Shadrack Mashabane is a traditional healer based in Bushbuckridge in Mpumalanga. He is one of 15 traditional healers who, in March, completed training to provide HIV counselling and testing. 

In an interview with Health-e News, the 37-year-old says that since receiving the training he informs all his patients about the importance of an HIV test and those who are willing to get tested are offered an HIV test. He has already tested 45 people for HIV. Of these patients, two tested positive and he quickly referred them to a local health facility for treatment. 

“One was very understanding about the situation. But the other one was finding it difficult to come to terms with the situation and I had to accompany him to the clinic, but I am happy that he is now on HIV treatment as we speak and I am grateful to have played a role,” says Mashabane.

The training was provided by the MRC/Wits-Rural Public Health and Health Transitions Unit (Agincourt), in collaboration with the National Department of Health and the health NGO Right to Care. The training is part of an Agincourt research project known as  Ntirhisano (a Tsonga word meaning ‘working together’). 

“Traditional healers are respected members of many communities across South Africa. We have found through our research that traditional healers are often more accessible than clinics,” says Dr Ryan Wagner, senior research fellow at Agincourt.

Wagner says there are more than 2000 traditional healers in Bushbuckridge, the area where Agincourt research is based. But healers were randomly selected from those working in the catchment area of several health facilities and were interested in providing HIV counselling and testing.

Improving adherence

The training covers several clinical topics, including the clinical presentation of HIV, how HIV can be transmitted and how antiretroviral therapy (ART) works and why it is important for patients to stay on treatment. An estimated 92% of people on ART are virally suppressed, this means they are adherent to treatment. 

Wagner says that they recognise that some people may turn to traditional healers before biomedical healthcare because of stigma, distrust of biomedicine or because they harbour more traditional beliefs. 

“By working together with traditional healers we may be able to reach people who do not regularly have access to the biomedical healthcare system. And having traditional healers support the patient during the ART initiation and follow-up may ultimately result in better ART adherence,” says Wagner.

This is not the first time that traditional healers are roped into the fight against HIV. Some of these programmes date back to 2017.  

Perfect route to take

Wagner says that equipping traditional healers such as Mashabane with essential information about HIV is the best route to follow in the effort to address the burden of HIV in South Africa and globally.

“We need to make sure that everyone who has HIV is on antiretroviral therapy and ultimately, that they are virally suppressed. We see working with traditional healers as one of the ways that we can achieve this,” he says.

Before receiving the HIV training, Mashabane says that he was finding it difficult to tell patients that they might have HIV without first conducting an HIV test.

“Even if you see that a patient is showing some symptoms which are associated with HIV, such as swollen legs and shingles. But it was not within my right to tell a patient that they might be HIV positive without conducting an HIV test first,” says Mashabane.

Eye opener

Mashabane says that the training he has received has really opened his eyes about HIV and everything he needs to know about the condition. 

“I am now able to understand more about the origin of HIV. I also have adequate information on how one can be infected with the virus and how to protect myself while treating patients of other conditions.  And I am also able to share most of this information with my clients/patients,” says Mashabane.

Wagner says there are big plans in place to scale up the training to several hundred healers all over South Africa.

According to Wagner, the traditional healers were extremely positive about the training and viewed the training as an opportunity to gain new skills.

“They felt empowered by being able to provide a new service to their clients and several expressed appreciation for this,” says Wagner. -Health-e News.