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Mulaudzi FM, Lebese RT, editors. Working with indigenous knowledge: Strategies for health professionals [Internet]. Cape Town: AOSIS; 2022. doi: 10.4102/aosis.2022.BK296.03
The African health care system is considered part of their cultural heritage, which has been assimilated over the years and has been passed from one generation to the next. This chapter focuses on the wearing of artefacts as an African indigenous practice of go thekga, where babies in infancy (from birth to twelve months) wear artefacts to prevent diseases and ward off evil spirits who can affect their being (physical, emotional and spiritual). This chapter provides knowledge and understanding of (1) the types of artefacts worn by infants and the different beliefs attached to the artefacts, (2) the purposes of the artefacts and (3) healers who provide artefacts. In certain societies around the world, artefacts are worn by infants for disease prevention and health care-promotion. Hence, it is imperative that the health care professionals based in health care settings have knowledge and understanding of such artefacts and for them to provide culturally competent care to these infants as they are constantly in contact with the children throughout infancy.
Artefacts are objects that signal the essential dimensions of lived realities, as they are seen as the assets of life that account for the culture and social processes of communities (Rowsell 2011, p. 334). Artefacts that are worn by infants are not only acquired from isangoma and inyanga but also from the indigenous knowledge holders (IKHs), some of whom are part of the infant’s heritage. Infants are very young offspring who can barely walk and are aged between zero- and twelve-months-old. In this chapter, ‘infant’ refers to any human neonate between the ages of zero- and twelve-months-old (Rikhotso 2017, p. 10). It is the responsibility of isangoma and inyanga to perform the traditional practices in infancy. The intention of putting all the different types of artefacts is to protect and strengthen the infant’s resilience to protect them from contracting diseases: bana ba a thekgwa [the infants are protected]. Go thekga as an African indigenous practice implies protecting a person to prevent diseases and ward off evil spirits that might affect their being (physical, emotional and spiritual). Go thekga is a practice that is usually performed by the traditional family healer in indigenous African families. Depending on the circumstances, the traditional health care practitioner might perform go thekga for the family on a yearly basis or when there are specific events in the family, like births. Many rituals and indigenous practices, like the provision and wearing of artefacts, are followed as a means of go thekga [to protect].
The acquisition of the artefacts goes with the conducting of disease prevention practices in African indigenous societies. Wearing of artefacts as part of disease prevention and health care-promotion practices has developed over many centuries and is still practised in many different parts of the world (Hassim, Heywood & Berger 2007, p. 300). Mukoko, Cooil and Bart (2015, p. 225) indicate that such practices existed long before colonisation and continue to outnumber biomedical health care practices. According to the Traditional Health Practitioners Act (Act 22 of 2007, p. 6), these practices, among others, include the performance of activities, processes, services and functions that underpin traditional philosophy. The practices are about the utilisation of traditional medicine or traditional practices to maintain and restore the physical or mental health function of African people. According to the Act, these include the diagnosis, treatment and prevention of physical or mental illness and the rehabilitation to enable the person to resume normal functioning within the family and community. The practices performed in infancy differ from one ethnic group to another. However, in some cases, the rituals performed are common and applied to get the same outcome.
Health care professionals, especially nurses in primary health care facilities in Africa, need to approach African indigenous practices such as wearing artefacts from both ‘etic’ (outsider) and ‘emic’ (insider) stances. The two stances clarify the positions that are held by the health care professional regarding African indigenous practices. The etic perspective refers to the explanations for the behaviours of an outside observer in ways that are meaningful to the observer (Polit & Beck 2021, p. 475). In this case, the health care professionals might not have the knowledge and the existence of the practice; however, they are to have an open mind without any preconceived ideas (Bell 2010, p. 93; Naaeke et al. 2010, p. 1) about the indigenous practices or African ways of living. Concurrently, through the emic stance, the health care professionals are to see go thekga from within instead of interpreting through the references of other societies. In this instance, the health care professionals will acknowledge the knowledge and the practices and recognise the existence of the collective memory.
The two standpoints are unavoidable for health care professionals who render western health care services to the African majority that goes through go thekga. African indigenous practices such as go thekga demand commitment (Bell 2010, p. 94) as they are about dissecting, integrating and looking beyond the multiple viewpoints. Moreover, the etic-emic continuum compels health care professionals to become aware of who they are as African beings (Owusu-Ansah & Miji 2013, p. 3). Africanness becomes a reality if the etic-emic viewpoints are honoured through the integration of the principles of indigeneity lens (Owusu-Ansah & Miji 2013, p. 1). Owusu-Ansah and Miji (2013, p. 2), among others, allude that: (1) knowledge is holistic, cyclic and dependent upon relationships and connections to the living and the dead; (2) there are many truths, and these truths are dependent upon individual experiences; (3) the relationship between people and the spiritual world is important and (4) the land is sacred. The aforementioned principles might assist health care professionals’ especially primary health care nurses as the first point of entry to many communities where they provide health care services. Primary health care nurses need to interrogate and understand go thekga as an African indigenous practice, especially the wearing of artefacts during infancy.
Through an indigenous lens, the wearing of artefacts during infancy as an African indigenous practice can be traced to the reciprocal relationship and connection that African people have with the dead. ‘The relationship between the living and the dead’ is embedded in the African belief system (Ekore & Lanre-Abass 2016, p. 369). Such a relationship is the core (re)presentation of who the African indigenous people are; the living must appease their dead to maintain peace and harmony in their lives. Concurrently, the dead exert their influence on the living and their destiny (Mulaudzi, Mogale & Masoga 2018, p. 243). The dead in the African belief system continue to exist after corporal death (Ekore & Lanre-Abass 2016, p. 369). The wearing of artefacts in any period of life strengthens such relationships.
Wearing artefacts during infancy has many experiential truths from the African indigenous perspective. African people wear artefacts for different reasons in their lifespans from as early as infancy. The artefacts symbolise different issues in accordance with the person’s beliefs and ancestral and family lineage (Miller 2002). Additionally, the practice of wearing artefacts illuminates African people’s spirituality. In African spirituality, the ancestors and God reside in our beings as the twosome are responsible for the well-being of all beings (Eliastan & Buqa 2018, p. 138). Eliastan and Buqa (2018) further cite African spirituality as the lived religion that allows confluence, unlike the institutionalised religious tradition.
Furthermore, the wearing of artefacts explains the sacredness of the land. This is clearly explained through the different totems that African people worship from the world of fauna and flora around them. Different parts of these animals and plants are used to make different types of artefacts that are worn even during infancy as a way of honouring and respecting their (fauna and flora) existence.
There are different types of artefacts that are worn in infancy to practice go thekga, including spiritual and cultural or ancestral artefacts.
African spirituality refers to experiences of connectedness with sacred beings as well as the way of being through relationships with others, nature and life (Ramanand 2016, p. 7). Lydon Lam (2012) adds that spirituality is about the content of the belief system and is significantly linked to experiences and relationships with others. The available evidence indicates that not all artefacts are received from traditional healers; others are from the elders and spiritual healers. The spiritual healers are from African churches such as Zion Christian Church (ZCC) and apostolic churches, for example, St John. Most of these spiritual artefacts are in the form of white beads or cotton cloths of different colours. Usually, these artefacts are worn as charms on the arms, legs and waist. They were installed while the infant was still very young (Beşer et al. 2010, p. 138). During the process of putting them on, prayers are performed with the overall aim of protecting the infant from evil spirits and people.
By definition, cultural practices are a way of life and ways of doing things in a particular ethnic group. The practices are transferred from one generation to the other. The use of artefacts on infants is one such practice and is part and parcel of fulfilling cultural practices and cementing cultural identity. Cultural and ancestral artefacts are usually from the carcass of an animal or totem (‘phoofolo ye ba e binago’ [‘venerate, uplifting the spirit of belonging, proclaiming dominance’]), which is burnt and a small portion is taken to make the charm (Ramaube 2018, p. 46). The tribal totem is either a flora, fauna or animal that a clan or family venerates. For example, the Mamabolo clan venerates the warthog, the Letsoalo clan venerates the buffalo and the Makgoba clan venerates the elephant (Joubert et al. 2015, p. 466). The belief is that wearing such a charm in infancy will protect the infant from the same animal as a totem. Hence the infant is forbidden to walk where the totem passed. Additionally, most ancestral artefacts are worn for the promotion of the heritage of the clan or family name. It is reported that an ancestor might not approve of the name given to the infant, and in that case, the infant will cry a lot and not sleep at night (Ramaube 2018, p. 47). On consultation with the iyanga, the parents will be told that ngwana o nyaka leina [the child is crying to be renamed]. In African indigenous culture, ancestors play an important role throughout an individual’s lifespan, starting from infancy. Hence some infants and children are sometimes referred as ‘bana ba ba badimo’ [‘children of the gods’]. The wearing of specific ancestral artefacts by infants makes them easily identifiable in their communities.
Wearing of artefacts in infancy serves various purposes, such as protection from childhood illnesses, evil spirits, people using strong muthi and illnesses caused by unstable sunken fontanelle (hlogoana). If an infant does not acquire such an artefact during infancy, their life might be at risk. Various African indigenous people, like the Batswana and AmaZulu, believe that diseases and misfortune are linked to angry ancestral spirits (Bogopa 2010, p. 3). Others hold the belief that not all diseases come from ancestral spirits but are caused by a disbalance between nature and human beings (Adu-Gyamfi & Anderson 2019, p. 7).
In most of the ethnic groups in South Africa, the ritual called imbeleko/mereko is performed to welcome the newborn infant into the family and introduce them to the ancestors (Bogopa 2010, p. 5). After performing the ritual, whereby an animal such as a goat is slaughtered, a band is made from the goatskin and is tied around the wrist of the infant as a symbol of introducing and connecting them to the ancestors. The artefact of a wristband is known as isiphandla in isiZulu (Makunga, Thwala & Edwards 2011, p. 373). In Sesotho, the ritual is known as hoananela, which is performed using sheep or ox fat. This fat is tied around the infant’s neck for some time (Opong 1997, p. 28).
In most cases, wearing artefacts during infancy is an African indigenous practice to guard and heal childhood illnesses, and for the protection from the totem as well as the evil spirits and people.
The words hlogoana and inhlokwana are used interchangeably by the people from Sotho and Nguni cultural backgrounds in South Africa. This, together with rigoni, is the main illness experienced during infancy. Rigoni is a red spot or mark on the occiput of an infant born of a mother with a sexually transmitted infection (STI). Rigoni is referred to by different names according to cultural and ethnic groups, which include lekone in Sepedi, ibala in isiZulu, goni in Xitsonga, or abuntu illnesses (Rikhotso 2017, p. 10), while in Tshivenḓa it is referred to as gokhonya. The infants suffering from these two diseases present with different symptoms such as fever, continuous crying, diarrhoea, vomiting, not sleeping at night and poor eye contact with the mother (Mulaudzi & Makhubela-Nkondo 2006, p. 49). Kindly view the chapter on STIs for a detailed description of rigoni. From the African perspective, some of these symptoms are associated with exposure to evil spirits, people using strong muthi and coming into contact with the infant and failure to please the ancestors (Elter, Kennedy & Chesla 2014, p. 5).
Totems are the selected ecosystems, animals, plants, rivers and mountains, considered sacred natural elements that serve as guardian spirits (Diawuo & Issifu 2015, p. 117). In totem worship, certain elements of the ecosystem have a significant sacred attitude for a specific clan hence the (elements) are venerated. Usually, in African indigenous practices, the use and destruction of totems are forbidden among the followers. Hence it becomes taboo for clan members to eat or destroy such totems (Benson 2021, p. 21). The totem is usually identified through the praise poems or songs of the clan. Infants usually acquire artefacts from the carcass of such an animal (Benson 2021, p. 21).
Evil spirits have been established as another challenge that contributes to the ill health of developing infants. According to the African indigenous perspective, the infant might be exposed to evil spirits when it comes across different people who might be using strong muthi or even children and infants who are ill. The said artefacts ensure that the health of infants is not at risk and acts as protective measures (Ramaube 2018, p. 14). In some cases, doepa, a smelly, manufactured homeopathic medicine that consists of an offensive sticky substance, is considered to be highly effective in warding off evil spirits because of its strong scent. The doepa is prepared for infants in cases where several people are expected to visit the homestead for events or celebrations and is smeared on the fontanelle (ukhakhayi). This is considered a susceptible point where hazards such as evil spirits enter the child. This will be done to protect the infant from meriti ya batho, that is, the presence of unknown people around the infant, such as people who might have recent deaths in their families (Ramaube 2018, p. 51). In some cases, doepa is put inside the artefact that infants wear around their necks. Wearing an artefact made from doepa will also prevent the infant from having makgoma. According to Lekgothoane and Ross (2020, p. 3), makgoma is a culture-bound disease characterised by severe bloating and restlessness, which usually happens when the infant is in contact with those who have recently undergone an abortion, attended funerals or been possessed by evil spirits.
The World Health Organization (WHO) estimates that 80% of people worldwide are utilising the services of traditional medicines for different health-related problems (Burman 2018, p. 166). In Africa, this includes the utilisation of traditional healers, knowledge holders and healers from various religions. The services that are offered by these other healers are usually specialised. Among these specialisations are artefacts for infants for go thekga.
Africa has a diverse landscape as far as religion is concerned. In conjunction with African spirituality, major religions among African people include Christianity, Islam, Hinduism and Judaism (Kubeka 2016, p. 8). Faith healers (abathandazi) comprise a sophisticated combination of traditional African religion and Christianity (Mlisa 2009, p. 186). From a Eurocentric perspective, abathandazi are faith healers and are known all over the world. In Germany, they are known as the helpraktiker (Stockigt et al. 2015, p. 1) and they mostly pray or lay hands on those who require healing, including infants. In the Muslim religion, faith healers are known as imams. Though the imams, like abathandazi, do not receive formal training in spiritual healing, they assist with various health care problems throughout the lifespan of a person. Mlisa (2009, p. 192) further explains that the connection of ancestors and the burning of sacrifices in the Old Testament are linked to most African indigenous rituals. Most of the artefacts that are worn by the infants are acquired from the Zionist and Apostolic churches where abathandazi practice. The abathandazi use spiritual energy (umoya) together with holy water, steam baths, purgatives and enemas as their healing methods. Munthali et al. (2016, p. 133) expound that after the performance of the rituals, they usually tie artefacts made of wool, cloth or beads of different colours, especially red coiled wool, on the infants.
According to the WHO (1978), as cited by Shankar et al. (2012, p. 124), a traditional healer is defined as a person who is recognised by the community as a competent person to provide health care using plants, animals and mineral substances and other methods based on social, cultural and religious backgrounds as well as on the knowledge, attitudes and beliefs that are prevalent in the said community. The Traditional Health Practitioner Act 22 of 2007, Section 1 refers to a traditional health care practitioner as a person who is registered under this Act in one or more of the categories of traditional health care practitioners. The Traditional Health Practitioner Council, as a professional body established by parliament, gives registered traditional health care practitioners the authority to issue medical certificates in line with the provisions of the Basic Conditions of Employment Act (BCEA) 75 of 1997 (Tshehla 2015, p. 267). The traditional healer is the name that is mostly used in various communities for different types of healers. Traditional healing is based on indigenous knowledge practised by generations of different tribes depending on the culture, religion or custom (Ekor 2013, p. 1).
In the case of artefacts in infancy, traditional healers are consulted by the parents to acquire relevant artefacts for the infant. In South Africa, the traditional health care practitioners are referred to as ngaka in Sepedi, selaodi in Sesotho, mungome in Xitsonga and vhomaine in Tshivenḓa, also known as izangoma or izinyanga in isiZulu and amagqirha in isiXhosa (Truter 2007, p. 57). In South Africa, the Traditional Health Practitioners Act 22 of 2007 recognises the legality of traditional health care practitioners and these include sangomas, diviners, herbalists, faith healers, traditional birth attendants and traditional surgeons (Republic of South Africa 2007, p. 6).
However, in general, South Africans refer to them as sangomas. According to Masoga and Shokane (2020, p. 315), sangomas ‘consider themselves to be members of a profession with a distinct intellectual tradition, one that undergoes critique, modification and change in the light of experience and myriad influences’. Sangomas regard traditional healing as involving a quest for good quality of life and providing access to support and health care. According to Asamoah-Gyadu (2014, p. 83) and White (2015, p. 5), they commence by consulting the bones and interpreting the cause of illnesses and prescribing the cure, which might be a particular artefact that the patient, in this case an infant, must acquire. Additionally, they might prescribe herbs (muthi) that are relevant to cure or prevent illnesses or evil spirits by performing rituals.
While other parents use the sangomas to acquire artefacts for their infants, some consult the inyangas or herbalists (Kubeka 2016, p. 21), also known as ixhwele in isiXhosa (Truter 2007, p. 57), while in Sepedi they are referred to as dingaka. The herbalist uses herbs and other forms of traditional medicinal preparations to make an artefact. During the acquisition of the artefact, herbs are prepared and rituals are immediately performed on the infant. Thereafter, an artefact with muthi is made and tied to the infant. The parent is usually given treatment to take home, and these are usually a concoction of the herbs which they have to continue using at home.
Some artefacts are acquired from IKHs. These are the people who possess indigenous knowledge in their communities. According to the Protection, Promotion, Development and Management of Indigenous Knowledge Systems Bill (RSA 2016, p. 5), indigenous knowledge implies the knowledge that has been developed in indigenous communities and has been assimilated into the culture and has an essential character to that specific community. Among others, such knowledge includes (1) scientific or technical knowledge, (2) knowledge of natural resources and (3) indigenous cultural expressions. According to Okka, Durduran and Degerli-Kodaz (2015, p. 501), indigenous knowledge is generational and it is transferred from one generation to another. An IKH means a member of the community from which indigenous knowledge originates and is the custodian of sacred knowledge (Kwame 2008, pp. 28, 43). According to Popova (2005, p. 66), Kayombo (2013, p. 3), Gottlieb (2004, p. 16) and Du Preez, Griffiths and Cameron (2008, p. 3), globally, the informants on the indigenous practices are usually senior females or grandmothers who are familiar with and have experience with the practices.
These grandmothers usually provide the artefacts and information to prevent, protect and cure diseases during infancy. The knowledge holders demonstrate to the mothers and caregivers how the artefacts are made. In New Zealand, such demonstrations are packaged by the IKHs as part of child-rearing practices (Jenkins 2011, p. iv). Most products that the IKHs use are teething beads, serokolo, dupa and stuipdruppels. These products are available at pharmaceutical outlets throughout South Africa (Moshabela 2012, p. cxi).
Artefacts are the objects that signal essential dimensions of lived realities and are seen as the assets that account for the cultural and social processes of communities (Rowsell 2011, p. 334). The artefacts worn in infancy, in the African indigenous practice of go thekga are for different purposes and are obtained from different healers, as stated. However, all these are for go thekga in infancy as an African indigenous practice. Figure 3.1 is a pictorial representation of the wearing of artefacts as an African indigenous practice during infancy.
The pictorial representation of the wearing of artefacts as an African indigenous practice during infancy go thekga.
The artefacts are usually worn around the necks, wrists, legs and waists as part of the traditional preventive practices against evil spirits. The artefacts symbolised different issues and they are in accordance with the parents’ belief system and culture. Most importantly, they are made of different materials such as wool, cotton material and beads of different colours. Wearing of artefacts is not only an African practice but prevails globally and is also used in South-East Asia in countries such as Thailand, where artefacts are worn as amulets (Armer 2014, p. 1; Srichimpa 2013, p. 49). Most people in these countries and infants wear these artefacts for religious purposes.
The wearing of artefacts around the different parts of the body is ascribed to the tradition and culture of the specific ethnic group. From an African indigenous perspective, healing is holistic and considers the physical, mental and spiritual processes of recovery, repair and reintegration that increase order, coherence and holism in the individual, group and environment (Phyllis 2008, p. 10). Healing may result in a cure. Explanation of healing in Aboriginal society is articulated as the means of mending bodies and souls, rekindling the flame that strengthens the spiritual as well as the physical, mental and psychological well-being (Fearns 2006, p. 11). In support, Kubeka (2016, p. 10) explains the African orientation of healing as everything being in spirit; the vital life forces known including the extrasensory the energy and consciousness, gods and guards and appearing materially as the five senses. For African children to experience this wholeness, parents frequently visit traditional health care practitioners, and this starts with a consultation shortly after birth to acquire artefacts.
The parents acquire artefacts from the different healers and this is supported by Popova (2005, p. 65), citing that a newborn baby is much more susceptible to the influences of various supernatural forces and spirits of illnesses; hence most treatment methods are based on this understanding. From an African perspective, for healing to occur, one must be at peace with the ancestors, as they are the ones that offer infinite protection (Mekoa 2020, p. 45).
Infants without these recommended artefacts, in most cases, present with different symptoms such as fever, diarrhoea, vomiting and not sleeping at night. These symptoms are associated with exposure to evil spirits, people using strong muthi and failure to please their ancestors (Elter et al. 2014, p. 5). As part of the tradition, when an infant presents with these symptoms, a specific artefact is prepared for them to wear.
The findings of this study urge the recognition of the co-existence of two healing practices (allopathic and traditional) for the health care and well-being of infants. The co-existence is supported by a WHO (2013, p. 15) document on traditional health care practices, as it was noticed that some of those community members rely on both allopathic health care and traditional health care services for their survival. Additionally, the findings highlighted the role of traditional health care practitioners as the most preferred and easily accessible to the community. The health care facilities such as clinics and hospitals are faced with the challenges of a severe shortage of personnel. The integration of traditional health care practitioners into the current health care facilities might address current challenges.
Biomedical health care professionals should have frequent reciprocal workshops with IKHs and traditional health care practitioners on comprehensive health care and wellness topics and practices relevant to the lifespans of African people.
The main purpose of this chapter was to provide knowledge and understanding of the types of artefacts worn by infants and the different beliefs attached to such artefacts. This includes understanding the rituals and processes that are followed to acquire such artefacts, and how wearing artefacts prevents disease and promotes health care in infancy. Different types of artefacts are worn by the infants as part of go thekga an African indigenous practice. The artefacts are intended to prevent, protect and heal infants from common illnesses. For the infants to acquire the artefacts, a healer of choice – an IKH, priest/pastor or traditional healer – is consulted. The healer will then perform rituals as part of the process to tie the artefacts to the infant. Most of the artefacts do not have a time frame assigned and are worn until they naturally fall off. Of importance is the fact that the artefacts worn depend on the ethnicity and belief of the parent(s). The artefacts seen are evidence that most Africans still use this African indigenous approach for their infants’ physical and social well-being.
Sections in this chapter represent a substantial reworking (more than 50%) of Masetopana E. Ramaube’s 2018 Master of Nursing (MNur) thesis, titled ‘Traditional disease prevention practices performed during infancy in a designated municipality ward in Tshwane District’, with study leader Prof. R.S. Mogale and co-study leader Prof. R.N. Ngunyulu, Department of Nursing Science, Faculty of Health Sciences, University of Pretoria.
How to cite: Ramaube, ME, Du Plessis, MAR & Mogale, RS 2022, ‘Wearing of artefacts for preventive and promotive care: An African indigenous practice of go thekga during infancy’, in FM Mulaudzi & RT Lebese (eds.), Working with indigenous knowledge: Strategies for health professionals, AOSIS Books, Cape Town, pp. 37–49. https://doi
This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
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