Healing Traditions

African Medicine, Cultural Exchange, and Competition in South Africa, 1820–1948

Karen E. Flint

• Publisher: Ohio University Press
• Year: 2008
• eBook ISBN: 9780821443026
• Topic: History
• Subtopic: African History
• Index: History

In August 2004, South Africa officially sought to legally recognize the practice of traditional healers. Largely in response to the HIV/AIDS pandemic, and limited both by the number of practitioners and by patients' access to treatment, biomedical practitioners looked toward the country's traditional healers as important agents in the development of medical education and treatment. This collaboration has not been easy. The two medical cultures embrace different ideas about the body and the origin of illness, but they do share a history of commercial and ideological competition and different relations to state power. Healing Traditions: African Medicine, Cultural Exchange, and Competition in South Africa, 1820–1948 provides a long-overdue historical perspective to these interactions and an understanding that is vital for the development of medical strategies to effectively deal with South Africa's healthcare challenges.

Between 1820 and 1948 traditional healers in Natal, South Africa, transformed themselves from politically powerful men and women who challenged colonial rule and law into successful entrepreneurs who competed for turf and patients with white biomedical doctors and pharmacists. To understand what is "traditional" about traditional medicine, Flint argues that we must consider the cultural actors and processes not commonly associated with African therapeutics: white biomedical practitioners, Indian healers, and the implementing of white rule.

Carefully crafted, well written, and powerfully argued, Flint's analysis of the ways that indigenous medical knowledge and therapeutic practices were forged, contested, and transformed over two centuries is highly illuminating, as is her demonstration that many "traditional" practices changed over time. Her discussion of African and Indian medical encounters opens up a whole new way of thinking about the social basis of health and healing in South Africa. This important book will be core reading for classes and future scholarship on health and healing in Africa.

PART I

Negotiating Tradition in the Zulu Kingdom, 1820–79

1

Healing the Body

Disease, Knowledge, and Medical Practices in the Zulu Kingdom

WHILE TRAVELING THROUGH the most northern coastal territories of the newly established Zulu kingdom in 1822, Henry Francis Fynn fell ill and “delirious” with fever, the dread of locals and travelers alike. Laid up in a hut and awaiting his ship, Fynn recalls being taken to and treated by a male healer and his two female attendants: “On coming into an open space, they lifted me up and placed me in a pit they had dug and in which they had been making a large fire; grass and weeds had been placed therein to prevent my feet from being burnt. They put me in a standing position, then filled the pit with earth up to my neck. The women held a mat round my head. In this position they might have kept me for about half an hour. They then carried me back to the hut and gave me native medicine.”¹ In his published diary, Fynn tells his reader that his recovery three days later resulted from this treatment and the African healer who doctored him. One of the first white traders and settlers in the Zulu kingdom, Fynn settled in Port Natal in 1824 and became fluent in Zulu. He not only received medical care from African healers, but claims to have studied their craft and administered African and European therapeutics to Africans and whites alike, something easily confirmed in the historical record.²

Because Fynn’s diary is the only source that mentions the fire-pit cure for fever, it is impossible to confirm the truth of his story. Used with caution, however, Fynn’s published recollections offer a rare glimpse at African therapeutic practice and knowledge during the period of the Zulu kingdom. But they also indicate the impossibility of separating out the African-European encounters that began before and would become more frequent during the “precolonial” period of the Zulu nation (1820–79). This interconnection is important to point out in a chapter that purports to talk specifically about healing practices in the Zulu kingdom. The historical interactions between Africans of the Zulu kingdom and white traders, missionaries, and Natal administrators and settlers reveal both the nature of these intercultural encounters and some of the medical practices and knowledge of persons within the Zulu kingdom. Though the Zulu kingdom remained politically independent until its defeat by the British in 1879, it was not unadulterated by white influences. British traders came to the Zulu kingdom in 1824 seeking trading relations and were granted permission to settle along the kingdom’s periphery in the area that became Port Natal (renamed Durban in 1835). Acting as a client chiefdom of the Zulu kingdom, Port Natal provided the Zulu ruler access to weapons and coveted trade goods, but it also attracted Africans who sought to konza, or submit themselves to, these new white chiefs (discussed in chapter 3). Initially this proved unproblematic; King Tshaka, the first Zulu king (1816–28), wielded enough power to demand subservience and the return of defectors from his kingdom. Another white presence, albeit a small one with minimal internal influence, was that of missionaries either invited or given permission to practice within the kingdom.

In 1838 a third white community—the Boers—settled along the western edge of the Zulu kingdom in the Drakensberg foothills after defeating a Zulu battalion at Ncome River. A year later they moved closer to the heart of the Zulu kingdom as King Mpande granted land in return for Boer military assistance to overthrow his brother King Dingane. Likewise Port Natal grew, attracting both whites and Africans alike, and eventually became recognized as the British colony of Natal in 1843. Zulu influence over their white neighbors declined greatly, and what had once been peripheral communities now had a much greater impact on events inside the kingdom. These white communities absorbed those wishing to avoid military service, seek political refuge, or earn money outside the grasp of the patriarchs. Even before the British annexation of Natal in the early 1840s, several chiefdoms had left the Zulu kingdom in favor of life under this new neighbor, though this sometimes worked in the other direction as Africans in the second half of the century sought to escape labor and taxation requirements in Natal. Over the years, not only did the presence of Natal provide an escape to individuals and chiefdoms of the Zulu kingdom, but white missionaries and traders from Natal also introduced new ideas and goods into the Zulu kingdom. Whites thus had an effect on the Zulu kingdom both militarily and by virtue of their bordering presence, yet their impact on African therapeutics and the social and political standing of healers within the kingdom was limited. It was only during Cetshwayo’s reign (1872–79), with its increased diplomatic relations with Natal, that concessions were made on this topic. Nevertheless these white sources, as well as African testimonies from the later half of the nineteenth century, have helped shape what we know of healers for this early period.

By carefully weighing and using the observations of cultural outsiders such as Fynn and other white settlers in this area in combination with African oral histories of the late nineteenth and early twentieth centuries, this chapter seeks to reconstruct the health ecology of the Zulu nation and the ways that communities and healers within the kingdom conceived of and sought to heal the body and illness. While the primary focus of this section is on the kingdom, that is not to say that there was or is anything intrinsically “Zulu” about the medicines and therapies practiced therein. Rather such knowledge and practices reflect the regional context from which they emerged. The nineteenth century was a dynamic period in which the Zulu kingdom expanded and incorporated various peoples and was affected by its growing imperial neighbor, the Natal Colony. The consolidation of the various chiefdoms into the Zulu kingdom and the introduction of new diseases and epizootics during this period resulted in the sharing of medical ideas and materia medica and demanded new health responses. The decline of the Zulu kingdom and the rise of urbanization, migrant labor, and consumer culture resulted in the disappearance of specialized knowledge of herbs, gathering techniques, and medical practices. Specialized and individual treatments of earlier times gave way to general remedies for a general public. Unfortunately, it is not always feasible to pinpoint when such changes occurred; where possible I have highlighted specific dates, though certain generalities remain just that. Despite these constraints I have tried to move away from an old but often cited historiography that has portrayed a static and synchronic notion of cultural beliefs and health practices of this area and often asserted such similarities through the mid-twentieth century. Likewise I seek to correct the false assertion that persons of the kingdom attributed all illness to ancestors and witches. By highlighting cultural approaches to the body and its ailments in the Zulu kingdom, I seek to establish a basis (albeit shifting) from which to observe further transformations and reconstructions of healing “traditions.” Likewise, such an exercise helps explain why certain biomedical drugs and procedures, such as inoculation, later came to be adopted or sought after while others, such as amputation or even pills, were rejected.

THE ZULU KINGDOM IN REGIONAL CONTEXT

Familiarity with local flora and fauna gleaned through observation and experimentation and then passed (sometimes sold) from generation to generation among kin, neighbors, friends and cohorts provides a basis for some of Southern Africa’s common folk remedies as well as the therapies of medical specialists. Unlike healers today, who may have knowledge of various ailments and remedies, medical knowledge of the past was highly specialized. This applied to individual healers and families, as well as communities in this region of southern Africa. Bryant claimed that this specialized knowledge can be traced back to the end of the eighteenth century, when single herbal remedies were known and owned by a family.³ In the nineteenth century several colonists mention purchasing healers’ secret remedies and that few healers or families seemed to have access to more than one or two remedies.⁴ If healers could buy and sell remedies, why did they not own more than one or two? Presumably, selling one’s remedies within a smaller community could eliminate one’s potential revenue source or pose a commercial threat; perhaps selling remedies to transient Europeans, whose evidence we have of this practice, seemed less problematic.⁵

African medical beliefs and local therapeutics currently practiced in KwaZulu-Natal show remarkable similarities with wider regional beliefs and practices, evincing a long history of interaction and some common origins. Though medical practices and materia medica may vary among different cultural groups, southern Africa’s local medical cultures share many key attributes. These include similar herbal remedies, surgical and non-invasive therapeutic techniques, and an occupational division between healers who use only herbs and those who heal through clairvoyant means. The area’s cultures also historically shared a maxim of no-cure, no-pay, a practice that has largely disappeared in the face of colonial and postcolonial changes. These regional similarities emerged due to three main factors: (1) older commonalities shared and spread through the much earlier movement of Bantu-speakers to southeastern Africa; (2) the consolidation and expansion of various African polities in southern Africa during the late eighteenth and early nineteenth centuries; and (3) the urbanization, industrialization, and labor migration that accompanied colonization and white rule in South Africa. The movement of peoples—whether by force or voluntarily—brought the prospect of new interactions and introduced many new herbal remedies, healing techniques, and tools, as well as apparitions, diseases, and psychological afflictions to southern Africa.

Linguistic and archaeological evidence shows that Bantu-speakers in southern Africa originated in central and east Africa, where they shared a common culture. As Bantu-speakers slowly migrated southward more than two thousand years ago and dispersed, their culture and language diversified and changed, resulting in a large variety of separate chiefdoms. Likewise each group developed its own medical and ritual specialists, learned to use plants that grew locally, and made therapeutic innovations. Evidence of an ancient common medical heritage, however, can be found in several medical word cognates such as ti (medicine), nganga (doctor), and ngoma (diviner). Anthropologist John Janzen convincingly argues that cultures throughout central and southern Africa share “ngoma,” a unique historical healing institution that demonstrates linguistic, behavioral, and structural similarities.⁶ Likewise, the medical knowledge of these various Bantu-speaking groups expanded and diversified as they interacted with the local Khoisan inhabitants of southern Africa and through the long-distance trading networks that developed from Delagoa Bay through the Basotho Mountains to the Fish River and northward to the Limpopo Valley.⁷ Tracking the exchanges and developments that occurred in African medical and healing systems over the past fifteen hundred years, however, is a difficult and arduous task beyond the scope of this book.⁸

On a wider regional level, different groups gained recognition for their possession of unique materials and skills. The Tonga people, for example, manufactured brass,⁹ whereas the Cube produced iron hoes and assegais (spears).¹⁰ Specialization also applied to medical goods and skills and contributed to regional trade. While some herbal plants grew throughout southern Africa, such as iloqi (datura stramonium), which was and is used to relieve asthma and bronchitis,¹¹ the growth of other plants, such as isibhaha (warburgia slutaris), popular for curing colds, malaria, toothaches, and other ailments, currently grows only in the most northern part of KwaZulu-Natal.¹² The early predecessors of the Zulus, the Ntungwa, were known for indungulu (siphonochilus aethiopicus), “a medicine for chewing or giving [to] children when having a fever.”¹³ The Zulu chiefdom reputedly introduced ikhathazo (alepidea amatymbica) for colds, the Mpondo produced umondi (cinnamomum zeylanicum) and genet cat skins, and the Kumalo and Kuze were sought for their igwayi (tobacco).¹⁴ Likewise, medical and ritual specialists often came from specific groups. Local chiefs were said to frequently appeal to the Zolo, Tshangala, and Swazi for rainmaking,¹⁵ whereas the Nzuza were sought for their skills as umsutus.¹⁶

Oral evidence alludes to the presence of several large and smaller chiefdoms between the Phongolo and Mzimkhulu rivers in the late eighteenth and early nineteenth centuries. Many of the similarities in therapeutics throughout southeastern Africa arose during this time as powerful chieftaincies competed, consolidated, and dispersed in the face of the emerging Zulu kingdom (1820) and Boer and Portuguese slave-raiding.¹⁷ While regional trade had ensured a degree of exchange in medical knowledges in earlier centuries, centralized rule brought together and incorporated peoples and healers from around the region in an unprecedented manner. The boundaries of the Zulu kingdom expanded and contracted several times during its existence, but the majority of the kingdom was situated between the Phongolo and Tugela rivers. Other chiefdoms, such as the Mpondo and Tonga, paid tribute to the Zulu kingdom at different periods and shared linguistic and cultural similarities as well as differences.¹⁸ Other African chiefdoms seeking to avoid warfare or subjugation during this period known as the mfecane brought local herbal and medical knowledge and practices into other areas of southeastern Africa as they fled north and east.

ECOLOGY AND EPIDEMIOLOGY IN THE ZULU KINGDOM

Comparatively speaking, the Zulu kingdom enjoyed a relatively healthy ecology, yet changes in neighboring Natal brought in new epidemics and epizootics that affected the health and well-being of the kingdom. Situated alongside the Indian Ocean, the land that became the Zulu kingdom encompasses a wide variety of ecological areas: woodlands, lowveld, tropical forests, great rivers and estuaries, rolling hills, and the steep inclines of mountains. Consequently the area exhibits a wide variety in temperatures and rainfall, as well as a high degree of botanical diversity.¹⁹ The land enabled people to grow five varieties of maize, seven kinds of sorghum, fifty-five vegetables, and twenty-five different wild varieties of spinach.²⁰ Early travelers recorded African cultivation of indigenous and protein-rich millet, sorghum, jugo beans, cow peas, dates, and nuts, as well as greens, round potatoes, pumpkins, melons, berries, and fruit.²¹ Vitamin C could be gotten from marula fruit, which contained two to four times the amount of vitamin C of orange juice, but was more likely obtained from the popular beverage utywala, a homebrewed mille...

Table of contents

• Cover
• Title
• Copyright
• Contents
• List of Illustrations
• Preface
• Acknowledgment
• Introduction What Is “Traditional” about Traditional Healers and Medicines?
• Part I Negotiating Tradition in the Zulu Kingdom, 1820–79
• Part II Negotiating Tradition and Cultural Encounters in Natal and Zululand, 1830–1948
• Epilogue
• Notes
• Glossary
• Bibliography
• Index