- San hunter–gatherers (referred to in earlier literature as Bushmen) who
are the true First Nations of the Southern African region, having
become established there more than 20 000 years ago.^1 - Khoe-khoe/Khoi-khoi pastoralists (formerly referred to as Hottentots)
who settled in the same region at some point in the last 2000 years.^6
Later migrations from the north brought to southern Africa the Nguni and
other Bantu language-speaking peoples whose TMP is now dominant in the
region. There is evidence to suggest that the different groups lived side by side
for several centuries, interacting and intermarrying.^7 By virtue of their supe-
rior numbers, the Bantu language groups slowly assimilated their San and
Khoi-khoi neighbours. After the arrival of European settlers in South Africa
in 1652, the inexorable process of cultural disruption continued, to the point
where only small isolated groups of San and Khoi-khoi peoples are to be
found in southern Africa today. Little remains of their traditional medical
practices and there is a real risk that much of their medical knowledge will be
lost to modern science. This is regrettable because the San in particular are
widely acknowledged as having been exceptional economic botanists.8,9To
the San hunter–gatherer, familiarity with the medicinal properties of plants
has always been a matter not merely of utility but also of survival. It is likely,
however, that, through intermarriage and cultural exchange, much San
medicinal plant lore has been subsumed into modern traditional medical
practice in southern Africa.
Perceptions of ill-health
The single unifying theme in African TMP is an enquiry into the causality
of ill-health. The patient consulting a TP will ask ‘Why am I ill?’, in contrast
to his or her counterpart in the western allopathic system whose question is
‘What is the nature of my illness?’ In African traditional medical practice,
disease is considered to be due to several possible agencies, the most
importantbeing:
- natural causes, e.g. normal developmental processes, life stages and
seasonal changes - behaviour offensive to the patient’s ancestral spirits, e.g. an immoral
act or the transgression of a social code - supernatural forces, e.g. witchcraft or intervention by evil spirits.
In a detailed study of traditional medical practice in Zimbabwe, it was
found that the greater part of the TPs’ practice was concerned with the
treatment of illnesses recognisable in terms of scientific medicine, and that
almost 50% of patients presented with complaints that were diagnosed by
the TP as being due to natural causes.^10
86 |Traditional medicine