THE MYTH OF MUTHI
Why are the lucky one per cent of South Africans
with HIV who receive antiretrovirals increasingly passing them up
in favour of muthi, traditional herbs and medicines?
Words PN’s Johannesburg correspondent
Workers
in Johannesburg go home for the weekend never to return. The death of a young
man here is
usually ignored; shifty eyes attribute his death to being ‘sick’.
No more is known, nor wanted to be known. Suddenly the scale of the tragedy
here looms out of a dark pool of denial. Death is everywhere, and everywhere
it is ignored. Like a fart at a posh dinner party, we all know but pretend
not to notice.
HIV in South Africa is not a ‘sector’, it affects everyone: rich,
poor, black, white, coloured. Everyone here knows someone who has died of
Aids in the past year. Every day the Avalon cemetery in Soweto groans with
coachloads of mourners. Thousands are buried here. Walking past this week’s
line of new graves, the average age on each headstone is 31. The same hollow,
incomprehensible waste of young life.
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Government
failure
The Minister of Health here is regarded as a national joke. Manto Tshabalala-Msimang
buffoons her way across the country in her motorcade, her preposterous outbursts
generally deflecting the media’s attention away from the government’s
other failures as well as provoking academics, medics, activists and journalists
into howls of outrage. She has famously advocated African Potato (Hypoxis
hemerocallidea), olive oil and garlic as palliatives against the effects of
HIV. Her department squanders fortunes on ‘nutritional advice’
and yet of an
estimated HIV population of five million, only 60,000 have access to antiretrovirals
(ARVs). In addition to ‘nutrition’, she has devoted millions to
promoting the use of tribal medicine or ‘muthi’.
How muthi works
Let’s not forget that until the early 20th century, the entire medical
armoury for European doctors was derived from apothecary jars of roots, herbs,
bark and minerals. So it is here today. The fantastic floral density and unique
ecosystems of South Africa has produced a cornucopia of unique plant species.
For at least five
centuries traditional healers have endured many years of training, rituals
and ceremonies to understand the powers and benefits of each herb and plant.
Muthi is frequently prescribed with a series of prayers, chants, ritual dancing,
cleansing, diet and abstinence. Sangomas (witch doctors) as easily prepare
cures for colds, flu, constipation and HIV-related problems as they do for
lifting a curse placed on you by an evil neighbour,
protecting your house from lightning or lifting a run of bad luck in job-hunting.
For this reason, Western doctrine has either dismissed the centuries of knowledge
as witchcraft or foolishness. It looks like that in some cases this may have
been a mistake. Sidestepping the rather more colourful aspects of muthi, pharma
companies are far from cynical about the commercial and therapeutic possibilities
of tribal medicine. It is almost impossible to visit a remote area of Africa
that has not been recently ‘assisted’ by an anthropological researcher
learning the ancient arts of each culture’s medicinal practices. Agents
for treating cancer, Hodgkin’s lymphoma, anticoagulants and a host of
other conditions have been isolated from around the world in the past decade.
It is entirely possible that agents to assist or even cure common HIV-related
conditions could be found growing wild on the high veld.
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From left; African Potato (the orange flesh yields the supposedly
HIV-fighting Rooperol); leaves from the Bushman Poison Bulb are ground and
used topically as an outer dressing for circumcision wounds as well as hysteria,
insomnia, boils, headaches and abdominal pain; leaves of the African Potato
Ditching therapy for muthi
Unfortunately, time is what most of South Africa’s five million people
living with HIV are running short of. While preaching the unproven benefits
of nutrition and vitamin supplements, the Department of Health has been running
a campaign designed to scare patients about the side effects of ARVs.
It’s working. Adherence, for the first time in Africa, is becoming a
problem. The lucky one per cent of HIV positive people who receive medication
are increasingly taking unplanned treatment interruptions in favour of muthi.
Unsurprisingly the medical profession has been forced into a position of opposition
in principle to muthi as it has been placed into an ‘either/or’
option for patients. This is sad as possible therapeutic benefits are being
trashed and potential community advocates, sangomas and respected elders are
becoming aligned against ARVs.
The future
In the six-and-a-half years of his South African presidency, Thabo Mbeki has
presided over the exponential increase in HIV to the extent that South Africa
now has the greatest number of people living with HIV in the world. Prevention
campaigns are scarce, stigma is almost encouraged and ARV treatment is rubbished
as a matter of government policy. Patients will continue to access muthi as
it is important to their cultural values and beliefs. As much as they are
advocated, there are key issues around toxicity, hygiene and financial cost.
Traditional healers have been implicated in the spread of blood-borne diseases
including HIV by the re-use of medical instruments and lack of hand-washing.
Clearly, efforts need to be made by the South African government and Manto
Tshabalala-Msimang to evaluate the possible benefits of muthi working alongside,
not alone from, HIV therapy, and to educate the population and traditional
healers of its findings.
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