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All volunteer Community Health Workers completed a community based, experiential training curriculum for a period of approximately three years after which successful candidates received certification as qualified Community Health Workers.

Our approach to traditional healers therefore changed from 1980 onwards to actively involve them in the health delivery system. Apart from their involvement in the Community Health Worker programme, meetings were held with traditional healers to exchange views and to share knowledge and experiences in a non-judgmental way in an attempt to change harmful practices into safe practices. Healers were encouraged to bring their patients to our clinic when biomedical treatment was needed. We in turn reported back to the traditional healers and in some instances referred cases with Zulu diseases back to them.

Thus through constructive engagement, a good relationship between the two systems of practice was fostered in our area of operation, where access to health care was a problem, not only due to lack of services, but due to the physical terrain which gave the area the name the Valley of 1000 Hills. It is estimated that in our operational areas there would be between 200 and 300 traditional healers. Through collaboration we therefore have that many more health workers at no extra cost to the health system and who would have been consulted in any event by 80% or more of our patients.

We therefore actively involve traditional healers in all our activities. Some are Community Health Workers. They are part of our TB control programme. They dispense oral rehydration fluid. They dont re-use razor blades. They help to run our health posts. They are involved in our social plant use programmes. They are involved in our nutritional programmes. They dispense condoms. They are part of our student training programmes.

Yes, there are the harmful practises which are delivered by some uninformed or unscrupulous practitioners, as happens in all professions. However, the gains of bringing traditional healers into the health care system far outweigh the negative impact of excluding them.