Background
On a world-wide scale, indigenous knowledge, including that related to traditional healing, is seen as waning [
1]. At the same time and paradoxically, global demand for traditional healing plants is growing [
2]. In Africa, the situation is similar. Despite evidence that over 72% of the African population use traditional medicine as their first choice when seeking health care [
3] and that trade in medicinal plants is growing rapidly [
4], some studies report that the custodians and practitioners of this knowledge are becoming fewer. [
5]. Peltzer [
6], for example, reports in a survey of South African traditional healing, that use of traditional healers has decreased in recent years. Furthermore, in a broad study which examined health care choices in South Africa, Grobler and Stuart [
7] noted a general decline in the use of traditional healers amongst South Africans.
Two reasons for this inconsistency are that recruitment to the profession of traditional healing is difficult to measure [
8] and that precise data, using both qualitative and quantitative methods, are lacking [
6]. Traditional medicines are now readily available to the public from muthi shops, which are African chemists selling traditional medicines for curing physical, spiritual and cultural ailments [
9], as well as from traders. This means that people can self-medicate without requiring the intervention of a trained traditional healer [
10]. This leads to the anomaly that although traditional medicines are generally preferred and used by most Africans [
11], the healers themselves complain that they cannot rely on the proceeds of their healing practice alone for their livelihoods, and emerging healers are few [
8].
Traditional healers in Africa may be decreasing, but they are still consulted on a wide scale and are readily available [
12], affordable and trusted [
13]. State-sponsored primary health care systems in Africa are limited and between 70% and 80% of the rural population lack access to these institutes [
14]. Where they are available, the quality is poor, thus people resort to visiting traditional healers who are still present in most communities [
15]. Furthermore, patients appreciate the holistic nature of a traditional healer’s curation approach, which attends to disorders of both mind and body [
16]. Traditional healers are socially acceptable to communities as they are of the same culture and are therefore more effective than allopathic practitioners at treating culture-based health problems [
12]. They are thus frequently the first health care providers to be consulted for bodily illnesses as well as spiritual matters [
17].
In the rural Blouberg area of the Limpopo Province, South Africa, traditional healers [
18,
19] as well as a state sponsored hospital and various clinics [
20] are available. Limited research has, however, been conducted on the importance of traditional healing to the communities in Blouberg and none on the socio cultural profile of these healers. It is not clear, therefore, whether traditional healing is a dying practice in this area, nor what the community’s attitude is towards their different health care options. Semenya and Potgieter [
19] conducted an overall study of the traditional healers of Limpopo and recommended further research with larger sample sizes for each municipality in order to verify their findings. This Blouberg study is therefore a response to the suggestion. Considering that in a review of the use of complimentary health practitioners in South Africa, Peltzer [
6] called for more research into the concurrent use of traditional health practitioners and allopathic health care, the Blouberg situation is of interest.
Allied to the concern that traditional healers are declining, is the recognition that on a global scale, medicinal plants are also rapidly dwindling [
2]. At the same time there is a world-wide surge of interest in these plants [
1] as evidenced by the recent publication of handbooks on medicinal plants and reviews on globally important medicinal species [
21-
23]. In Africa, commercial interest, as well as a growing population, many of whom use traditional medicinal plants, has resulted in a sharp increase in harvesting of these plants [
24]. In the past, traditional healers would themselves collect the plants they required for their healing practices. There were rituals and traditions associated with this collection, which, to a certain extent, protected the plants from over-harvesting, either by limiting the amount of material removed or by restricting the type of harvesting such that damaging procedures were restricted [
25]. With the growth of the “muthi” (medicinal) plant industry in Africa, commercial harvesters have come to dominate the collection of medicinal plants and rituals and traditions are not observed [
26]. These collectors are not closely associated with the environments from which the plants are sourced and do not have an interest in sustainable harvesting. If the resource base collapses in one area, they then source plants from another. The result is over-harvesting, which is exacerbated by a weak legislative framework governing the use of plant resources and inadequate environmental law enforcement [
27].
Within the Blouberg area, the Blouberg Mountain is a rich repository of medicinal plants and home to declining species such as
Boophane disticha (L.f.) Herb. and
Hypoxis hemerocallidea Fisch., C.A. Mey. & Avé-Lall., as well as endangered species such as
Warburgia salutaris (Bertol.f.) Chiov. [
28]. This is not surprising as the mountain is part of the Soutpansberg Centre of Endemism [
29], and has recently been defined as a Critical Biodiversity Area in the Limpopo Provincial Conservation Plan 2013. Vegetation types include endangered grassland, fynbos, savanna, sourveld and forest elements, each of which support a different suite of medicinal plants [
18]. Despite the conservation importance of the Blouberg Mountain, it is currently not protected.
Natural resources in general are under threat and there is a call for including the public more strongly in developing policies for the protection of the natural environment [
30]. The presence of people in a community who value their local natural resources affords these ecosystems some informal protection [
31]. People who are knowledgeable about the uses of local biodiversity and are already organized into a group which functions towards common goals make valuable contributions towards protecting local natural areas [
32,
10].
The traditional healers of Blouberg are an example of such a group. Blouberg Mountain is under threat of transformation by the mining sector as well as by the development of housing and roads [
33]. The healers in the area have an interest in conserving the natural plant resources close to them and although they would harvest the plants, this could be more efficiently managed for biodiversity conservation than the overall transformation that mining or large scale infrastructure development would bring [
34]. Indeed, Hamilton [
2] emphasises that conservationists who are interested in protecting medicinal plants should never do so in isolation from the people who use them. As he further explains, conservationists need to have an understanding of the human communities that are dependent on the plants, including the culture, economics and social structure of the relevant society. An understanding of the socio-cultural profile and demographics of the Blouberg traditional healers would thus be useful to conservationists managing the Blouberg Mountain. Understanding the traditional healing sector in this area will give insight into how such people may already be safeguarding the natural resources in Blouberg, and how they might do so more effectively in the future.
In the context of this discussion, the broad term “traditional healer” is used. This term generally includes herbalists and diviners [
35]. Herbalists are those who work mainly with the application of herbal remedies [
16]. They diagnose the illness of a patient through careful observation and discussion with the patient and prescribe plant-based medicines for everyday ailments. In contrast, diviners diagnose primarily via spiritual means and serve as important intermediaries between humans and the supernatural [
11].
Both herbalists and diviners are present in the Blouberg area; however, most traditional healers define themselves as herbalists, whereas only a minority are seen as diviners. During meetings, Blouberg traditional healers stressed that both herbalists and diviners in the area use medicinal plants collected from the Blouberg Mountain [
18]. Furthermore, Richter [
36] stated that a strict separation between traditional healers and diviners is becoming more difficult in modern times. For these reasons, no distinction is made between herbalists and diviners in this paper and they are referred to interchangeably as traditional healers.
This study contributes to the dialogue on traditional healers by investigating the demographics and socio-cultural profile of Blouberg’s traditional healers, as well as the attitudes of the Blouberg community to traditional healing. It clarifies whether or not the practice is disappearing in Blouberg and relates this to the scenario in Africa as a whole. The potential of the traditional healers to act as custodians of their natural environment is discussed, as is the impact on the environment of a decline in traditional healers and associated knowledge.
Competing interests
The authors declare that they have no competing interests.
Authors’ contributions
MKM, conceptualised the idea, collected the data, analysed, drafted and submitted the manuscript. BAE, participated in drafting, finalising and proof reading of the manuscript. HJD, participated in drafting and proof reading of the manuscript. MJP, helped in drafting, proof reading and finalising the manuscript. All authors read and approved the final manuscript.