Thesis (MPA (Public Management and Planning))--University of Stellenbosch, 2010. / ENGLISH ABSTRACT:
The Department of Health estimates that 80 percent of South Africans consult traditional
healers before consulting modern medicine. The aim of this study is to investigate the
extent of the use of traditional medicine in local communities in the Limpopo Province, and
add 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 the
same cultural beliefs and values as their patients. They are respected in their
communities. In South Africa, traditional healers have no formal recognition as health care
professionals.
Despite the advantages of modern medicine, there is a dramatic evolution in traditional
medicine developing and developed countries. In recognition of the value that traditional
medicine has added to people’s health needs, government organisations have realised the
gap and needed to embark on public participation to bring to light the solution, by
implementing a relevant policy (Matomela 2004).
According to research done by Pefile (2005), positive outcomes that resulted from the use
of traditional medicine include a more holistic treatment, a wider choice of health care that
suits people’s needs, and scientific advancement, this paves a way forward for a policy to
be put into place for the legal recognition of traditional medicine. New legislations have
been brought about in regulating traditional medicine and practitioners.
This paper provides a synopsis of government initiatives to close the gap and address the
concerns of integrating traditional and modern medicine. The thesis addresses the
challenges involved in incorporating the two disciplines for the best possible impact of
local 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 interviewed
regarding the draft policy on traditional medicine. This was to obtain information on the
challenges, gaps and possible solutions regarding the integration of African traditional
medicine 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 herbs
that they prescribe, and Western doctors feel that traditional healers should only treat
patients spiritually unless they have a scientifically tested scope and limitations on their
field. The study also found that traditional healers want to be registered and integrated
into the health care system, but do not agree to have regulated price fixing. Other
conclusions included that the communities seek traditional help for cultural reasons and
more benevolent purposes, but are changing their focus towards seeking medical help
from clinics where it is provided for them. However, people within the communities are
still confused whether to seek traditional or western medicine and therefore seek both. It
was found that medications are not readily available in district clinics and hospital waiting
times force people into seeking traditional help. Nurses, doctors and caregivers
acknowledge that traditional healers are hampering the health care of patients by delaying
hospital treatment of patients hence progressing illnesses. However, they also state that
traditional healers help people spiritually and mentally. Therefore policy makers have
found solutions to educate healers and create regulatory boards to limit and create a
scope 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 practice
and train over the age of 21. They must be prohibited from certain procedures, for
example: drawing blood, treating cancers, and treating AIDS/HIV. They should only be
allowed to practice midwifery if they have had training. They should be prohibited from
administering injections and supervised drugs, unless trained at a tertiary level traditional
healers can be used as home caregivers, spiritual healers, and traditional advice
counselling entities in the communities. Traditional healers must be prevented from
referring to themselves as a ‘doctor’ or ‘professor’. This misleads people into believing that
they are allopathic doctors. ‘Traditional health practitioners’ must realise that they are
holistic 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 health
practitioner be registered annually with the relevant board. A good suggestion is for
traditional health practitioners (THP) to attend formal training courses, under an experienced herbalist, and it should be documented on paper. A written record of the
location of practice, and specialty must also be documented. There must be policies on
health and safety, hygiene and sterility that need to be in place. It is suggested that
training on patient confidentially must be taught and implemented. A code of conduct and
a standard of professional ethics must also be implemented. Health and safety regulations
pertaining to the profession and the citizens must be listed. Efforts towards dispelling
myths and making people aware, thereby filtering out the positive side of the traditional
medicine (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 traditional
practitioners, it is recommended that the use of exchange workshops between the two
professionals needs to be developed. Also scientific information and technology must be
available to traditional healers. A continued professional development (CPD) programme
should be a mandatory requirement, as for all other health care professionals. It seems
the development of traditional hospitals, in which a scope of practice is defined, can be
used as a recovery ward and a spiritual guidance centre.
The above recommendations will encourage a healthier, safer and transparent health care
system in South Africa, where all disciplines of medicine co-exist in one National Health
Care System. / AFRIKAANSE OPSOMMING:
Nadat navorsing deur die Departement van Gesondheid gedoen is, is daar gevind dat 80
persent van Suid-Afrikaners tradisionele genesers besoek. Die doel van hierdie navorsing
is om ondersoek te doen na die gebruik van tradisionele medisyne deur landelike
gemeenskappe in die Limpopo Provinsie, en om ook ‘n bydrae te lewer tot die
konsepbeleid wat deur die Minister van Gesondheid bekendgestel is (South Africa,
Department of Health 2007a).
Tradisionele genesers kan beskou word as ‘n belangrike hulpbron in die nasionale
gesondheidsdiens. Hulle deel in kulturele gelowe en waardes van hulle pasiente en word
ook gerespekteer in hulle gemeenskappe. Suid-Afrika egter, gee geen erkenning aan
tradisionele genesers of die feit dat hulle in die gesondheidsdiens is nie.
Ondanks die feit van moderne geneesmiddels, is daar ‘n dramatiese evolusie wat besig is
om plaas te vind in die Westerse Wêreld. Die erkenning en waarde van tradisionele
medisyne wat bydra tot mense se gesondheidkwaliteit, het daartoe gelei dat
Staatsorganisasies begin insien het dat daar ‘n gaping is en dat publieke peilings gedoen
word om ‘n oplossing te vind en ‘n beleidsdokument saam te stel wat tradisionele
genesers insluit (Matomela 2004).
Die ondersoek wat Pefile (2005) gedoen het, het positiewe resultate getoon by die gebruik
van tradisionele medisyne wat ‘n holistiese behandeling in ‘n wyer verskeidendheid van
medisyne insluit by gebruikers. Ook die wetenskaplike vooruitgang van tradisionele
medisyne het daartoe bygedra dat ‘n beleidsdokument in plek gesit word vir die wettige
erkenning daarvan. Nuwe wetgewing is in werking gestel om beheer uit te oefen oor
tradisionele genesers en tradisionele medisyne.
Hierdie dokument verskaf ‘n sinopsis van die Staat se inisiatiewe om die gaping tussen
moderne medisyne en tradisionele medisyne aan te spreek en ook om landelike
gemeenskappe toe te laat om hulle reg uit te oefen soos wat in die Grondwet vervat is.
Die studie is kwalitatief waar relevante praktiserende tradisionele genesers, verbruikers,
Westerse dokters, verpleegkundiges, bestuurders en staatsdiensbeleidvormers ondervra is
oor ‘n konsep beleidsdokument oor tradisionele medisyne. Dit was gedoen om informasie rakende die uitdaging , gapings en 'n moontlike oplossing te vind vir die integrasie van
Afrika se tradisionele medisyne in die gesondheidsorgsisteem van Suidelike Afrika.
Belangrike bevindings sluit die volgende in: die meerdeerheid tradisionele genesers stem
nie saam dat wetenskaplike toetse gedoen word op kruie wat hulle voorskryf nie;
tradisionele genesers will geregisteer en geïntegreer word in die gesondheidsorgsisteem
maar stem nie saam oor prysregulering en prysvasstelling nie; Westerse dokters is van
mening dat tradisionele genesers net pasiënte geestelik moet kan behandel tensy hulle ‘n
wetenskaplik getoetse doel en beperkings in hulle veld het; Westerse dokters glo dat
tradisionele genesers dwarsboom die gesondheidsorgsisteem deurdat hulle behandeling
vetraag; die gemeenskap soek tradisionele hulp op vir kulturele redes en ander
welwillendheidsredes maar gaan soek mediese hulp by klinieke waar dit aan hulle verskaf
word; mense van gemeenskappe is verward en raadpleeg beide tradisionele genesers en
Westerse dokters vir hulp; sommige medisyne is nie altyd by klinieke beskikbaar nie en
mense sien nie kans om in lang rye te wag by hospitale nie en dit noop dat hulle
tradisionele medisyne gebruik; verpleegkundiges en gesondheidswerkers erken dat
tradisionele genesers mense vertraag om gesondheidsorg en behandeling by hospitale te
kry, maar verstaan ook dat tradisionele genesers aan mense geestelike hulp verleen; en
besleidskrywers moet oplossings vind om tradisionele genesers op te voed en om
komitees te stig wat tradisionele genesers se ruimte van praktisering in toom te hou.
Die volgende word as voorstelle tot aanpassing van die genoemde beleidsdokument
geïdentifiseer:-
Tradisionele genesers mag alleenlik praktiseer en opleiding verskaf na die ouderdom van
21 jaar. Hulle moet verbied word om sekere prosedures, byvoorbeeld die trek van bloed;
behandeling van HIV/VIGS; om voor te gee dat hulle mediese praktisyns is; om
vroedvroue te wees slegs indien gekwalifiseer daartoe; om inspuitings toe te dien en
medisyne uit te reik slegs indien hulle tersiëre opleiding gehad het. Tradisionele genesers
se dienste kan gebruik word as gemeenskapsgesondheid hulpwerkers, geestelike
genesers, en kan tradisionele advies en begeleiding aan die gemeenskap lewer.
Tradisionele genesers moet belet word om die titels “Dokter” en “Professor" te gebruik.
Tradisionele genesers moet daarop let dat hulle holistiese genesers is en moet
daarvolgens aangespreek word. Hulle moenie pasiënte mislei deur voor te gee dat hulle allopatiese geneeshere is nie. “Tradisionele genesers” moet hernoem word na “geestelike
genesers”.
Tradisionele genesers moet by ‘n erkende organisasie geregistreer word en moet so-ook
jaarliks registrasie hernu. Formele onderrig wat deur ‘n ervare kruiegeneser aangebeid
word moet bygewoon en gedokumenteer word. ‘n Geskrewe rekord van die ligging van die
praktyk en betrokke spesialisering moet bygehou word. Beleidsvoorskrifte wat verband
hou met gesondheid en veiligheid, hygiene en sterilisasie moet in die tradisionele
gesondheidgeneserspraktyk geïmplementeer word. Opleiding in pasiëntkonfidensialiteit
moet aangeleer en toegepas word. Samewerking en werkswinkels tussen moderne
mediese dokters en tradisionele gesondheidgenesers moet geïmplementeer en ontwikkel
word. Mediese wetenskapsinligting en tegnologie moet aan tradisionele genesers bekendgemaak
word. Voorts moet ‘n voortgesette professionele ontwikkelingsprogram (POP) aan
alle gesondheidswerkers voorgeskryf word. Dit blyk wenslik te wees om tradisionele
hospitale tot stand te bring waar die bestek van praktyk gedefinieer word. Sulke hospitale
kan dien as plekke waar pasiënte aansterk en geestelike onderskraging geniet. ‘n Etiese
kode en standaard vir professionele etiek moet geskep word vir tradisionele genesers.
Gesondheids- en sekureitsregulasies moet van toepassing wees en geïmplementeer word.
Pasiënte moet ingelig word oor die wegdoen van mites en fabels. Daardeur kan die
positiewe sy van tradisionele medisyne (byvoorbeeld mediese voordele van kruie), en
uitroei van “kwakke” (byvoorbeeld dra van gelukbringers om die lywe), verdryf word.
Dit sal die aanmoediging van ‘n gesonder, sekuriteitbewuste en deursigtige
gesondheidsorg sisteem bewerkstellig in Suid-Afrika waar alle dissiplines van medisyne
saam bestaan in die Nasionale Gesondheidsorgsisteem.
| Identifer | oai:union.ndltd.org:netd.ac.za/oai:union.ndltd.org:sun/oai:scholar.sun.ac.za:10019.1/5248 |
| Date | 12 1900 |
| Creators | Latif, Shamila Suliman |
| Contributors | Burger, A. P. J., University of Stellenbosch. Faculty of Economic and Management Sciences. School of Public Leadership. |
| Publisher | Stellenbosch : University of Stellenbosch |
| Source Sets | South African National ETD Portal |
| Language | en_ZA |
| Detected Language | English |
| Type | Thesis |
| Rights | University of Stellenbosch |
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