Published on New Africa Daily.

Over the past two weeks, the incidence of COVID-19 cases in South Africa has almost doubled, and now there’s a testing backlog because of a global shortage of test kits. While the race to develop a vaccine continues apace, local healers are striving to produce indigenous remedies based on herbal wisdom and plant-derived active compounds known to alleviate diseases such as flu, malaria, cancer, and HIV/AIDS.

South African media described the first two months of the pandemic as “the quiet before the storm”. When lockdown was imposed in late March, shutting down the country’s economy, hospital staff buckled up for a rocky ride and citizens impatiently waited for the first opportunity to resume business as usual.

Now, the southern tip of the continent prepares for a relaxing of the lockdown restrictions. Level 3 will allow most of the workforce to resume activities, schools to partly reopen, religious gatherings to take place, and shops to recommence selling alcoholic beverages from June 1.

However, a surge in the number of COVID-19 cases and an increase in daily deaths have created a dilemma for South Africans, who will return to their offices, schools, and places of worship amid fear and uncertainty.

Making a Case for Artemisia and Other Herbs

Since the beginning of May, African governments have scrambled to produce or buy herbal mixtures based on the artemisia plant.

Madagascan president Andry Rajoelina grabbed international headlines when he endorsed a local herbal tea named COVID-Organics, made of sweet wormwood (Artemisia annua). He went on to question the impartiality of the World Health Organization with regard to testing, and criticized the alleged Western polarization of the pharmaceutical industry.

In South Africa, the artemisia plant more commonly used in traditional medicine is Artemisia afra, known as wild wormwood, wilde-als (Afrikaans), mhlonyane (Zulu) or lengana (Tswana).

While scientists prepare to carry out clinical trials to test the potential of artemisia in the treatment of COVID-19, some people have already turned to traditional remedies.

“I drank wild dagga and sutherlandia three times every day and got better very quickly”

“I went to the clinic with high fever and COVID-19 symptoms,” says Irvin Mothibe from Soweto, south of Johannesburg. “They told me to quarantine myself, so I spent two weeks in a hut at Credo Mutwa Village. The great healer [Credo Mutwa, who passed away in March] had planted many medicinal herbs in the village. I drank wild dagga [Leonotis leonurus] and sutherlandia [Lessertia frutescens] three times every day and got better very quickly.”

Indigenous healers recommend a variety of natural solutions to their clients.

“When the pandemic arrived, we consulted among healers and we prayed to our ancestors,” says Sheila, a sangoma, or traditional healer, based in Alexandra, Johannesburg. “My recipe against the virus? A mix of sihawuhawu [nettle], isiphephetho [wild ginger], umavumbuka [Sarcophyte sanguinea], mayisaka [Thesium multiramulosum], and intolwane [Elephantorrhiza elephantina].”

“We are working on a product combining different local herbs and Artemisia annua, which is more potent than the indigenous Artemisia afra,” says Willem Bronkhorst, a director at the African National Healers Association. “I don’t know yet how effective this will be against COVID-19, but I can say for sure that it will help.”

Many healers from Johannesburg suggest they use artemisia in combination with valerian, mint, garlic, moringa, African potato, and cayenne pepper, ingredients that can easily be found on the shelves of a supermarket or pharmacy. “You can boil them and drink them hot or cold,” says Mmapelle Khunou. “Some sangomas prefer to mix them with porridge, to make it easier for patients to take the medicine.”

“It’s important to use the right quantities, depending on the person and how bad the disease is,” she clarifies. “If you are advised by the wrong healer or take herbs without prescription, you could harm yourself.”

What Standards for Herbal Remedies?

It is risky to believe in the existence of a miracle cure against an unknown disease. The World Health Organization does recognize the importance of traditional medicine and its achievements, but there are rigid requirements in place to ensure the quality, safety, and efficiency of a product.

“There are many therapeutic options that are being suggested as possible treatments for COVID-19,” says Stavros Nicolaou, a senior executive at Aspen Pharmacare Group and a key contributor to South Africa’s medical response to the pandemic. “At his point in time, there are no registered treatments that cure COVID-19. Whilst there might be many candidate or established medicines under investigation, none of these have been proven under clinical trial conditions.

“The pharmaceutical industry will continue investigating these candidate medicines under appropriate clinical trial conditions, and would only be in a position to make them available when they have been proven effective and safe in clinical trials, and when the necessary medicines regulatory agencies have approved them for specific indications.

“This approach is for all medications, including indigenous and herbal medicines,” Nicolaou says.

“The medical profession is trying to engage with indigenous healers, because they do a tremendous job in communities and provide health to the people”

“Artimisinin [a compound derived from Artemisia annua] is a powerful active ingredient,” says another pharmaceutical expert. “However, one needs to apply rigorous controls in the production chain to guarantee its standard quality. The medical profession is trying to engage with indigenous healers, because they do a tremendous job in communities and provide health to the people. But the healers also have to adhere to the conditions required of the medical profession.”

These requirements, however, raise suspiciousness among many healers: “We also took an oath,” Mmapelle Khunou says. “The problem between us and Western doctors is that we put the people first, instead of profit.”

Doctors, Psychologists, and Community Leaders

Indigenous healers do not just provide medical advice. Their input ranges from psychological to religious factors, while tightening the social fabric. Two months of lockdown tore families, villages and townships apart, forcing a transformation in everyone’s life.

“Men are no longer able to provide for the family,” says Khunou. “If my man can’t do his job, I will question him and ask him to make a plan. But he is also human and has his weaknesses. His manhood is questioned: some men snap and become violent, and households grow apart.”

The recognition of traditional healers as essential workers would facilitate the diffusion of health practices and create awareness about the rising costs of the epidemic.

“I don’t believe in this virus,” says Violet, a resident of Alexandra. “Have you met anyone who has it?”

In the streets of the township, people walk and commute casually. Even where social distancing and the use of masks are possible, habits prevail. Small crowds gather in front of spazas (small shops). To buy a kota (a meal of a quarter loaf of bread, processed meat, and chips), you have to close your eyes to basic hygiene requirements.

“What about masks?” asks another local. “They tell us to wear them, but we don’t know why. Cloth masks become dirty and can also carry diseases.

“When the government makes announcements,” he adds, “they speak a language many people don’t understand. We heard no vernacular in the news; old people don’t even know what’s going on.”

A Rainbow Jigsaw Puzzle

When the first COVED-19 case was reported in South Africa, the nation was already on the verge of a financial crisis, while afflicted by profound inequality. President Cyril Ramaphosa has repeatedly called on his fellow citizens to embrace cohesion and brotherhood in facing the pandemic. However, despite the spirit of ubuntu (humanity towards others) that unites South Africans, there are visible discrepancies when it comes to the same residents taking practical action.

It is difficult, for a government, to answer to the business world while backing millions who live in extreme poverty. Similarly, it is challenging for people with completely different upbringing and heritage to live shoulder to shoulder and understand each other.

It is also difficult to bridge the gap between private and public health, international standards and tradition. Equality in South Africa is long due. It is too late now to try to bridge tremendous gaps while the pandemic is raging on. COVID-19 is killing thousands in far better prepared countries, with state-of-the-art healthcare and cohesive populations.

What South Africa can do—and it has done in many past instances—is to accept its uniqueness and take advantage of its complexity. If businesses and informal traders can sit at the same table, if medical experts and traditional healers could abandon prejudice and stigma to enter the same lab or the same ndumba (sacred hut or shrine), they could find a shared solution that speaks many languages: a medical, psychological, and cultural approach to be followed in all South African cities, townships, and villages for the benefit of all.