December 6, 1999
Mozambique Enlists Healers in AIDS Prevention
Depth: The AIDS Epidemic
Mozambique from Microsoft Encarta Concise Encyclopedia
Discussion on The AIDS Epidemic
By RACHEL L. SWARNS
EIRA, Mozambique -- The traditional healer stretches her hands to
the heavens and her body trembles,
her rattles hiss and her shack rumbles as she cries out to the spirits of
Then she opens her eyes and gets
down to business.
"Have you ever heard of condoms?" she asks her astonished patients, who have come to whisper
about two-timing husbands and sexually transmitted diseases. "You
should wear them to protect yourself
from these diseases."
Meet Eufrásia Fernandes, one of
the newest and most unlikely foot
soldiers in Mozambique's national
crusade against AIDS.
For nearly two decades, government officials derided traditional
healers like Ms. Fernandes as
quacks and enemies of the state.
They burned the healers' tools and
barred them from practicing.
In the early 1990's, Ms. Fernandes
had to hide her drums and sneak into
the countryside to chant and cure.
During the civil war that ravaged
this nation until 1992, other healers
allied themselves with the rebel
army, promising soldiers spiritual
protection against the government's
But today, traditional healers --
known as curandeiros -- are being
embraced by the government as vital bearers of the safe-sex message
in an impoverished country where
millions of people still lack adequate
access to doctors and modern medicine.
Next year the government
plans to expand on this national
strategy by linking teams of trained
healers directly to hospitals, which
have been overwhelmed by an influx
of patients infected with H.I.V., the
virus that causes AIDS.
The traditional healers will treat
the patients at home -- freeing up
hospital beds for other sick people --
and using herbs and plants that
health officials here say effectively
treat opportunistic ailments, like diarrhea and pneumonia, that afflict
people whose immune systems are
impaired by AIDS.
The program is still a small one.
Fewer than 100 of the thousands of
practicing healers in this country
have attended the seminars on AIDS
and sexually transmitted diseases,
and the government is still sorting
out how the linkages between hospitals and healers will work.
But health officials say they plan
to expand the program, leaving the
healers to marvel at their newfound
freedom and to push their businesses
out into the open.
In the dusty market here, where
hawkers sell mangoes, bananas and
colorful squares of cloth, a healer
named Ousmane Ba posted a sign
promising treatment of headaches,
sterility and asthma. "Children under 2 don't pay," his sign said.
The regional office of the Association of Traditional Doctors of Mozambique rents an office here, and
every Tuesday and Thursday, people
lodge their complaints before its
grievance board. The board fines
healers who abuse their powers and
bars amateurs from dabbling in the
Last year, Ms. Fernandes opened a
tiny consultancy on a bustling residential block with the blessing of the
local authorities. She still counsels
the bewitched and exorcises spirits,
but she also sells condoms and tells
her patients how to avoid AIDS and
"Before, I couldn't work openly
like this, right here in the city," said
Ms. Fernandes, 39. "Now, I play my
drums and there's no problem."
In a country where nearly 15 percent of the population is believed to
be infected with H.I.V., the government's change of heart was critically
important, health officials say.
Ricardo Trindade, a deputy director in the Health Ministry, said only
about 50 percent of the population
had access to the fledgling national
health system, whose predecessor
was virtually destroyed during the
16-year civil war. The rest rely almost exclusively on traditional healers.
"The majority of people in Mozambique seek treatment from curandeiros, even those who go to hospitals," Trindade said. "The government's changing attitude is definitely a good thing."
The chilly relationship began
warming decisively two years ago,
the healers say, when the government officially recognized their professional association and began
warning them about AIDS.
Health officials feared that the
healers themselves were unwittingly
spreading the fatal disease. The healers typically use razor blades in their
treatments, making small incisions
in the flesh and pressing medicines
directly into the blood. And they were
often using the same blade on dozens
A private group, Population Services International, began offering
seminars on AIDS and other sexually
transmitted diseases. The healers
were urged to boil razors, to encourage patients to buy their own razors
and to sell condoms along with homemade remedies for malaria, cholera
and other ailments.
Titosse Ofisso, the regional president of the healers' association in
Nharichonga, said he welcomed the
"People don't know you need to
use clean razors or that if you don't
put condoms on, you can spread your
disease to someone else," said
Ofisso, 22, whose rural village lacks
electricity and indoor plumbing.
"People don't even know what condoms are. They still ask me, 'What is
Ms. Fernandes was reluctant at
first to take part in the program.
after attending the seminar, she said
she no longer worried much about
mixing the modern with the traditional. After all, she has always been
pragmatic when it comes to patients
suffering from diseases she cannot
treat on her own.
"If someone comes here with diabetes and a bad spirit, I take out the
bad spirit and send them to the hospital," she said. "Now, when people
have sexual diseases, I tell them to
wear this condom so it doesn't
It is the healers' broad popularity
that makes them so valuable to
health officials. More than 70 percent
of Mozambique's population are
rural people, who hold tight to their
Francisco Zonjo, 66, a retiree,
turned to the healers when medical
doctors could not explain why several relatives had fallen sick and
Carlitos Pereira, 19, turned to the
healers when he lost his job as a bus
conductor and his wife suffered several miscarriages.
Santos Aleixo, 42, a musician with
a virulent skin disease, turned to the
healers after a local hospital turned
him away because he could not afford the doctor's fee of $12.50.
Members of the healers' association acknowledge that they cannot
cure all ailments and social problems, even though some claim such
powers. They say they want to work
more closely with health professionals, to get some training and to share
their knowledge of the herbs and
plants and, maybe, to help find a cure
In the meantime, they are proud to
have finally won the respect of government officials and to have a clear
role to play in preserving the nation's
"The problem of AIDS is out
there," said Chapal Maconha, the
president of the regional healers' association here. "But the people don't
have televisions and they don't know
about condoms. They don't know people are dying.
"In the outskirts there are no hospitals, no clinics to help them, to tell
them what is happening. But there
are curandeiros. We are the secret
weapon. We can spread the message.
We can help save the people."