1. INTRODUCTION
5.2 ESTABLISHING THE TRADITIONAL HEALERS' CONSTITUTION, OFFICE UNDER THE MINISTRY OF HEALTH AND SOCIAL WELFARE AND THE
COUNCIL.
5. 2. 1 The Process
A series of meetings to encourage the process of establishing the office and developing the constitution of traditional healers were conducted. The results were as follows:
Meeting with the Ministry of Health and Social Welfare
The Principal Secretary recommended that the issue be handled by the Director of Medical Services in Swaziland. There were discussions with the Director who showed appreciation and approval of this proposa1. It was suggested that the traditional healers should meet and develop their own constitution which should be drafted for them by a lawyer. The Ministry of Health would then take this document through to parliament to be debated and ifit passed, the King would sign it. This document should have all the logistics of how the traditional healers would develop their office and how they think it would function with resources (equipment, personnel and some buildings) within the Ministry of Health and Social Welfare.
Meeting held with 'Tinyanga Temdzabu Organization'
The organization's leaders expressed their gratitude for this move. They saw this initiative as their road to freedom When it came to actual implementation of the legal body, they were not forthcoming. They stated that their organization was experiencing some internal problems. They could only participate by making sure that the registered members be informed and by providing a list of their members so that they can be contacted and not left out in these developments.
Meeting with the vice chairperson of the Traditional Healers Organization
This traditional healers organization has a long history. The vice-chairman mentioned that this was not the first time an office had been requested. It was started in 1975. This followed the request made by the late King Sobhuza that the Ministry of Health should organize traditional healers. The Minister at that time was Dr. S. Hynd. He also failed to organize or form a legal body of traditional healers. After 1975, when nothing was done about traditional healers, the King appointed Mr. Nhlavana Maseko to be trained in Germany to organize traditional healers.
In 1984 Prince P. Dlamini, the then Minister of Health, was the only one who managed to contact traditional healers. He held a series of workshops with the traditional healers in that year. The traditional healers communicated their problems to him, such as building of pit latrines at their homesteads, having telephones to be able to liaise easily when they need an ambulance, and clearing of roads leading to the homes traditional healers for easy access. Maseko also attended the workshops in 1984, and in 1985 he formulated the Traditional Healers Organization of which he is still the leader. He opened gates for all healers in Swaziland including the Zionists to register under his organization. Attempts were made to create a traditional healers office, but the administrators of the Ministry of Health called them 'Witch doctors". The traditional healers were then discouraged by such labels.
Meeting held at Sithobela Rural Health care Centre with Traditional healers and Western Trained Health Care Workers and Clients
This was the first meeting with all traditional healers, western trained health care workers and client to discuss about how to proceed with the establishment of the regulatory body. In this meeting the participants were informed about how the leaders from the Ministry of Health and
Social Welfare and from their organizations felt about this move as well as conveying their opinions . .
Traditional healers in this meeting decided that they needed a small office in Sithobela. They expressed concern that the faith healers were left out of this initial meeting since there was only one faith healer, a Zionist. They decided that they should formulate a committee and from the committee they would choose two members to work on this issue and report back to the committee. They stated that for this project to be implemented fast, all tinkhundla ( constituencies) of Swaziland should be involved. There should be two members chosen from each constituency and all these members would then form a group of traditional healers that would work on the development of the constitution and report back to their constituencies. These members would represent each constituency and would put forward ideas from their own committees.
They also realized that there are 55 administrative constituencies and 220 chiefdoms in Swaziland, and that this process might therefore take a long time. They suggested that from each of the four regions of Swaziland they should deal with only two constituencies and that would make 8,
choose two members from each of these 8 constituencies and this would make 16 members to work on the constitution. After the constitution has been drafted all traditional healers should be able to review it in their respective constituencies. After they were all satisfied, then a lawyer can be hired. After the lawyer had worked through the document, they would review it to see if the wording still corresponded with their proposals or deliberations. When they were satisfied, the document would be submitted to the Ministry of Health by the 16 traditional healer delegates, and the Minister would take it to the Prime Minister who would then take it to the Prime Minister who
would present it to Parliament.
They formulated a committee consisting of nine members. The committee realized this move required some resources such as financial support. It was decided that traditional healers would all contribute towards a fund which will be looked after by the treasurer. This money would be used for traveling expenses of the two traditional healers chosen to go around publicizing or disseminating information about this project and participating in the development of the constitution. The two traditional healers from each constituency would work with the researcher.
The meeting adjourned with all of them expressing hope for the future.
Meeting held with the leader of the Traditional Healers Organization
The leader of this organization was very positive about this development of the traditional healers' constitution. He mentioned that he was trained in Homeopathy in Germany, after which he came back to establish the Traditional Healer's Organization. In his organization he had developed forms for admission of patients, medical certificate and a passbooks as well as referral forms. These forms were only used by traditional healers under his organization. He would like to see the traditional healers having a Ministry of Traditional Healers. He had a dream of all traditional healers organizing to build their own clinics and hospitals which would be controlled by the Traditional Healers Organization Department.
He mentioned that his organization started a long time ago working for the establishment of an office with the Ministry of Health, but they were not successful. They also participated in primary health care activities in the years 1985 to 1987 when they worked with western trained health care workers to hold workshops which were funded through World Health Organization. This issue
of collaboration was not new to him. The only problem was the change of politicians, as a result of which initiatives never developed into permanent structures. Traditionalhealers also participated in immunization campaigns proposed by the Ministry of Health.
One of the problems they faced with the Ministry of Health was the issue ofHIV I AIDS since they felt that the ministry withheld information from the traditional healers. They would have wished to treat a patient suffering from this illness to see if traditional medicines failed or not, before the Ministry of Health claimed that traditional healers cannot treat HIV I AIDS patients. At present the Traditional Healer's Organization is part of the structure developed by the Government with all Government sectors to develop strategies on how the HIV/AIDS pandemic could be controlled in Swaziland.
Meeting with clients, traditional healers and western trained health care workers at Dvokolwako Health Care Centre
This was the first meeting in this area to discuss about the process to follow when establishing the legal body of traditional healers.
In this meeting most traditional healers asked questions about the establishment of the office. They discussed a lot of issues about ensuring they had official referral forms and that they were allowed in the hospitals. The leader of the Traditional Healers Organization was present. The whole meeting changed focus. They began deliberating about the affairs of the Traditional Healers Organization and soliciting for new members to join. At the end it was decided that another meeting should be held to discuss about how to go about implementing this project.
The leader of the Traditional Healers' organization rejected the Act of 1905 ( see Addendum, p.
276) in which traditional healers were named as 'witch doctors'. He explained how traditional healing developed in Swaziland from the time they were called 'witch doctors' to the time when efforts were made by King Sobhuza 11 to put in place the " Order in Council' for them to be able to function in Swaziland. The leader of the Traditional Healers' Organization dominated the discussions, such that no one had any chance to talk. The whole meeting lost direction and that is why it was rescheduled.
5. 2. 2 Analysis of the problems of establishing the legal structure of traditional healers Six months into the process an assessment was done to identify why moves to establish such a body were not success~ and what was delaying the current process. A number of factors were identified, as described in the following paragraphs:
Organization and Exclusion
It would seem that in the past plans to have such an office were made by one ofthe organizations, the ''Traditional Healers Organization". These plans excluded traditional healers who were under the other organization, Tinyanga Temdzabu, and those who were not under any organization.
Hence this exclusion led to the failure of the office being established, since most traditional healers did not perceive this move as their own. Even if it had succeeded, the other traditional healers would have felt left out.
Leadership style
The leaders have been doing things without the knowledge of the majority of traditional healers.
This came out when one traditional healer said "Much as we claim we have a leader, we do not feel we have one, since the one we have never communicates most things with us, he only
brings things to us. We strongly feel that we need a strong leader who will be democratic and be open with us." Traditional healers perceived the lack of leadership and lack of shared governance in the leadership styles of their organizations. The other organization, "Tinyanga Temdzabu", also expressed concerns with their leader who was failing to call and hold meetings so that such issues can be discussed.
Traditional and Cultural Structures of Swaziland
The cultural structure of having constituencies and having several chiefs under one constituency delays progress, since one chief cannot take any decision until all chiefs in that constituency agree.
Making an appointment with a chief means one has to go three or more times to be able to meet with the target group. First, one has to visit the chief to explain why the target group is being called for a meeting. The chief will then meet with his runners to explain to them, then the runners will call the target group to discuss a specific date to meet the speaker. The speaker will then be called to discuss the date of the meeting. After that the meeting will be announced through the constituency and by radio. By the time the meeting takes place one has been to see the chiefs or the authorities of the constituency more than three times, and maybe after the explanations, the target group will not decide until they have met with their respective chiefs. Then another meeting will be scheduled to discuss the issue and decide the way forward without the outsider being present. It is therefore a very slow process in the rural constituency areas to implement any project.
Lack of resources, especially in terms of Finance
Traditional healers have to finance their own activities. The lack of financial support from government makes it difficult for traditional healers to implement their plans in a timely fashion.
Some traditional healers also complained that their leaders would request monetary donations from certain organizations, but never have any feedback on how the money was utilized. One traditional healer said" We need to have our own bag in our own constituency where we could monitor how we use that money. We are tired of our leaders who request us to pay some money to the organizations, but we never see where our money goes to. Up to now we do not know what they do with our money. So we better have our own treasurer whom we can controL We all have to pay the money for this project to continue". In this constituency they chose a committee early in the process, had a treasurer and they decided how much each traditional healer would have to pay.
Traditional healers do not have the skills and knowledge for soliciting funding from organizations such as WHO. Owing to the lack of proper traditional healers' official structure, money donated for traditional healers' welfare ended up not being utilized by them Funding cannot be channeled to organizations, since some traditional healers do not belong to these organizations and it is also difficult to give donations to individual traditional healers.
Apart from finance, they did not have resources like a central office through which traditional healers can be reached, no do they have communication systems like transport and telephones, and importantly they also lack technical assistance in terms of developing a constitution.
Poor Communication
From the discussions it was found that traditional healers themselves lack ways of communicating with one another. Traditional healers have a tendency oflooking down on one another. If one traditional healer called a meeting, other traditional healers will not turn up. They would only attend if someone other than a traditional healer called them They also respond when the chief summoned them since they feared penalties.
Traditionally, the culture of traditional healers requires them to show the utmost respect to their senior traditional healers. The writer noted in one of the meetings that most of the traditional healers could not eat in front of their leaders, as a sign of respect. One therefore wonders how they could constructively communicate with one another. It seems communication is mainly from leader to members, and there is a lack of a two-way system of communication. The researcher noted that the leader is impatient with the lack of cooperation when he said" I am sick and tired o/telling them what to do and they do not act accordingly, I have now decided to go with those who are willing and leave those who are not willing." It is not clear whether he ever used a more inclusive and democratic approach to ensure commitment.
Change of Politicians due to elections or reshuffling
The other problem which caused delays was that the politician's term of office would expire before the traditional healers had implemented their proposal for an office. When a new politician was elected or came into office after a reshuffling, the whole issue was treated as a new case.
Sometimes that politician might not be interested in handling traditional healers' issues, since he or she might have other priorities. For instance, one traditional healer stated that in 1975 traditional healers did not have an organization. When they contacted the Minister at that time to propose
an organization of traditional healers, the Minister did not have any interest in their case. In 1984 they met a new Minister of Health who did show an interest and they were able, through his efforts, to form the present Traditional Healers Organization. They also started attempts to have a traditional healer's office in the Ministry of Health at that time, but unfortunately the Minister's term of office ended and the new Minister who was elected, as well as her Principal Secretary, did not have any interest in traditional healers. Traditional healers were then discouraged from continuing with this issue.
Lack of a proper plan of action and a time frame
From the time the researcher started work with traditional healers, it was noted that they did not attach any time frame to their plans of action. They acted as if they had all the time in the world.
They did not have target dates and did not identify people to complete specific tasks and decide when to report back to all the traditional healers. When there was a meeting, some traditional healers would not turn up. When another meeting was called, there would be new faces and the same issue had to be clarified again and again. This lack of a proper plan for attending meetings delayed implementation since by the time one thought it was time to implement the issues, the traditional healers who were coming for the first time were still asking questions which had been repeatedly debated. lbis delayed progress and a proper grasp of what was going on.
Diversity of traditional Healers categories
Traditional Healers by nature of their training, type of ancestors or spiritual possession and the way they practice are very diverse. They have a tendency to believe that one type of traditional healer is more important than another type. This element brings about a lack of contact and cooperation.
Among faith healers there are also different types who treat their own type as better that the other
types, and ridicule the other's practice. This applies also to the traditional healers who are either possessed by ancestors or trained through dreams or learned from their fathers how to treat patients. They also believe what they are is more important than other types of healers. It becomes very difficult when they have to make decisions, since it will depend on the majority of which type of traditional healer is present for a positive conclusion to be reached.
5. 2. 3 Action Plans
After the .above analysis of problems leading to the delay in implementing the proposal of establishing an office of traditional healers, the researcher held meetings with traditional healers where feedback about causes of the delay was given. After the feedback traditional healers elected some of their members to work on this issue and set specific target dates that will be discussed
Establishment of Committees
In Sithobela they had already established a committee to represent the Shiselweni region and two
members from that committee were to be members of the committee to work on their constitutional document. At Dvokolwako in one ofthe meetings two committees were formulated, one committee was to represent Manzini region and the other committee to represent the Hhohho region. From each committee two members were voted to be part of the bigger committee to look into the issue of the constitution. At this meeting it was decided that they would choose two members to represent the Lubombo region. Eight members would work on the issue of establishing this office. They would start with the constitution formulation which would direct how, where, and when the office would be. They decided that these members would rotate venues
when doing their work. They named the eight member Committee the ''Traditional Healer's
Constitutional Development Committee".