Many people find that the aims and themes of traditional medicines stand in a precarious position as we see the imminent rise of technology-based medicines/therapies in the wake of biotechnology. The biggest reason for this may be in the way traditional medicines and health practices, tend to focus on more than just the physical components of sickness and well-being and this does not always communicate well with the new technologies and practices making their way into the healthcare space of South Africa. For instance, someone who may be ailed by a twitching eye, may be diagnosed on the physical aspects of their eye, which is then understood considering pathology around visual/ocular components of the face. Then the additional step of relating this to the psycho-social-spiritual status of the person with the twitching eye. The purpose of this blog entry is to investigate the developing space of biomedicine & biotechnology and how this new paradigm in medicine works with traditional medicines in South Africa.
To begin, in Southern Africa traditional medicine and health practices are widely used by the population where there are “between 200,000―300,000 traditional healers in South Africa; with the healer-patient ratio of 1:500–1200, as compared to the medical doctor-patient ratio of 1:40000” (Mothibe & Sibanda 2019). This distribution/ratio is one which may have increased or decreased since the census data had been collected but nonetheless emphasises the reliance on traditional medicine even with the availability of Western medicines and practices.
More so, unlike Western medicines that may have emphasis on the physical/material aspects of healthcare along with pathology, traditional medicine is fundamentally different in that it has two branches. The first branch consists of ‘medication therapies, which involve healing by knowledge of herbs and nature’ (Makinde, 1988: 88). The second branch is known as ‘non-medication therapies, which use manual, physical, mental and spiritual methods,’ or even a combination of these to treat the ailed (International Bioethics Committee, 2013: 3). Traditional medicine aims at treating ailments by considering more than just the physical manifestations of the ailments, but also consider psychological, social and spiritual manifestations of the ailments too.
“A man may esteem himself happy when that which is his food is also his medicine.“ .
– Henry David Thoreau
In South Africa, biotechnology is an emerging field with a lot of research being conducted currently relating mostly to the methods and practices of western medicine. Nonetheless, there seems to be a space for traditional medicine to have a closer relationship with biotechnology since traditional medicine and biotechnology/biomedicine are both concerned with the biology and physical make up or organisms and how ailments can be addressed at this level. However, when one must consider the psychological, social and spiritual aspects of traditional medicine, there seems to be an incommensurability that builds between traditional medicine and biotechnology. And thus, the studies of traditional medicine and those of biotechnology diverge quite significantly and even how one becomes a practitioner and practices in each paradigm is really worlds apart. Nonetheless, there is both common ground and unfamiliarity for both that I will discuss below.
Scientific Validation & Regulation
Within the width of the medical practices available biotechnology/biomedicine and traditional medicine find themselves sitting at opposite ends of the table for a number or reasons. Firstly, when considering how one becomes a practitioner of the various paradigms there are several things to keep in mind. Firstly, to become a practitioner of biomedicine and biotechnologies one must be trained in the field of medicine for 7 years, at a reputable and accredited institution, then proceed to do some service years after your studies and then finally work in a clinic, hospital, or private practice. It is then at this point where one learns about new technologies (practices based on technology availability) being developed in their individual fields and begins to make use of them on their own patients. One gets a certificate and is inducted into HPCSA as a serving member of the professional body and has a clear roadmap of how they became a practitioner, along with their obligations.
The traditional medicine route is not the same, having a fundamentally different structure and institutionalisation. Firstly, when one wishes to become a Sangoma (traditional healer in South Africa) the way in which they receive knowledge and are taught may be irrational or cryptic. “It is often kept secret, being mainly transmitted orally, as pointed out above. It can also combine natural and supernatural resources and be deemed to be acquired at birth or through a gift or special revelation to certain initiates” (International Bioethics Committee, 2013).
One who becomes a practitioner of traditional medicine is one who is already chosen by certain conditions and not necessarily someone who pursuits being a practitioner out of interest or wonder. One who wants to be a practitioner is then initiated by school of traditional medicine, which may or may not be registered under the Traditional Healer’s Council/Traditional Healers Organisation, and that may take months or years, depending on the individual. Once the initiation process is completed, the initiate has a ceremony done and is then granted the cloths/materials that are worn by accomplished practitioners, besides that there is very little to tell regarding the quality of their education or even the roadmap they took to completion. Many of the practitioners of traditional medicine are registered by the Traditional Healers Organisation, yet many more remain unregistered and undocumented, even with the sheer numbers they serve regularly. The presence of traditional healers in the HPCSA is something which is rather removed from the professional body and remains a bit of an anomaly when one must look at health policy in the country.
“The plants have enough spirit to transform our limited vision.”
– Rosemary Gladstar
Biomedicine in this case presents a more scientific approach with rigorous testing, core principles, hypothesis and replicable results and traditional medicine in this case deals with a traditional, spiritual approach, based on tailored-individuated responses to ailments and non-standard tests, dosages and approaches. This means that there is a divergence in the way in which these practices are conducted and based on the view one takes, it is possible to value each for different reasons. Nonetheless, in the era of technology that we find ourselves, one sees that traditional medicine has less and less ground to integrate biomedicine let alone biotechnologies. Moreso, when one looks at the regulatory issues around traditional medicine, there seems to be a big issue of inclusion into the HPCSA.
Traditional medicine practitioners have, for the longest time, enjoyed the perks of being undocumented and non-standard because of how individualised (non-objective) the approaches of many practitioners has been. This freedom has allowed them to experiment and find new ways/old ways in nature without the red tape that professional bodies come with. Nonetheless, this means that the regulation of traditional medicine varies widely, with some practices not subject to the same stringent standards as biomedicine. This can lead to concerns about safety, quality, and efficacy. Many traditional medicine practices have not undergone the extensive clinical trials that biomedical treatments require. This makes it difficult to scientifically validate their efficacy and safety. The quality of traditional medicine products can vary due to differences in preparation methods, ingredients, and dosages. This variability poses a challenge for scientific validation. Traditional remedies often involve complex mixtures of ingredients, making it difficult to isolate the active compounds and understand their mechanisms of action.
From the looks of things, the relationship between biotechnology/biomedicine and traditional medicine is one which is still maturing and may become something fruitful for all in the future. However, as things stands, there is a lot of work to be done to bring them closer to one another and this begins with understanding their individual values. At this stage, nonetheless, traditional medicine has no place in biotechnology and thus cannot be considered biomedicine as of yet, but they may yet change in the future.
Written by: Tony A Shabangu
References:
International Bioethics Committee. 2013. ‘Report of the IBC on traditional medicine systems and their ethical implications.’ International Bioethics Committee. Website: https://unesdoc.unesco.org /ark:/48223/pf0000217457, (accessed 19 January 2019).
Makinde, A. (1988). African Philosophy, Culture, and Traditional Medicine. Center for International Studies Ohio University.
Mothibe, M. E. & Sibanda, M. (2019). African Traditional Medicine: South African Perspective. Sefako Makgatho Health Sciences University, Pretoria, South Africa.