Introduction
While Western medicine is a key component of the primary healthcare system, traditional medicine remains widely utilized and continues to be popular among many Black South Africans. Over 60% of those living in rural areas of South Africa seek advice and treatment from traditional healers before consulting a medical doctor; many who engage with formal healthcare also consult traditional healers (Zimba and Tanga Reference Zimba and Tanga2014). According to Oguntibeju (Reference Oguntibeju2018), between 60 and 80% of the South African population has consulted an Indigenous healer at some point in their lives. Traditional health practitioners (THPs) play a vital role in the healthcare of most South Africans and across the African continent (Zuma et al. Reference Zuma, Wight, Rochat and Moshabela2016). This may be due to the belief that African traditional healing is closely tied to cultural and religious values, emphasizing its holistic approach to the physical, psychological, spiritual and social aspects of both the individual and their community (Truter Reference Truter2007). Sundararajan et al. (Reference Sundararajan, Langa, Morshed and Manuel2021) and Hassan (n.d.) suggest that traditional healers are often preferred and sometimes serve as the primary health service providers, especially in rural areas, due to the respect and trust they command within their communities.
The World Health Organization (1978:9) defines a traditional healer as:
… a person who is recognized by the community in which he/she lives as competent to provide health care by using vegetable, animal and mineral substances and certain other methods based on the social, cultural and religious background as well as on the knowledge, attitudes and beliefs that are prevalent in the community regarding physical, mental and social well-being and the causation of disease and disability.
According to Zuma et al. (Reference Zuma, Wight, Rochat and Moshabela2016), the term “traditional healer” is used broadly to describe someone who provides healthcare within their community. Traditional healers, like Western doctors, are not a homogeneous group, as they undergo different types of training and possess varying levels of expertise (Mokgobi Reference Mokgobi2014). For this research article, and in the context of South Africa, I focus on two main types of traditional healers: the sangoma (diviner) and the inyanga (herbalist). As evidenced by the above discussion, traditional healers are trusted and respected members of the community who are believed to employ a holistic, culturally informed approach to treating their patients. However, this research has found that some traditional healers exploit their position of power to commit heinous crimes, such as the rape of their patients or initiates under the guise of healing them or transferring healing powers. Even though the rape of patients and initiates by traditional healers is a known phenomenon, there is little public and academic discourse on this topic in South Africa.
Literature Review
At the time of this research, there was no local, regional or international research on the phenomenon of rape perpetrated by traditional healers, resulting in a lack of literature referenced in this article on the subject. Furthermore, it is widely acknowledged that Indigenous knowledge systems are poorly documented from a scientific perspective; thus, the scientific literature on traditional healing was also scarce during this research. This led me to rely too heavily on certain sources, including those that were unscientific or outdated.
Context of Traditional Healing in South Africa
Traditional healing in South Africa, a practice that connects communities to their ancestral roots, has been passed down through generations (Katega Reference Katega2024). However, the apartheid era not only oppressed the Indigenous people of South Africa but also suppressed their right to practise Indigenous customs that existed before the country was colonized in 1652 (Mokgethi Reference Mokgethi2018). During this time, any form of traditional healing was considered witchcraft under the Witchcraft Suppression Act 3 of 1957 (Mokgethi Reference Mokgethi2018). As a result, traditional healers were equated with witches, and anyone found consulting Indigenous healers or practising traditional healing faced prosecution and execution (Mokgethi Reference Mokgethi2018). Despite efforts by colonizers and apartheid leaders to suppress traditional healing, it remains a fundamental aspect of the African Indigenous belief system. The South African government has attempted to formalize traditional healing through the Traditional Health Practitioners Act 22 of 2007 (Republic of South Africa 2007). This act states that THPs can only be recognized as healers after completing traditional healing training. The act defines traditional healing as:
the performance of a function, activity, process or service based on a traditional philosophy that includes the use of traditional medicine or practice, with the aim of—
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(a) maintaining, restoring, or preventing physical or mental health functions; or
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(b) diagnosing, treating, or preventing physical or mental illness; or
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(c) rehabilitating an individual to enable them to return to normal functioning within the family or community; or
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(d) physically or mentally preparing an individual for puberty, adulthood, pregnancy, childbirth, and death; however, it excludes the professional activities of individuals practicing any of the professions governed by the Pharmacy Act 53 of 1974, the Health Professions Act 56 of 1974, the Nursing Act 50 of 1974, the Allied Health Professions Act 63 of 1982, or the Dental Technicians Act 19 of 1979, as well as any other activity not based on traditional philosophy (Republic of South Africa 2007:8).
The three purposes of the act are to: “(a) establish an Interim Traditional Health Practitioners Council of South Africa; (b) provide for the registration, training and practices of traditional health practitioners in the Republic; and (c) serve and protect the interests of members of the public who use the services of traditional health practitioners” (Republic of South Africa 2007:8).
Types of Traditional Healers in South Africa
According to Van der Watt et al. (Reference Van der Watt, Biederman, Adbulmalik, Mbanga, Das-Brailsford and Seedat2021), traditional healers play a vital role in the healthcare system of sub-Saharan Africa. It is crucial to understand their training, experiences and perceived roles in society. South Africa has two main types of traditional healers: the sangoma, or diviner; and the inyanga, or herbalist. A sangoma operates within a traditional, religious and supernatural context, acting as a mediator between the physical and spiritual realms (Lange Reference Lange2018). Sangomas are consulted to heal illnesses, social disharmony and spiritual difficulties (Ross Reference Ross2025). They diagnose mysterious illnesses by interpreting messages from the ancestors through bone-throwing and reading or during a trance. The patient or the diviner throws bones on the floor, but it is the ancestral spirits who control the pattern (Ross Reference Ross2025). Ross (Reference Ross2025) explains that the bones may include animal vertebrae, as well as items such as dominoes, dice, coins, shells and stones, each with specific significance in human life. The healer interprets the metaphorical arrangement concerning the patient’s afflictions, the ancestors’ requirements and the actions needed to resolve the problem. Diagnosis and treatment are achieved through a series of throws.
Inyanga means “man of the trees” in isiZulu, an Indigenous South African language. Inyangas use herbs, plants, animal products and minerals imbued with spiritual significance to create traditional medicine called muti, meaning “tree” in isiZulu, to treat diseases (Thobane Reference Thobane2015). They concoct potions for physical and mental ailments, social disharmony and spiritual difficulties, as well as for protection, love and luck. Inyangas undergo extensive training to comprehend the properties of various traditional medicines, which may be toxic if administered in the wrong dosage (South African History Online 2011).
Traditional healers believe their ancestors called them to undertake this esteemed and respected role in society (Lange Reference Lange2018). They are deeply revered within the communities they serve and do not choose their profession. According to Kubeka (Reference Kubeka2016), to become an Indigenous healer, one must accept the calling and undergo intense training, known as intwaso/ukuthwasa, which can last from a few months to a decade. This training is guided by a healer referred to as ugobela. Wana (Reference Wana2023) explains that if a person refuses to heed the ancestral calling, they may begin to experience physical or mental illness, or they or their family may face hardships or misfortune; the apprentice diviner learns from their gobela how to throw the bones and manage the trance-like state that enables communication with ancestral spirits, while the apprentice herbalist is instructed by their gobela about various traditional medicines and their healing properties (Lange Reference Lange2018). Intwaso commences when one receives the calling or idlozi (the spirit) from their ancestors through dreams or altered states of consciousness (Wana Reference Wana2023).
Not everyone can become a sangoma or inyanga; the ancestors must call one. Consequently, being called is regarded as a significant honour or a gift one is born with (Cumes Reference Cumes2013).
Definition of Rape
The World Health Organization (2020) defines rape as “physically forced or otherwise coerced penetration of the vulva or anus with a penis, other body part or object”. The Criminal Law (Sexual Offences and Related Matters) Amendment Act 32 of 2007 (SORMA; Republic of South Africa 2007) expands the World Health Organization’s definition by including penetration of genital organs or any other body part of a person with any part of the body of an animal. Section 3 of the SORMA further stipulates that any person who engages in the act of sexual penetration without the consent of the complainant is guilty of the offence of rape (Republic of South Africa 2007). Section 1(2) of the SORMA defines consent as a voluntary or uncoerced agreement. Additionally, Section 1(3) of the SORMA lists coercive circumstances where consent is vitiated. Consent does not exist:
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(a) Where B (the complainant) submits or is subjected to such a sexual act as a result of—
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(i) the use of force or intimidation by A (the accused person) against B, C (a third person) or D (another person) or against the property of B, C or D; or
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(ii) a threat of harm by A against B, C or D or against the property of B, C or D;
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(b) where there is an abuse of power or authority by A to the extent that B is inhibited from indicating his or her unwillingness or resistance to the sexual act or unwillingness to participate in such a sexual act;
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(c) where the sexual act is committed under pretenses or by fraudulent means, including where B is led to believe by A that—
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(i) B is committing such a sexual act with a particular person who is, in fact, a different person; or
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(ii) such a sexual act is something other than that act; or
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(d) where B is incapable in law of appreciating the nature of the sexual act, including where B is, at the time of the commission of such sexual acts—
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(i) asleep;
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(ii) unconscious;
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(iii) in an altered state of consciousness, including under the influence of any medicine, drug, alcohol or other substance, to the extent that B’s consciousness or judgment is adversely affected;
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(iv) a child below the age of 12 years; or
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(v) a person with a mental disability (Republic of South Africa 2007:18).
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This research article focuses on coercive circumstances (b), (c) and (d) to elucidate the crime of rape perpetrated by traditional healers against patients and apprentice healers in the three locations where the study was conducted.
Methodology
The data in this article originated from focus group discussions (FGDs) involving members from three communities: Alexandra; Diepkloof; and the eThekwini Inanda, Ntuzuma and KwaMashu (INK) area. Each focus group discussion comprised approximately 15 participants, including traditional healers and community members. Participants were selected through purposive sampling from the Masiphephe Network, a project to which this study was a sub-project. The Masiphephe Network aims to reduce the vulnerability of community members to gender-based violence and enhance the local governance response and prevention strategies. The project is implemented across three provinces in South Africa: Gauteng; KwaZulu-Natal; and Mpumalanga.
Focus groups are a dynamic and robust qualitative method for gathering rich, nuanced insights into human behaviour, attitudes and perceptions from individuals who share common interests (Basnet Reference Basnet2018). Basnet (Reference Basnet2018) further explains that FGDs uncover genuine feelings and issues, providing more detailed information than one-on-one interviews or surveys, as the dynamics of a group facilitate more developed responses. Furthermore, by assembling a diverse group of participants who share a common interest in the research topic, researchers can collect a range of perspectives on a phenomenon. The following steps were followed to conduct the FGDs:
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1. Established the research topic and objectives;
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2. Recruited potential participants from the Masiphephe Network. Around 15 participants per site were chosen;
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3. Developed a discussion guide that included open-ended questions;
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4. Selected interview locations with consideration for the participants’ convenience;
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5. Conducted the group discussion. Each discussion lasted approximately 120 minutes;
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6. Recorded the discussion. An audio recorder was utilized in all discussions, with the participants’ consent;
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7. Transcribed the audio-recorded data;
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8. Translated the transcripts. To promote clearer expression, participants were encouraged to speak in their vernacular if they preferred. Consequently, alongside English, other languages used in the discussions included various South African official languages such as IsiZulu, IsiXhosa, Sesotho, Setswana and Sepedi. A language editor proficient in all the aforementioned languages was utilized for both transcription and translation;
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9. Analysed the data. For the analysis, I utilized Braun and Clarke’s (Braun and Clarke Reference Braun and Clarke2006) six-step thematic analysis, which comprised the following steps: (i) familiarizing myself with the data; (ii) coding; (iii) generating initial themes; (iv) reviewing themes; (v) defining and naming themes; and (vi) writing up this research article.
FGDs have limitations, as this study illustrates. First, although each group consisted of around 15 participants, some individuals spoke more than others. To address this, I endeavoured to create a relaxed and welcoming atmosphere, pausing regularly to invite quieter participants to share their thoughts and reassuring them that their opinions were valued and mattered. This approach was effective; however, I noticed that certain participants were more vocal than others. Consequently, the study’s findings should not be generalized as they reflect the views and perspectives of a small number of individuals.
Nevertheless, the research provided a rich, contextual understanding of an underexplored problem that requires urgent attention rather than generalizing the findings. Second, participants sometimes became overly invested in specific topics, which led to discussions becoming overly drawn out. At the outset of each discussion, I established clear objectives, outlining what needed to be achieved by the end of the session. When discussions were extended, I reminded the group of our objectives without dismissing valuable input. I also encouraged each participant to share their thoughts concisely, promoting diverse contributions while maintaining momentum.
This study obtained ethical clearance from the University of South Africa (UNISA) College of Law Research Ethics Committee, with a research ethics approval letter issued (reference ST53-2021). To ensure that discussions were conducted ethically, a consent letter was signed and dated by all individuals participating in the FGDs. Confidentiality and audio recording were emphasized as ethical principles in the consent letter and throughout the discussions. Although complete confidentiality cannot be guaranteed in a focus group setting, I explained to the participants the procedures I would implement to maintain the confidentiality of the research data. I further clarified, both in the consent letter and verbally, that they were each expected not to divulge what was said in the focus group to anyone outside of the group. Permission to audio record the discussion was obtained from the participants through both written and verbal consent.
This study was supported by UNISA’s Vision Keepers Grant, which I received in 2020 and completed in 2023.
Findings and Discussion
Historically, rape was defined as forced sex with a woman who was not the perpetrator’s wife (Sparrow Reference Sparrow2022). According to Sparrow (Reference Sparrow2022), feminist activists have made significant strides in reforming the law by eliminating the requirement for force and marital exemption, leading to a broader understanding that rape involves sexual penetration without consent. Chapter 2, section 3 of the SORMA provides the following definition of rape: “Any person (‘A’) who unlawfully and intentionally commits an act of sexual penetration with a complainant (‘B’), without the consent of B, is guilty of the offense of rape” (Republic of South Africa 2007:2). According to Chapter 1, section 1 of the SORMA:
“sexual penetration” includes any act which causes penetration to any extent whatsoever by—
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(a) the genital organs of one person into or beyond the genital organs, anus, or mouth of another person;
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(b) any other part of the body of one person or any object, including any part of the body of an animal, into or beyond the genital organs or anus of another person; or
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(c) the genital organs of an animal, into or beyond the mouth of another person” (Republic of South Africa 2007:15).
This paper focuses on the following three coercive circumstances outlined in Chapter 1, section 3 of the SORMA that render consent invalid:
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(a) The abuse of power or authority.
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(b) The sexual act is committed under pretenses or by fraudulent means where the complainant is led to believe by the perpetrator that such a sexual act is something other than that act.
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(c) The complainant is incapable in law of appreciating the nature of the sexual act, including where the complainant is unconscious or in an altered state of consciousness, including under the influence of any medicine, drug, alcohol or other substance, to the extent that B’s consciousness or judgment is adversely affected (Republic of South Africa 2007:18).
The Abuse of Power and Authority: Rape by Coercion
There is a common misconception that rape can only occur when a perpetrator uses physical force to overpower a victim who does not consent and that the victim must have visible physical injuries to prove they resisted (Feltoe Reference Feltoe2018). However, rape can happen in situations where there is no actual physical violence or threats of violence, such as when a perpetrator uses coercion to force a victim into sex. Feltoe (Reference Feltoe2018) further explains that numerous instances exist where someone in a position of power, influence or authority over a victim exploits that position to engage in sexual activity with them. These cases should be classified as rape, as the victim has been coerced into having sex against their will.
Below is a scenario derived directly from a research participant, where a gobela, a traditional healer responsible for teaching and facilitating the initiation process and guiding apprentice healers on their training journey, abuses their power and authority by engaging in sexual activities with initiates. As described by community member 1 from the INK area:
… there is a man with many initiates. I visited him to inform him of my decision to join the two organizations. What baffled me was witnessing initiates massaging him. He confessed to having slept with them. He sleeps with these initiates. It is fine; we are just waiting to pounce on him.
Chapter 1, section 3 of the SORMA identifies the misuse of power and authority as a coercive circumstance that vitiates consent. Due to the traditional healer’s position of power and influence as a teacher, their initiates or students may struggle to refuse sexual advances because of the inherent power imbalance. When one person holds more power – whether social, economic or physical – than another, it can create an environment where coercion is likely. Chapter 1, section 3 of the SORMA highlights situations where the perpetrator has misused their power or authority to such an extent that the complainant is unable to express their unwillingness or resistance to the sexual act. Chapter 1, section 2 of the SORMA defines consent as a “voluntary or uncoerced agreement” to have sex. Consequently, a complainant cannot be deemed to have consented to sex where the accused uses their position of power to intimidate or pressure the complainant into submitting to the act. In essence, consent cannot be considered voluntary when a significant power imbalance exists.
The Sexual Act Committed Under False Pretences or by Fraudulent Means: Rape by Deception
Two research participants’ verbatim responses in this section illustrate how traditional healers gain consent for sexual relations with their patients or initiates through deceit or fraud. Sparrow (Reference Sparrow2022:870) points out that “rape by deception occurs when the victim ‘consents’ to sexual penetration due to certain types of deception by the perpetrator”. Rape by deception involves obtaining consent for sexual penetration through fraud (Green Reference Green2020). Green (Reference Green2020) suggests that broadening the definition of rape by deceit involves three steps. First, rape should be viewed as a violation of a victim’s sexual autonomy. Second, a victim’s sexual autonomy is violated when they are subjected to sex without their consent. Dowds (Reference Dowds2020) emphasizes that the concept of sexual autonomy is crucial in understanding the wrongfulness of rape. Dowds (Reference Dowds2020) explains that this concept implies that individuals have the right to make autonomous decisions about their sex lives. The notion that rape is a breach of sexual autonomy is fundamental in establishing consent, rather than force and resistance, as the core of definitional constructs of the offence (Dowds Reference Dowds2020). Third, deception or fraud undermines consent in the same way that force does (Green Reference Green2020).
A prospective apprentice healer/initiate from the INK area told:
I will begin by stating that I am discussing something I have personally experienced. A specific healer evaluated my situation. My ancestor had not yet been activated, so I was ineligible to attend the initiation. The healer advised me to visit his residence, undergo an assessment, and then he would inform me of my problems. I went to his residence in Mayville. I knocked him out with a punch when he said he needed to insert a type of herb into my vagina. This, he claimed, would activate my ancestor. Consequently, I postponed the initiation because I could no longer trust the initiator. The incident led me to loathe traditional healers and sangomas.
One of the research participants lamented that: “No muti should be administered through the vagina or sexual intercourse. That is diabolical!” (traditional healer from Diepkloof).
A community member from Alexandra added:
The child is facing difficulties and does not understand what is happening. When parents lack information, this is when some male traditional healers may sexually abuse their children. They might assert that resolving this problem involves partaking in a ritual that necessitates sex with you to drive away the demon.
The scenarios above show that the traditional healers in question are guilty of rape because they engage in sexual relations with their patients or initiates after deceiving or persuading them into believing that the act is a medical procedure rather than sexual intercourse. Traditional healers employ fraudulent means or pretences to convince their initiates or patients that the act is something other than a sexual act, as highlighted in Chapter 1, section 3 of the SORMA.
Deceiving someone into engaging in sexual activity is morally wrong as it undermines their ability to give fully informed consent (Brogaard Reference Brogaard2017). For informed consent to be valid, an individual must genuinely understand what they are agreeing to when consenting to sex. According to Brogaard (Reference Brogaard2017), sexual encounters involving deception that may be considered sexual misconduct include, among others, lying about using contraception, misrepresenting one’s age, gender, marital status, religion or occupation, lying about having been tested for sexually transmitted diseases and infections, pretending to be someone’s partner, and, as seen in this study, misleading the individual into believing that the sexual act is a medical procedure.
Green (Reference Green2020) explains that there are two types of cases in which sex is obtained through fraudulent medical procedures, both involving a doctor or someone impersonating one. In the first type, the offender claims to be conducting a non-sexual procedure (such as a routine vaginal examination) while engaging in intercourse. In this instance, the victim is unaware that they are participating in sexual activity. In the second type, the offender falsely informs the victim that sexual intercourse is necessary for medical reasons (Green Reference Green2020). In this research, the latter scenario, where traditional healers falsely inform their victims that sexual intercourse is necessary for medical reasons, is evident, as demonstrated by the two verbatim responses. The prospective initiate from the INK area was told that to activate her ancestral calling, the gobela needed to administer muti via her vagina. In the second scenario mentioned by the community member from Alexandra, the parents of a sick child are informed that for the troubled child to be healed, the traditional healer must engage in sexual intercourse with the ill child. In both scenarios, THPs use deception to persuade their victims to engage in sexual relations with them, rendering consent invalid and thus making both healers guilty of rape.
The Complainant is Incapable in Law of Appreciating the Nature of the Sexual Act: Rape of an Unconscious Person
According to Chapter 1, section 3 of the SORMA, sexual activity with an unconscious person invalidates consent and thus constitutes rape. Community member 2 from the INK area described:
This is what Traditional Healer XYZ does. Once he has a woman inside his house, he boils a particular herb. Remember that to steam, one must remove their clothes. Traditional Healer XYZ vacates the room to allow the woman to undress and begin the steaming process. As the woman steams naked, the herb sedates her. Traditional Healer XYZ knows how. He even knows how long it will take before she is unconscious. He then walks in on the sedated woman, removes the blanket from her body, and helps himself however he wishes. Fortunately, he was caught in the act and fled the area.
The verbatim response above illustrates a scenario in which a traditional healer uses muti to sedate patients and subsequently engages in sexual relations with them. The SORMA in Chapter 1, section 3 highlights that if an individual’s consciousness or judgment is impaired by medicine, drugs, alcohol or other substances, they cannot consent to sexual activity. Therefore, engaging in sexual acts with patients sedated by muti, which compromises their ability to comprehend the act, constitutes non-consensual sex and amounts to rape. A person who is unconscious or in an altered state of consciousness cannot give sexual consent.
Reasons Why Traditional Healers Rape Initiates and Patients
When research participants were asked why traditional healers commit rape against patients and initiates, two key themes emerged: imposters who do not have the ancestral calling and abuse it; and the absence of registration for practitioners. According to traditional healer 2 from the INK area:
We will need to divide this into two parts. There is an authentic healer whose healing abilities have been passed down through their great-grandparents or ancestors. Then, some do it for money. I do not believe that a healer with proper and pure ancestors would behave in that manner. I doubt that the aforementioned ancestors would approve of their descendants sleeping with clients. Such behaviour would warrant punishment from the ancestors. I consider someone who engages in that practice not to be a genuine healer.
Traditional healer 1 from the INK area commented:
That is why people often end up being raped. These charlatans infiltrate the practice with malicious intent. They dress up in traditional healer’s robes and look the part. The reality is that they deal in dark herbs that enable them to perform black magic. It is usually these fake traditional healers who practise witchcraft. When you see traditional practitioners taking off like wildfire, it makes the practice seem fashionable. A phony or unscrupulous healer will initiate someone when all they needed was to take a cleansing herb. There are some dishonest people out there, but the lack of knowledge is the real issue. Ultimately, we will have to involve the community and educate it. We have already advised people to be brave and ask healers, “Which organization are you affiliated with?”
Participants in my research emphasized that traditional healing has evolved into a business or a means of generating income, often exploited by individuals who lack the ancestral calling. Consequently, community members seeking assistance from THPs may suffer harm when individuals without a genuine calling are initiated into the profession.
Like Western doctors, traditional healers are also expected to specialize in specific areas, such as diviners or herbalists.
According to a traditional healer from Alexandra:
You are chosen for a specific purpose … someone else will be a sangoma who initiates others. For instance, if there are three of us who have been initiated … you did it to initiate others, and another person has done it to facilitate healing, while yet another has undertaken it to gain greater knowledge about medicines.
However, driven by greed and the misuse of their calling, many Indigenous healers operate outside their areas of expertise, resulting in the perpetuation of illegal activities. This aligns with the report by Ryan (Reference Ryan2023), who states that a wave of fake sangomas is sweeping across South Africa, employing a mix of hallucinogenic drugs, romance scams and promises of spiritual encounters with deceased ancestors.
As explained by a community member from Diepkloof:
There is a distinction between witches and traditional healers. The true sangomas genuinely focus on healing, while those who engage in terrible acts are not sangomas; they are witches.
The verbatim response from a community member in Diepkloof expresses the conviction that sangomas who commit atrocities, such as rape, are not genuine traditional healers and compares them to witches. In the South African context, witchcraft typically refers to the manipulation of malevolent individuals or powers inherent in people, spiritual entities and substances to harm others (Petrus Reference Petrus, Sadique and Stanislas2016). Petrus (Reference Petrus, Sadique and Stanislas2016) explains that a witch may use two methods to cause harm, misfortune or death. First, witches may employ psychic witchcraft or witchcraft with familiars. Familiars are thought to be invisible spiritual agents, often in the form of animals, that the witch may “send” to victims to attack them (Petrus Reference Petrus2009). The second method a witch may use is the practice of witchcraft with medicines (Petrus Reference Petrus, Sadique and Stanislas2016). Similar to herbalists, a witch who uses muti may possess specialized knowledge of their properties and ingredients and utilize this knowledge to create potions that may harm or kill a victim (Petrus Reference Petrus, Sadique and Stanislas2016).
Participants in my study also emphasized that traditional African healing is frequently misused, as most traditional healers are not registered with any regulatory body. As described by traditional healer 2 from the INK area:
I am moving on to THO [Traditional Healers Association] now. Many healers are reluctant to join the organization. THO has a process requisite for entry. A healer pays a R450 joining fee before they undergo training. I stand to be corrected, but I believe the training takes five days. It is essential to remember that these organizations exist to protect both the healer and the office. THO states that, before registering, you must specialize in three ailments. There is an area in the registration form that must be completed by your guide or the healer who initiated you. So, if you have neither a guide nor a healer you trained under, you have a problem. At the same time, you must have an existing office. It should meet the standards to house a reputable healer. Therefore, if you do not have one, working from unstable rented spaces will create difficulties. I mentioned that a healer needs to have three areas of specialization. This does not mean that they are limited to just those. The three are simply what the system requires. Once you are registered, you will receive a certificate and a book in which the three ailments are recorded.
A community member from the INK area responded:
We must attend training to encourage others to ask healers whether they have licences.
A traditional healer from Alexandra added:
We have the organizations. Ours is ABC, which is registered and recognized. The others are smaller, but I am referring to the one to which I belong. By coming together with other sangomas to share our knowledge, we aim to provide them with more information about their work, rights and responsibilities as traditional healers. Therefore, I ask, especially of traditional healers, that they attend and be registered. We share the information we possess with them so they can offer accurate information to their patients and the wider community, ensuring that our name is not tarnished in the end, as we are not all like that. Thank you.
As evidenced in the above verbatim responses, currently, no single authority in South Africa governs all traditional healers. Instead, they are organized and licensed by various organizations across the country’s nine provinces. Although these organizations are officially registered under the Companies Act, they are not recognized as healthcare providers (Pretorius Reference Pretorius1999). While their members adhere to a code of ethics, the associations lack the power to enforce it, leaving room for quacks and charlatans.
Despite advancements in legislative development, traditional healthcare in South Africa is progressing slowly toward the legalization and professionalization of the practice. The South African government aimed to formalize traditional healing through the Traditional Health Practitioners (Republic of South Africa 2007 Act 22 of 2007); however, the objectives of this act have yet to be achieved. The Interim Traditional Health Practitioners Council was established by the provisions outlined in the Traditional Health Practitioners Act 22 of 2007 (Republic of South Africa 2007), and a chairperson was appointed in early 2025. Nevertheless, South Africa continues to encounter several challenges regarding traditional healing, namely:
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Many THPs remain unregistered and operate outside the boundaries of the law;
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There is a lack of standardized training programmes in traditional medicine disciplines;
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There is distrust between Western medical professionals and traditional healers, and
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There are concerns about safety risks, particularly regarding the use of unregulated treatments (Mpembe Reference Mpembe2025).
Until these issues are addressed, impostor healers will continue to exploit the discipline and community members seeking Indigenous healthcare.
Recommendations
To safeguard the practice and community members from fraudulent healers, I recommend prioritizing the finalization of the Traditional Health Practitioners Regulations of 2024. This legislation will facilitate the mandatory registration and oversight of all THPs operating in South Africa by a single governing body (e.g. the Traditional Health Practitioners Council of South Africa) that must oversee both ethics and practice. Furthermore, the Traditional Health Practitioners Council of South Africa should devise strategies to identify and eliminate unscrupulous healers from the system, holding those who commit criminal activities accountable and ensuring that they face the full force of the law. Additionally, it is essential to train community members to distinguish between legitimate and fraudulent healers. Community members must also be educated to discern between legitimate medical procedures and illegitimate practices that are criminal. Moreover, the community should be empowered to report any illegal activities committed against them by THPs to the police, thereby facilitating accountability for the actions of unethical healers.
Concluding Remarks
Although there is limited research on this topic, this article highlights the pervasive issue of rape committed in traditional healing settings, particularly in South Africa. Drawing on the lived experiences and opinions of community members, as well as the professional knowledge and views of THPs, this paper unpacks three coercive methods believed to be employed by traditional healers to engage in non-consensual sexual acts with patients or initiates. These methods include: (i) abusing their power or authority; (ii) manipulating patients or initiates through pretences to convince them that the acts are something other than sexual intercourse (e.g. a spiritual ritual or medical procedure); and (iii) engaging in sexual activities with patients or initiates who are unconscious or in an altered state of consciousness after the use of traditional medicine. Furthermore, I examine how consent is undermined in each of these situations, rendering traditional healers who employ these methods of sexual coercion liable for rape. The three types of rape discussed are rape by coercion, rape by deception and rape of an unconscious person. This research suggests that the perpetration of rape against patients and initiates by traditional healers stems from the exploitation of the practice by impostors lacking an ancestral calling, as well as the absence of registration and regulation for African traditional healers.
Acknowledgements
I want to express my gratitude to the Masiphephe Network for facilitating the completion of this project, to UNISA for providing the Vision Keepers funding, and to the participants whose invaluable contributions made this project possible.
Competing interests
The author declares she has no financial and competing interests.
Mahlogonolo Stephina Thobane is an Associate Professor of Criminology in the Department of Criminology and Security Science at the University of South Africa (UNISA). She is a Master of Arts in Criminology and a Doctor of Literature and Philosophy in Criminology. Her research interests encompass bank-related violent crimes, such as cash-in-transit heists, gender-based violence, contemporary crime issues, female criminality, critical criminology, Indigenous research methods, and correctional studies. Her research aims to centralize the African voice and “ways of knowing” within criminological ideologies. In 2023, she was elected as the first Black female President of the Criminological Society of Africa.
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