LISTEN | Patients hide traditional medicine use fearing stigma, study finds

New research at Gauteng public hospitals has found that fear, stigma and poor communication prevent many South Africans from telling doctors about their use of traditional medicine, potentially putting their health at risk.

Dr Lindiwe Gumede of the University of Johannesburg found that patients often do not disclose their use of traditional remedies before seeking medical treatment, making it harder for healthcare professionals to provide appropriate care.

Gumede’s study, which was conducted among physicians working in public hospitals, revealed an absence of clear procedures that encourage patients to disclose their use of traditional medicines. This is despite the widespread use of traditional remedies in the country.

One physician interviewed during the study recalled a case involving a severely ill infant whose condition deteriorated after receiving traditional medicine, something like imbiza.

“The child was unconscious. The child had herbal intoxication, like they’d given an overdose of some herbal drug. That child was going to the ICU [intensive care unit]. The mother kept on denying it [the use of traditional medicine]. I was upset,” the doctor told researchers.

According to the physician, the child’s mother repeatedly denied administering any traditional medicine while the child was being treated.

The baby was admitted to ICU and remained there for a month before recovering.

Only after the child was discharged did the mother return to the hospital to admit that she had given the child traditional medicine.

“Doctor, you were right, and I want to confess, but at that time I could not disclose because I could see you were angry,” she reportedly told the physician.

Gumede’s research also suggests that fear of judgment and negative reactions from healthcare professionals often discourage patients from speaking openly about traditional remedies.

Traditional healer Abraham Mnguni said the problem is rooted in longstanding stereotypes surrounding traditional healing practices.

“You must know that the issue of traditional medicine, as well as the disclosure of patients having to disclose it, is systematic,” said Mnguni.

“We are a sector that is known to be demonic. If you are using services of traditional healers, you are often seen as someone who practises witchcraft. Because people do not want to be associated with these labels, they avoid telling doctors that they have used traditional medicine.”

Mnguni said some patients fear being ridiculed or judged by healthcare workers who hold personal religious beliefs against traditional healing practices.

“As soon as some patients disclose that they are taking imbiza or other traditional medicines, they fear being told that they are lost in life, that they are involved in demonic practices or that they should abandon traditional healing altogether,” he said.

As a result, many choose to remain silent even when the information could be important for their treatment, he said.

The study also found that medical consultation forms rarely include specific questions about traditional medicines. Instead, healthcare workers generally ask patients whether they are taking medication, often referring only to prescription or over-the-counter medicines.

According to Gumede, this gap in communication can have serious consequences, particularly when patients use traditional remedies alongside prescribed medicines.

“There can be interactions between traditional medicines and allopathic medicines, which is why healthcare professionals need to know what patients are taking,” she said.

However, Mnguni said the problem of non-disclosure does not exist only in hospitals.

He explained that traditional healers also depend on patients being honest about their medical history, chronic illnesses and prescribed treatments so appropriate decisions can be made about traditional remedies.

“We promote disclosure on our side,” said Mnguni. “We advise our patients that when they go to a hospital, they must tell doctors what traditional medicine they have been taking so that there is no clash between the medicine that we have given them and the medicine they receive at the hospital.”

Mnguni said he also encourages patients to disclose information to traditional healers.

“I would really appreciate patients disclosing to me that apart from the things that I’ve seen during consultation, are there any other things that they are not telling me,” he said.

“For instance, I may not pick up cancer, I may not pick up HIV, but I would appreciate them telling me that they are going for chemotherapy, they are taking ARVs, or they are taking medication for a chronic disease.”

According to Mnguni, this information is vital because some traditional remedies are intended to cleanse the body and may not be suitable for patients undergoing certain medical treatments.

“This therefore helps me to know that I don’t give you strong medication,” he said. “I don’t give you something that will flush out whatever you took for the chronic disease that you have.”

He said a lack of disclosure can create serious complications for patients and unfairly place blame on traditional healers.

Both Gumede and Mnguni agree that stronger communication, mutual respect and collaboration are needed to improve patient outcomes.