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20 September 2021 | Story Nombulelo Shange | Photo André Damons
Nombulelo Shange, Lecturer in the Department of Sociology, asks what it would look like if we looked inward and invested in our own indigenous methods of nurturing and encouraging this and similar practices? Could other important scientific innovations emerge from it?

Opinion article by Nombulelo Shange, Lecturer in the Department of Sociology, University of the Free State.
Last year I wrote an opinion piece on the importance of indigenous knowledge, especially in healing practices. The piece detailed the origins of modern vaccines as an old, culturally appropriated African practice that was instrumental in fighting smallpox in 1700s Europe. That piece is perhaps even more significant this year, as many Africans are afraid of the COVID-19 vaccine. The hesitancy comes from a distrust of Western medicine, which has been responsible for many atrocities all over the world, as well as the South African biological warfare created by the apartheid government and led by Wouter Basson, who was dubbed ‘Dr Death’. 

African knowledge systems have come a long way – from being overlooked as valuable sciences or being misrepresented by Western scholars, who for a long time saw themselves as the only suitable custodians of our experiences, ideals, history, culture, and knowledge. Today, although a lot more needs to be done, we are seeing a rise in African intellectuals, practices, and solutions. In the academy, we see this in the calls for decolonised education, which has emphasised the importance of Southern African scholarly contributions locally and internationally. 

In our day-to-day lives, we also see this shift towards reclaiming African solutions to deal with modern-day challenges. Practices such as visiting sangomas/traditional healers and the general practising of African traditional religion were seen as taboo or often labelled as hedonism. Many were forced to acknowledge their ancestors or perform sacrifices in private. But today, many are openly practising their cultural rituals when they want to give thanks for good fortune, when they are struggling to find employment, and for both physical and emotional healing that individuals or the collective needs. Although not ‘scientifically verified’, the African herb called umhlonyane helped many during the COVID-19 pandemic, especially during the major waves that overwhelmed and threatened to cripple our healthcare system. Many have turned to this herb as a solution to help them fight COVID-19. Umhlonyane is commonly used by sangomas for a variety of reasons; to boost the immune system, for patients with illnesses that attack the respiratory system, and many other things. This kind of revitalisation and mainstreaming of indigenous knowledge systems and epistemological pedagogies can undo challenges such as vaccine hesitancy and general distrust of biomedicine, while elevating African knowledge.

The missing link

Despite these and many other positive strides that place African knowledge at the forefront, something is still missing, because we are still far from where we need to be as a continent. There are many things we can draw from to make sense of why the progress is slow. We could draw from the usual arguments around the missing, undervalued African Renaissance. We could also argue that while African ideals are gaining prominence, they are often only invoked as an ‘alternative’ or afterthought. Arguably, even with umhlonyane, it was only from desperation that people turned to it. All of these are valid, but I also what to argue that we are limited by a kind of epistemological slavery, where we use conflicting Western systems of knowledge production in producing African knowledge. We rely on Western methodologies for knowledge production, Western schooling systems for how we engage with and use the knowledge, and even Western systems for how we store and preserve the knowledge. 

Trapping African knowledge in Western epistemology

The April Cape Town fire, which has spread to the University of Cape Town and destroyed the African Studies library, is one illustration of the danger of trapping African knowledge in Western epistemological systems. Much of what was lost in the fire is work that will most likely be lost forever; it is possible that no other records of it exist elsewhere. The issue is that in Africa, knowledge is communally produced, shared, and owned. Western systems encourage the containment and individual ownership of knowledge. Traditionally, African knowledge is often shared in the sense that the process of producing and sharing this knowledge is done as a collective and is built into the day-to-day practices rather than being crafted as a separate experience in the way that mainstream Western education and research is done. 

Reimagining African epistemology 

There is an important method of passing down useful skills that you still find in African households even today. As kids, we often hated it, because it took us away from our games, watching TV, or general leisure time. As Zulus, we refer to it as ukuthunywa/thuma – the English translation of ‘running errands’ does not adequately represent what it means, but it will do. I want to argue that this practice has traditionally been an important epistemological tool for producing and sharing knowledge. As a child growing up in a family of farmers, for example, you are taught how to be a farmer through these ‘errands’. You might start off with small requests, such as having to watch while the grown-ups or older children perform certain tasks; as time goes on, you are expected to take on more and more responsibilities in the family trade or even in helping neighbours and other community members. Even when it came to storing and preserving knowledge, it was done in such a way that it was still easily accessible. It would be stored as rock art, songs and performances, everyday crafts, and practices. And contrary to Western beliefs that Africans never wrote or documented, for cultures such as the Egyptians and Ashanti, knowledge was even stored as written inscriptions. 

When we move away from ukuthunywa towards the more Western mainstream, some challenges arise. Students are almost exclusively taught in theoretical ways, separate from their everyday experiences, which makes it difficult to understand and value the knowledge and its place in society. Knowledge goes from being communally owned to being owned by an individual researcher or institution, which limits who has access to the information, who has the right to use it, and even limitations on how it can be used. At times, even the communities from which the knowledge originally came, are limited by copyright laws. I want to argue that if we had created African knowledge using African practices or possible methodologies such as ukuthnywa, the loss of the UCT African Studies section wouldn’t have felt so bad, because the knowledge would be actively existing in society and the ability to recreate and redocument it would feel within reach. 

The freeing of our indigenous knowledge systems requires that we shift from looking outwards for solutions. For example, instead of looking towards dangerous fossil fuel and expensive Western renewable energy solutions to address our ongoing energy crisis, why not look inward and invest in our own indigenous methods of creating cheaper, sustainable biogas using animal and food waste. Imagine if we did it in ways that empowers black rural women who are the custodians of this knowledge, so that while dealing with the energy issues, we simultaneously address poverty and environmental degradation. What would it look like if we continued to nurture and encourage this and similar practices? Could other important scientific innovations emerge from it? Could it grow to the level of informing global discourse? Could we finally be uhuru?

News Archive

Heart diseases a time bomb in Africa, says UFS expert
2010-05-17

 Prof. Francis Smit

There are a lot of cardiac problems in Africa. Sub-Saharan Africa is home to the largest population of rheumatic heart disease patients in the world and therefore hosts the largest rheumatic heart valve population in the world. They are more than one million, compared to 33 000 in the whole of the industrialised world, says Prof. Francis Smit, Head of the Department of Cardiothoracic Surgery at the Faculty of Health Sciences at the University of the Free State (UFS).

He delivered an inaugural lecture on the topic Cardiothoracic Surgery: Complex simplicity, or simple complexity?

“We are also sitting on a time bomb of ischemic heart disease with the WHO (World Health Organisation) estimating that CAD (coronary artery disease) will become the number-one killer in our region by 2020. HIV/Aids is expected to go down to number 7.”

Very little is done about it. There is neither a clear nor coordinated programme to address this expected epidemic and CAD is regarded as an expensive disease, confined to Caucasians in the industrialised world. “We are ignoring alarming statistics about incidences of adult obesity, diabetes and endemic hypertension in our black population and a rising incidence of coronary artery interventions and incidents in our indigenous population,” Prof. Smit says.

Outside South Africa – with 44 units – very few units (about seven) perform low volumes of basic cardiac surgery. The South African units at all academic institutions are under severe threat and about 70% of cardiac procedures are performed in the private sector.

He says the main challenge in Africa has become sustainability, which needs to be addressed through education. Cardiothoracic surgery must become part of everyday surgery in Africa through alternative education programmes. That will make this specialty relevant at all levels of healthcare and it must be involved in resource allocation to medicine in general and cardiothoracic surgery specifically.

The African surgeon should make the maximum impact at the lowest possible cost to as many people in a society as possible. “Our training in fields like intensive care and insight into pulmonology, gastroenterology and cardiology give us the possibility of expanding our roles in African medicine. We must also remember that we are trained physicians as well.

“Should people die or suffer tremendously while we can train a group of surgical specialists or retraining general surgeons to expand our impact on cardiothoracic disease in Africa using available technology maybe more creatively? We have made great progress in establishing an African School for Cardiothoracic Surgery.”

Prof. Smit also highlighted the role of the annual Hannes Meyer National Registrar Symposium that culminated in having an eight-strong international panel sponsored by the ICC of EACTS to present a scientific course as well as advanced surgical techniques in conjunction with the Hannes Meyer Symposium in 2010.

Prof. Smit says South Africa is fast becoming the driving force in cardiothoracic surgery in Africa. South Africa is the only country that has the knowledge, technology and skills base to act as the springboard for the development of cardiothoracic surgery in Africa.

South Africa, however, is experiencing its own problems. Mortality has doubled in the years from 1997 to 2005 and half the population in the Free State dies between 40 to 44 years of age.

“If we do not need health professionals to determine the quality and quantity of service delivery to the population and do not want to involve them in this process, we can get rid of them, but then the political leaders making that decision must accept responsibility for the clinical outcomes and life expectancies of their fellow citizens.

“We surely cannot expect to impose the same medical legal principles on professionals working in unsafe hospitals and who have complained and made authorities aware of these conditions than upon those working in functional institutions. Either fixes the institutions or indemnifies medical personnel working in these conditions and defends the decision publicly.

“Why do I have to choose the three out of four patients that cannot have a lifesaving operation and will have to die on their own while the system pretends to deliver treatment to all?”

Prof. Smit says developing a service package with guidelines in the public domain will go a long way towards addressing this issue. It is also about time that we have to admit that things are simply not the same. Standards are deteriorating and training outcomes are or will be affected.

The people who make decisions that affect healthcare service delivery and outcomes, the quality of training platforms and research, in a word, the future of South African medicine, firstly need rules and boundaries. He also suggested that maybe the government should develop health policy in the public domain and then outsource healthcare delivery to people who can actually deliver including thousands of experts employed but ignored by the State at present.

“It is time that we all have to accept our responsibilities at all levels… and act decisively on matters that will determine the quality and quantity of medical care for this and future generations in South Africa and Africa. Time is running out,” Prof. Smit says.
 

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