When 54-year-old Themba Sepeng developed a second sore on his foot in the space of a year, he followed the advice of his friends and consulted a traditional healer, who attributed it to witchcraft. 

In 2021, Sepeng, who lives in Klipgat near Mabopane, North West Province, developed a blister beneath his left foot. He immediately sought medical care at Dr George Mukhari Academic Hospital. He says doctors did not explain to him what had caused the blister. 

A year later, he developed a similar blister.

“The same type of wound reappeared in 2022, and this time it was on my toe. People around me advised it was not a good omen to have the same sores in a very short space of time, they suggested it was sefola, so I decided that I should not consult for Western or medical help but went the traditional way,” says Sepeng.

In Setswana and Sepedi culture, sefola refers to a severe, non-healing skin wound or swelling traditionally believed to be caused by a bad spell or supernatural forces. 

Sarah Mahasha, who’s worked as a traditional healer for 35 years in Refentse, Hammanskraal, says how a wound looks determines how it’s treated. 

“We can tell if it is serunya or sefola, there are signs of wounds that cannot be addressed with herbal balms as a traditional healer, and I will refer such patients for western treatment immediately.” 

A study in Tshwane found that traditional health practitioners associated sefola with a sore that doesn’t heal, and expressed interest in being trained on certain skills used within the biomedical system.  

Misdiagnosis delayed critical medical care

“The traditional healer did not disappoint, he said that it was witchcraft, there are neighbours who cast a bad spell through sefola. That was exactly what I wanted to hear. He gave me some herbal balms and concoctions to drink and defend myself from my enemies,” says Sepeng. 

After three months of traditional treatment, his condition worsened and Sepeng was in unbearable pain. “I had nightmares, I couldn’t sleep. What started as a swelling became a sore. My belief that traditional healing will give me my spark back was not working. The only option left was professional medical treatment.”

By the time Sepeng sought medical advice in 2022, he was diagnosed with diabetes. He says following the recommended diet was difficult because of the associated costs. 

“I wish the government could have special provision of the food recommended for the diabetics, though they have tried their best by providing social grants. But one should look after your diet.”

Had he sought professional medical advice earlier, Sepeng would have learnt that he had a diabetic ulcer. High blood sugar caused by diabetes can damage nerves in the feet and restrict blood circulation so that small injuries, blisters, or scratches often go unnoticed, don’t heal properly, and can quickly become serious ulcers or turn into gangrene. 

One study shows 28% of diabetic patients present to primary healthcare clinics with diabetic foot ulcers (DFUs), often presenting in advanced stages of ulcer severity.

In early 2023 Sepeng was referred to a specialist, but by then the wound on his foot was so infected that his leg had to be amputated to save his life. 

“I lost weight dismally, my left foot toe was now rotten, pus was spouting out of my affected toe. The doctors at Legae Private hospital advised that it will affect my body if it mixed up with blood and I could lose my life as a result. The social worker gave me counselling and advised amputation. There was no other solution but scissors”, says Sepeng. 

After spending six months in hospital, Sepeng received assistance with wound care and rehabilitation. With support from his wife, Naomi, and his late mother, Fredah, he has learned to adapt to life without his leg.

Life as an amputee

Sepeng was fitted with a prosthetic limb and despite the amputation, manages to live an active life. He drives, does household chores, and manages a local soccer club. Following his experience, he encourages people, especially men, to visit clinics for regular health check-ups and to seek medical assistance early when they notice unusual wounds.

“Had I taken a decision to go for medical help at first, I believe I wouldn’t have gone this far,” says Sepeng, pointing to his amputated leg. 

According to diabetes clinical guidelines, any foot sore that is deep, weeping, or showing signs of infection needs immediate medical attention. Applying non-sterile balms or home remedies can trap bacteria and worsen tissue damage. 

Primary health clinics are equipped to clean and dress these wounds safely, and getting to a clinic early is often the single most important factor in saving a limb.

“I live a healthy life now, despite my condition,” says Sepeng. “I am active and can spread the word that diabetes is not a death sentence to its patients, you only need to consult at your local clinic.”