The dashed dreams of medical quackery

White South Africans harbour numerous carefully nurtured prejudices about their fellow citizens and delusions about themselves. One is that blacks are uneducated and backward, eschewing reason for superstition. Whites, in contrast, are masters of reason, hacking a scientific path through thickets of ignorance.

Such assumptions are particularly glaring in health matters. Although the term “witchdoctor” has become unacceptable, it still sums up what most whites think of the sangoma whom many blacks consult. This is, of course, to ignore the fact that the term “alternative medicine” is simply an invention of whites to make acceptable their own forays into witch-doctory, by adding the gloss of science.

In fact, phrases like “traditional healing” or “alternative medicine” are camouflaging euphemisms. Let’s name these treatments for what they are — dangerous quackery — that almost always lack the empirical foundation underpinning modern medicine and consequently extract a high price from the gullible and the desperate.

Our racial assumptions about health are often simply wrong. Africa Check, the independent fact-checking organisation that seeks to dispel the fog of bias often obscuring perceptions of Africa, recently investigated the widely quoted statistic that traditional healers are the first point of medical contact for 80% of black South Africans.

It eventually traced back the figure — peddled as gospel by authorities as disparate as the BBC, the World Health Organisation (WHO) and a South African Medical Journal article — to a 30-year-old out-of-print book by a former WHO adviser, who provided “no evidence, no references and no data” to support his assertion.

Africa Check found that sangoma visits were considerably fewer than assumed. According to surveys, something between 1.4% to 5.2% of respondents had, in the previous month, visited a sangoma to treat a medical — as opposed to a socio-cultural — complaint.

Africa Check’s figures would come as “no surprise” to anyone working in the field of HIV treatment, a case-hardened medical doctor of my acquaintance comments. The uptake of anti-retrovirals has been huge in the black community and in his experience “sangoma visits have been far less of problem than people being lured by crooks offering immune boosters and mega-dose vitamins”.

It was his withering further assessment that possibly “a greater proportion of white South Africans use homeopaths, faith healers and other idiots”, than blacks use sangomas. There is anecdotal support for this view that whites’ historical advantages in education and income don’t necessarily equate to good sense when it comes to health.

Newspapers report that Anton Neethling, the “alternative health” practitioner treating Joost van der Westhuizen, the white rugby icon diagnosed as being in the late stages of motor neurone disease (MND), claims to have cured his patient. Joost, too, believes that he has been “healed” but it is a fact of “real medicine” that MND is invariably fatal.

According to The Star, Neethling, who runs a thriving facility for the credulous called the Biological Human Ionisation Clinic, claims also to cure cancer, multiple sclerosis, diabetes and Aids, using “alternative therapies”. On Sundays he walks on water.

In his new book Killing Us Softly — a remorselessly rational dissection of the dangers of alternative medicine — Dr Paul Offit explains part of its lure: whereas modern medicine is often experienced by the patient as “spiritless and technological”, alternative medicine is seemingly “spiritual and meaningful”.

Offit does not gainsay that there is space for placebo medicine. In 1900s Gabon, the renowned physician and humanitarian Albert Schweitzer worked comfortably with the local sangoma. Schweitzer offered specific treatments for treatable diseases while the sangoma “offered placebo medicine when nothing more was necessary or available”.

Nothing much has changed when it comes to magical thinking. But when it comes to real diseases in a modern society, what the likes of Neethling peddle is not medicines but false hopes.

Whether you are poor and black and choose a sangoma, or wealthy and white and choose an alternative medicine charlatan, the result is much the same. Empty pockets, dashed dreams and almost invariably, worse health than when you started.

We are all ultimately responsible for the healthcare decisions we make and those decisions should be credible. As Offit puts it, there’s no such thing as alternative medicine, only medicine that works and medicine that doesn’t work. The only way to distinguish between the two is through rigorous scientific studies.

* Killing Us Softly: The Sense and Nonsense of Alternative Medicine, by Dr Paul Offit. Published by Fourth Estate.