Medical Insurance Now Covers Herbs and Ancient Cures

Horatio Zungu, a traditional African doctor, was trying to be helpful. “We don’t use a medical system like Western doctors,” he explained.

Indeed. His patient, Victor Shabalala, removed his shoes to show respect to the ancestors. Then he lifted a goatskin bag, pressed it to his forehead and tapped it on each knee before spilling the contents on the floor.

Zungu poked a stick at the scattered bits of bone, shell, ivory and coins to form his diagnosis. The patient was silent.

“He is out of work,” Zungu concluded after a moment. “And he has bad luck. His problem is a spell was cast against him. I will prepare medicine to help him.”

Zungu put several handfuls of herbs and brown plant matter, plus a pinch of pink powder, on a torn newspaper page. He folded it, then prepared two more prescriptions.

One sachet is for bathing, he told Shabalala, the next should be boiled for drinking, and the last must be burned “to ward off evil spirits” in his home.

Like most South African blacks, Shabalala, 28, only sees a Western-style doctor for X-rays, immunizations, broken bones and the like. For most ailments, physical or spiritual, he visits a traditional healer who relies on herbs, ancestors and ancient folklore for cures.

Zungu’s herbs, branches and other ingredients are stored in dusty bottles, bags and jugs on the floor.

Perhaps the most unusual object in the room is a certificate on the wall. It is from Thamba Administrators Ltd., and means that a visit to Zungu now may be covered under certain medical insurance programs.

Ever since democratic elections ended white rule in 1994, the government has pledged to incorporate the estimated 200,000 traditional African healers into the formal health delivery system, which includes some of the best health care in the world.

The problem is that traditional healers attend no special school, are not licensed and have no written body of knowledge. Many healers accuse their rivals of being quacks or worse. Police routinely report incidents in which human hearts and other organs are used to make medicine.

But last month, Thamba began acting as a broker for employers willing to let workers use traditional healers under medical insurance.

“We see it as traditional healing working in conjunction with Western medicine,” said Murray Tonathy, director of Thamba.

In theory, the system works like this: Healers are registered in Thamba’s computers. Workers who sign up for it are issued coupons to use instead of cash when visiting an eligible healer.

“Our main problem is 70-80% of providers of traditional medicinal practitioners are functionally illiterate,” Tonathy said.

To get around that, registered healers are given strips marked with a bar code to stick on patients’ coupons in place of a signature. Then they mail the coupons to Thamba for computer scanning. Payment is transferred to their bank accounts.

This attempt to marry the computer age with ancient ways has met considerable skepticism. Most Western doctors scoff at what they consider the unhygienic and unscientific practices of traditional medicine.

Many healers are also suspicious.

“There’s no advantage,” declared Solomon Mahlaba, who heads one of the 150 or so healers’ associations. “I don’t want to wait for my money, which may come or not.”

Although talks with other public and private companies have begun, only Eskom, the national electric utility, has agreed to try Thamba’s program so far.

But Peter Adams, the Eskom spokesman, said the scheme is under review.

“We can’t go for any of this way-out voodoo stuff with chicken blood and feathers,” he said. “It must be real herbalist treatment.”

Most important, perhaps, the workers remain doubtful. Only 20 of Eskom’s 40,000 workers and 10,000 pensioners have signed on to the coupon system for healers. “Everyone is moving with extreme caution,” Adams said.