Ukugula Kwabantu: The construction of mental health by 

traditional healers in a peri-urban area.1 

 

 

 

 

Sinethemba Makanya 

783036 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 
 

 Thesis submitted to the Faculty of Humanities, University of the Witwatersrand, 

Johannesburg, in fulfilment of the requirements for the degree of Doctor of Philosophy.  

 

 

1 The title of this thesis is further discussed in the Introduction, p. 18-19, for further elucidation. 

 



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UKUGULA KWABANTU 

Declaration 

 

I declare that this thesis is my own unaided work. It is submitted for the degree of Doctor of 

Philosophy at the University of the Witwatersrand, Johannesburg. It has not been submitted 

before for any degree or examination at any other university.  

 

 

 

  

Sinethemba Makanya 

March 2021 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 



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UKUGULA KWABANTU 

Abstract 

This thesis explores the question “How do traditional healers construct mental health?” It is 

concerned with understanding African ways of viewing health and disease which are 

inextricably linked to the nature of knowledge as shared and negotiated, within the African 

cosmology. This thesis challenges a foregrounding of theories imported from the global 

North and the perceived and imposed superiority of biomedicine. I argued that as a contextual 

starting point, an orientation into the worldview of a traditional healer is imperative to locate 

the study within the context of a peri-urban area such as Chiawelo in Soweto as a case study. 

I used qualitative phenomenological interviews with traditional healers in and around 

Chiawelo as well as an autoethnography of my own initiation into traditional healing to 

counter my researcher bias and afford me the opportunity to think from the worldview of a 

traditional healer. I examined the African cosmological view of reality to arrive at an 

understanding of how reality, knowledge, and the human are conceived of within African 

metaphysics. These notions informed the theoretical framework through which to enter the 

worldview of a traditional healer.         

 An exploration of how knowledge is transmitted within the training of the traditional 

healer gave a practical view of how material and immaterial realities interface within the 

African cosmological view of reality. This gave insight into the nature of the relationships 

between various sites of knowledge or key stakeholders within traditional healing. Examining 

the traditional healer provided a case study of the processes within the human, thereby 

providing an account of the nature of the human. Finally, I examined notions of disease 

causation within this cosmological view of reality and isolated categories that construct 

traditional healers’ understandings of health or more specifically of mental health.  

 I found that mental health within traditional healing is thus constructed in relation to a 

general category of health and in relation to an expanded view of the human. I argued that 



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UKUGULA KWABANTU 

while the notion of mental health is essentially a Euro-American construct, it is implicitly 

considered in traditional healing interventions. The health of an individual is constructed 

across spiritual, psycho-spiritual, psychosocial, ecological, and physiological domains of 

existence. These categories are deeply entangled in one another, and traditional healers 

engage in the comprehensive and systematic assessment of the health (or ill-health) of their 

patients. Furthermore, traditional healers acknowledge the boundaries of their practices and 

show a willingness to refer should treatment fall outside the boundaries of their expertise. It is 

upon these boundaries that collaboration with other mental health care workers can occur, 

and a system of integration proposed.   

Keywords: mental health, knowledge, traditional healers, health and illness, cosmology, 

African, humans. 

 

 

 

 

 

 

 

 

 

 

 

 

 

 



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UKUGULA KWABANTU 

Acknowledgements 

Walking multiple journeys simultaneously is no easy feat. It has been a series of excavations, 

round abouts, balancing acts and both fortunate and unfortunate incidences. There were 

moments where I did not think I would get to the stage where I would give thanks, not for 

completing these journeys, but for getting to this milestone. Where the child is finally birthed. 

So, the saying goes, ‘it takes a village to raise a child’ in my case, it took multiple villages to 

birth this child, and for this I give thanks.       

 Beginning and proceeding with the PhD journey would not have been possible were it 

not for The Wits Institute of Social and Economic research (WiSER) and The Centre of 

Excellence in Human and Community Development. Thank you for taking a chance on me 

and this research and awarding me a Mellon Foundation Scholarship and DST-NRF 

Scholarship (respectively) to ensure that I was provided for while embarking on this work. 

Thank you to WiSER who provided me with office space, a computer, internet, and other 

resources that made it possible to research and write. Thank you for providing me the space 

in which to think, uninterrupted. Thank you for the various seminars and platforms that 

allowed me to develop the academic language I needed to articulate the complex and nuanced 

concepts in these pages. Thank you for the coffee, which kept me going day in and day out. 

Ngiyabonga.           

 To my supervisors and midwives, Professor Catherine Burns and Dr Victor de 

Andrade, who with compassion and dedication, guided me to this point. Thank you for being 

there from the very beginning. For listening, not only with your minds but also your hearts 

and your spirits, to the various ideas which were forming and the musings, both conscious 

and unconscious. Thank you for helping me narrow down my questions and providing the 

intellectual space in which to test out my thought experiments. Thank you for the various 

provocations that pushed me to think deeper on the language I was developing. For 



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UKUGULA KWABANTU 

encouraging me. For believing in me. Thank you for your patience as I was navigating both 

the academic and spiritual journeys, and for helping me reconcile these. Thank you for 

witnessing the making of both the intellectual and healer in me, even when it was tough, you 

saw and heard me. Thanking you for hanging in there with me and seeing these journeys 

through. Thank you for allowing me the space to unlearn and re-learn, for being my Gobelas. 

I will forever be thankful to both of you. Kukhanye, kwande.     

 I would like to thank the healers that allowed me into their homes and consultation 

rooms and gave their time and energy to respond to my questions. Thank you for opening 

your practices, gifts, and ancestors to me. A special mention to Athini AmaZulu Dlungwane, 

for your mentorship and for being a shoulder to cry on when it all got too much. Thank you 

for talking my ancestors down when we all got too angry. Thank you for hearing and 

understanding me when I thought nobody could. And for eventually agreeing to an interview 

when I could not fill my quota. Kunina nonke bantwana beThongo, ngiyathokoza, isandla 

phezu kwesinye, ngokukhulu ukuzithoba, ngithiMakhosi. Zindlondlo.    

 To Dr Sarah Nuttall, thank you for taking the time to read my reflections, to give me 

feedback and your impressions of what I was attempting to do, and for believing in this work. 

I always left your office feeling that I was worthy, seen, and heard. Thank you for 

encouraging me to continue with this work, for making me feel its importance and helping 

me see its potential. Thank you to Adila Deshmukh, for stretching my funding as far as it 

could go, for helping me keep up with timelines and the numerous books you helped me 

purchase. Thank you for packing my daughter lunch sometimes, and for being her other 

mommy at Mimosa. Thank you for encouraging me and checking in on me. Thank you to Dr 

Emery Kalema, for always reminding me that I was able, capable, and brilliant. Thank you 

for reading my loosely constructed chapters and always cheering the work on. Thank you to 

Dr Renee Van der Wiel, as office mate, colleague, and friend who walked the journey with 



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me. Thank you for being slightly ahead and helping me navigate the admin and processes, for 

being a shining beacon and inspiration always reminding me that the end will come soon. 

Thank you to all the staff at WiSER that I did not mention by name, for the chats in the 

kitchen, the smiles on the corridors, and your interest in my work. I hope one day soon, to 

come and present to you. Kwande.         

 Thank you to Professor Linda Richter, Lethu Kapueja, Wendy Landau, and Beth 

Amato, from the Centre of Excellence, for the numerous workshops and incentives as part of 

your student development program. Thank you for your hands-on approach to funding and 

for introducing me to the media. The interviews and opportunities that came from you 

nominating me to the Mail and Guardian Young 200 helped solidify me as a public 

intellectual and ensuring that the intellectual side of traditional healing stayed alive in South 

Africa’s imaginary. Thank you helping me believe that I too had a voice and helping me 

share this voice with the rest of the country. Ngiyabonga.     

 Time played a big role in this journey, and many times as something I ran out of. 

Running out of time resulted in running out of funding. A big thank you to my family who 

helped me with funds when I had none, for food and for data. A big thank you to Elizabeth 

Lacy, Beth Amato, Busisiwe Ntsalaze, and Melusi Mntungwa for keeping me fed during this 

time, especially over the lockdown when I could not do odd jobs to sustain myself. Thank 

you for being my shoulders to cry on, for lending me your ears when I needed to vent, and for 

reminding me that I could do this, come hell or high water. To Kali Ra, thank you for being a 

good father to our daughter. For taking her to be with you so that I could complete this labour 

of love for our daughter. To my partner Weleza Rambau, though coming in at the latter part 

of my journey, thank you for being here, for providing a soft place to land even between a 

rock and a hard place. Kukhanye. Kwande.         

       



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UKUGULA KWABANTU 

Dedication 

 

 

For my daughter Khanyisa iNkosazane. Uyilanga, inyanga, nezinkanyezi. Thank you for 

lighting the way for my ancestors to reach me. Without your light, none of this would be 

possible. 

Gogo MaCele, uwele kahle Ndlovukazi 

Mkhulu ZaneMvula, oguduza ekujuleni kwamanzi. Andize emkhathini. Ozigi zakhe 

zizwakala engakabonakali. Ndlondlo. Makhosi. 

Gogo Nombalabala. Maguqula. Somhlolahlola. Isbani Sothingo esavela esgodleni seLembe. 

Umkhulu wena 

 

 

 

 

 

 

 

 

 

 

 

 

 

 



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UKUGULA KWABANTU 

Contents 

Declaration           ii 

Abstract           iii 

Acknowledgements          v 

Dedication           viii 

Contents           ix 

List of figures           xii 

Prologue - iNdlela yeNyanga: journeys away and towards    1 

Childhood and upbringing        1 

Adulthood and university        3 

Ukugula kwabantu as a thesis        13 

Introduction           17 

Research question and aims         18 

Chapter one - Constructing beyond a single story: rationale and literature review 22 

I – Traditional healing         27 

II – A dynamic psychology        37 

Constructing the research: Research methodology and design   43  

Building blocks: Phenomenology       46 

Autoethnography         46 

Chiawelo as a grounding setting       49 

Gathering data          50 

The institutionalisation of knowledge       52 

Participant recruitment        54 

Consolidating: analysis and writing       62 

Methodological concerns: afterword on collection and analysis   68 



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UKUGULA KWABANTU 

Ethical considerations         73  

Chapter two - Theoretical framework: The African cosmological view of reality 74 

A South African traditional healing cosmology      78 

  The immaterial world         80 

   The material world        92 

The human’s cosmology: Implications for health      110 

Disease causation          110 

Chapter three – The construction of knowledge: Ukuthwasa    116 

A gift (or debt) from the ancestral spirits       120 

Different types of knowledge traditions       128 

Initiation as developmental         132 

A child is chosen: Development from childhood to adulthood    133 

Discussion on healers’ stories        136 

Signs and signifiers         149 

Affinity and/or ability        149 

Altered states of consciousness as parallel processing    151 

Training: Technologies, devices, and methods      161 

  Gobela (guide)        166 

  Cleansing plant therapies        172 

Ukugida          177 

  Skills development and assessment       182 

  Continuous development       184 

Chapter four – Constructions of (mental) health      187 

Ancestral causation          194 

Human development          201 



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UKUGULA KWABANTU 

Psychosocial and/or socioeconomic factors       207 

Chemical Imbalance          220 

The complexity of taxonomisation        223 

Chapter five – Archaeology and Architecture       231 

Recommendations for future research      251 

Conclusion           254 

Appendices 

Appendix I: Biographical information of traditional healers    259 

Appendix II: Stories of initiation       260 

Appendix III: Ecological causes of illness      269 

Appendix IV: Ethical clearance certificate      277 

 

 

   

 

    

 

 

 

 

 

 

 

 

 



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UKUGULA KWABANTU 

List of figures 

Figure 1.1: The African cosmological view of reality      115 

Figure 1.2: The African cosmological view of the human      115 

Table 1: Summary table – Categories of disease causation      230 

 

 



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UKUGULA KWABANTU 

Prologue 

iNdlela yeNyanga2: Journeys Away and Towards 

The calling to become a healer for me came as a grave inconvenience. The journey to dig 

deeper into the roots and expression of my calling has been filled with mental and existential 

crises. There was a push to deconstruct and interrogate what I had come to know from my 

upbringing, which was heavily influenced by Christianity and schooling. The journey toward 

this PhD has been heavily influenced by my own search for meaning making and finding 

ground within two worlds. Deeply entangled, the journeys deeper into the grounds of the 

ancestral call and my academic studies have afforded me the opportunity to interrogate 

aspects of influence and consequence on my lived experience and culminating knowledge in 

unique ways. With multiple influences along these two paths, I find myself in the unique 

position of the middle ground. A ground itself that warrants mention and reflection. Falling 

outside of the scope of a conventional doctoral thesis, I write this prologue by way of 

describing and reflecting on the journey that has afforded me my unique positioning. 

Childhood and Upbringing 

I was born into a middle-class Christian family. My mother was a lecturer at a teacher’s 

college and my father, a headmaster at a high school. Throughout my childhood, my parents 

were furthering their education. My mother holds a master’s degree in education and when 

the college closed, she moved on to work at the district Department of Education. While in 

high school, I have memories of helping my father type out his honour’s research paper in 

education. When he passed away in 2008, he was working toward his master’s degree in 

theology with aspirations to start his own church. As a result, I was always surrounded by 

 

2 This has a double translation either meaning ‘the way of the healer’ or ‘the healer’s journey’. The double entendre is two-

fold here as inyanga means healer but also refers to time through its meaning the moon or month. While these meanings are 

circumstantial, this shows the complexity of translation and interpretation and perhaps forewarns the reader of the complex 

material they are about to step into.  



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UKUGULA KWABANTU 

books. Avid Christians, my parents held leadership positions within the church, and books on 

Christian spirituality sat alongside books on education and psychology. The dedication to 

Christianity alienated our family from African beliefs, ceremonies, gatherings, and 

resultantly, the rest of our extended family who held on to these beliefs.   

 Both my parents were active within the church. My father oscillated between ‘pastor 

in charge’ and deputy pastor and my mother, part of the leadership of the church and other 

sub-committees. Members of the church and their families held the place of our extended 

family and social structure. Many of my early friendships were formed with young girls in 

the church. Deeply embedded in this community, I was also active within the church, holding 

a position of leadership in the teenager’s committee and served as Sunday school teacher. My 

home was often the venue for home prayer services and mid-week bible study sessions which 

were often taught by my parents.         

 From a young age, I would narrate my vivid dreams and intuitions to my parents, in 

many instances the dreams would come true. There were also instances where I would lay 

hands and pray for people through what we understood as an impulse from the Holy Spirit. A 

moment my mother continuously goes back when she is perplexed with my current path in 

life, is the arrival of an unannounced visitor in our home. She was a young girl in obvious 

distress, and she had told us a voice told her she would find someone to pray for her here. 

While both my parent laid hands on her in prayer, she refused and told them I was the one 

that needed to pray over her. I was sixteen at the time. This to them signified that I had a 

spiritual call. In response to this call, my plans for after matric were to study psychology with 

the noble intentions of helping people through both my studies and the gifts of the Holy 

Spirit.            

 

 



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UKUGULA KWABANTU 

Adulthood and University 

For my undergraduate degree, I majored in Psychology and Philosophy. I soon changed from 

Philosophy to Drama and Performance Studies as I became more engrossed in the world of 

theatre. The difference in the ways of knowing offered by Psychology and Drama, soon 

became the cause for much dissonance as they came towards and away from each other in 

complex ways. While my upbringing was sheltered from thinking too much about race and 

inequality, in university I was able to observe race relations and privilege in a way that I had 

not done before. Alongside abnormal psychology, I was taking courses in critical and socio-

cultural psychology. Here, I was learning about the tools and instruments used in 

psychological assessment alongside critiques of the Eurocentrism of these tools and 

instruments. My critical and socio-cultural psychology lecturers, Nhlanhla Mkhize and Jacob 

Wambugu, played a pivotal role in my initiation into critical theory. For the first time, I was 

reading the works of black authors such as Steve Bantu Biko, Frantz Fanon, bell hooks, and 

the like and was considering the implications of critical race and anti-colonial theory. Where 

I initially thought psychology would help me understand my gifts of the holy spirit, 

spirituality was rarely discussed in psychology and at that age and level, I couldn’t draw clear 

links. I soon decided that the dissonance created by my critiques of psychology and the 

alienation I felt from my gifts, was too much and focused most of my attention on drama.

 Parallel to this, I became fascinated with the spiritual concepts and learning about the 

body in my actor training. I was also interested in the drama in education and applied drama 

courses, through which I was considering critical race theory and the uses of drama beyond 

the stage. As an actor, I became deeply engrossed with entering the lifeworld of a character 

and playing them on stage. In these moments, I felt similar sensations as those I felt in church 

through the movement of the Holy Spirit. I gravitated towards the works and theories of 

Artaud (1958) who deepened my understanding of the relationship between theatre, 



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UKUGULA KWABANTU 

liminality, and catharsis. His work on Theatre of Cruelty (Artaud, 1958) shaped my 

understanding of the possibilities of theatre as a liminal space through which to achieve 

emotional and spiritual catharsis. I was also influenced by Growtowski’s (1968) concept of 

“poor theatre” which placed great emphasis on the skill of embodiment of an actor 

performing with minimal props. In this approach, I envisioned an actor as the main tool of 

theatre and catharsis. Himself as a student of Artaud, Grotowski (1964) coined the term “the 

Holy Actor: 

The actor who undertakes an act of self-penetration, who reveals himself and sacrifices 

the innermost part of himself - the most painful, that which is not intended for the eyes 

of the world – must be able to manifest the least impulse. He must be able to express, 

through sound and movement, those impulses which waver on the borderline between 

dream and reality. In short, he must be able to construct his own psycho-analytic 

language of sounds and gestures in the same way that a great poet creates his own 

language of words (Growtowski in Barba, 1964, p. 35). 

The concept of the Holy Actor deeply resonated with how I felt in church and on stage. 

Through my applied theatre and drama in education modules, I was introduced to the works 

of Freire (1968) and Boal (1979). Their concepts allowed me to envision an actor-practitioner 

who was able to use the art of acting not just to ‘be’ a character but to also ‘do’ the work of 

educating, creating awareness, and healing. Through these works, I deepened my 

understanding of the systems of oppression which influence the political and economic 

struggles of black people. In this way, I was exploring in depth and through an embodied 

way, aspects of critical and socio-cultural psychology. I became interested in the relationship 

between the “holy actor” and the shaman to interrogate the role and function of the actor-

practitioner.            

 At the time, my perception of a shaman was a healer who acts as a “bridge between 



5 

UKUGULA KWABANTU 

the unseen world of spirit and the material reality of humanity” (Glaser, 2004, p. 77). My 

understanding of the term ‘shaman’ came primarily from the literature we were taught in 

drama in relation to theatre and ritual (Schechner, 1973). As part of my research, I had 

proposed to interview a sangoma, as what I understood to be an African shaman, and this, 

would be my first-time meeting one. Our meeting was mediated by her initiate that I had met 

through contacts in the university. I was introduced to a white man, husband to one of my 

psychology lecturers, who was in initiation to be a shaman. He then introduced me to his 

teacher, who was a sangoma. She agreed to the interview on condition that I would accept my 

calling to be a healer. To do this, I would participate in a ritual process that proved to her that 

I was committed to both university education and traditional knowledge. I had drifted away 

from the church and was living on campus, rarely going home on weekends. Although I was 

also questioning aspects of Christianity, I was, however, not ready to delve into traditional 

healing in that manner as I still held Christian beliefs that demonised ancestors. The 

dissonance created by this meeting pushed me to forego the interview and focus on an 

honours paper that compared literature to examine the relationship between the holy actor 

and shaman. My conclusions in my research, although unclear pushed me further to consider 

the relationship between acting and healing.      

 Through this research and deepening my understanding of applied theatre, I was 

fascinated by drama therapy as I felt it would allow me to learn more about drama as a tool of 

therapy. That I was awarded a Fulbright Scholarship to pursue a master’s degree in Drama 

Therapy at New York University, solidified the idea that the calling to healing was to work 

through drama. In comparison to psychology, I felt that studying drama therapy would give 

my role of holy actor more agency to move the art beyond entertainment to something more 

meaningful like therapy. Studying drama therapy in New York, turned out to be a journey 

that pushed me to deeper interrogate what my understanding of healing and health were. 



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UKUGULA KWABANTU 

During this time, my experiences in New York were giving aspects of myself room for 

expression. I had to start developing my role as a drama therapist alongside my accidental 

role as a musician. I soon found that my role as musician became my escape from the 

complexities that my role as African intern drama therapist in America were introducing to 

me.          

 Theoretically, the school of thought I was introduced to in drama therapy was Landy’s 

Role Theory (Landy, 1986). Role theory postulated that the human personality is a system of 

interrelated roles which provide a sense of order and purpose (Landy, 1994, p.  102). Through 

this theory, Landy (1993), systematically organised repeated roles through theatre history 

“according to six domains, corresponding to prominent aspects of human beings: somatic, 

cognitive, affective, social, spiritual, and aesthetic” (Landy, 1994, p. 90). He called this the 

‘Taxonomy of Roles’ which he proposed would have “great potential in elucidating not only 

the kinds of roles that clients will take on in drama therapy, but also the process of treating 

clients through role method” (Landy, 1994, p. 95).      

 This theory and practice informed my understanding of the human as layered and 

helped me begin to grapple with my own layers and roles. I also found similarity between, the 

taxonomy of roles and multi-axial diagnosis. I saw the usefulness of the taxonomy of roles, in 

a drama therapist’s diagnosis and treatment of the client. Role theory afforded me theoretical 

grounding in drama therapy, and I became interested in the taxonomy as a classification 

system. As Robert Landy was my lecturer, I got the opportunity of class discussions with 

him. A challenge I posed of role theory was that it was based on Euro-American ways of 

thinking about health as well as forms of theatre and characters. Because of this, I was 

concerned that the roles reflected in the taxonomy were only based on Euro-American 

characters and may only be partially relevant in South Africa. I also argued that it lacked a 

socio-cultural orientation and focused solely on the individual’s internal processes. 



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UKUGULA KWABANTU 

 For my internship, amongst placements in children’s hospitals, correctional services, 

and inpatient psychiatric units, I chose to intern at a nursing home and psycho-social club for 

the homeless and formerly homeless. I felt that the former placements were too clinical and 

would require me to work with case files and previous diagnoses from the abnormal 

psychology that I had questioned in my earlier years. In retrospect, I realise that the nursing 

home and psycho-social club, allowed me to meet and sit with my clients as they were. I was 

dissatisfied with a model of classifying disease that required me to think of the relationship 

with my clients as one between a clinician and diseased other. I was also not comfortable 

with the idea, that I was expected to make a person better from a clinical diagnosis, that 

despite my undergraduate in psychology, I could not relate to or understand.  

In the nursing home, I worked amongst the elderly in various stages of Alzheimer’s. 

My clients were bed-ridden and barely conscious. Here, my interventions were to sit with 

these clients and act as a companion in the last days of life. I used music as a form of 

connection and would sing and hum to these clients. In those moments, I felt connected to 

them, and they would use movements of their hands, open their eyes, or smile to 

acknowledge my presence. Some of the nurses would also comment on my singing and 

assured me at this stage, this was all I could do for these clients. I also took over an activity 

group with the elders to facilitate a telling and sharing of stories. In my one-on-one sessions, 

my goal was not to do ‘therapy’ with my clients because at that time, I was unsure exactly 

what therapy was supposed to do. I chose to keep them company and help them process 

whichever areas of their lives they wanted to at these end stages.  

My work at the psycho-social club for the homeless and formerly homeless entailed a 

therapeutic theatre group, for the ‘regulars’. In these sessions, we used the container of a play 

to help clients process their experiences on the street, in the New York shelter system, and the 

hopes to get placed in state housing. This culminated in a production at the end of my 



8 

UKUGULA KWABANTU 

internship there. I also had one on one sessions with clients who were living on the streets 

and not taking medication. I was particularly drawn to and drew black men. Although I had 

access to some case files, I chose not to use these. My one-on-one sessions were rarely with 

the same clients as people would come and go. I did, however, see some of them on a regular 

basis. I was always warned to take caution by my site supervisor, who was a drama therapist, 

who informed me that fresh off the street, some were actively psychotic.   

In my sessions with the young men in the psycho-social club, I did not experience 

them as mentally ill, but rather frustrated with racial inequalities and the system of 

subjugation in America. I found their ‘aggressive’ natures, for which they were often 

alienated by members in the club, to be apt expressions and reactions to their day-to-day 

struggles living in the streets of New York. I also found their references to themselves as 

god-like figures, not symptoms of a mental illness such as schizophrenia or narcissistic 

personality disorder, as was informally believed by my supervisor, but an assertion of their 

wish to overcome these circumstances. I found that I could understand their frustration of 

wanting help from the psycho-social club but also a fear of being sucked into the system of 

The State. I was cognizant that I was the only black person on the team. My placements gave 

me an opportunity to enter the life world of my clients without judgement. This also helped 

me understand the context of New York and the socio-cultural experience of dispossession 

and displacement felt by many of my black clients there.      

 In these placements, I was also faced with having to learn to work with and balance 

my spiritual gifts. I used one on one supervision sessions to process an unusual sense of what 

my supervisor called, heightened cases of transference and countertransference, that would 

see me taking on certain physical and emotional characteristics of my clients. Through 

guidance, I learned to read these instances of empathy to gain a deeper understanding of my 

clients’ life worlds and foster greater connection between us. As these were sometimes 



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UKUGULA KWABANTU 

overwhelming and difficult to hold, I was encouraged to find ways to create boundaries 

between myself and clients to mediate the transference and countertransference. In group 

supervision sessions with my classmates, I often felt alienated and unreadable as I was trying 

to make sense of symbolic and spiritual imagery given to me by my clients. This imagery and 

symbolism often found me questioning the relationship between mental illness and 

communication from the spirit world. I was also grappling with the socio-cultural, political, 

and economic realities of many black people in America and the impacts these have on 

mental health.  

Through music, I was introduced to a whole range of black artists and soon found a 

place familiar to home amongst a community in Brooklyn. Through this community, I was 

afforded more exposure to the socio-cultural experiences of black people. I was exposed to 

spirituality across the African diaspora which deepened my understanding of spiritual gifts 

and their relationship to art and music. Performing music was an introduction to performing 

myself in a way that acting had not afforded me. Through the writing of songs, I was drawn 

deeper into the spiritual world as many of the songs I was writing were filled with spiritual 

and symbolic imagery that I could not understand. I often felt as though I was not writing 

songs, rather that I was being given songs by entities outside of me. My mentor, Masauko 

Chipembere, made me aware of the belief that songs were communication from the spirit 

world given to us for the purposes of prophecy, guidance, and healing. He also pushed me to 

think of the healing quality of voice and my voice as a healing instrument in relation to my 

work as a drama therapist. I saw the opportunity to interrogate aspects of drama therapy, 

shamanism, and traditional healing.        

 For my dissertation, I examined the notion that named the shaman an “ancient 

predecessor of the expressive arts therapist” (McNiff, 1981, p. 3). I examined the role and 

functions of the figure of the shaman in dramatherapy literature (McNiff, 1981; Pendzik, 



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1988; Linden, 2009; Glaser, 2004; Landy, 2008). I compared the notion of the shaman to 

literature in anthropology and psychology on the sangoma (Ngubane, 1977; Edwards, 1986; 

Freeman & Motsei, 1992; Hill, Brack, Qalinge & Dean, 2008). At this stage of my education, 

I found that the shaman, as a figure, lacked any connection to culture, context, and 

consideration of the various ways, they expressed their healing gifts. I argued that to abstract 

a healer from their context was unhelpful in understanding the nature of their role and 

function (Makanya, 2012, p. 40). My perception of the shaman was as an “archetypal figure, 

a universal character, who helps deepen and expand the image of creative arts” (McNiff, 

1988, p. 287).  I understood the notion of the shaman as “an academic term used by Western 

practitioners to contain the idea of indigenous healers” (Makanya, 2012, p. 41) and to give 

credence to their work as drama therapists.        

 To consider my practice of drama therapy in South Africa, I moved the enquiry away 

from the shaman to the sangoma in a more directed way. From this work, I concluded that the 

notion that there was a relationship between the drama therapist and the shaman could not 

hold in my worldview. That, “the drama therapist and the sangoma are incomparable… [and] 

that making such a comparison is highly pretentious and perpetuates the Western tendency of 

taking from indigenous societies and recreating for its own gains” (Makanya, 2012, p. 80). 

Although I found that both drama therapy and traditional healing “are valid in their own 

right… they operate in different paradigms” (Makanya, 2012, p. 79). My journeys in drama 

therapy and spirituality moved away from each other and held their ground as two distinct 

journeys.            

 Another pivotal point was the birth of my daughter, who was born prematurely at 

seven months of pregnancy, whilst I was writing my dissertation. Khanyisa iNkosazane was 

an expression of two worlds coming together, in much the same way my dissertation, 

Between Two Worlds, was. Her name was chosen by her father and me, after a naming 



11 

UKUGULA KWABANTU 

ceremony. It means ‘to bring light to The Goddess’ in reference to Nomkhubulwane, the 

concept of which I had been introduced to by the works of Mkhulu VusamaZulu Credo 

Mutwa. Coming back to South Africa, with a child out of wedlock, came with the anxiety of 

disappointing my Christian mother for the first time. I felt the responsibility of having to 

provide for myself and my daughter so that I would not prove to be a further disappointment 

to my mother. Fortunately, coming back as the first black drama therapist, I secured 

employment in Johannesburg. I was relieved to get away from home to mitigate the guilt I 

was feeling for having a child and going against the teachings of the church. I worked at an 

applied theatre organisation where I was tentatively practising drama therapy and applied 

theatre. I was also employed at Drama for Life at Wits University where I was teaching 

applied theatre and drama therapy. Part of the requirements of this work was to work toward 

registering as a drama therapist with the Health Practitioners Council of South Africa 

(HPCSA).            

 The more I taught and practiced drama therapy, however, was the more I felt a gap 

between theory and practice. In interrogating this gap, I published a paper in the journal, The 

Arts in Psychotherapy, The Missing Links: A South African perspective on the theories of 

health in drama therapy (Makanya, 2014). In this paper, I explored African notions of health 

and healing (Ngubane, 1977; Mkhize 2004; Manda; 2008) and considered how these could 

inform the practice of drama therapy in South Africa. I argued for a more integrated approach 

of thinking about health within drama therapy to consider African notions. I concluded that 

“work in South Africa would need to take on an ecological nature where not only the 

individual is reached but also the environment, the community, and the spiritual forces at 

work within the environment and the individual” (Makanya, 2014, p. 305). I thus posed a 

challenge to the role of the drama therapist who does not understand concepts of African 

spirituality. In this way, found opportunities for collaboration with traditional healers.



12 

UKUGULA KWABANTU 

 During this time, I was also struggling with mental dis-ease and crises that found my 

way to my first teacher who would begin my initiation into traditional healing. Although this 

reality was ever-present, I had never moved it into the realm of practice. Reading about 

traditional healing through my honours and masters research had allowed me to understand 

basic concepts and was now comfortable stepping into this realm. At this point, my Christian 

beliefs and relationship with my family was further challenged and I had no support for the 

journey I was taking. I was drifting further away from my inherited worldview and what I 

had learned through my ‘western’ education and religion could no longer hold. I came to 

understand the nature and role of ancestors more deeply and made sense of how and why they 

passed gifts down to me. I also came to understand the importance of embarking on this 

journey, to facilitate a smooth hand down of gifts from myself to Khanyisa. This initiation 

into traditional healing, helped me make sense of my experiences as an intern drama therapist 

and helped me understand the ancestral gifts that I was introduced to because of it. Although 

I was tentatively stepping into the realm of traditional healing, the idea of becoming a 

traditional healer was still an idea, one that I was not particularly tied to and would want to 

abandon repeatedly during my journey.       

 With the coming together of my two worlds of drama therapy and traditional healing, 

I questioned more and more whether drama therapy was what I wanted to do. My questions 

of the relevance of drama therapy in South Africa forced me to revisit my dissonance with 

psychology. I decided I was not ready to become a drama therapist at that point and opted out 

of registering. I wanted to think more deeply about the relevance of both drama therapy and 

psychology in South Africa, to think more deeply about my role and what my practice would 

look like. A PhD would give me the discipline and space to interrogate these issues.  

 Concerned with philosophical issues of theoretical grounding and what was a 

metaphysical analysis of knowledge, I applied to the Philosophy department at Wits 



13 

UKUGULA KWABANTU 

University. I proposed to examine the theories underpinning drama therapy and traditional 

healing to think through the praxis of both. My application was delayed, as the philosophy 

department tried to find a suitable supervisor for me. By the time I was accepted into the 

philosophy department, I had already applied and got accepted for a Mellon Foundation 

Scholarship to complete my PhD in medical humanities at the Wits Institute of Social and 

Economic Research (WiSER). Like the feeling of confirmation, I felt with the success of my 

Fulbright Scholarship, I felt that this success meant that I was on the right path. Although at 

the time, I was unsure what medical humanities entailed, a PhD in this field has allowed me 

the security of grounding within the field of psychology and the freedom of multi-

disciplinary thought, across other fields such as history, anthropology, and African 

metaphysics. Being part of the community at WiSER gave me access to wide range of critical 

thinkers, literature, and conversations. This added a rich experience upon which to examine 

traditional healing as a theory and practice steeped within the socio-cultural and socio-

political context of South Africa. 

Ukugula KwaBantu as a thesis 

Proposed as an auto-ethnography, of my initiation journey into traditional healing, and 

phenomenology, this research found my insider/outsider positionality complex and fraught. 

On the one hand, my autoethnography was not proceeding as planned because of my 

difficulty in finding and negotiating the research aspect of my initiation with a teacher. This 

was negatively impacting upon my proposed timelines. On the other hand, finding and 

interviewing participants bought with it a myriad of challenges that led me to question the 

nature of research with traditional healers. Although initially intended to understand the 

construction of mental health within traditional healing, the research took on a metaphysical 

purpose. To understand mental health, I had to understand the ontologies and epistemologies 

of traditional healing through full participation in the practices. Through this research, I was 



14 

UKUGULA KWABANTU 

able to observe how I was engaging with the knowledge more broadly. I explored what 

knowledge was, how it was accessed, and how it was constructed by myself and traditional 

healers in initiation and training. It became a painful work of wrestling with the realities of 

colonization and apartheid. Of deconstructing systems, I had internalized, that were 

perpetuating power dynamics and violence by how I was approaching my research question, 

methodology, and analysis.          

 The dissonance in both my doctoral and ancestral journey led to many moments of 

disconnection with the academy, feeling displaced and uncomfortable on campus. At WiSER, 

although found the seminars and reading groups interesting and had formed a close 

relationship with the director, I found it difficult to engage with the community. Language 

and readability were my major challenges. Because of my discomfort on campus, I was 

barely present and when I was, I often kept to myself. I often found myself in the ‘edgelands’, 

although a member in the community, was not of the community. I experienced strain in my 

relationships with my supervisors as I found difficulty in expressing the metaphysical 

challenges that I was experiencing as a result or as part of both the research and initiation into 

traditional healing. Finding the language to articulate in writing my thoughts and ideas was 

challenging and I often needed space and a lot of time to access this in a way that was 

clashing with the timelines to complete this research. I often felt as though my supervisors 

did not think that I was serious about the work and often felt the pressure of having to 

produce even though I was not ready. At moments, although my research garnered much 

interest, I felt that it was misplaced in Academia and felt as though I was failing as an 

academic.            

 The work also challenged my view of traditional healing. Feeling let down by the 

Traditional Healers’ Organisation, I had to find other ways of accessing healers. Accessing 

these healers put me face to face with the fragility of my ‘insider’ role. That although I was 



15 

UKUGULA KWABANTU 

black, female, and had responded in part to the ancestral call, by virtue of what I was trying 

to do within The University, I was more aligned to ‘western’ systems of thought. The way in 

which I was approaching my research method, highlighted the tensions and power dynamics 

implicit in the practice of research. This bought many reflections on the history and violence 

of research with traditional healers and black people more broadly. I spent a short time in 

Chiawelo as part of my own initiation ritual. In this time, I observed how socio-economic 

factors influenced competition and jealousy amongst traditional healers. I witnessed more 

closely how these factors influence the practice of witchcraft within the community. These 

experiences further complicated my view of traditional healing as deeply entangled with the 

social context of South Africa. That I was unable to complete this initiation ritual, further 

served to alienate me from the traditional healing community. This also bought up questions 

about the legitimacy of the calling I had come to known as part of me and which was a vital 

part of this research.         

 Amidst these challenges, the opportunity to use my voice became a turning point. A 

year into my research, I was awarded a scholarship by the Centre of Excellence in Human 

and Community Development. As part of building the capacity of their scholars, they held a 

workshop in science communication which culminated in a competition. The winner of the 

competition would be the person who was able to explain the aim and relevance of their 

research to non-scientists in two minutes. I was awarded the prize and with this came the 

opportunity to speak about my research on many public platforms including radio, 

newspaper, and television. I was chosen to be on the Mail and Guardian young 200 list in the 

category of science and technology and garnered more media attention through the research. 

As my research became more public, I was able to experience firsthand the socio-cultural 

significance of my work. I found the confidence and was beginning to develop the language 

to write as questions from interviewers and conference attendees helped define the core 



16 

UKUGULA KWABANTU 

questions and concerns that I was to address. Question and answer opportunities on radio 

shows such as Metro FM breakfast shows, 702 with Aubrey Masango, and the Power Hour 

lunch time shows on PowerFM, further helped develop this language and I valued the 

dialogic nature through which it was forming. The material from my public speaking 

engagements became evidence of my process and productivity upon which my supervisors 

and I could engaged.  This material is deeply embedded in the analysis of my data.  

 The writing of this work, however, has been slow and challenging. The work itself 

refused and continues to refuse to fit into the conventional form of a Psychology doctoral 

thesis. As a result of this, the theoretical framework and literature review are not stand-alone 

sections but appear throughout the chapters to support and in contrast to my research 

findings. This is also indicative of my own process of research. It was a process of moving 

back and forth literature on African metaphysics, analysis of stories of initiation, and my 

lived experience. As my own experience of the metaphysical realities of traditional healing 

deepened- through my autoethnography- so too did my reading of literature and framing. I 

was presented with the urgency of need for an updated African metaphysical perspective 

from Southern Africa as I found that much of the work in African Metaphysics was coming 

from North and West Africa. I was and continue to be inspired by the works of Harriet 

Ngubane and Nomfundo Mlisa. Weaving these together, I developed a theoretical framework 

through which I would interpret the making of a traditional healer and the construction of 

health. The theoretical framework itself is a work in progress, which I am testing by 

continuously placing it in conversation with the chapters throughout the thesis and encourage 

the reader to read it as such. Additionally, the auto-ethnography portion of this work is not 

just presented as a stand-alone segment. It is weaved through in the ways in which I have 

placed the chapters, conducted, interpreted, and analysed the interview material and presented 

the ideas in the work.  



17 

UKUGULA KWABANTU 

Introduction 

The title of my research is Ukugula KwaBantu, translated directly as the illness of African 

people. This term is a temporal adaptation from a notion by Harriet Ngubane (1977) in her 

monograph Body and Mind in Zulu Medicine3. In this book, Ngubane examines notions of 

health and disease in a Zulu community from an anthropological perspective. As a Zulu 

woman herself, she gives ground-breaking analyses which critique the works of 

anthropologists who had written on the subject before her, these anthropologists were white 

men, who as outsiders, had missed the nuances of language and genealogies of the practices 

they sought to research. Ngubane examines notions of disease causation in Zulu thought. She 

cites natural causes of illness due to biological factors often cured by medicines that are 

“believed to be potent and effective in themselves.” (p. 23). The understanding of the natural 

causes of illness is common to most people globally, i.e., “people from outside Africa” (p. 

23). As such, “there is readiness to use curing techniques and medicine of the western type” 

(p. 23).           

 Alternatively, ‘ukufa kwaBantu’ is considered a class of disease where “the 

philosophy of causality is based on African culture, this means not that the diseases, or rather 

symptoms, are seen as associated with African people’s only, but that their interpretation is 

bound up with African ways of viewing health and disease” (p. 24). In this sense Bantu refers 

to “peoples native to Africa” (p. 24) only. Although there is distinction between the different 

societies of African Indigenous people, there is accepted, an “affinity between the different 

cultures (within Africa) regarding the worldview which makes it possible for a Zulu medical 

practitioner to operate in a Sotho, Pedi, Shona, or Thonga society, and vice versa” (p. 24). In 

 

3I use ‘ukugula’ and Ngubane uses ‘ukufa’. This speaks to the temporality of language and how it changes through the 

generations. In my generation (and locality) “ukufa” means death although in older forms of isiZulu it can mean disease; the 

word “isifo” (derived from ukufa) can either mean there is an illness or a death. I am more comfortable with using the term 

“ukugula” to mean illness or disease as for me “ukufa” feels more fatalistic.  



18 

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this way, the term abantu refers to peoples of African descent only. Similarly, the term 

ubuntu, does not refer to humanity or humanism as a quality all peoples have access to, but a 

specific humanity only accessible to the Bantu. In other words, this research is concerned 

with a “distinctly black mode of existing- whether one may identify an ontological structure 

that may be associated with being-black-in-the-world” (Manganyi, 1973, p. 38). In it, I am 

interested in the ways in which the Bantu have been grappling with forms of knowledge and 

the impact of changes in the social, historical, and cultural contexts and the implication of 

these on their wellbeing (Mkhize, 2004; Chavanduka, 2001, Ngubane, 1977, Chonco, 1972; 

Gelfand 1964; Sundkler, 1961).  

The second part of the title, The construction of mental health by traditional healers 

in a peri-urban area, may not be apt for the content that follows in this thesis. While this is 

the proposed title, the thesis took six years for me to complete. During these six years, I 

constantly had to shift my enquiry and research methods, to respond to the need of my 

research and research participants. In the section on my research methodology, I go to great 

lengths to tell the story of my research and elucidate that because of the complexity of my 

already fraught ‘insider/outsider’ role, I was constantly working back and forth to refine, the 

methodology and interview schedule. Adamant that I aim to engage with the traditional 

healers that I interviewed in this research from a worldview that is in line with their own, 

defining and refining my theoretical framework became key. As such, the way in which I 

recruited and engaged with traditional healers evolved from those initially proposed and 

attempted. In the second iteration of my interviews, the conversation was less about mental 

health and more about their life stories and practice. This allowed me to set the context and 

describe the worldview or paradigm from which I was to parse responses about mental 

health.             

 As further elucidated in chapter four, I found my questions on the construction of 



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mental health to be obsolete as I recognized that this was a category that I was importing 

from a Euro-American framework. Instead, what I found was a complex and holistic 

construction of health. While concepts of mental health and wellness were implicit in the 

construction of health by these traditional healers, these were not considered separate from a 

broader view of health by the traditional healers that I interviewed. Furthermore, I understand 

that the views of ten traditional healers, in which I include myself, cannot be generalized to 

all traditional healers. Parallel to this realization is a sober acknowledgement that of these 

traditional healers only one admitted to treating people with mental illnesses, and therein the 

problem could lie. This one traditional healer, however, also did not see a distinction between 

the complex and holistic view of health and mental health. It would have been ideal for me to 

rethink recruitment and recruit healers who treat those with mental illness, while I tried and 

did not find any, this would have further delayed the process of completion.   

 On the one hand, I acknowledge that the title needs to be amended to consider these 

shifts in the questions I was asking, the types of traditional healers I was speaking to, the 

structure of, and the content which was eventually included in the thesis. I am thankful to an 

examiner for pointing out this misalignment of the title and ultimately the question. The 

amendment process at the University of Witwatersrand, however, is drawn out and would 

further and unnecessarily delay the process of completion for which I have fought and 

worked so hard. On the other hand, the misaligned title may also be evidence of an argument 

that I return to throughout this thesis, one that suggests that in the decolonization of the 

academy, there needs to be greater alignment between the frameworks and theories used 

within the academy, and those of marginalized- which are mostly ‘indigenous’- communities. 

The thesis itself inspires different types of reactions, ranging from an aversion to the various 

misalignments in the thesis, to a celebration of these misalignments. The celebration of 

engaging with and disruption of categories that are legacies of the coloniality of knowledge 



20 

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and a recognition, within this disruption of the journey of undoing, that the starting question 

is perhaps the wrong one. Here I should quote another examiner who maintains that such a 

recognition is “the signal of a deeply worthwhile intellection journey if ever there was one!”  

Research question and aims 

The title of the research, Ukugula Kwabantu: The construction of mental health by 

traditional healers, illuminates the aims of this research. I am concerned with understanding 

African ways of viewing health and disease which are inextricably linked to the nature of 

knowledge as shared and negotiated, within the African cosmology4. I argued that an 

orientation into the worldview of a traditional healer is imperative. My aim was thus to 

examine the African cosmological view of reality to arrive at an understanding of how 

reality, knowledge, and the human are conceived of within African metaphysics. I suggested 

that an examination of the training of a traditional healer will yield important information on 

the nature and sites of knowledge. An exploration of how knowledge is transmitted within the 

training thus gave a practical view of how material and immaterial realities interface within 

the African cosmological view of reality. This gave insight into the nature of the relationships 

between various sites of knowledge or key stakeholders within traditional healing. A view of 

the traditional healer provided a case study of the processes within the human, thereby 

providing an account of the nature of the human.  Finally, I aimed to examine notions of 

disease causation within this cosmological view of reality to isolate categories that construct 

traditional healers’ constructions of health or more specifically of mental health.   

 The structure of this thesis is as follows. The introductory section contains the 

prologue and introduction, I orientate the reader on the pathways that have led me to this 

research. I reflect on the resultant emic and etic positions and spaces I inhabit and the 

 

4 While the question is one of mental health, as the research evolved, as explicated in the previous section about my title, I 

recognised that mental health was a category imported from Euro-American frameworks I deduced by me through an 

understanding of concepts of health and disease. 



21 

UKUGULA KWABANTU 

tensions and entanglements between these. Chapter One introduces the research question and 

aims as well as the rationale and building blocks from literature that have informed this 

inquiry. I will present my research methodology where I will elaborate on the research 

design, data collection, and the process and method of developing theoretical frameworks. 

From an auto-ethnographic perspective, I will elaborate on the tensions and lessons learned 

from my fieldwork experience, conducting interviews with traditional healers. I will reflect 

on how the lessons learned influenced the ways in which I collected and interpreted data to 

foreground the traditional healing paradigm.       

 In Chapter Two, I examine the construction of reality, through a reading of literature 

in African Metaphysics and an analysis of the material collected in interviews. I found the 

African construction of reality as one that conceives of multiple worlds simultaneously 

existing parallel and in overlap to each other. The beings in this world are considered as 

forming a hierarchy and a natural order, based on the amount of life force and influence. The 

immaterial world includes what I have called the Creator Beings as the sources of life force. 

Within the immaterial world are also different ranks of spirits that show themselves in 

various ways in the material world, the ecology, and the inner and outer life worlds of the 

human. The human is thus considered as part of both material and immaterial reality and is 

affected by and can affect both worlds. In this chapter, I also interrogate the philosophical 

assumption that the human is a microcosm and composite of its cosmology. In this way I also 

examine the nature of the human and how it can access these multiple realities.  

 In Chapter Three, I examine the construction of knowledge and the traditional 

healer’s relationship to knowledge. I use studies of other healers in literature and interviews 

with traditional healers from my fieldwork. I am grounded by and in Mlisa (2009) psycho 

analytic view of ukuthwasa as a developmental process. Pointedly, the idea of the material 

and immaterial as both indivisible and separate was also highlighted as a space through which 



22 

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the knowledge is negotiated and constructed. In this space knowledge presents itself as 

infinite, as part of multiple dimensions and temporalities. In this chapter, although I examine 

the traditional healer, I argue that they are an example of a human and illuminate how the 

human has access to the knowledge through their connection with multiple dimensions and 

temporalities as is made manifest in their cosmology of ancestors. This example elucidates 

how material and immaterial interact and are entangled within the human to produce a view 

of reality, knowledge, and other processes such as health.      

 In the fourth chapter, I examined the interviews from my fieldwork experience. I 

focused on the practice of the traditional healer in relation to categories of causation of the 

illnesses they are presented with. Not considered a separate category of health, I found that 

mental health is deeply entangled in the causes and effects of illness and dis-ease more 

broadly. Traditional healer constructions of health present themselves to be complex and 

interrelated. The health of an individual is constructed across spiritual, psycho-spiritual, 

psychosocial, ecological, and physiological domains of existence. Traditional healers 

provided a comprehensive and systematic assessment of the health (or ill-health) of their 

patients. Furthermore, traditional healers also provide the boundaries of their practices and a 

willingness to refer should treatment fall outside the boundaries of their expertise. It is upon 

these boundaries that collaboration with other mental health care workers can occur, and a 

system of integration proposed.          

 In the conclusion Chapter Five, I reiterate the idea that this thesis has been a thought 

experiment and assess whether this experiment has been successful by summarising the 

lessons, arguments, and findings of the preceding chapters. I argue that collaboration and/or 

integration is possible and give suggestions of how this can be achieved. I argue for a 

rethinking of how psychologists are trained to give room for other form of thinking about 

health and illness. Considering questions of the validity and reliability of traditional healers, I 



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UKUGULA KWABANTU 

suggest that further research into indigenous methods of quality assurance is needed. I 

examine how this research has contributed to new knowledge in African metaphysics, 

psychology, medical humanities, and critical theory more broadly. I reflect on opportunities 

for research within these and other fields such as gender studies, and education.  

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 



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Chapter One: 

Constructing beyond a single story5: Rationale and literature 

South African morbidity data indicate that mental disorders are the third highest contributor 

to the local burden of disease, after HIV and other infectious diseases (Bradshaw, 2003; 

Myer, 2008; Seedat, Williams, Herman, Moomal, Williams, Jackson, Stein, 2009). The rise 

in the number and proportion of people in South Africa living with mental disorders, as 

indicated by these statistics, highlights the growing mental health burdens and challenges 

facing the country. Despite the increasing need to turn the focus to mental health issues, as 

well as the need to establish the appropriate services to maintain mental health, services in 

South Africa are “grossly under-resourced and there are many barriers to health care for the 

mentally ill” (Seedat et al., 2009, p. 347). These barriers may include acceptability and 

availability of services, stigma, and discrimination due to a lack of awareness of mental 

health issues, language barriers, culturally conflicting models of mental health care, and 

questions of efficacy. Resultantly there is a need to reform services to potentially allow for 

greater sustainability, distribution, uptake, relevance, and efficacy.    

 Amongst other factors, this reform necessitates an integration of medical services to 

ensure greater sustainability. My thesis focuses on the need to include traditional healers in 

these services. Several studies have shown that traditional healers may play an important role 

in offering care for those struggling with mental health challenges. Traditional healers 

provide care that is associated with the indigenous explanatory models of illness held by 

many South Africans (Nattrass, 2005; Freeman, 1994; Mbanga, 2002; Sorsdahl, 2009; 

Campbell-Hall, Petersen, Bhana, Mjadu, Hosegood, Flisher & Happ, 2010). They are 

“sensitive to one’s culture6 and their methods serve as healing sources in times of distress.” 

 

5 Mkhwanazi, 2016 
6 Although a fraught concept, my understanding of culture in the instance of this paper is more associated with worldview, 

epistemology, and cosmology. 



25 

UKUGULA KWABANTU 

(Benjamin-Bullock & Seabi, 2013, p. 343). Although subscription to indigenous African 

beliefs is said to be more prevalent in rural and under-developed areas of the country, studies 

and experience indicate that such beliefs are also widely held by people living in urban 

settings. In many instances many African people develop the ability to hold hybridized 

explanatory systems which allow for the incorporation of both Euro-American and 

indigenous African premises (Bodibe, 1992; Hamber, 1995; Eagle, 2004). It is this type of 

medical pluralism (Levine 2012; Thornton 2017) I argue that can be optimised within 

healthcare systems to offer a more sustainable approach to healthcare such that well-being 

can be encouraged.  

 In the National Mental Health Policy Framework and Strategic Plan 2013-2020, 

traditional healers and faith-based organisations are identified as partners to implement and 

achieve the ambitions of the policy. These ambitions to transform mental health services 

include aims to ensure “that quality mental health services are accessible, equitable, 

comprehensive and are integrated at all levels of the health system, in line with World Health 

Organization (WHO) recommendations” (South African Department of Health, 2013, p. 3). 

In line with the broader health sector transformation process this policy framework intends to, 

amongst other things, contribute to “the re-engineering of primary health care, 

implementation of national health insurance, human resource development and infrastructure 

revitalization” (South African Department of Health, 2013, p. 3). The South African state 

thus aims to encourage the implementation of the Traditional Health Practitioners Act by 

“facilitating links between mental health services and traditional healers and faith healers at 

local district levels, including appropriate referral pathways in both directions” (South 



26 

UKUGULA KWABANTU 

African Department of Health, 2013, p. 41).        

 The Traditional Health Practitioners Act no 35 of 20047 maintains that the aim is:   

To establish the Interim Traditional Health Practitioners Council of South Africa; to 

provide for a regulatory framework to ensure the efficacy, safety, and quality of 

traditional health care services; to provide for the management and control over the 

registration, training and conduct of practitioners, students, and specified categories in 

the traditional health practitioner’s profession; and to provide for matters connected 

therewith (Government Gazette, 2005, p. 3). 

 

This Act recognises the need to include traditional healers in policy. As a beginning, it 

proposes the need for regulatory and standardizing framework. I understand the need to 

ensure the safety and quality of traditional healing services. I, however, echo the sentiments 

of Levine (2012) and are concerned that such an Act perpetuates the marginalisation of 

traditional healing by imposing scientific evaluation, regulation, and standardization in 

accordance with modern scientific medicine standards. Reading through the Act, the intention 

appears to be to fit traditional medicine within a modern scientific framework and little 

research has been done or attention given to the worldviews of traditional healers. I commend 

The State for considering the inclusion of traditional healers in the National Mental Health 

Policy Framework and Strategic Plan 2013-2020. However, absent from the policy is any 

intention of sensitising and educating medical practitioners in the frameworks and 

worldviews of traditional healers. This lack of suggestion of reform at a grassroots level 

makes me cynical that traditional healers will not be subjected to a form of neo-colonialism, 

where they are bent to suit the needs of The State. The superficial nature in which traditional 

healers are included within a bio-medical framework policy, further motivates for this 

research.           

 In this conversation on mental health and care, as practitioner (drama therapist and 

 

7 There is also a Traditional Health Practitioners Act no 22 of 2007. This act, from 3 years later has not changed at all. This 

reiterates my argument that while The State makes mention of traditional healers, little work is done to research, refine and 

implement any plans they make. While noble, the inclusion of traditional healers in policy is superficial and not well thought 

through 



27 

UKUGULA KWABANTU 

traditional healer), I seek to better understand the interdependent forces that shape the mental 

health of South Africans.  My research question is “How do traditional healers construct 

mental health in a peri-urban setting?” and is an examination of how traditional healers 

conceive of the interdependent forces that shape mental health within a traditional healing 

paradigm. It necessarily falls within multiple disciplines and is transdisciplinary in nature. 

Within the field of critical psychology, it looks to enhance the understanding of local 

phenomena and “expand our vision of what forms psychological functioning may take in 

diverse cultures” (Nsamenang, 1995, p. 737). The stakes here are raised as this research goes 

beyond a call for the indigenization of psychology or promoting an indigenous form of 

psychology. Rather, it seeks to examine and refine a conceptual framework from the 

traditional healing canon that is “consistent with the sociocultural experiences, worldviews, 

and goals” (Mkhize, 2004, p. 29) of abantu in South Africa in the twenty-first century. This 

framework, I suggest, may have psychological bearing, and can be used within psychology in 

efforts to decolonise or indigenise the discipline.     

 Medical Humanities provides fertile ground particularly in South Africa, for the 

critical examination of interrelated political, ethical, and intellectual aspects of medical 

knowledge and intervention. It aims to encourage the greater study of and reflexivity amongst 

those who wield knowledge and power over life and death matters (Tsampiras 2018), in the 

promotion of a theory from the South (Levine, 2012). This discipline affords me an 

opportunity to challenge “the marginal status of indigenous medicine forms [which] results 

from an imposed scientific evaluation in the accordance of the modern scientific medicine 

standards” (Levine, 2012, p. 62). In this research, I conceive of traditional healers as trained 

within their worldview to become medical practitioners. In challenging the knowledge 

hierarchies in medicine, I argue that “there is a need to make room for the traditional and 

indigenous knowledge of traditional healers to pioneer new frontiers of medical knowledge 



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for the progression of medicine” (Burns, 20198). I, thus, centre practitioners’ narratives in a 

way that critically engages their knowledge and practices as more than complementary (or 

add on) to biomedicine.         

 I examine traditional healing as a canon of medical knowledge influenced by and 

based upon African philosophical thought. My philosophical intentions are twofold. First, I 

seek to contribute to literature within African philosophy written by Africans living in Africa. 

Thus, this is a project of “self-definition and determination” (Wiredu, 2004, p. 1), that 

concerns itself with locality and location. From this intention, I seek to strengthen the models, 

practices, and perspectives on traditional health. Chonco (1972) maintains that an important 

role of traditional healers is to evolve new methods of diagnosing illness based on the 

changes in the environment (p.296). This shows traditional healing as dynamic and constantly 

interacting with various stimuli. This is a work concerned with documenting, describing, and 

analysing the experiences of traditional healers as a form of Afromodernity (Comaroff & 

Comaroff, 2012) in contribution to a written intellectual history. With the state of urgency in 

relation to mental health issues, I also aim to offer a critique of traditional healing to 

encourage traditional healers to be critically reflective of their practices within an ever-

changing context. This call is not one that seeks to align healers within academic institutions 

for credibility or standardisation. It aims to challenge the stigma and discrimination toward 

healers from the various corners of society.      

 Secondly, I seek to produce literature from an African perspective to expand existing 

knowledge of the world and what it means to be human (Wynter, 2013; Mkhwanazi, 2016). 

This is thus a project also concerned with demonstrating that this type of knowledge can be 

utilized to strengthen the universal knowledge (Hountondji, 2004) and contribute to the 

 

8 These words were said at a talk we both gave at the School of Medicine, University of Pretoria 



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proposals for theory from the South. I arrived at a methodology that allowed me to navigate 

this terrain from various perspectives and arrive at frameworks accessible to both Euro-

American and African schools of thought. To arrive at the construction of mental health, I 

had to understand the worldview of the traditional healer, the nature of knowledge within this 

worldview, how one arrives at this knowledge, and what this form of knowledge can tell us 

about the relationship between the human, health, and disease.     

 This thesis is thus the culmination of various journeys and navigations through 

multiple spaces. It affords me the unique opportunity to interrogate and explore multiple 

forms of knowledge. My positionality has allowed me to examine knowledge through 

multiple lenses. Using a thematic analysis, I have begun to challenge notions about theory 

and the production of knowledge. This is the beginning stages of a lifework that will 

transform based on my development and lived experience. This thesis does not aim to 

produce a history of traditional healing but captures this moment grounded in a particular 

context and time from which I have begun the work of classifying, mapping, and ordering 

phenomena (Mamdani, 2019). My choice to focus on traditional healing as a techné and 

praxis is a move to develop new and multiple reference points through which researchers 

from the South can build theory (Mamdani, 2019).      

 As a beginning, the following chapter is a brief review of the literature I have built 

upon in this thesis. In reviewing this literature, I have identified gaps to which my research 

may contribute. In the first section of this chapter, I begin from the World Health 

Organisation’s definition of traditional medicine as the global body supporting member states 

to develop policies and action plans to strengthen the role traditional medicine plays in health 

promotion. I challenge this definition as one that does not do justice to the heterogeneity and 

hybridity of this practice with the understanding that it is the responsibility of the member 

states to know and define this practice based on their context. I argue for a need to rethink the 



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terms traditional healing and traditional medicine in South Africa, as they too are limiting and 

do not consider the dynamism and temporality of traditional healing as a praxis. I briefly 

review literature that describes the traditional healing worldview and argue for a need to 

examine deeper and abstract better the philosophy underpinning traditional healing.  A brief 

examination of the literature describing the traditional healer, describes the varying categories 

and types of traditional healers. Here to, I argue that it is not enough to merely describe the 

traditional healer. More thorough analysis of the initiation and training processes is necessary 

to understand the knowledge a traditional healer may hold and how this knowledge is 

negotiated and informs their paradigm. Lastly, I review literature pertaining to traditional 

healing and mental health. I argue that this literature lacks orientation into the traditional 

healing paradigm and is therefore limiting in helping the reader understand constructions of 

mental health. A vast majority of the literature examines how traditional healers perceives 

mental illness, thereby, creating binaries upon which to describe health. I suggest more 

nuanced understandings of the traditional healing paradigm can offer health as inhabiting a 

continuum upon which to think through categories such as mental health.   

 Traditional healing is a broad field, the philosophies of which may contribute to the 

decolonisation agenda and impact a wide range of theories at use within the university. As 

this thesis is concerned with zooming into the usefulness of traditional healing with regards to 

mental health, an orientation into psychology helps position this thesis in a direct way. In this 

vein, a brief overview of the developments within psychology helps to frame my enquiry. 

The literature reviewed gives a historiography of the shifts within the fields of psychiatry and 

psychology. The literature charts the move in biomedicine, and resultantly in psychiatry and 

psychology, from consideration of health and illness as dichotomies and considers the 

continuum of health and illness. In this way, the World Health Organisation considers mental 

wellbeing as more pertinent than the health-illness dichotomy. Perspectives on the Diagnostic 



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and Statistical Manual (DSM) commend this shift as it has come with greater inclusivity of 

the socio-cultural context. There does, however, remain a gap in considering perspectives that 

are not orientated in Euro-American frames of reference. Another critique of this model 

through which to consider mental wellbeing, is the lack of focus on the aetiology of disease. 

While causation is a strength of the traditional healing model, the new DSM still focuses on 

symptoms resulting in a gap through which to consider illness.  As such, through this 

literature review, there is an opportunity that this thesis may fill these gaps within psychology 

as well as influence research on traditional healing to make similar shifts. 

I 

Traditional Healing 

Traditional medicine is defined by the World Health Organisation (2002) as the use of “plant, 

animal and/or mineral based medicines, spiritual therapies, manual techniques, and exercises 

to maintain well-being, as well as to treat, diagnose or prevent illnesses”. As an umbrella 

term, this definition of traditional medicine fails to capture the heterogeneity of the practice 

as “encompassing different types of healers with different types of training and expertise” 

(Mokgobi, 2014, p. 29). While the practice is traditional in the sense that it is derived from 

pre-colonial philosophical practices, I argue the same can be said of biomedicine as based 

upon colonial philosophical traditions. Like biomedicine, traditional medicine varies “across 

the world [is] dynamic and variable because of the different regions and countries of origin 

and because of the different agricultural systems in which they exist… [It] varies from culture 

to culture and from region to region (Mokgobi, 2014, p. 28).     

 On the other hand, if traditional is used in the sense that it is outdated, the term 

traditional healing and traditional medicine is incorrect and does not convey the dynamism 

and hybrid forms the practice may take. While traditional medicine and healing are “derived 

partly from pre-colonial African systems of belief, it has multiple roots that extend across 



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time, cultures, and languages. The practice is broadening and changing as healers are exposed 

to a wide variety of other healing traditions and religious views” (Thornton, 2009, p. 17). 

They thus barely resemble the practices of the older traditions. African traditional beliefs 

have been well-documented over the years across multiple disciplines including anthropology 

(Chonco, 1972; Ngubane, 1977), psychology (Mlisa, 2009; Sorsdahl, 2009), and religious 

studies (Mndende, 2004). Thornton (2009) ascertains that these practices are fast changing (p. 

17) to keep up with South Africans’ highly pluralistic search for therapy. African traditional 

healing thus “competes with and borrows from many other modes of healing, including new 

age therapies (healing with crystals and essential oils, reiki, and massage), Chinese, Indian, 

and European traditional medicines” (p. 19).      

 There is an influx of traditional healer presence on print and social media as well as 

radio and television. Some of the well-known and public figures in traditional healing 

include, Mkhulu VusamaZulu Credo Mutwa, Dr. VVO. Mkhize, Gogo Dineo9 and Gogo 

Moyo10. Dr. VVO Mkhize is the founder of Umsamo Institute, an organisation that is 

comprised of traditional healers and researchers and offers services such as healing services, 

intwaso, workshop, training, and public speaking services11. The institute is currently forming 

a partnership to offer immersive experiences and lectures with University of Kwa-Zulu Natal 

in Pietermaritzburg and is showing how traditional healing is moving towards the university 

in progressive ways. These healers are also showing how practices of traditional healing have 

co-opted technology and are able to access and be accessed by more South Africans. Their 

YouTube, Instagram videos, and online classes teach about various aspects of ancestors, 

rituals, the use of medicine in traditional healing, and are often platforms where subscribers 

and followers can ask questions and engage with the healers. Groups such as “The Footprints 

 

9 www.gogodineondlanzi.com 
10 Gogo Moyo TV: youtu.be/QIHCB0609yY 
11 www.umsamo.org.za 



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of our Ancestors” on Facebook have 88223 followers. In such groups, members have access 

to a wider variety of healers and teachings and can seek assistance and advice from these. My 

own experience with radio, newspaper, and television portrays that although it may seem as 

though “traditional healers remain outside the experience of many South Africans, they are 

fully part of South African life and consciousness” (Thornton, 2009, p. 17). In this thesis, I, 

thus use the term traditional healing begrudgingly and for lack of a better word.   

 Within traditional healing, health and illness are conceived of in relation to the 

African cosmological view of reality (Chonco, 1972; Ngubane, 1977; Chavanduka, 1980; 

Omonzojele, 2004; Mawere, 2011). Within this view there is constant dialogue and 

interaction between material and immaterial reality (Chonco, 1972; Ngubane, 1977; 

Chavanduka, 1980; Omonzojele, 2004; Mawere, 2011; Sodi, 2011; Matoane, 2012; Makanya, 

2014, Nwoye, 2015). This interaction manifests itself in the relationship between human 

beings, God, the ancestors, and the ecology. Health is also dependent on community and the 

relationships of the individual within the community (Ngubane, 1977; Mkhize, 2004; 

Makanya, 2014). Illness within this paradigm results from two categories of causation, 

natural and unnatural causes (Ngubane, 1977; Chavanduka, 1980; Eagle 2004). Unnatural 

causes are often cited in the face of a sudden or difficult illness that refuses to remit after all 

medicines (including Western hospitalization) have been administered (Chavanduka, 1980; 

Bodibe & Sodi, 1997; Edwards, 1986; Ngubane, 1977; Nwoye, 2015). The term ukufa 

kwabantu (Ngubane, 1977) refers to those illnesses that are linked to ecological dangers and 

the anger or withdrawal of the ancestors in some shape or form. This is translated to mean 

black people’s death, of which western practitioners are assumed to know nothing about. In 

instances of unnatural causes, the tendency is to view the illness not as ordinary but as 

“problems that carry a hidden text and message that must first be decoded and its meaning 

interpreted before a proper resolution or cure can be found” (Nwoye, 2015, p. 309). The 



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implication is that these unnaturally occurring illnesses are “approached as meta-

communications to be ‘read’ and interpreted, rather than to be categorized or classified as 

emphasized in the Western Diagnostic and Statistical Manual of Mental Disorder” (Nwoye, 

2015, p. 310).  As such health is also conceived of in relation to the spiritual, ecological, 

biological, and social context of the human. Human beings are thus seen as multi-

dimensional in nature, simultaneously, biological, social, ecological, and spiritual and 

occupying these various interrelated worlds (Ngubane, 1977; Chavanduka (ND), Swartz, 

1997; Sodi, 2011; Matoane, 2012; Makanya, 2014).      

 Thus, traditional healing offers a model which categorizes the health of an individual 

into spiritual, biological, ecological, and psychosocial domains of existence. In this approach, 

‘humans and spirits are not seen as separate but are all within the world, and even with the 

use medicines they influence these forces on the physical, psychological, and 

spiritual/transpersonal levels’ (Sobieki, 2014, p. 2). In Chapter Two, I extend this idea of 

humans and spirits as indivisible by examining in-depth the link between the two as this idea 

is inextricably linked to constructions of health and illness. Through parsing the literature and 

interview data, I arrive at an understanding of what I refer to as the cosmological view of 

reality, through which I aim to describe the philosophy of causality upon which “ukufa 

kwabantu” (Ngubane, 1977) is based. Furthermore, as a worldview, framing this thesis upon 

this philosophy can illuminate traditional healers’ lexicons and constructions of health.   

 As a vocation, traditional healers are often ‘called’ to this path by their ancestors 

‘through dreams and other significant experiences’ (Eagle, 2014, p. 6) such as economic, 

psycho-social, and physiological crises (Mlisa, 2009; Booi & Edwards, 2004). The initiation 

process generally takes place at the home of a more experienced healer to learn methods of 

diagnosis and treatment. The duration of the training is generally, 6 months to one year, the 

duration, however, varies depending on the type of initiation, the speed at which the initiate 



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learns and reaches each milestone, and on the finances available for the training. As this is a 

heterogenous practice, there are various types and ranks of traditional healers under different 

traditions and schools of thought. These are ever changing with South Africa’s dynamic 

context and to reflect the diversity in the country. Nwoye (2015) maintains that throughout 

Africa, traditional healers have over the years developed various methods to establish the 

cause and treatment approaches for the various conditions that their clients present with. The 

literature shows that delineation between healers can best be understood in relation to their 

specialisations.          

 Diagnosis through divination is the specialisation of the sangoma. Two major 

diagnostic mechanisms are followed by izangoma; instrumental divination (Nwoye, 2015, p. 

310) is the use of tangible objects such as the divination bone oracle (Ngubane, 1977; 

Chavanduka, 1980; Freeman and Motsei, 1992; Thornton, 2009; Mokgobi, 2014; Sodi, 

2009). Mediumistic divination is the use of umbilini (Mlisa, 2009), intuition (Ngubane, 

1977), or direct communication with the ancestors (Lebembe; Athini).  The diagnostic 

procedures used are based on factors like the healer’s preferences, geological location, and 

the nature of training received (Mokgobi, 2014). While undergoing initiation, the trainee 

sangoma is taught by the master sangoma about the composition, characteristics, and 

meaning attached to each bone and the positioning of the bone in relation to the other bones 

(Sodi, 2009, p. 61). The divination bones are much more than just a clinical instrument and as 

such are not only used as a medical tool. In keeping with the holistic orientation of the 

traditional healing model, “diagnostic bones may also be used to predict economic, social, 

and political problems as well as giving an indication of how these problems can be 

overcome” (Sodi, 2009, p. 62).         

 The diagnostic process itself is intuitive or spiritually informed (as communication 

from the ancestors) and is also “informed by local culture and knowledge systems. It is this 



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influence of local traditions and practices that probably account for greater variations in the 

assessment systems of indigenous healers” (Sodi, 2009, p. 63). The sangoma, as diviner 

and/or seer, acts as intermediary between patient and their ancestors and uses their knowledge 

of the different types of methods with which to communicate with the different types of 

ancestors (Thornton, 2009) to diagnose and treat illness. While the sangoma uses imithi to 

heal, their knowledge of imithi foregrounds the spiritual and ritual properties of medicines 

(Chonco, 1972; Ngubane, 1977; Freeman and Motsei, 1992; Schuster-Campbell, 1998; 

Thornton, 2009; Mokgobi, 2014; Athini).      

 Inyanga is a “highly skilled and devoted” herbalist (Petrus & Bogopa, 2007, p. 5) 

‘who specializes in herbal medicine’ (Freeman & Motsei, 1992; p. 1183).  The calling and 

skill of inyanga is learned and passed down through instructive dreams from ancestors or 

through apprenticeship. Inyanga specialises in a whole host of herbal remedies and 

vaccination treatments (Sodi, 2009, p. 63-64) for “physical illness and for culturally related 

afflictions” (Cocks & Moller, 2002, p. 388). While the accomplished inyanga may also be 

skilled in divination, their practice foregrounds the physical use of medicines to treat diseases 

such as high blood pressure and diabetes (Zingisa), enhance wellbeing, boost immunity, 

cleanse blood (Cocks & Moller, 2002). The ecological, social, and spiritual uses of medicine 

through the lens of inyanga are as protection from evil spirits, to bring luck, and to ward off 

attacks through witchcraft (Ngubane, 1977; Cocks & Moller, 2002). The practice of inyanga 

illustrates that traditional medicine and its system of diagnosis and treatment are not based on 

intuition and divining alone, but also on the “testing of such plant therapies for observed and 

replicable effects for many generations” (Sobiecki, 2014, p. 4).  

 Umthandazi or umprofethi emerged from the rise of the “independent churches that 

sought to Africanise Christianity by including African traditions and customs in their 

religious practice” (Mokgobi, 2014, p. 28). They often cite the calling from the Christian 



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Holy Spirit in lieu of an ancestral call and believe that they “receive guidance from god and 

the angels while [izangoma] are guided by ancestral spirits” (Mokgobi, 2014, p. 30).  Many 

of the roles of isangoma ‘have been taken over by umthandazi within a modern supernatural 

religious and urban setting’ (Edwards, 1986). Umthandazi mainly uses water and prayer to 

heal, although they may use herbal medicine from time to time. Abathandazi “share a 

common theory of health and disease with traditional healers” (Mokgobi, 2014, p. 30), the 

basic difference is guidance from either the Holy Spirit or ancestral spirits, respectively. The 

presence and culminating practice of umthandazi illustrates not only the temporality and 

dynamic nature of traditional healing, but it also portrays the willingness to “embrace other 

beliefs and practices” (Chavanduka, 1980, p. 80) resulting in the heterogeneity of healing 

modalities and knowledge traditions under this umbrella term.     

 In keeping with the plurality and parallelism of traditions in South Africa, it is not 

uncommon to see a sangoma and/or inyanga who is also umthandazi as traditional healers 

also form members of churches (Thornton, 2009). This is also true of the healers I 

interviewed in Chiawelo whom I found to hold a varying amount of proficiency across 

multiple healing modalities and knowledge traditions. It is for this reason that although in this 

research I have reported on different types and categories of healers, the lines are blurred as 

one healer may have a wider repertoire of modalities they use for their patients. Furthermore, 

there are other forms of traditional healers which are less documented and widespread such as 

isanusi and inyanga yabalozi. In Chapter Three, I examine more closely, the initiation and 

training of a traditional healer to abstract how the healer is prepared for their role. My aim in 

this chapter is not to categorise different types of healers but to understand, through 

abstraction, how knowledge is negotiated across the different healing modalities and 

knowledge traditions. In this analysis, I aim to expand the understanding of the context in 

which and how the traditional healer constructs health within their practice. 



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Traditional healing and mental health research 

Omonzejele (2004) maintains that although Africans have no written history of mental health 

care, like most other knowledge in African tradition, procedures in mental health care have 

been transmitted via oral tradition from one generation to another (p. 165). Defined in 

relation to the African cosmological view of reality, Bodibe (1992) suggests that mental 

health from the African perspective focuses on interpsychic relationships where one projects 

themselves outwards and focuses on their relationships with their community, ecology, and 

cosmology. In this way, intrapsychic relationships of thoughts and feelings, are rarely 

considered and fall outside the scope of the work of the traditional healer. Chavanduka 

(1980) suggests, however, that the non-observance of taboos and anticipated withdrawal and 

anger from the ancestors may also result in mental illness. In this way, he proposes that 

psychology may be a helpful frame through which to view the intrapsychic effects of the 

interpsychic relationships.         

 In their own research study, Madzhie, Mashamba, and Takalani (2014) maintain that 

“traditional healers [in Thohoyandou] perceive mental illness as madness and disturbance in 

the person’s brain, memory, and personality. It is an illness that affects the person’s mind and 

its functioning. Mental illness results in behaviours which are culturally not accepted” (p. 

322). This state speaks to a breakdown in the mentally ill person’s interaction 

environmentally, socially, and physically (Omonzejele, 2004). Resultantly, the mentally ill 

person is prone to interpreting issues haphazardly, is unstable, may be unable to differentiate 

between realities and imaginations, may not pay heed to impending dangers, and may be 

unable to recognize people previously known to him (Ozekhome, 1990, p. 104). From a 

traditional healing perspective, the possibility of the “origin of psychopathology arises not 

only from the illness of the body, mind, or social contexts but also from the spiritual or the 

ancestral background of the individual manifesting the illness” (Nwoye 2015, p. 309). 



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Traditional healers have also cited witchcraft as a main cause of mental illness (Madzhie et 

al., 2014; Sorsdahl, 2009). In this way “psychopathology does not refer only to the key 

problems of mental illness, such as psychosis or schizophrenia, but also to irregular or strange 

behavioural presentations that often arise from mysterious origins” (Nwoye, 2015, p. 310).

 The literature reviewed above, though helpful as a starting point, places health and 

disease as binaries or dichotomies, with most of the writers concerned with perspectives on 

mental illness. The common evaluation of the causes of illness is also placed on the binary of 

natural and unnatural or supernatural. I find that these binaries are unhelpful in understanding 

the continuum in which the traditional healer operates. As such there is little to be said about 

concepts such as well-being or how health is constructed in the absence of disease. Ukugula 

Kwabantu, responds to the call for research that centres and deepens the understanding of 

traditional healers’ perspectives on mental health. Through this research, I aim to contribute 

to this literature by expanding the classifications of the causes of mental illness and illness 

more broadly, beyond that of natural and unnatural causes. Much of the literature is 

descriptive and lacks nuanced analysis of the worldview from which traditional healers 

operate. Resultantly, the writers rarely start from a frame of reference that is in line with the 

traditional healers they seek to research and report on. Through this research, I aim to do the 

work of abstraction and interpretation, parsed in relation to the philosophy of traditional 

healing.  My aim is to strengthen the understanding of traditional models of health and illness 

by examining them as existing on a continuum. In this way, offer categories pertaining to the 

construction of mental health by traditional healers in a peri-urban setting.  

II 

A Dynamic Psychology 

In the history of biomedicine, psychology, and psychiatry are recent innovations, coming into 

existence from the eighteenth and nineteenth centuries. This period saw in scientific 



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medicine, an expansion in its claims regarding “the abilit