TNHA REJECTS DRAFT REGULATIONS FOR THE REGISTRATION OF TRADITIONAL HEALTH PRACTITIONERS
On the 3rd of November last year the National Department of Health gazetted draft regulations for the registration of traditional health practitioners (Gazette No 39358 / Notice 1052). Three months have been given for comment, ending on the 3rd of February 2016.
The draft regulations lay out the criteria which practicing traditional health practitioners and those who undergo training must adhere to before they will be eligible to register with the statutory Traditional Health Practitioners Council of South Africa (THPCSA). Registration with the THPCSA will be mandatory for all traditional healers who will practice for gain, and will confer upon them the legal right to practice traditional medicine. Certain classes of traditional health practitioners will also be authorised to compound and dispense African Traditional Medicines to their bona fide patients.
Many traditional healer associations who have studied the proposed regulations have rejected them outright, and protested at the National Department of Health’s head office in Pretoria before they closed for the summer holidays. We are aware that more traditional healer groups as well as sectors of civil society are preparing more protests in the near future.
WHAT PRECEDED THIS MESS
The Traditional Health Practitioners Council became an Interim Council only three years ago, despite the Traditional Health Practitioners Act being signed into law in 2007 (Act 22 of 2007). In these three years the National Department of Health appointed a 22-member Interim Council and set up a Directorate of Traditional Medicine within the Department which has been given the task to coordinate the functioning of the Council and to draft regulations which will enable the Act.
We have learned that various members of the THPCSA are not happy with the establishment of the Directorate of Traditional Medicine as an oversight and negotiating body for the THPCSA, as future policies and draft regulation are being dictated to by it via the National Department of Health. Section 47 of the Traditional Health Practitioners Act effectively gives the THPCSA, in consultation with the Minister of Health, the exclusive mandate to draft policies and regulations.
A growing number of THPCSA members are unhappy with the Director General of the National Department of Health, Ms Malebona Precious Matsoso, who appears to be drafting policies on their behalf when neither her or the Acting Director of the Directorate of Traditional Medicine, Mr Bruce Mbedzi, are traditional health practitioners themselves. The latest draft regulations demonstrate their lack of understanding of how traditional healers are subject to a spiritual ‘calling’, and how they undergo training, whether semi-formally in an apprenticeship, or by being led by ancestors in dreams and divination.
Over the last 18 months both Matsoso and Mbedzi have hosted meetings with the members of the THPCSA, and have handed over proposed regulations to the members, without workshopping or debating their contents. THPCSA members are appointed from the nine provinces of South Africa, and were never afforded the opportunity to circulate the proposals (due to confidentiality issues) and consult with the approximately 220 national traditional healers associations which will be affected by the rules and regulations proposed by the National Department of Health.
In terms of the Traditional Health Practitioners Act, Parliament was supposed to approve seed funds for the establishment of the THPCSA, under instructions from the Health Minister, Aron Motaseldi. It has been over a year since the THPCSA requested funding to carry out their mandate and to function as an organ of State. To date, no funds have been forthcoming and no Council House has been secured, nor any administrative staff appointed who will deal with the expected 220 000 applications for registration when the registers open.
The delays in capacitating the THPCSA, and the Department of Health usurping of the Council’s mandate, via the Directorate of Traditional Medicine has effectively rendered the properly constituted THPCSA nothing more than a rubber stamp to fulfil the wish lists of Matsoso and Mbedzi.
Matsoso is a trained pharmacist and lawyer, and served as registrar of our pharmaceutical drug regulator, the Medicines Control Council. She also served as Director of Technical Cooperation for Essential Drugs and Traditional Medicine for the World Health Organization in Geneva prior to becoming the Director General of the National Department of Health in 2010. There is no public record relating to where Mbedzi worked before taking office as Acting Director for the Directorate of Traditional Medicine.
THE REGULATIONS ARE INAPPROPRIATE FOR TRAINING IN AFRICAN TRADITIONAL MEDICINE
These regulations are the first in a raft of regulations which must be gazetted in terms of section 47 of the Traditional Health Practitioners Act to breathe life into the Council. Among other regulations to follow are included scopes of practice for the four modalities which will be registered, disciplinary procedures and the rules related to traditional medicines in order to protect the public and to ensure their safety or use, administration and application.
The current draft regulations relating to minimal training standards to register as a traditional health practitioner are based on the Western model of education and training (subject learning and certifications). It completely discounts the unique training which African traditional healers undergo to become respected healers in their cultures and communities, plus ignores entirely the ‘call to heal’ which all genuine traditional healers experience, which aspect is utterly absent in all Western medical systems, which are purely profit-driven.
SOME OF THE FUNDAMENTAL ISSUES AND ERRORS WITH THE DRAFT REGULATIONS:
- The regulations were not drafted by traditional healers, but Western trained bureaucrats and lawmakers.
- The regulations were published with only three months comment period. They were published for comment over the festive season when the Department of Health and national healers associations were closed. This short time frame prohibited the majority of healers from accessing and deliberating on the regulations. The Department of Health did not provide adequate public or stakeholder participation platforms.
- The regulations were published only in English, and were not disseminated to the national associations for comment. Literacy rates among traditional healers are low, with many never having attended high school. Therefore the proposed laws could not be relayed to them in a manner which they would understand.
- Approximately 220 national healers associations, which the National Department of Health are aware of, were never invited to deliberate on the draft regulations before they were published. They only held one provincial workshop in each province, where none of the details of the regulations were revealed and no consensus was reached on the way forward.
- All healers, despite having already qualified as healers in their cultural frameworks, and some having practicsd for decades, must now have an Adult Basic Education and Training (ABET) Level 1 qualification to qualify for registration. There has never been any formalised Western-prescribed training in this regard, nor any current appropriate training proposed in this regard.
- According to the draft legislation, all healers must be over the age of 18 years to register. This requirement disregards the reality on the ground, in which many healers receive the ‘calling’ and begin training as early as 12 years of age, according to cultural norms and practices. Healer groups say government needs to understand that people may have the ‘calling’ at any age. There is no particular time that ancestors say, ‘Well we are going to wait for you until you are a particular age.
- Many traditional healers did not attend high school and have no ability to undergo the formal instruction required to attain or maintain registration due to lack of formal Western education. The standpoint clearly is, that Western mechanical education cannot be enforced as a barrier to entry into the multidimensional world of Spirit.
- According to the draft legislation, all healers who are eligible for registration will have to undergo upgraded Western education over a period of years, primarily aimed at teaching them about medical health conditions such as HIV and TB, and will be forced to travel great distances and expend time to learn medical diagnostic skills and basic pharma drug-therapy. This will undermine their unique, cultural primary care role, and turn their profession into a glorified scheme to refer people to hospitals and clinics to advance the roll-out of Western chemical drug-therapy.
- Most traditional healers are not happy to Westernise their training as it will corrupt and destroy the fabric of their culture and traditions.
THE RESPONSE OF TRADITIONAL HEALERS ASSOCIATIONS
The regulations have given rise to a lobby group made up of various stakholders called #VukaMngoma. This alliance demands that the National Department of Health repeal the draft regulations stipulated in the Gazette, and demand that they should not be implemented until grievances raised by the campaign are comprehensively addressed.
Head of the Traditional Healers Organisation, Ms Phephsile Maseko, said her organisation was in support of regulating the sector but that the regulations should be developed by traditional healers themselves, and be appropriate to African culture and healing systems.
The TNHA will support our traditional medicine alliance partners by formally responding to these regulations on or before the public comment period ends on the 3rd of February. We are currently consulting with our partners in this regard. The TNHA seeks to end neo-colonial efforts to subjugate, expropriate and ultimately destroy non-drug therapies in South Africa.