyl acetate/formic acid (CEF: 50:40:10) as the mobile phase. The successive chromatograph and TLC afforded two compounds of Rf 0.420 (blue) and 0.831 (yellow) with the over-the-counter (OTC) drugs. These compounds were not totally elucidated due to their small quantity and instability. However, hydroxyl (OH) and carboxyl groups (COOH) was established as common to the extracted compounds, which might be responsible for the biological activity recorded for the plant extract.

MA (Psychology) / Department of Psychology / See the attached abstract below

MA (African Studies) / Centre for African Studies / This study explored indigenous medicinal knowledge of Phonda in the Vhembe District. It has been noticed that phonda is becoming a scarce crop. The objectives entail seeking to solicit information on the uses of phonda, to understand the attitudes of local households towards phonda and to establish what can be done to restore the cultivation of phonda. The study used qualitative method involving unstructured interviews to collect and thematically analyse data. Purposive sampling and snowballing methods were used to make up the study sample. From literature, it is known that traditional health practitioners used phonda for treatment of certain diseases and illnesses. Phonda is no longer common, but the study sought to encourage the cultivation of phonda. The study employed an Afrocentric paradigm of social change as the conceptual framework. The study found that many households no longer plough phonda as they used to in the past. The study recommends that people should be educated on the importance of phonda to encourage them to plough it. Additionally, the researcher recommends further studies into different purposes of phonda and areas to boost its farming.

MRDV / Institute for Rural Development / Traditional medicine still plays a bigger role in people dealing with health and disease. Research shows that in some Asian and African countries, traditional medicine forms the primary mode of health care for 80% of the population. This is actively promoted in South Africa and is used by at least 70% of the country’s population. This study investigated the contributory factors leading mental health care users to use a combination of traditional and modern medicine in rural areas. The study was conducted using qualitative research methods. The population of this study were MHCUs, Mental health practitioners and traditional healers. Purposive sampling was used to select participants. Data was analyzed through a computer programme called Atlas TI. The results revealed the following as contributory factors leading mental health care users to use modern and traditional medicine in rural areas : cultural factor , belief in witch craft , influence by significant others (family members and friends), poor PHC intervention and treatment method. Recommendations to the health care practitioners and policy makers around the use of traditional and modern medicine was made based on the findings.