The study found that the most common conditions that patients mentioned were physical problems such as chest pain, cancer, headache, diarrhoea, STIs and stomach ulcer, cholera, vomiting, high blood pressure, infertility, painful or swollen legs, including HIV and social problems and evil spirits. Most of these conditions were similar to those found in other studies on faith healers (Edwards, 1983
; Peltzer, 1999
; January and Sodi, 2006
), and a study on traditional healers (Peltzer et al., 2006
). In his study on faith healers, Peltzer (1999)
also found that the most commonly treated illnesses included STIs, chest pains, sugar diabetes and high blood pressure.
We implemented and evaluated an HIV/STI education programme for faith healers in rural Vhembe district, South Africa. Following the training faith healers in this study significantly improved their HIV/AIDS and to a lesser extent TB knowledge. Some myths of HIV and in particular TB transmission need to be further emphasized and addressed in trainings programmes. Other studies with traditional healers also found significant improvement of HIV/AIDS knowledge after the training (Peltzer et al., 2006
). While 74% of faith healers felt at risk of HIV infection when praying or healing a client. This significantly reduced after the training. This may be attributed by increased knowledge on how to protect oneself from HIV.
The study found that in the intervention group no significant improvement was found in HIV/STI management strategies such as HIV/STI risk behaviour counselling, referral of clients for HIV testing, keeping condoms at stock in church, and church community HIV/AIDS/STI education. The Information-Motivation-Behaviour Model was used in conducting the training. The training was not long enough to emphasize critical issues such as skills training. It is important to note that faith healers addressed some of the major known behavioural risk and protective factors such as partner reduction and condom use. Therefore, faith healers could be more widely utilized in HIV prevention programmes as risk reduction counsellors, in particular on matters of community-level education. Considering that in this study the faith healers were mostly females, they could possibly provide support to other women, given the gendered nature of the HIV epidemic in South Africa, and the need for strategies to enhance women's ability to protect themselves.
According to the (South African) Department of Health (2004)
, the continuum of care developed for the HIV and AIDS care and treatment programme should involve traditional health practitioners, and we suggest faith healers too, as an essential and irreplaceable component of the comprehensive care provided. Moreover, traditional health practitioners including faith healers can enhance the implementation of the antiretroviral therapy component of this plan by mobilizing communities, drawing patients into testing programmes, promoting adherence to drug regimens, monitoring side effects, sharing their expertise in patient communications with biomedical practitioners, and vice versa, and continuing their acknowledged mission in improving patient well-being and quality of life. A holistic approach to living with HIV and AIDS is known to be a key factor for success in living a longer, healthy life with the syndrome . Research should be conducted on how faith healers (especially those who are practicing full-time) could fulfil the role of “community HIV/AIDS treatment adherence supporters”, either in the form of supporting the directly observed HAART programs and/or as social and emotional support to those receiving treatment.
This study has limitations. The sample of faith healers included in the study was not representative of faith healers in the study area and South Africa. Assessment relied on self-report from faith healers only and did not include onsite checks of HIV prevention activities. Post training assessment was not conducted at different times, i.e. immediately after the training, at 6 and 12 months but only at 2 months following the training. Effects of the training may have faded away after the long time interval. A one-shot training was not sufficient for sustainable effects. This study only included faith healers from the Apostolic church and there is a need to conduct similar programmes and studies with faith healers from other religious groups.
As a conclusion, faith healers improved and retained their knowledge of HIV/AIDS, even 2 months after their training. They also played an important role giving culturally acceptable STI and HIV/AIDS counselling and community education. Their contribution can be further strengthened by involving them in future HIV/AIDS programmes.
We recommend a more systematic training of faith healers of at least 4 days in South Africa. After initial trainings supervisory and follow up trainings should be conducted. Randomized control trials of HIV interventions should be conducted with faith healers from different churches to further establish their effectiveness in HIV/STI prevention, care and treatment.