South Africa hosts a plural healthcare system that includes an allopathic sector and a complementary and alternative healthcare sector. This research report seeks to understand the motivations behind why people use the complementary system of Ayurveda, in South Africa and how they decide on its use through processes governing their decision making methods. The literature review summarises the key theoretical framework which moulded the study. The themes incorporated in the review include medicine’s evolution, Ayurveda, medical pluralism and complementary and alternative medicine, the illness experience and help seeking behaviour, the sick role and its relation to help seeking behaviour, and the Health Belief Model. The research was qualitative in nature and entailed semi structured interviews that were conducted with twenty seven Ayurveda users and three Ayurvedic doctors. The findings and analysis draw on the literature review, and when analysed, are developed into three coherent themes namely Ayurveda in South Africa (sets the scene of Ayurveda within the country), Reasons for using Ayurveda (the motivations behind people’s help seeking behaviours toward the system), and the use of Ayurveda in relation to other healing systems. The research found that Ayurveda is currently undergoing resurgence in South African society and in the process links itself to the wider global context that Ayurveda has situated itself. We also discover that participant’s decisions on the use of Ayurveda were decided upon through a multitude of factors and often Ayurveda was also utilised in many different situations rather than for a single case. Such interconnecting factors include their socialisation, lay referrals, interest in alternative systems, a sense of Indian pride and a cynical perception of Western medicine. Alternative or complementary system use was decided upon through factors that linked to people’s access of the alternative services and its affordability. Decisions ultimately were made to use Ayurveda as a complementary system to allopathy. Finally the conclusions of the study indicate that Ayurveda was transferred to South Africa, from India, through the country’s system of indentured labour where knowledge of the practice was passed down along generations. The research also deduces that it is primarily the Indian race that uses Ayurveda in South Africa and as such the healing system is more prominent in Indian areas. In addition, Ayurveda was not found to be a viable health or healing option for the wider South African population for whom its affordability and accessibility pose barriers.

Dissertation submitted in partial compliance with the requirements for the Masters Degree in Technology: Homoeopathy, Technikon Natal, 1997. / The aim of this study was to assess pharmacists' perception of complementary medicine in the health care system of South Africa / M

Dissertation submitted inpartial compliance with the requirements for the Masters Degree in Technology: Homoeopathy, Technikon Natal, 1998. / The aim of this investigation was to determine the perception of medical practitioners with regard to complementary medicine in health care in South Africa. This involved establishing medical practitioners attitude, as well as their experience and knowledge of complementary medicine: homeopathy, chiropractic, acupuncture, ayurvedic medicine, herbalism, reflexology, aromatherapy and osteopathy / M

The formal recognition of traditional healing has been controversial for some time with traditional healers being labelled by those of conventional medical orientation as a medical hazard and purveyors of superstition. The support for the development of traditional medicine and establishment of co-operation between traditional healers and allopathic heath practitioners was first promoted in the international health arena by the World Health Organisation. Estimating that 80% of the population living in rural areas of many developing countries was using traditional medicine for the primary healthcare needs, this organisation advocated for the establishment of mechanisms that would facilitate strong cooperation between traditional healers, scientists and clinicians. The study was undertaken in the Amathole District Municipality, Province of the Eastern Cape based on Chapter 2, Section 6(2) (a) of the Traditional Health Practitioners Bill 2003, which required regulation and promotion of liaison between traditional health practitioners and other health professionals registered under any law. The purpose of the study was to develop and propose strategies to facilitate collaboration between traditional and allopathic health practitioners to optimise and complement healthcare delivery. The conceptual framework guiding the study was derived from Leininger’s theory of Cultural Care Diversity and Universality chosen because of its appropriateness. The terms used throughout the study were defined to facilitate the reader’s understanding. Ethical principles were adhered to throughout the research process. To ensure trustworthiness of the study, Guba’s model (in Krefting,1991:214-215) was used where the four aspects of trustworthiness namely, truth value, applicability, consistency and neutrality were considered. A qualitative, exploratory, descriptive and contextual research design was used which assisted in articulating the appropriate strategies to develop to facilitate v collaboration between allopathic and traditional health practitioners. The study was done in two phases. Phase one entailed data collection using unstructured interviews, a focus group interview, literature control and modified participant observation. In Phase two strategies to facilitate collaboration between allopathic and traditional health practitioners were developed. The population in this study comprised three groups of participants. Group 1 consisted of allopathic health practitioners, Group 2 comprised traditional healers and Group 3 was composed of participants who were trained as both traditional healers and allopathic health practitioners. All participants had to respond to three research questions which aimed at:  exploring and describing the nature of the relationship between allopathic and traditional health practitioners before legalisation of traditional healing and their experience as role-players in the healthcare delivery landscape in the Amathole District Municipality.  eliciting the viewpoints of allopathic and traditional health practitioners regarding the impact on their practices of legalisation of traditional healing and  developing strategies to facilitate collaboration between allopathic and traditional health practitioners. Data obtained from each group was analysed using Tesch’s method as described by Creswell (2003:192). Themes emerging from data and the corresponding strategies to address the themes were identified for each group. The participants’ responses to the three research questions revealed areas of convergence and divergence. Of significance was the reflection by the participants on their negative attitude towards each other. They also highlighted that there was no formal interaction between traditional and allopathic health practitioners in the Amathole District Municipality. Their working relationship was characterised by a one-sided referral system with traditional healers referring patients to allopathic health practitioners but this seemed not to be reciprocated vi by the latter group. The exception was the case of traditional surgeons whose working relationship with allopathic health practitioners was formally outlined in the Application of Health Standards in the Traditional Circumcision Act, Act No.6 of 2001. Allopathic health practitioners attributed their negative attitude as emanating from the unscientific methods used by traditional healers in treating patients, interference of traditional healers with the efficacy of hospital treatments and delays by traditional healers in referring patients to the hospitals and clinics. Traditional healers stated that they were concerned about failure of allopathic health practitioners to refer patients who talked about “thikoloshe” and “mafufunyana” to the traditional healers. Consequently, these patients presented themselves to the traditional healers when the illness was at an advanced stage. A reciprocal referral system was perceived by the traditional healers as the core element or crux of collaboration. There were ambivalent views regarding the impact of legalisation of traditional healing on the practices of both traditional and allopathic health practitioners. Elimination of unscrupulous healers, economic benefits, and occupational protection were benefits anticipated by traditional healers from the implementation of the Act. The possibility of having to divulge information regarding their traditional medicines, monitoring of their practice resulting in arrests should errors occur were however, cited by traditional healers as threatening elements of the Act. A lack of understanding the activities of each group with an inherent element of mistrust became evident from the participants’ responses. Ways of fostering mutual understanding between them were suggested which included holding meetings together to discuss issues relating to healing of patients, exposing both groups of health practitioners to research, as well as training and development activities. The participants also highlighted areas of collaboration as sharing resources namely, budget, physical facilities, equipment and information and role clarification especially pertaining to disease management. The participants vii strongly suggested that there should be clarity on the type of diseases to be handled by each group. The need for capacity building of traditional and allopathic health practitioners in preparation for facilitating collaboration was advocated by all and the relevant activities to engage into were suggested. Analysis, synthesis and cross referencing of the themes that emerged from the data culminated in the identification of three strategies that were applicable to all groups of participants and which would assist in facilitating collaboration between allopathic and traditional health practitioners. The researcher coined the three strategies “Triple C” strategies abbreviated as the TRIC strategies. The first “C” of the three “Cs” stands for “change attitude”, the second “C” for “communication” and the third “C” for “capacity building.” Each of the proposed three strategies is discussed under the following headings:- Summary of findings informing the strategy  Theory articulating the strategy  Aim of the strategy  Suggested implementation mechanism As the strategies had to be grounded in a theory which would serve as a reference point, the researcher used the Survey List by Dickoff, James and Wiedenbach (1968:423) as a conceptual framework on which to base the proposed three strategies. The results of this study and recommendations that have been made will be disseminated in professional journals, research conferences and seminars.

A dissertation submitted to the Faculty of Science under the School of Molecular and Cell Biology, University of the Witwatersrand, Johannesburg, in fulfilment of the requirements for the degree of Master in Science. Johannesburg, June 2017. / In South Africa, the anti-HIV-1 activity of various indigenous plants has not been studied extensively. Most of the phytochemical screening work has focused on anti-cancer activity with less attention given to infectious diseases. A large proportion of South Africans (70-80%) still rely on traditional medicines for treatment of various ailments. And, therefore, there is a need to evaluate and validate the effectiveness of the traditional medicines. The aim of this study was to identify, screen, phytochemically characterize and isolate bioactive compounds from a South African herbal extract that exhibit the best anti-HIV-1 activity. Three extracts were prepared: an ethanol extract, a dereplicated ethanol extract and an aqueous extract from a herbal concoction comprised of a mixture of six plants. These herbal concoctions were investigated for anti-HIV-1 subtype C activity. Phytochemical profiling of the ethanol- and dereplicated ethanol- extracts from the herbal concoctions showed the presence of intermediate polar compounds (flavonoids, alkaloids, sugars and terpenes) for both extracts, while the aqueous extract contained predominantly highly polar compounds. Anti-HIV-1 screening of the three extracts showed that the ethanol and dereplicated ethanol herbal- extracts had the best anti-reverse transcriptase activity. The ethanol extract had mean IC50 values of 56.53, 53.96 and 55.39 μg/ml against MJ4, Du179 and CM9 HIV-1 subtypes C isolates, respectively. The dereplicated ethanol extract had mean IC50 values of 51.87, 47.56 and 52.81 μg/ml against MJ4, Du179 and CM9 HIV-1 isolates, respectively. The aqueous extract was inactive against HIV-1 activity. Moreover, both the ethanol- and dereplicated ethanol- extracts showed activity against HIV neutralization. The ethanol- and dereplicated ethanol- extracts had mean IC50 values of 36.33 and 32.06 μg/ml, respectively. Furthermore, they also potently neutralized Vesicular stomatitis virus (VSV) yielding mean IC50 values of 24.91 and 20.82 μg/ml for ethanol- and dereplicated ethanol- extracts, respectively. All extracts were inactive against Murine leukemia virus (MLV). The isolation and phytochemical characterization of the bioactive compound(s) was done by utilizing various chromatographic and spectroscopic methods. Four homoisoflavanoids were isolated and tested for anti-HIV-1 subtype C activity. Three compounds (1, 3a and 3b) were inactive while compound 2 was found to be bioactive against HIV-1 reverse transcriptase (RT) and yielded mean IC50 values of 7.23 ± 1.88, 12.83 ± 0.41 & 12.81 ± 0.10 μg/ml for MJ4, CM9 and Du179 HIV-1 subtype C isolates, respectively. Compound 2 had a mean CC50 value of 23.08 ± 0.1981 μg/ml against HEK293T cells. Overall, the data suggested that ethanol- and dereplicated ethanol- herbal extracts possess direct and indirect anti-HIV-1 activity. They possess a cocktail of phytochemicals that can inhibit HIV-1 RT, HIV-1 entry. Furthermore, these extracts possess phytochemicals that can lower the activation of inflammatory responses during an infection and, hence, reduction in the number new cells infected during the course of HIV-1 infection. Moreover, they possess phytochemicals that have antioxidant activity which, in relation to HIV infection, results in a boosted immune system response in order to ward off the virus. / MT 2017

M.A. (Psychology) / Please refer to full text to view abstract

Thesis (MA)--Stellenbosch University, 2014. / ENGLISH ABSTRACT: Across the globe scientists are taking issue with pseudoscience, as well as the role of the media in promoting it. Articles based on pseudoscience, especially those relating to Complementary and Alternative Medicine (CAM) that fall outside the realms of orthodox medicine, are common in all forms of media, but especially in women’s health and lifestyle magazines. Scientists are quite vociferous in their condemnation of CAM for both ethical and safety reasons, since neither the therapies nor the remedies associated with CAM practices have been proven to be efficacious, or even safe. In fact, some of the therapies and advice offered by CAM practitioners are dangerous and, in some instances, may even be life threatening. Nevertheless, the media continue to promote CAM, and the public continues to support it – despite the warnings and denunciation by scientists. This is an exploratory study to determine the prevalence of pseudoscience, generally, in South African women’s health and lifestyle magazines, and to uncover the reasons the public supports it. The magazine Longevity is used as an example of this type of publication, and a content analysis is used to illustrate the prevalence of pseudoscience articles and adverts in South African media, while field research, in the form of personal interviews, attempts to determine the reasons people support CAM in spite of its denunciation, as well as the media’s role in fostering this support. Both mainstream science and pseudoscience are described, while a literature review reveals the scientific perspective of CAM, provides examples of the more popular forms of CAM and the dangers inherent in them, as well as the ways in which science and pseudoscience in general, are handled by the media. Using the hypodermic needle theory, plus the results of the content analysis and field research, this study shows that media promote pseudoscience because it pays; the public support CAM because they believe it works; and that that belief is primarily the result of public disillusionment with the practice of orthodox medicine, rather than the result of media’s promotion of CAM, as scientists contend. / AFRIKKANSE OPSOMMING: Wetenskaplikes van regoor die wêreld het ’n probleem met pseudowetenskap, sowel as die rol wat die media speel om dit bevorder. Artikels gebaseer op pseudowetenskap, veral dié met betrekking tot Aanvullende en Alternatiewe Medisyne (AAM), wat buite die grense van ortodokse medisyne val, is algemeen in alle vorme van media, maar veral in gesondheid-en lewenstyltydskrifte vir vroue. Wetenskaplikes is baie uitgesproke in hul veroordeling van AAM om beide etiese en veiligheidsredes, omdat nóg die terapie nóg die middels wat verband hou met AAM praktyke bewys is om doeltreffend, of selfs veilig te wees. Trouens, sommige van die terapieë en advies wat aangebied word deur AAM beoefenaars is gevaarlik, en in sommige gevalle selfs lewensgevaarlik. Tog hou die media aan om AAM te bevorder, en die publiek om dit te ondersteun – ten spyte van die waarskuwings en veroordeling deur wetenskaplikes. Hierdie narvorsing is ’n verkennende studie om die voorkoms van pseudowetenskap in Suid-Afrikaanse vroue se gesondheid- en lewenstyltydskrifte te bepaal, en die redes te ontbloot waarom die publiek dit ondersteun. Die tydskrif Longevity word gebruik as ’n voorbeeld van hierdie tipe publikasie, en ’n inhoudsanalise word gebruik om die voorkoms van pseudowetenskaplike artikels en advertensies in die Suid-Afrikaanse media te illustreer, terwyl navorsing in die veld, in die vorm van persoonlike onderhoude, poog om die redes te bepaal waarom mense AAM ondersteun, ten spyte van veroordeling, sowel as die rol wat die media speel in die bevordering van hierdie ondersteuning. Beide hoofstroom wetenskap en pseudowetenskap word beskryf, terwyl ’n literatuuroorsig die wetenskaplike perspektief van AAM ontbloot, voorbeelde van die meer populêre vorme van AAM word verskaf asook van die gevare daaraan verbonde, sowel as die maniere waarop wetenskap en pseudowetenskap in die algemeen, hanteer word deur die media. Met behulp van die spuitnaald teorie, plus die resultate van die inhoudsanalise en navorsing in die veld, bewys hierdie studie dat die media pseudowetenskap bevorder, want dit betaal; die publiek ondersteun AAM omdat hulle glo dit werk; en dat daardie geloof primêr die gevolg is van openbare ontnugtering met die beoefening van ortodokse medisyne, eerder as die gevolg van die media se bevordering van AAM, soos wetenskaplikes beweer.

M.Tech. (Homoeopathy) / Complementary and Alternative Medicine (CAM) describes a group of natural healthcare interventions that may be employed in conjunction with (Complementary) or instead of (Alternative) conventional medical treatments (Barnes and Bloom, 2008).The prevalence of CAM use in industrialised countries has shown a significant increase in recent decades, amongst consumers and professionals alike, and is being utilised by up to 50% of adults in developed communities (Astin et al., 1998). The general public are starting to take their health and well-being into their own hands by investing in CAM products and consulting with various CAM practitioners. This study is designed to gain valuable insight into the subjective experience of typical CAM users in Johannesburg. Such information may raise awareness within the current CAM climate and may be of value in formulating future marketing and educational strategies for the various CAM professions. Several global surveys have been done to determine patterns and prevalence of CAM use. In South Africa, such studies have been conducted in Cape Town (Du Plessis and Pellow, 2013) and in Durban (Singh et al., 2004). The Allied Health Professions Council of South Africa (AHPCSA) is the regulatory body of CAM in South Africa. It currently regulates and registers 11 CAM professions, namely Homoeopathy, Chiropractic, Ayurveda, Traditional Chinese Medicine, Unani-Tibb, Osteopathy, Naturopathy, Phytotherapy, Therapeutic Aromatherapy, Therapeutic Massage and Therapeutic Reflexology. Most CAM products are freely available in various retail outlets. The aim of this study is to determine the attitudes and perceptions of Complementary and Alternative Medicine users in Johannesburg health shops. This will be evaluated by means of a questionnaire survey.

MAAS / Centre for African Studies / See the attached abstract below

The purpose of this study was to determine the profile of parents with children in Early Childhood Development (ECD) centres using Over the Counter (OTC) homeopathic remedies, specific to the Pretoria East region. Secondary objectives included determining the extent of use of OTC homeopathic remedies, the perceptions of parents regarding homeopathy and natural remedies as well as the positioning of homeopathy. The research was designed around descriptive and exploratory methods using quantitative research techniques. Aspects such as demographic information and the general health of families, attitudes, perceptions and opinions specific to homeopathy, natural remedies and conventional medicine, as well as details on remedy usage and brands, were addressed. From the findings of the study a clear profile could be identified. Further to the profile, the perceptions of respondents regarding OTC homeopathic remedies as well as reasons for using these remedies are discussed. The positioning of OTC homeopathic remedies was done based on spider graphs, exploratory factor analysis, cluster analysis and multidimensional scaling. Several recommendations were made to the homeopathic industry, the Ministry of Health, medical professionals, Medical Aid Schemes, pharmacists and the pharmaceutical industry, as well as the Department of Social Development. The study concludes with details specific to the limitations of the study and further research suggestions. / Economics / M.A. Commerce (Business Management)