South Africa: Pilot study uses traditional healers to test for HIV

Traditional healer Florence Khoza talks to a patient

In an attempt to tackle the stigma and reluctance of people to test for HIV, South African authorities are recruiting traditional healers.

The healers are part of a pilot study to encourage more people, especially the young, to have the test and to seek medical treatment if needed.

Shadrack Mashabane is a traditional healer in the small town of Buskbuckridge in Mpumalanga province.

His home is covered with traditional fabrics and there are glass bottles with herbs and medicines. But what stands out is a white box containing an HIV testing kit.

Mashabane is one of at least 15 traditional healers who are taking part in a pilot study run by the University of Witwatersrand.

Researchers have trained them to carry out HIV testing and counselling to encourage more South Africans to be aware of their HIV status and prevent the spread of the disease.

It is the most significant public health programme to involve traditional healers.

Mashabane says at first patients found it difficult to believe he was offering HIV testing, because it's a service they associate with health clinics.

“Many were not convinced. I had to show them my certificate to prove I was qualified to do this,” he says.

The process includes the signing of a consent form to be tested, along with a follow-up to ensure that patients who test positive receive treatment from the local clinic.

“For some clients, going to the clinic (after their results) is a big problem. More so, especially among men,” says Mashabane.

South Africa has one of the highest rates of HIV in the world.

And although antiretroviral medication and pre-exposure prophylaxis are free, the stigma around testing and treatment remains high in many communities.

Concern about privacy at clinics also keeps people from seeking help.

“I found that they prefer to come to us (traditional healers). I found they had many concerns about discretion at the clinic. They don’t feel safe,” Mashabane explains.

Florence Khoza is another traditional healer who has been trained to test for HIV.

She says risky sexual behaviour is common and often dispenses traditional herbs and medication to treat gonorrhoea. Now she goes further by advising patients to test for HIV.

Khoza says although she was uncertain about the project in the beginning, she now finds her new role professionally fulfilling.

“I am now enthusiastic when working with someone with HIV, I ensure that I follow up so that they take their treatment correctly, for them to live.”

She even goes so far as going to the clinic herself, or accompanying her clients to pick up their medication.

There are plans to expand the programme later this year, with at least another 325 healers undergoing training to become certified HIV counsellors.

Researchers at the university will compare rates of HIV testing to see whether more people prefer to get tested by the  healers rather than the clinics.

Many people in rural areas see traditional healers as their first point of contact for illnesses, and the project hopes they can help change attitudes about the disease.

Wonderful Mabuza, a researcher on the pilot run by the University of the Witwatersrand Agincourt, says using traditional healers makes access much easier.

“Some villages still have issues where they don't have a clinic. So for them to access the clinic, they have to travel a longer distance. And now with a traditional leader who's testing, who's next door,  who is a neighbour, then it's easy for them to access them,” he says.

Researchers hope testing and treating by traditional medicine practitioners could ultimately lead to the end of new HIV cases in communities such as rural Mpumalanga.

Their ultimate aim is to inspire South Africa's government to roll out the programme nationally.