Indigenous Knowledge and the Environment in Africa and North America

Chapter 12: Reinventing “Traditional” Medicine in Postapartheid South Africa

Chapter 12 Reinventing“Traditional” Medicine in Postapartheid South Africa Karen Flint In August 2004, South Africa officially recognized its “indigenous” medical system and the practice of traditional healers.1 After years of being criminalized under white minority rule and largely condemned by the biomedical community, South Africa’s 350,000 traditional healers—who heal through a combination of local remedies and ancestral interventions— will soon have to obtain a government license to practice.2 Healers will be restricted from treating fatal diseases such as cancer, HIV, and AIDS, but given their popularity—80 percent of the South African population attends such healers—they are seen by many as a necessary component of health-care delivery and as important agents for educating the populace on the biomedical realities, perils, and prevention of HIV and AIDS. Incorporating traditional healers and medicine into a state medical system that has overwhelmingly preferred the biomedical sciences has not been easy. These two medical cultures not only embrace different ideas about the body and origins of illness, but share a history of commercial and ideological competition as well as different relations to state power. History also shows us that what is considered “indigenous” is constantly in flux, subject to various interactions, knowledge flows, and influence by those in power. 260 | Karen Flint The process of legalization and regulation of traditional medicine has the potential to radically alter our notions of what is or is not traditional medicine. It also presents a number of difficult questions: How will a largely local, unsystematized, nonhierarchical and oral collection of therapies that as of yet is largely unregulated come to be systematized and brought under the regulatory eye of government? Given that governments tend to favor institutional sciences and those who are Western educated and bureaucratically literate, is it possible to rectify the imbalances of power that would enable healers to be meaningfully incorporated in a state-sanctioned system of medical pluralism?3 In addition to the challenges of regulating African medicine, healers in the future will have to cope with the growing HIV/AIDS epidemic,4 an overharvesting of medicinal plants, protecting intellectual property rights, avoiding exploitation for commercial gains, and possibly losing control over the ways in which future generations utilize traditional medicines. Changes in South Africa during the 1990s profoundly altered the stakes of traditional medicine and created new stakeholders that now include pharmaceutical companies, government departments, and university research labs. Bioprospecting of indigenous medicinal plants is now seen as a legitimate and necessary government project. It is promoted not only for its potential health and commercial benefits, but as a means of highlighting the nation’s strengths. A former health minister stated:“South Africa is blessed with a rich heritage of medicinal plants that through sustained research and development, could offer a solution to some of the common health problems the world is grappling with.”5 An integral part of bioprospecting is collecting and collating existing local medical knowledge in a form that is useful and knowable to government, university labs, and pharmaceutical companies. While the collection of medicinal botanical knowledge has roots in the colonial period and the collaboration of healers and scientists is not new, the University of Cape Town’s Traditional Medicine Program (TRAMED) began a new type of collaboration in 1994. This program brought in traditional healers during its initial phases, helped them to write articles, produced a Traditional Healer’s Primary Care Book (1997), promised benefit sharing in the case of successful bioprospecting, and has created an expanding national databank of South Africa’s medicinal plants. In addition to helping bridge local and scientific medical knowledges, TRAMED largely shaped the government’s agenda regarding the future regulation of traditional medical practitioners and their medicines, and prioritized government funding and research. Reinventing “Traditional” Medicine in Postapartheid South Africa | 261 A number of factors in the 1990s changed government and scientists’ ideas about the importance of African healers and medicinal plants. First, the HIV/AIDS crisis of the 1990s encouraged new collaborative efforts between healers and biomedical practitioners. While such schemes had detractors , evidence of successful collaboration existed.6 More important, the end of apartheid brought a flush of international funding that sought to support collaboration and HIV/AIDs training for healers.7 Second, the“legitimacy ” of African medicines gained national prominence when Thabo Mbeki assumed the presidency in 1998 and articulated his vision of an“African Renaissance.”An important component...