Analysis of Traditional Healers in Lesotho:
Implications on Intellectual Property Systems

WORKING PAPER SERIES No. 68

ATPS (2013): Analysis of Traditional Healers in Lesotho: Implications on Intellectual Property Systems. ATPS Working paper No. 68

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ATPS (2013): Analysis of Traditional Healers in Lesotho: Implications on Intellectual Property Systems. ATPS Working paper No. 68

2Analysis of Traditional Healers in Lesotho:
Implications on Intellectual Property Systems

Pitso Masupha
National University of Lesotho; Crop Science Department
Lefa Thamae
Department of Science and Technology
Mofihli Phaqane
HIV and AIDS Civic Society	
  ATPS (2013): Analysis of Traditional Healers in Lesotho: Implications on Intellectual Property Systems. ATPS Working paper No. 68

3This paper should be cited as:
African Technology Policy Studies, ATPS 2013:Analysis of Traditional Healers in Lesotho:
Implications on Intellectual Property Systems. [Pitso Masupha, Lefa Thamae, Mofihli
Phaqane], ATPS Working paper 68© 2013Published by the African Technology Policy Studies Network

ISBN: 978-9966-030-52-8

ATPS (2013): Analysis of Traditional Healers in Lesotho: Implications on Intellectual Property Systems. ATPS Working paper No. 68

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Table of Contents
Acknowledgement							

6List of Acronyms								

7Abstract									

8

1.

Introduction							9

2.

Objectives							

11

3.

Literature Review							

12

4.

Methodology							

20

5.

Results and Discussion						

22

6.

Conclusion and Recommendations					

30References								

32Appendix								

35ATPS (2013): Analysis of Traditional Healers in Lesotho: Implications on Intellectual Property Systems. ATPS Working paper No. 68

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Acknowledgement
This paper was produced as part of the implementation of the ATPS phase VI Strategic Plan,
2008-2012 funded by ATPS Donors including the Ministerie van Buitenlandse Zaken (DGIS)
the Netherlands, amongst others. The authors hereby thank the ATPS for the financial andtechnical support during the implementation of the Intellectual Property Program. The authors
particularly thank Prof. Kevin Urama, the Executive Director of the ATPS for his visionary
leadership as programme director; Mr. Joseph Wekundah the Executive Director of the
Biotechnology Trust Africa (BTA) and Prof. Moni Wekesa (Mount Kenya University) who werecoordinators of the programme and Dr. Nicholas Ozor, Senior Research Officer (ATPS) andall the ATPS team members for their technical support during programme implementation.

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List of Acronyms
ABS		
AIDS		
ARIPO		
ART		
AU		
CBD		
ESA		
HIV		
IKS		
IP 		
IPR		
KYS		
LDC		
LENEPWHA
OAU		
R&D		
SADC		STIP		
STD		
S&T		
TB		
TCE		
TK		
TRIPS		UNAIDSUSA		
WHO		
WIPO		
WTO		

Access and Benefit Sharing
Acquired Immune Deficiency Syndrome
Africa Regional Intellectual Property Organization
Anti Retroviral
African Union
Convention on Biodiversity
Eastern and Southern Africa
Human Immune Deficiency Syndrome
Indigenous Knowledge System
Intellectual Property
Intellectual Property Rights
Know Your Status
Least Developed Countries
Lesotho Network of People Living With AIDS
Organization of African Unity
Research and Development
Southern African Development Community
Science and Technology Policy
Sexually Transmitted Diseases
Science and Technology
Tuberculosis
Traditional Cultural Expression
Traditional Knowledge
Trade-Related Aspects of Intellectual Property Rights
United Nations- Acquired Immune Deficiency Syndrome
United States of America
World Health Organization
World Intellectual Property Organization
World Trade Organization

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Abstract
Traditional healers in Lesotho and other African countries have since pre-historic times
played a major role in primary health care, counseling and the rituals performed for different purposes in the society. Traditional healers in the past had their houses located very
close to the main house of the village chief. This was to ensure that the healer is always
accessible to the chief as they were not only entrusted in disease healing and driving away
witchcraft but they were also the main advisors to the chief. The knowledge traditional
healers have on forecasting certain events, protecting crops and animals from hail andthunder storm, healing the sick, and driving away the evil spirit is often not documented andas a result it is slowly going into extinction. This valuable knowledge is often not protectedby law and known by a few.
The emergence and complexity of diseases like HIV and AIDS and other chronic diseases
have always been interpreted by the society to be related to witchcraft. That misconception
has resulted in many people also emerging especially in urban areas as traditional healers
claiming to cure certain diseases including HIV and AIDS. It was noted during the interview
that more than 50% of traditional healers don’t believe in HIV and AIDS and they attribute it
to certain diseases, witchcraft or failure to observe certain cultural activities.
The rapidly growing number of people claiming to be traditional healers has put pressure
on the biodiversity as certain plant species are recklessly being harvested from the rural
areas and sold in the cities. The study revealed that herd boys who are considered to bevery knowledgeable about the herbs growing in the rangelands and the forests are used to
guide in the identification of these herbs or harvest them. They are paid very little money forthis activity therefore the community does not benefit from their genetic resources. Healers interviewed agreed that they now have to travel long distances to get certain herbs fortheir patients which never used to be the case. More than 80 % of the doctors interviewed
agreed that there should be a policy in place that protects their knowledge and traditional
medicine. Beneficiaries to traditional medicine pointed out that they would prefer to get
traditional medicine packed in more hygienic containers and the healers should operate inmore decent places like the modern doctors.

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81. Introduction
1.1

Background

Lesotho is located in Southern Africa and it is completely surrounded by South Africa. It ison the highest part of the Drakensburg escarpment with the altitude reaching 3,482 meters
above sea level at some places. It lies between 300 South and 290 Eastern longitude andhas a total surface area of 30 648 km2 (Chakela 1999). Lesotho is divided into four agroecological zones namely the Lowlands, 1500-1800m high, the foothills 1800- 2200m high,and Mountains 2200-3000m. The Senqu River valley which is the fourth agro-ecologicalzone is the extension of the lowlands into the eastern mountain along the Senqu River.
Ever since the discovery of HIV and AIDS in Lesotho in 1986, Lesotho has continued todeteriorate from bad to worse. Lesotho is currently the third highest HIV and AIDS hot-spotin the world (UNAIDS 2007). Furthermore, Lesotho is confronted by a multiple crisis causedby high HIV prevalence, now estimated at approximately 23% of adults aged between 15-49,
and that, 57% of all infection are in females (UNAIDS,2005). In addition to the 300,000 adults
estimated to be living with HIV, at the end of 2007, approximately 20,000 children were also
HIV positive, and by the end of 2007, close to 90,000 had lost one or both parents to AIDS.
The spread of HIV and AIDS, along with diseases like tuberculosis (TB), Multi-drug resistant
TB, Pneumonia and high unemployment rate, mainly due to retrenchment of many Basothominers, are among the most important causes of poverty and vulnerability. Along with the
migration towards urban and peri-urban areas, and the absorption of many young female
workers by the textile industries, these trends are affecting the traditional social structures
within the household and at village level. As a result, the social protection mechanisms which
so far have helped the Basotho people cope with shocks and stresses are in decline. At thesame time, public welfare policies have failed to take over these tasks (Turner 2005).
Basotho, like other communities, have their own unique traditional knowledge, beliefs andculture that help them raise their children, unify them as a nation, protect themselves, theirlivestock and crops from natural disasters and diseases and to manage their environment
better in a sustainable manner. However, this valuable knowledge is often hidden,
undocumented, usually known by a few and mostly the elderly in the society. And in mostcases, some of these elderly people die with this valuable treasure. As an old African proverb
states “when the old man dies, the library burns to the ground”, societies are slowly losing
some of the important knowledge as old people die. According to (Louise, 1998), indigenous
knowledge is stored in people’s memories and activities. It is expressed in stories, songs,
folklore, proverbs, dances, myths, cultural values, beliefs, rituals, community laws, local
languages and taxonomy, agricultural practices, equipment, materials, plant species andanimal breeds.
Lesotho Science and Technology Policy 2006 – 2011 fifth objective of the five objectives
emphasizes on the Promotion and commercialization of indigenous knowledge systems.
Important components of IK-systems like Intellectual Property Rights (IPR) and Access andBenefit Sharing (ABS) are not clearly articulated in the policy. Therefore there is a need fora national multi-stakeholder policy dialogue that will lead to the development of Indigenous
Knowledge Systems (IKS) policy or strengthening of Science and technology policy on IKS.
Murthi (2005), pointed out national development policies especially those related to agriculture
and tradition, need to be taken into account when dealing with Traditional Knowledge (TK)ATPS (2013): Analysis of Traditional Healers in Lesotho: Implications on Intellectual Property Systems. ATPS Working paper No. 68

9based approaches in their considerations, from economic measures to the use of publicly
funded Research and Development (R&D), devoted to participative research with TK using
communities that feel they own and can use R&D to strengthen their innovative capacity anddevelop their own development systems.
The use of indigenous knowledge in innovation development has led to a number of surprising
successes. The use of indigenous knowledge systems has demonstrated positive resultsin the fields of: Land and water resource management, use and conservation of genetic
material and use of indigenous knowledge on medicinal plants (Hambly and Angura, ed.,
1996; Mendoza and Luning, 1997; Leonti, 2003; Tshabalala 2005).
The importance of IKS in the sustainable development cannot be overemphasized. However,very few studies have been done in Lesotho to determine the existing, preservation, promotion,
intellectual property rights and access and benefit sharing on indigenous knowledge systems.

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102. Objectives
The overall objective of this investigation is to understand the role played by the traditional
healers in primary health care systems and the cases of intellectual property Rights.
Specific objectives:
•
•
•
•
•
•

To identify the sources of traditional knowledge systems especially traditional medicine.
Determine the existing knowledge traditional healers have on HIV and AIDS and the role
they play in primary health care.
Determine the cases of access and benefit sharing and intellectual property rights intraditional medicine.
To determine the use and confidence the society has on traditional healers.
To determine if traditional healers realize their impact on biodiversity through harvesting
herbs for medicine.
Recommend ways in which traditional medicine can be promoted and commercialized toenhance the fifth objectives of Science and Technology Policy.

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3.Literature Review
3.1
Traditional medicine and International Organizations and treaties
Herbal remedies are considered the oldest forms of health care known to mankind on thisearth. Prior to the development of modern medicine, the traditional systems of medicine thathave evolved over the centuries within various communities, are still maintained as a great
traditional knowledge base in herbal medicines (Mukherjee and Wahil, 2006). World HealthOrganization (WHO), defines traditional medicine as sum total of all the knowledge andpracticals whether, explicable, mental or social imbalance and relying exclusively on practicalexperience and observation handed down from generation to generation, whether verballyor in writing. According to M’Vunganyi (2009) in most African societies traditional medicine
plays an important role in the lives of millions who cannot access western medicine. It is partof the first set of response mechanisms that people rely on in cases of medical emergencies.
PAHO (1999) further states that in developed countries the use of traditional medicine
is increasing because of better health care, while in developing countries the demand isdue to economic issues and availability, as the only source of health care. Daniels (2007)
also pointed out that the great majority of Africans routinely use the services of traditional
healers for primary health care and the estimates put the number as high as 85% in SubSaharan Africa. Traditional healers remain popular because they are accessible, affordable,
adaptable and culturally familiar and thus acceptable and respected in the wider community.
Furthermore; Traditional medicine is highly popular in many developing countries because
it is firmly embedded within wider belief systems. Stanley (2004) explained that Africa’s
traditional healers can be most instrumental in HIV and AIDS prevention. For starters, these
specialists treat most of the cases of STD’s which are believed to be major co-factors in the
spread of HIV.
Conserve Africa (2004), explained that in rural areas one sometimes travels days before
finding the nearest dispensary and pharmacy; therefore, people loose working days,
transport fares and the high cost of medicine. In spite of the enormous role played bytraditional medicine in primary health care, it continues to be disregarded in development
planning and its contribution to the society is generally neglected. The majority of Africancountries including Lesotho are currently geared towards the privatization of state hospitals
therefore the dispensation of free care and free medicine is no longer going to be in place;as a result, health services are going to be very expensive. International organizations likeWorld Health organization (WHO), World Trade Organization (WTO), World Intellectual
Property Organization (WIPO), African Union (AU) and the Regional bodies like SADC in
Southern Africa, civil societies and the governments have started recognizing the role playedby traditional herbalists in primary health systems. However, few African countries have alegal framework for controlling access to indigenous knowledge and biological resources,
or ensuring benefits arising from their use are shared fairly (Hebden, 2006). Therefore, anumber of strategies and the policy frameworks are continually being developed to increase
formal participation and protection of traditional herbalists in the health systems.
The WHO 2002 - 2005 strategy on traditional medicine outlines a number of challenges
on the use of traditional medicine. One of the challenges is lack of policy on traditional
medicine by a number of WHO member states. Policy provides a sound basis for defining
the role of traditional medicine on health care delivery, ensuring that necessary regulatory
and legal mechanisms are created for promoting and maintaining good practice, that access
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is equitable, and that the authenticity, safety and efficacy of therapies are assured. Anotherchallenge concerns the intellectual property and patent rights, addressing questions about
how best the benefits accrued from traditional medicine can be shared between the innovatorsand the holders of the technology. There are some international and regional organizations
and agreements aimed at helping the member states to address these problems.
3.2
World Intellectual Property Organization (WIPO)
World Intellectual Property Organization (WIPO) which is a specialized agency of theUnited Nations mandated to develop a balanced and accessible intellectual property (IP)system works through a number of programs. Programs that specifically address traditional
medicines are Traditional knowledge, genetic resources and traditional cultural expressions/folklore program. WIPO’s work addresses the role that intellectual property (IP) principles
and systems can play in protecting traditional knowledge (TK) and traditional Culturalexpressions (TCE) from misappropriation and in generating and equitably sharing benefits
from their commercialization and the role of IP in access to and benefit-sharing in genetic
resources. One of the decisions taken by WIPO’s working committee on TK and TCEs in
October 2009 is to take text-based negotiations with the objective of reaching an agreement
on a text of international legal instrument which will ensure the effective protection of GRs,
TK, and TCE and the text is expected to be completed by 2011.
3.3
Trade-Related Aspects of Intellectual Property Rights (TRIPS)
Agreement on Trade-Related Aspects of Intellectual Property Rights (TRIPS) administeredby World Trade Organization (WTO) attempts to narrow the gaps in the way these rights areprotected around the world, and to bring them under common international rules. It establishes
minimum levels of protection that each government has to give to the intellectual property offellow WTO members. However; there are unresolved issues and disagreements between
the Western World (America & Europe) and the Developing World on the TRIPs Article
27.3(b). The mentioned article states that WTO Member must provide Patent protection overmicro-organisms and microbiological processes, such as those used in biotechnology today,
but countries are free to exclude plants and animals from their patent law. However; allnations must provide intellectual property titles over plant varieties either through patents or
through an effective Sui generis System. TRIPS therefore provide opportunities for countries
to have alternative ways of protection rather than Intellectual Property Rights. Countries are
therefore free to come up with policies and legal frameworks that address the needs of local
people e.g. protection of Traditional Knowledge and Farmers` Rights. TRIPS have a numberof agreements referred to as flexibilities which member states are expended to implement.
These flexibilities include: transition period, compulsory licensing, public non-commercial
licensing of patents, parallel importation, Exceptions from patentability, and limits on dataprotection (Musungu; 2005).
Transition period is divided into three categories based on the state of development (Developed,
Developing and Least Developed countries-LDC) of each country. This agreement provides
the transition period for the implementation of TRIPS minimum standards. The expiry date forthe developed countries and developing countries lapsed in 2005 while the least developed
countries like Lesotho, Angola, and Zambia in the SADC region have been given up to 2016
with the possibility of an extension (Mabika: 2006). Munyuki and Machemedze, (2010),
recommended that the least developed countries in the Eastern and Southern Africa (ESA)
regions must make their case at the WTO for the waiver of the transition period beyond 2016
and also for the extension on patent protection. This is in view of the fact that the European
Community (EC) wants ESA countries to agree on protecting intellectual property rights
especially for EU companies involved in Research and development. ESA countries will thenbe required to implement certain provisions that will favor EU countries at the expense ofdeveloping nations making them to pay heavy royalties for any technology developed by EU.

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3.4
Africa Regional Intellectual Property Rights (ARIPO)
Africa Regional Intellectual property Rights (ARIPO) was formed after the member states
realized the benefits they would derive from effective and continuous exchange of informationand harmonization and co-ordination of their laws and activities in industrial property matters.
In August 2010, ARIPO and its members adopted a protocol on the protection of traditional
knowledge and expression of folklore. This was adopted in a conference that was heldin Namibia at the coastal town of Swakopmund and the protocol was therefore named
Swakopmund. The Protocol, upon entry into force, will empower the custodians and holdersof traditional knowledge and expressions of folklore to utilize their knowledge for socioeconomic development and wealth creation. The implementation of the Protocol will curtailthe ongoing misappropriation, bio-piracy and prevent illicit claim of traditional knowledgebased inventions and patent applications and enable the ARIPO Office to register traditional
knowledge and expressions of folklore that are trans-boundary and multicultural in nature,
the so-called regional traditional knowledge and expressions of folklore (ARIPO 2010).
3.5
The Convention on Biological Diversity (CBD)The African Union African Model Law (2000) has clauses on the Rights of Local Communities,
Farmers and Breeders as well as the regulation of access to Biological Resources. The
Law stipulates that the State and its people exercise sovereign and inalienable rights overtheir biological resources and communities also have rights over their biological resources,
knowledge and technologies that represent the very nature of their livelihood systems andthat have evolved over generations of human history. The Law further mentions prior rights
which take precedence over rights based on private interests.
The Convention on Biological Diversity (CBD) is another important convention which has
created a new environment for the protection of biodiversity and indigenous knowledge
and for benefit sharing. It goes beyond conservation and addresses issues like bearing theburden and sharing the benefits fairly and equitably between countries which supply andcountries which use biological resources on the one hand, and between indigenous andlocal communities and users in the modern sector on the other. Article 8(j), of CBD explicitly
recognizes indigenous and local communities’ contribution to biodiversity conservation,
calls for respect and support for their knowledge, innovations and practices, and confirms
indigenous people’s rights over the knowledge they hold. The Article also calls for equitablebenefit sharing. (WWW.CBD.int/convention) CBD is more specific on Access and Benefit
Sharing which involves genetic resources where Traditional Medicinal Plants can be protected
through various legal frameworks. According to Timmermans (2001), the main principles of
the CBD of immediate interest in the context of traditional medicine are: State sovereignty
over genetic and biological resources; Access to and use of genetic and biological resources
and associated knowledge should be based on mutually agreed terms and be subject toprior informed consent of both the State and the providers of the resources/the holders of theknowledge; Fair and equitable sharing, on mutually agreed terms, of the benefits arising fromthe use of genetic resources and associated knowledge.
3.6
AU Declaration on traditional medicine and Africa health strategy
In a statement delivered by Gawans, B in 2005 on the celebration of the African Traditional
Medicine day, he pointed out that in July 2001 the Assembly of OAU heads of states andgovernments at the summit held in Lusaka declared the period 2001 – 2010 as the decadefor African Traditional Medicine. The health Strategy for Africa: 2007 – 2015 has indicatedthat African Union Member States should consider establishing coordinating mechanisms
at national and regional levels to facilitate the implementation of the Traditional Medicine
Plan of Action. Research in Traditional Medicine should be promoted and funded to identify
efficacious and safe traditional medicines and assist Traditional Health Practitioners patent
their products. Furthermore, countries should integrate African Traditional Medicine into theirhealth systems recognizing its strengths and its limitations.

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The priority areas for the strategy for the implementation of the Plan of Action on the AU
Decade of African Traditional Medicine include:
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.

Sensitization of the Society on Traditional Medicine
Legislation on Traditional Medicine
Information, Education and Communication
Resource Mobilization
Research and Training
Cultivation and Conservation of Medicinal Plants.
Local Production of Standardized African traditional medicines.
Protection of Traditional Medical Knowledge (TMK)
Partnerships
Evaluation, Monitoring and Reporting Mechanisms

3.7
SADC Pharmaceutical Business Plan 2007 – 2013
The overall goal of the SADC Pharmaceutical Business Plan is to ensure availability ofessential medicines including African Traditional Medicines to reduce the burden of diseases
in the region. Its main objective is to improve sustainable availability and access to affordable,
quality, safe, efficacious, essential medicines including African Traditional Medicines. In orderto achieve the overall goal and the main objective, the following strategies will be pursued:i)Harmonizing standard treatment guidelines and essential medicine lists;ii)
Rationalizing and maximizing the research and production capacity of local andregional pharmaceutical industry of generic essential medicines and African 		
Traditional Medicines;
iii)
Strengthening regulatory capacity, supply and distribution of basic pharmaceuticalproducts through ensuring a fully functional regulatory authority with an adequate
enforcement infrastructure;iv)
Promoting joint procurement of therapeutically beneficial medicines of acceptablesafety, proven efficacy and quality to the people who need them most at affordable
prices;v)
Establishing a regional databank of traditional medicine, medicinal plants and 		procedures in order to ensure their protection in accordance with regimes and		
related intellectual property rights governing genetic resources, plant varieties andbiotechnology;vi)
Developing and retaining competent human resources for the pharmaceutical 		programvii)
Developing mechanisms to respond to emergency pharmaceutical needs of the 		region; andviii)
Facilitate the trade in pharmaceuticals within SADC.
3.8
Lesotho Vision 2020
Lesotho’s vision 2020 states: “Lesotho shall be renowned for its environmental management.
The country’s diversity of life systems will be supported and protected by a nation which isenvironmentally conscious and whose people are in balanced existence with the naturalenvironment. Basotho will derive continuing benefits from the conservation and sustainable
use of their biological diversity. The several global conventions and treaties that Lesotho
has signed and ratified shall be translated into concrete actions which will sustain care andmanagement of the environment at large.”
3.9
National Biodiversity Strategy and Action Plan Priority Activities
Priority activities to enable implementation of biodiversity conservation goals are as follows:• Identification of biological diversity components through research and compile inventories
to improve biodiversity conservation.
• Identification of processes likely to threaten Lesotho’s biodiversity.
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•
•
•
•
•
•
•
•
•
•

Identify and implement strategies that ensure sustainable conservation of biodiversity
components (PAs, RMAs, ERMAs, Botanical gardens, Maboella).
Strengthening of legal measures.
Develop human resources and improve the skills required for biodiversity management.
Increase participation of rural households in forest activities through their own initiatives,
for their own purposes and under their own control.
Identify and enhance management of Lesotho’s unique wetland systems.
Reform agricultural practices in Lesotho, manage and constrain human activities that are
responsible for destruction of biodiversity.
Perform Environmental Impact Studies prior to implementation of activities that are likely
to affect biological diversity adversely.
Establish measures of benefit sharing.
Develop material incentive program to change people’s behavior so that future land title
holders make appropriate conservation decisions.
Engage in international strategies that facilitate security of national and regional
biodiversity components.

3.10
Biodiversity Loss in Lesotho
Recently, there is also an alarming rate of over-harvesting of biological resources as ethno
medicines and sources of fuel wood. Truckloads of plant medicines are seen crossing theborder to the neighboring states and in particular into South Africa. The medicinal plants
mostly harvested and sold in the markets of neighboring states and urban areas of Lesotho
are the Alepidea amatymbica (Lesoko), Urginea capitata (Moretele o moholo), U. basutica
Moretele o mofubelu), Pachycarpus ridigus and Phytolaica heptandra (Poho-Tšehla), Dicoma
anamola, Teedia lucida (Hloenya), and Aloe polyphylla. These are harvested to extinction by
unscrupulous Basotho acting on own account and in some instances acting as agents offoreign biodiversity merchants. For instance, the world reckoned Lesotho true endemic, thespiral aloe has been seen in home gardens of South Africa and as far afield as in southern
Carlifornia, USA. (Lesotho first CBD report, 2000).
The fourth Lesotho CBD report has also reported that, lately medicinal plants are overharvested for commercial market, and in the advent of emergence of HIV Pandemic for
instance, the use of indigenous herbs has intensified because of the assumed potency inmanaging the viral conditions, and relatively easier access associated with the herbs against
the cost of conventional medication. This phenomenon has created a heavy demand onthese herbs, hence their overexploitation of the resource thus invariably deplete somecolonies completely. What then takes place is marginalization of the species populations,which ultimately affects the species diversity, because their relatives are subsequently
accessed as substitutes.
3.11
Health Providers and their sources of knowledge
Lesotho society includes a complex of “indigenous” healthcare provision as well as “western”
healthcare provision. Categories of indigenous health care include: Ngaka chitja (herbalist)
generally obtaining knowledge from training by a recognized and acknowledged traditional
healer, Ngaka ea litaola (diviner) also acquires the knowledge through training but theyalso claim to have ancestral guidance in diagnosing their clients, Ngakana- ka- Hetla thosestill under training and are not generally recognized as qualified health providers by thecommunity, but play significant roles as healers and protect families from evil spirits. Marlise(2003) stated that the diviner usually provides diagnosis through spiritual means, while theherbalist then chooses and applies relevant remedies. Mbiti (1991) further clarified thatdiviners deal with the question of finding out why something has gone wrong. They tell who
may have worked evil magic, sorcery, or witchcraft against the sick or the barren. For theirwork they use divination where pebbles, numbers, bones of certain animals, dice and other

ATPS (2013): Analysis of Traditional Healers in Lesotho: Implications on Intellectual Property Systems. ATPS Working paper No. 68

16means are used. Traditional healers also act as counselors, rain makers, seers and priests
in the society.
Another large category is that of the Mathuela who are distinguished by their dress and formof training which is different from others. During their graduation ceremony they use a goatfor the rituals, whereas amongst the Basotho people sheep is mostly preferred. According
to Motlamelle (1988) Mathuela are not originally healers from Basothoand this is evidenced
by their language which has Zulu connotations like Siya vuma, hlophe and mkoba. They
normally function as diviners and healers.
Colonial powers and structures have played an overpowering role in changing the culturallandscape and practices of traditional healers. This has also led to the emergence of certain
forms of Christian segments acting as traditional healers. Examples are Moapostola (aBasotho form of Zionism in which moapostola establish communities of health practice);
Moprofeta (another form of Basotho Zionism, generally located in an already existing
religious community); Pentecostal faith healers; religious leaders and health providers fromPentecostal, Roman Catholic or Protestant denominations. They use water, prayer and herbs
in healing the patients. They obtain their knowledge of herbs from reading medicinal plants
books.
3.12
Traditional healers’ importance in primary health care
The WHO estimates that up to 80% of the population in Africa makes use of traditional
medicine. In Sub-Saharan Africa, the ratio of traditional healers to the population isapproximately 1:500, while medical doctors have a 1:40 000 ratio to the rest of the population(Marlise 2003). Madamombe (2006) pointed out that, traditional healers are often the firstand last line of defense against the most contagious and debilitating diseases that plague theAfrican lives. Although Western medicine is generally accepted throughout Africa, it has not
replaced but rather augmented indigenous health approaches. With regard to primary healthcare in South Africa (SAMJ 2004) found that traditional healers are still firmly establishedhealth care providers in their respective communities. They are familiar to their clients. Bothshare the same language and how they view the world. Health and illness are perceived in
the same light. Healers are consulted for a wide range of physical, psychological, spiritual,moral and social problems. Another important reason for seeking the healer’s ministrations
is prevention of illness and misfortune.
The study conducted by Amhed et. Al., (1999) in Southern Sudan showed people visiting
traditional healers ranged between 21 and 40 years and were mostly women. Visitors wereless educated compared to the general population in the area. The main reasons given forattending traditional healers sessions were treatment and blessing. It is clear that traditional
healers play an influential role in the lives of African people and have the potential to serveas crucial components of a comprehensive health care strategy.
3.13 Traditional Healers role in Tuberculosis (TB) treatment
The President of Lesotho Traditional Healers Association Mr. Liau Malefetsane reported thatthousands of traditional healers are helping in the fight against tuberculosis (TB) in Lesotho.
They have been trained to recognize TB symptoms such as a persistent cough and areaware of their responsibility to advice patients with suspected TB to get properly diagnosed.
In Lesotho, when people fall ill, it is customary for them to go to their traditional healers first.
Healers don’t have the equipment necessary to test for TB, neither are medical practitioners.
Instead of trying to treat a suspected TB patient using traditional medicine, healers are trained
to refer them to the nearest TB clinic.
Traditional healers have experience in herbal and mystical remedies and they live by their

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trade of treating the community. Healers have a strong incentive to forego the revenue
they would earn if they tried to treat the patient themselves, because they recognize that if
clinical TB treatment is delayed, the disease can be fatal.
3.14
Traditional healers and HIV/AIDS
Traditional healers provide a substantial proportion of health care in resource-poor settings,
including countries with high burdens of HIV in sub-Saharan Africa. Traditional healers haveplayed many roles in HIV care, but some biomedical providers view them as obstacles inproviding HIV treatment. The study that was conducted by Furin (2011) in two districts ofLesotho showed that traditional healers provide a wide range of HIV services prior to theanti-retroviral (ART) rollout. Traditional healers took on a variety of roles in the ART rollout,
including HIV prevention activities, HIV testing, monitoring patients, and participating in
joint learning sessions. The study further concluded that traditional healers can provide
a variety of community-based HIV services and are not obstacles for advancing care in
the communities they serve. According to Mills et al. (2006) currently, there is mounting
evidence of the importance of traditional healers in the management of the HIV/AIDS
epidemic although poorly researched and understood, and to reduce the impact that sometraditional healing interventions may play on the spread of HIV/AIDS and unsafe treatment
of infected patients. While there are few collaborative projects between traditional healers
and biomedical health providers, there is an enthusiasm on the part of traditional healers
to collaborate and learn from their western-trained counterparts. Burnet et al. (2007) also
revealed that there was more support for collaboration among traditional healers thanamong formal health workers. Both traditional healers and formal health workers havesignificant and complementary roles in the field of HIV/AIDS in Zambia, but there is muchdebate concerning the relationship between them.
3.15

Lesotho Science and technology Policy (STIP) Objectives

1.
To foster a stronger S&T human resource base
• Sustain relevant and accessible S&T programs of learning and advocacy in technical,
vocational and science-based disciplines;• Accord high priority to S&T education, funding and research;• Appraise the education system and devise a funding scheme for S&T training andresearch programs;• Set up plan to regularly upgrade critical S&T supplies & equipment for researchlaboratories, textbooks and journals for schools and universities.
2.
To develop a culture of Innovation for technological production• Develop and promote a S&T support network and activities targeted to entrepreneurs
and SMEs;• Enhance and diversify the export base; Provide cost-effective technical support toentrepreneurs and enterprises from production to marketing stages;• Set up and nurture a national S&T innovation system and network;• Facilitate access to national, regional and global S&T information networks.
3.
•
•
•

To create job opportunities and poverty reduction through the use of
S&T initiatives
Build maximum synergy, cooperation and coordination between and among S&T users
and R&D institutions;
Undertake R&D and diffuse technologies that would improve quality of life;
Ensure participation of women in S&T management, teaching, learning, R&D, etc.

4.
Build a vibrant information society• Take proactive approach to knowledge acquisition and information dissemination in linewith the ICT policy, with a view to building a strong knowledge-driven economy

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5.
Promote and commercialize indigenous knowledge systems• Safeguard the indigenous knowledge systems;• Where possible, convert these to innovative products and services for both domestic andglobal markets.
3.16
Intellectual Property Systems in Lesotho
One of the greatest challenges facing the Country is the management of the Traditional
Knowledge Systems especially traditional medicine, due to lack of regulatory framework.
Important components of IK–Systems such as Intellectual Property Rights (IPR) and Access& Benefit Sharing (ABS) have no policies that safeguard them. The Industrial Property Order,
1989 and Copyright Order, 1989 do not address the issue of IK systems directly especiallytraditional medicine.
The industrial Property Order of 1989, Part II under matters excluded from patent protection
has the following sections which totally exclude Protection of indigenous knowledge.
4.2, (b) “Plant or animal varieties or essentially biological processes for the production of plants
and animals, other than microbiological processes and the products of such processes”;(d) “Methods for treatment of the human or animal body by surgery or therapy, as well as
diagnostic methods practiced on the human or animal body. This provision shall not apply to
products for use in any of those methods”.
3.17
Access and Benefit Sharing
Specifically, ABS is the acronym for access (to genetic resources and associated traditional
knowledge) and benefit sharing from their utilization. “Genetic resources” refers to the genesthat make up every living organism. Seen to have commercial value, such genes havethus become “resources” that can be bought and sold, along with all the other vast natural
resources that originate in Indigenous Peoples’ territories. It is these genetic resourcesthat governments and industry want access to for commercial exploitation and economic
development. (Le’a Malia, 2010). Lesotho does not have a regulatory frame work on ABS.
However, with the establishment of local councils at village level, the councilors use theprovisions of the local government act 2007 which allow them to make their own by laws toensure that they benefit from the utilization of their resources in their territory. Currently, theemphasis is more on natural resources such as building sand, thatch grass and quarries forroad construction than medicinal plants and animals including traditional knowledge.

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4. Methodology
4.1
Introduction
The study was carried out in the seven lowlands districts of Lesotho. The study comprisedof two sets of questionnaires. The first one targeted the traditional healers whilst the second
one was directed to the beneficiaries of traditional medicine which were basically households
living in the villages with traditional healers. Since not all Traditional healers are registeredwith the healers association of Lesotho, they were identified with the help of the chiefs
as custodians of culture in the villages. The questionnaires were piloted in three districts
and these were done along with the Focused Group Discussions. Departments and Civil
organizations linked to traditional medicine, access and benefit sharing and intellectual
property rights were interviewed as key informants in this study.
4.2
Questionnaire Survey
Structured questionnaires used for the traditional healers had four major components:
these were: household characteristics (i.e. marital status, sex, family size, education andemployment). The second component was on sources of knowledge, access and benefit
sharing. The third component was on the ability to cure diseases including HIV/AIDS andthe fourth component checked Biodiversity issues, policy and the enforcement mechanisms.
A total of ninety one traditional healers were interviewed. The second questionnaire on
beneficiaries had three major categories. The first referred to household characteristics as in
the first questionnaire, followed by the assessment of the communities’ use and confidence
to traditional healers. The last one centered on the policy and modernization of traditional
medicine. One hundred and eight beneficiaries were interviewed.
4.3
Focused Group Discussion
Focused group discussions conducted in the three districts piloted were composed of 8 – 12people selected from a number of villages. The group was composed of traditional healers;
people involved in initiation schools and the village councilors. The discussions were mostly
dominated by the elderly people with their age ranging from around fifty to eighty. The highest
percentage of the participants was male. These people were identified and invited by thearea chiefs. Discussions were on; sources of traditional medicine knowledge, preservationof traditional medicine, promotion of such traditional medicine (awareness), cases of accessand benefit sharing, interaction with the modern doctors and ways in which their knowledge
could be protected. A total of three focused group discussions were conducted.

4.4
Key Informants Interview
Departments and civic associations which their core business is related to traditional
healers and medicine, intellectual property rights, Access and benefit sharing, HIV/AIDS andconsumer protection were identified and visited. The following Government departments
were visited: Department of Parks (CBD), Department of environment (ABS), Law office(IPR), Science and Technology (Traditional Knowledge system policy) and Parliament
Portfolio committee on HIV/AIDS. Civic associations consulted were: Consumer associationof Lesotho, Traditional doctors association of Lesotho and Lesotho network of people living
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with HIV/AIDS (LENEPWHA).
4.5
Data Analysis
Data collected from traditional healers and beneficiaries were coded and analyzed using
SPSS version 19. Analyzed information was presented in the form of illustrations, frequencies,
percentages, tables and charts.

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5. Results and Discussion
5.1
Age
Most of traditional healers range within the age group of 46-55 years (26.4%). They arewithin this range because it is at this stage whereby they have completed necessary ritesof passage, notably initiation school. These are followed by those who are around 36-45
years of age (23.1%) who also constitute a reasonable number, thus in most cases these are
newly inaugurated traditional healers. Although the age groups 56 – 65 and 66+ constitutelower percentages of 17.6% and 16.5% respectively, these groups are highly trusted by
the community due to experience they have acquired and the number of doctors they havetrained. Thus at this age their decisions are credible based on their maturity level.
5.2
Education Standard of Traditional Healers vs Beneficiaries
A significant number of Basotho traditional doctors has only gone up to primary level - 56%.
Table 1 below shows that, 23% constitutes those who have not been to formal school andsome (14.3%) of this group has only attended traditional school. This group possesses
indigenous knowledge gained from initiation school and their elders while still tending
livestock. Beneficiaries interviewed in this study were ordinary Basotho randomly selectedfrom the population and these could be depicting the educational levels of the Basotho people
especially those in the rural areas as the study covered mostly the rural areas. Therefore thegreatest number of the rural population have gone up to secondary (41.7%) followed byhigh school (25%) and tertiary with 13%. The study therefore reveals that the majority of
traditional healers are below formal educational level of the country.
Table 1: Educational standards attained by traditional healers and beneficiaries
Education

Traditional &no schoolingPrimary

SecondaryHigh

Tertiary

No response

Traditional Doctors
N= 91

23.1%

56%

14.3%

4.4%

2.2%

0

Beneficiaries
N=108

3.7%

6.5%

41.7%

25%

13%

13%

5.3 Traditional Healing in Lesotho
5.3.1 Sources of Traditional Healing
Most people who are traditional healers have acquired knowledge from their ancestors (34%)
through the process of “HO THOASA”. This is a situation whereby an individual receives
instructions from his ancestors while asleep. These instructions are well packaged andwill include the traditional healer who will train that individual on the use and other rituals
concerning traditional healing and the sacred place where such rituals are supposed to be
performed during the training. This is more common with the mathuela category of healers.
The same percentage (34%) acquired the knowledge from their elders. Usually these people
have been employees of traditional healers and they have acquired this knowledge through
ATPS (2013): Analysis of Traditional Healers in Lesotho: Implications on Intellectual Property Systems. ATPS Working paper No. 68

22being sent out to fetch herbs or medicinal plants and animals. The study revealed that there
is another category with 28% who never went for any form of training but claim to have beenshown various medicinal plants and animals whilst asleep by their ancestors.
5.3.2 Traditional knowledge transfer
The majority of the traditional healers (75%) are willing to share their knowledge with otherpeople with a charge. Normally these are people coming to them either voluntarily or througha calling by their immediate ancestors. More than 28% obtained the knowledge without acost. In most cases this revolves around the clan usually to the most trusted and disciplined
members in the clan-family. Although more than 24% gained their knowledge through paying
money compared to more than 19% who acquired it through paying livestock but the baseline
for payment is livestock usually a cow, calculated in monetary terms. In the past before
the advent of the money economy, livestock was the mode of payment hence the reason
why traditional payments such as lobola are still quoted in livestock terms. However sometraditional healers especially the elderly ones who still value their tradition demand payments
to be done through livestock. As shown in table 2 below more than 13% of the interviewed
healers are adamant that they cannot share their knowledge and close to 9% cannot share
the knowledge for personal reasons while more than 7% are avoiding competition from theirtrainees.
Table 2: Knowledge transfer and costs on training
WILLINGNESS TO SHARE KNOWLEDGE WITH OTHER PEOPLE
Yes, free of charge

Yes, but at a costNo

No response

8.8%

74.7%

13.2%

3.3%

REASONS FOR NOT SHARING
Not Applicable

Avoid Competition

Retain Knowledge as Family
Treasure

Personal

No response

74.7%

2.2%

7.7%

8.8%

4.4%

COST INCURRED DURING TRAINING
Not Applicable

Nothing

Money

Livestock

No Response

25.3%

28.6%

24.2%

19.8%

2.2%

COST CHARGED BY TRADITIONAL HEALERS ON CLIENTS
Not Applicable

Money

Livestock

OthersNo Res

22.0%

37.4%

35.2%

2.2%

3.3%

5.3.3 Traditional healers Relations with Modern Doctors
A majority of traditional healers 75.8% showed that they do not have any forum with modern
doctors. As indicated in table 3 below 73.6% also pointed out that they are never consulted
by the modern doctors in disease curing.
This was echoed by the president of Lesotho traditional healers association, Mr. Malefetsane
Liau during a Key Informants Interview. He showed that they are never consulted in any
way by their modern counterparts to demonstrate their knowledge in the field of medicine.
This situation is different with what happens to the neighboring country of the Republic ofSouth Africa, whereby both traditional healers and modern doctors do have forums where
their information is shared. This absence of consultations with traditional healers is a clear
indication that modern doctors in Lesotho have a negative attitude towards traditional healers.
However there is a contradiction here, as some traditional healers indicated during the
focused group discussions that they are sometimes consulted by the modern doctors, when
they seek promotions or good fortunes in their surgeries. They normally come to traditional
healers covertly. It is highly likely that 1.1% and 7.7% who showed that modern doctors haveextreme and partial confidence, respectively, in them are those that are consulted by themodern doctors in this fashion.
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Table 3: Traditional healers’ relations with modern doctors
FORUMS ATTENDED WITH MODERN DOCTORS
0

Yes

No

No response

1.1%

17.6%

75.8%

5.5%

MODERN DOCTORS CONFIDENCE IN TRADITIONAL HEALERS
Not
applicable

Extremely

PartlyVery Little

Not At All

No Response

74.7%

1.1%

7.7%

5.5%

7.7%

3.3%

INVOLVEMENT OF TRADITIONAL HEALERS BY THE MODERN DOCTORS IN PATIENTS’
TREATMENT
0

Yes

No

No Reponse

3.3%

3.3%

73.6%

19.8%

5.4 Traditional Healers capacity and their perception on HIV/AIDS
In all the diseases listed above and other illnesses, more than 70% showed competencein curing those diseases. The highest, (81%) showed ability to cure sexually transmitted
diseases. Figure 1 below, indicated that 56.0% is aware of the existence of HIV and AIDS.
However, in Lesotho it is highly important to note that 26.4% are totally denying the existenceof HIV/AIDS and 15.4% are not sure. These numbers are highly significant considering thealarming rate of infection in the country. Lesotho is now estimated at approximately 23% of
adults infected aged between 15-49, and that, 57% of all infection are in females (UNAIDS,
2005). Thus this cannot be left unchallenged, because this indicates a risky situation. The
study revealed that the majority of these healers who deny HIV/AIDS existence or are
unaware of HIV/AIDS, classify it as one of the sexually transmitted diseases such as syphilis,
gonorrhea, or mahae, (a disease which is associated with someone who had sex with awoman whose husband has just passed away and is still in her mourning gowns). This could
be one of the reasons why modern doctors consider them deceiving and misleading in theprovision of primary health care. Ignoring the existence of traditional healers who are stillin denial or ignorant could be fatal to the society as they are the first to be consulted in thecommunity whenever people fall sick.

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24

%
R
e
s
p
o
n
s
e
s

Competence on various diseases

Figure 1: Traditional healers’ competence on various diseases

%
R
e
s
p
o
n
s
e
s

Perception of HIV/AIDS

Figure 2: Traditional healers’ perception on HIV/AIDS5.5
The impact of traditional medicine on biodiversity
More than 86% of traditional doctors admitted being faced with declining sources of traditional
medicine, plants and animals used in the preparation of medicines. The Lesotho fourth
Biodiversity report showed that with the emergence of HIV Pandemic, the use of indigenous
herbs has intensified because of the assumed potency in managing the viral conditions. Muchof these herbs are harvested from the rural areas usually smuggled and sold in urban areas
ATPS (2013): Analysis of Traditional Healers in Lesotho: Implications on Intellectual Property Systems. ATPS Working paper No. 68

25where they are in high demand by the city dwellers. The reason for this is that most of thepeople in towns have migrated from rural areas and are still attached to their traditions and stillconsult traditional healers for medicine. It emerged during the Focused Group Discussions
that this uncoordinated harvesting is done by people who are not licensed healers but grew up
in the villages and are familiar with the herbs. It was further indicated that they often use thespades hence removing everything that would allow the plant to re-grow. Trained healers arevery particular when looking for the sources of traditional medicines. They avoid harvesting
young plants and killing young animals as they expect them to grow and multiply. In an
attempt to counteract this erosion of herbs and animals, Ministry of Tourism, Environment
and Culture has embarked on massive campaigns to educate traditional leaders, community
councilors and traditional healers on environmental conservation. Currently 50.5% haveshown that, they do not wait for plants to grow before harvesting them, while 39.6% haveshown that due to the education they received and campaigns conducted by environmental
officers, they do wait for plants to reach maturity and they have engaged themselves in theprocess of having their own community botanical gardens.
5.6

Access and Benefit Sharing and Intellectual Property Systems

5.6.1 Access and Benefit Sharing
Participants from all areas visited did not show any benefit reaped from the use of theirbiodiversity resources. It was gathered during the key informants’ interviews with the
Department of Environment that there were some people coming from South Africa who
were smuggling some traditional medicinal plants from Lesotho for commercial purposesin South Africa. Some of these products are sold in the streets whilst some are sold to thefast growing traditional medicine industries in South Africa. Head boys are used in thismassive harvesting. This normally takes place in the remote areas like the mountains andrangelands where this cannot be easily noticed. Interviews at the Department of environment
showed that there is no regulatory framework on access and benefit sharing. However, due
to overharvesting of certain plants and animals for medicinal purposes, the Department
included in the Environment law as amended in 2008, protection of endangered species.
This was instituted to prevent the harvesting of the species protected under this law without
the permission of the environment authorities.
Local councils have the provision to make by laws under the local government act of 2004.
It was noticed during the focused group discussions that some village councils have madeby laws governing the use of resources in their territory by people coming from outside.
However, this mostly applied to resources like building sand and quarry. The contract issigned between the two parties; usually to construct a graveled road or provide drinking or
small irrigation facilities. Although this is outside the periphery of CBD but in principle, it is inline with some of the major requirements of CBD and the Nagoya Protocol on Prior Informed
Consent (PIC), agreement of terms and benefits from the utilization of their resources.
Therefore, once the national policy for Access and Benefit Sharing on genetic resources is inplace, it will be easier to implement it based on what communities are doing already.
The Department of environment has applied for funding from Global Environment Facility
to facilitate in the development of access and benefit sharing and ratification of the Nagoya
protocol.

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5.6.2 Intellectual Property
More than 92% of Basotho traditional healers believe that they should be legally protected.
Lesotho, like any other country, has its own traditional healers system which dates as far backas pre-historic period; in fact, this is part of their culture. But this art is not legally protected.
Although there is Industrial Property Order, 1989 and Copyright Order, 1989; the two acts
do not explicitly spell out, to what extend are traditional healers protected by law within
the country. Industrial Property order, 1989 has taken a stand of shall as opposed to maysuggested by WIPO on under matters excluded under patents that “Methods for treatmentof the human or animal body by surgery or therapy, as well as diagnostic methods practiced
on the human or animal body. This provision shall not apply to products for use in any of thosemethods”. Therefore, traditional healers’ methods of diagnosis and healing cannot under
any circumstances be protected for ethical reasons as stipulated in WIPO. However, ARIPO
realizing the importance of traditional knowledge came up with the swakopmund protocol
which has been adopted by ARIPO members but it is not yet operational. The protocol seeks
ways of protecting traditional knowledge and expressions of folklore. According to the office ofthe registrar general in the Ministry of Law, Justice and Human Rights, various stakeholders
were sensitized on the protocol prior to the signing and there is a radio program runningon issues pertaining to the affairs of the ministry and intellectual property systems, relatedorganizations and protocols form part of the programs.
5.6.3 Beneficiaries Perspective towards training and sensitization on IKS and ABS
More than 85%, agree that, community based leaders must be given adequate training on
enforcing policies governing traditional healers. This also came up during the focused group
discussions that some chiefs and community councilors connive with city street vendors fora bribe in smuggling some herbs from the villages. This sentiment extends further to thepolicemen. Before policies are formulated, traditional healers indicated that policymakers
should have an induction course on Indigenous Knowledge System (IKS). About 90% of the
traditional healers also agreed that the Police Service must also be trained on IKS policy andlegislation so that they are enlightened to enforce it.
In general, 89% of traditional healers agree that, policy makers and the community at large
should be sensitized or educated about issues of policies surrounding Indigenous Knowledge
System. They strongly believe that if the community is aware of issues related to IP and ABS
natural resources like the biodiversity can be used to the advantage of all. This will make it
impossible for those who may try to manipulate the system. These include bogus traditional
healers who are not only affecting the biodiversity, but are also killing innocent lives throughmaladministration of wrong herbs.
5.7
Traditional healers’ consultations by the society
The results as shown in figure 3 indicates that more than 47% of the people interviewed
have never been to a traditional healer in 2010. However, more than 50% had consulted
the traditional healers with the majority being there four to five times. This is in line withwhat Gawans 2005 said at the common African Traditional day that Africans have relied on
traditional medicine since time immemorial and still remains the mainstay of primary healthcare for the majority of those in the rural areas in Africa. This is partly because of lack ofaccess to health care and services but also because of traditional belief systems.

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27

%
R
e
s
p
o
n
s
e

Frequency of visits
Figure 3: Frequency of visits to the traditional healers in 2010
However, the study indicated that more than 73% have modern clinics near their homes and80% showed that they take less than an hour to reach the modern clinic therefore lack ofaccess to health care services does not probably apply but believe in traditional medicine as
more than 60% agreed that they go to traditional healers because they believe in traditional
medicine. WHO estimates also show that about 80% of the African population reverts totraditional medicine when taken ill.

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5.8
Modernization of Traditional Healers
The results as shown in figure 4 indicated that more than 90% of the respondents supported
modern packaging of traditional medicine. These findings are in agreement with what was
discovered in Nigeria that packaging, which enhances attractiveness and also increases
shelf life, were not only appreciated by the usual low class customers of traditional medicine
but attracted upper class consumers (M2 Magazine 2010). It has also been observed in
Lesotho that packaging of traditional medicine in a modern way attracted people from allclasses. Mrs ‘Mamotlatsi Dlankamandla is one such traditional healer who has modernized
her surgery such that it operates like a modern clinic. Her well packaged products are not
only sold at her surgery but around the country and beyond the borders of Lesotho.
%
R
e
s
p
o
n
s
e

Packaging and certification of traditional medicine
Figure 4: Modernization of traditional medicine
She has more than 50 employees around the country and she is one of the potential sponsors
of a number of activities in the country. More than 86% agreed that traditional healers shouldbe certified by the traditional healers association. Certification of traditional healers is doneby the association of traditional healers, but this does not justify that people who are notregistered and certified with the association cannot practice as traditional healers. Therefore,
if there is no policy and the enforcement of that policy, registration and certification with theassociation will not help.

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29

6. Conclusion and Recommendations
The existence of traditional healers and the influence they have on the day to day lives ofboth the rural and urban communities cannot be overlooked. Traditional medicine is oneof the oldest concepts that people have been surviving on. There are quite a number of
traditional healers international and regional declarations, strategic plans and conventions
that African countries are party to, but very little has been done to implement them, protect
and improve the knowledge. In the era of HIV and AIDS and other hard to cure diseases theknowledge is being taken advantage of for the purposes of self-enrichment by people whoare not at all healers. This does not only pose as a threat to biodiversity and the lives of thepeople but also robs the people’s money/resources that could have been spent on qualified
traditional healers or modern doctors.
Traditional healers do have an association which is also responsible in giving out certificatesto the healers. It must be noted that; certificates are not awarded on the basis of competence
and there is no thorough scrutiny on the credentials of the individual before being awarded
a certificate. This is simply done to increase the membership of the association to sustain it
through the fees that is paid for registration and annual subscription. Therefore, it is importantthat a standardized competence test is offered to the healers before being registered with theassociation and practicing as traditional healers. It is also recommended that only certified
traditional healer’s clerks should be allowed to harvest the herbs in the villages.
The impact of uncoordinated harvesting of medicinal plants is a serious concern to theenvironmentalists and the communities as a whole. Medicinal plants are being harvested at an
alarming rate despite the enactment of the environment act of 2009. It is also recommended
that every traditional healer must have a botanical garden in his yard or field which will
be protected by law from any form of intrusion. Another recommendation is that; medicinal
plants being sold should be done by the people licensed by the traditional healers associationand this activity must be governed by the association. Again, traditional medicine should besold in decent buildings or shelters just like the modern pharmacy. As it has been shown
from the results, that beneficiaries would prefer to have traditional medicine well packaged,
it is therefore recommended that traditional pharmacies are guided by people trained inpreservation and canning to have their medicines properly and hygienically packaged.
This is already being practiced by some traditional healers in the country and the rewards
are astonishing and there are quite a number of healers going into modernization of theirbusinesses but quality and safety of their products is one area that must be researched.
It is shocking to discover that the majority of traditional healers either do not believe in theexistence of HIV and AIDS or are not sure about it. This calls for immediate intervention by
all the stakeholders dealing with HIV and AIDS, as traditional healers are also regarded ascommunity leaders commanding much respect from the society. Their lack of knowledge
about the disease holds serious problems for the community and the people they serve.
Negligence by the modern doctors may be observed as one of the factors contributing to
ATPS (2013): Analysis of Traditional Healers in Lesotho: Implications on Intellectual Property Systems. ATPS Working paper No. 68

30their ignorance. It is therefore recommended that medical council of Lesotho Doctors and the
Nurses Association of Lesotho should find a way of conducting awareness campaigns forthe traditional healers on serious illnesses like TB and HIV and AIDS. This must be done insuch a way that will not infuriate traditional healers otherwise that initiative will fail. This will
make the doctors’ jobs easier as some people spend most of their time consulting traditional
healers on illnesses that they don’t have capacity to diagnose and cure.
On the overall it has been observed that legal instruments (Industrial Property Order of 1989
and copyright order 1989) addressing intellectual property rights are silent on traditional
knowledge especially traditional medicine. Therefore, it is important that the government fast
tracks the formulation of IP policies on indigenous knowledge systems to facilitate a smooth
implementation of Swakopmud protocol. It has also been observed that there is no legislation
on ABS issues. Lesotho is party to CBD and has the right to ratify the Nagoya protocol. The
protocol calls for nations to formulate legislations that would allow for the implementation of
the said protocol, therefore, the country must act swiftly so that when this protocol is put inplace draft policies, awareness campaigns and education have been carried out.

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Lesotho Vision 2020. www.gov.ls
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34

Appendix
Appendix 1
Questionnaire for Traditional Herbalists
1.0 How many people are there in your household?
I.
Children []II.
Adults [
]
2.0
I.
II.
III.
IV.
V.
VI.

Which of the following age categories do you belong to?
15-25
26-35
36-45
46-55
56-65
66+

3.0
I.
II.

GenderMale
Female

4.0
I.
II.
III.
IV.

Marital status
MarriedSingleSingle parent
Divorced

5.0
I.
II.
III.
IV.
V.

What educational level did you acquire?
No schooling
Traditional school (Initiation School)
Primary education
Secondary education
High school

6.0
Do you do any work other than being a doctor? (please specify)_____________________________________________________
7.0
I.
II.
III.
IV.

How did you acquire the knowledge on traditional medicine?
Gift from the ancestors.
Gift from the ancestors and training by the herbalist.
Taught by the elders.
Gift from God.

8.0 If you obtained it through training in 5 (II) and III) what was the cost?
II.
Nothing.
III.
Money.
IV.
Livestock.
V.
OthersATPS (2013): Analysis of Traditional Healers in Lesotho: Implications on Intellectual Property Systems. ATPS Working paper No. 68

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9.0 Which human diseases are you good at?
I.
Respiratory.
__________________________________________________________________________________________________________________________________II.
Digestive.
_________________________________________________________________________________________________________________________________
III.
Mental_________________________________________________________________________________________________________________________________IV.
STDs__________________________________________________________________________________________________________________________________V.
Others____________________________________________________________________________________________________________________________
10.
I.
II.

Do you believe that there is a disease called HIV/AIDS?
Yes
No.

11.
I.
II.
III.

If no what do you think HIV/AIDS is?
Cancer.
Syphilis
Other_________________

12.
I.
II.

If yes have you ever treated HIV/AIDS patient?
Yes.
No.

13.
I.
II.
III.
IV.

If Yes, In general, what was the outcome?
Patient completely cured.
Patient recovered but was not completely cured.
People come when they are too sick to cure.
Failed to cure.

14.
I.
II.
III.
IV.

If completely cured how you can justify this?
Tests proofed him/her negative after my treatment.
The patient regained her/his normal weight/life.
Both I and II
Nothing done

15.
I.
II.

Any attempts to make the above information known to the public?
Yes.
No.

16.
I.

If yes what did you do?
Informed other herbalists.

ATPS (2013): Analysis of Traditional Healers in Lesotho: Implications on Intellectual Property Systems. ATPS Working paper No. 68

36

II.
III.
IV.
V.

Informed village local health personnel.
Informed the media.
Informed community based leaders.
All of the above.

17.
Is there any formal forum where you meet with the modern doctors and shareideas on your duties as doctors?
I.
Yes.
II.
No.
18.
I.
II.
III.
IV.

If yes, do you think they have confidence in you?
Extremely.
Partly.
Very little.
Not at all.

19.
I.
II.

Are there some cases where modern doctors involve you in patient’s treatment?
Yes
No

20.
I.
II.
III.
IV.
V.
VI.

If yes, which diseases are you always invited to treat?
Respiratory[ ] Yes		[ ] NoDigestive[ ] Yes		[ ] NoMental[ ] Yes		[ ] NoSTDs		[ ] Yes		[ ] NoWitchcraft[ ] Yes		[ ] NoOthers (Specify)

21.
I.
II.
III.
IV.
V.

In general what do you always use in treating diseases?
PlantsAnimals
Both Plants and animals
Water
Others_______________________

22.
I.
II.
III.
IV.
V.

In most cases how do you prepare them?
Concoctions.
		[ ] Yes
Juice extracted from plants.
[ ] Yes
Powder made from dried animal and plants [ ] Yes
Paste from animal and plant products[ ] Yes
Others_____________________

23.
I.
II.
III.
IV.
V.

How do you administer them to your patients?
Consumed/drink orally		[ ] Yes		[ ] NoInhaled			[ ] Yes		[ ] NoInfused through small cuts
[ ] Yes		[ ] NoFumigate			[ ] Yes		[ ] NoOthers_____________________

24.
I.

As a traditional doctor, what challenges do you face?
Declining sources of medicine especially animals and plants. [ ] Yes[ ] No[ ] No[ ] No.
[ ] NoATPS (2013): Analysis of Traditional Healers in Lesotho: Implications on Intellectual Property Systems. ATPS Working paper No. 68[ ] No
37

II.
III.
IV.
V.

Poor working relations with Modern doctors.
[ ] Yes
No policy on issues related to traditional knowledge systems. [ ] Yes
Failure of patients to pay their fees.			
[ ] Yes
Traditional medical practices not being
accepted by religious churches 				[ ] Yes[ ] No[ ] No[ ] No[ ] No25.
For 22 above, (I), are you aware of the environmental degradation caused byharvesting medicinal plants.
I.
Yes.
II.
No.
26.
If yes, what do you do to minimize the impact on the environment?
I.
Replanting.						[ ] Yes[ ] NoII.
Defer harvesting until plants have grown and seeded again. [ ] Yes[ ] NoIII.
Work closely with Community Based Leaders (CBL)in proper land management. 					[ ] YeS[ ] NoIV.
Others_______________
27.
V.
VI.
VII.

Are you willing to share your knowledge with other people?
Yes, free of charge.
Yes but at a cost.
No

28.
I.
II.
III.

If yes, but with a cost. What is your charge?
Money
Livestock.
Others

29.
I.
II.
III.

If not, what are the reasons?
Avoid competition.
Retain the knowledge as a family treasure.
Others (Specify)___________

30.
Other than human diseases, are there any skills that you have that you use tobenefit the community?
I.
Yes.
II.
No
31.
If yes, please indicate.
____________________________________________________.
32.
I.
II.

Do you think traditional medicine should be protected legally?
Yes.
No

33.
If yes, what do you think should be done to enforce the policy on traditional
medicine?
I.
Training Community Based Leaders.		
[ ] Yes		[ ] NoII.
Training of Police on IKS. 			
[ ] Yes		[ ] NoATPS (2013): Analysis of Traditional Healers in Lesotho: Implications on Intellectual Property Systems. ATPS Working paper No. 68

38

III.
IV.

Training of Policy Makers on IKS.		
Public awareness on IKS issues			[ ] Yes		[ ] Yes[ ] No[ ] No34.
Like modern medicine that is taught in schools, do you recommend traditional
medicine in the school curriculum?
I.
Yes.
II.
No.
35.
I.
II.
III.
IV.
V.

If yes at what level do you think it should be taught?
Primary.
Secondary.
High school.
Tertiary.
All of the above

36.
If taught at schools, must it be optional for only those who are interested?
							[ ] Yes [ ] No

Appendix 2

Questionnaire For Traditional Medicine Beneficiaries
1.
I.
II.

How many people are there in your household?
Children [ ]Adults [ ]ATPS (2013): Analysis of Traditional Healers in Lesotho: Implications on Intellectual Property Systems. ATPS Working paper No. 68

39

2.
I.
II.
III.
IV.
V.
VI.

Which of the following age categories do you belong to?
15-25
26-35
36-45
46-55
56-65
66+

3.
I.
II.

GenderMale
Female

4.
I.
II.
III.
IV.

Marital status
MarriedSingleSingle parent
Divorced

5.
I.
II.
III.
IV.

What religion (denomination) do you belong to?
Roman Catholic Church.
Lesotho Evangelical Church.
Anglican Church of Lesotho
Other;

6.
I.
II.
III.

Where do you reside?
Rural
Peri-urban
Urban

7.
VI.
VII.
VIII.
IX.
X.

What educational level did you acquire?
No schoolingPrimary education
Secondary education
High school
Certificate or above

8.
I.
II.
III.
IV.

What is your occupation?
Unemployed
Self employed
Employed part time
Employed full-time

9.
I.
II.
III.
IV.
V.

How many times did you visit a traditional healer this year?
None
Once
Two to three times
Four to six times
More than six times

10.
I.

Did other members of your family also visit a traditional healer this year?
Yes

ATPS (2013): Analysis of Traditional Healers in Lesotho: Implications on Intellectual Property Systems. ATPS Working paper No. 68

40

II.

No

11.
Think back to 2004-2008. Have the number of times that you visited a traditional
healer changed in the last few years?
I.
I now go more oftenII.
I now go less oftenIII.
I now go the same as beforeIV.
I no longer go
12.
If you have changed your use, why?
_______________________________________________________________________________________________________________________________________________
13.
Why do you visit a traditional healer? Indicate your level of agreement/
disagreement to the following reasons of why you might visit a traditional healer.
Strongly
Disagree Do not know Strongly
Disagreeagree
1. I want traditional
Medicine
[]
[]
[]
[]
2. I could not be cured at the clinics

[]

[]

[]

[]

3. There are no clinics close towhere I live[ ] 				4. Other medicines are too expensive
5. Other reasons

[]
[]
[]

[]
[]
[]

[]
[]
[]

[]
[]

14.
I.
II.
III.
IV.
V.
VI.

Which illness have you taken to the traditional healer this year?
Respiratory[]
Digestion[]
Mental[]STDs[]
Infertility[]
Others
[]

15.
I.
I.
II.
III.

How long does it take you to reach the traditional doctor?
Less than an hour
2-5 hours
A day
More than a day

16.
How many times did you visit a medical doctor/clinic or doctor last year? (Nota traditional healer)
I.
None
II.
Once

ATPS (2013): Analysis of Traditional Healers in Lesotho: Implications on Intellectual Property Systems. ATPS Working paper No. 68

41

III.
IV.
V.

Two to three times
Four to six times
More than six times

17.
I.
II.
III.
IV.

How long does it take you to reach the doctor?
Less than an hour
2-5 hours
A day
More than a day

18.
If you could get treated at a clinic, is it more expensive or cheaper than a
traditional healer?
I.
Cheaper
II.
Same
III.
More expensive
19.
If you had the choice between going to a medical doctor/clinic and going toa traditional healer, what would you choose? (Your first choice, forgetting about thecost.)
I.
Go to a traditional healerII.
Go to a modern clinic
III.
It depends on what treatment I needIV.
Do not know
20.
I.
II.
III.
IV.

Do you think that you will use more or less traditional medicine in the future?
More
Less
The same
Do not know

21.
Would you prefer traditional medicines to be packaged in a more hygienic andmodern way?
I.
Yes
II.
No
III.
I do not know
22.
I.
II.
III.

Would you prefer traditional medicines to be certified by a healers association?
Yes
No
I do not know

23.
Would you prefer to see the place where you buy medicines made more
modern?
I.
Yes
II.
No
III.
I do not know

ATPS (2013): Analysis of Traditional Healers in Lesotho: Implications on Intellectual Property Systems. ATPS Working paper No. 68

42Appendix 3
Key Informants Interviews
Director Parks: Mrs. Bokang Theko: Ministry of Tourism, Environment and Culture
The core mandate of her department is primarily to conserve Biological Diversity in Lesotho.
She pointed out that the department holds community conservation forums, which work
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43

closely with Assistant Environment Officers at district level. Their major purpose is to educate
the community about the importance of the environment in their daily lives. Traditional
healers are part of these forums as key players in the use of biodiversity resources. With theestablishment of Local Government Authorities at local level, the officers have embarked on
educating traditional healers, herds boys and the community at large about conservation of
biodiversity and their response is highly encouraging. The legal protection of some medicinal
plants from being harvested is a clear indication that the department is very serious on
the protection of biodiversity, especially species likely to face extinction. There are plants
such as Aloe polyphylla and Teedia lucida which are protected from being harvested by
the Environment Act of 2009. Traditional healers are encouraged and assisted to develop
Community Botanical gardens whereby they can plant species that are under heavy use andthose protected by the law. Asked to explain on the measures taken to prevent smugglingof the indigenous medicinal plants out of the country; she pointed out that, at border posts,
the immigration officers have been sensitized on plants which are protected by law and theycannot leave the country without permission from the ministry. Those who want them apply
for permission from her ministry. Finally, she showed that by the year 2010 they celebrated
International Year of Biodiversity and activities which took place during the celebration include
planting of indigenous trees and educating communities about the importance of protecting
the environment. They also have on-going districts’ campaigns on conserving nature.
Mohau Mabote (Mr.) – President: Network of People Living With HIV and AIDS(LENEPWHA)LENEPWHA was established in 2004 and formerly launched in 2005. The primary objectiveof this organization is to protect the rights of people living with HIV and AIDS.
Asked to explain on the role played by traditional healers in their lives; the president outlinedthat they do not have any relationship with them. He indicated that their people are notencouraged to attend to them for purposes of treatment. The reason for this is only that
medicines prescribed by traditional healers are not scientifically proven. Again there is nomonitoring and evaluation as is the case with people on ARVs. On the question of having
any forums to share ideas about HIV and AIDS with them, he showed that in his current
leadership there has never been such a forum. He showed that very few traditional healers(only 10%) believe on the existence of HIV and AIDS. Asked whether they are exploring
ways of finding cure on the pandemic together with the traditional healers, he indicated thatthey only meet on prevention and support (through support groups at village levels), not on
treatment of patients. Strongly, he indicated that there are no joint efforts on finding the cure
together. Commending the approach by ATPS, he indicated that he now sees a need to haveongoing joint forums with the traditional healers in Lesotho.

Mr. Malefetsane Liau - President: Traditional Healers’ Association of Lesotho
The Association dates as far back as 1960s, and its mandate is to protect the indigenous
knowledge of the Basotho as a nation and the existence of traditional healers. It wasemphasized during the discussion that Medical Association of Lesotho does not recognize
their presence in the field of medicine. Therefore, they do not have any forums to sharecommon knowledge on diseases affecting the nation and yet they are placed directly at
the center of the community. Asked whether they are provided with any capacity building

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44

workshops by professional medical practitioners; he said they are not equipped withsuch workshops. When showing their role during the period of HIV and AIDS, he showedthat the disease has presented a serious challenge to them as they regard themselves as
people who are supposed to protect and cure people from diseases. These challenges
include lack of cooperation from medical practitioners, denial of access to treat theirpatients when in hospital and declining believe in the value of traditional healers by somemembers of the community.
Senator T. Khomari, Chairperson on HIV and AIDS Senate Committee
The Chairperson indicated that although their mandate is Constitutional as the Upper
House of the Parliament, they find themselves obliged to engage in the fight of thepandemic because as a nation they are directly involved and it is Government Policy toengage in the fight against the pandemic. He showed that the committee is strategic due
to its composition. It is largely made up of twenty-two Principal Chiefs from Lesotho. Thismeans that chiefs have direct control and impact to their subjects at village level.
One of the major ongoing activities carried out by the committee is to support the chiefs tomobilize their people to take part in the government initiative on KNOW YOUR STATUS(KYS) Campaign which encourages people from all walks of life to know their HIV status
and be able to take the right measure in the fight of the pandemic. More often, the chiefs
encourage the youth to take part in campaigns aimed at reducing the rate of infection in
Lesotho.
On the protection of medicinal plants in Lesotho, he pointed out that as the upper houseof parliament, they are aware of The Environment Act of 2009, and the special species
to be protected and fines to be paid by the offenders. However, he admitted that vigorous
campaigns are needed to enforce this act from the village level. About the cooperation
with traditional healers, he showed that his committee respects the knowledge
possessed by the traditional healers and believes that if they could have joint efforts withthe professional doctors by empowering traditional healers with accurate information on
HIV and AIDS; this could be of great help to the nation as they are often the first people
consulted whenever people are ill. He also added that in most cases, people prefer to
see traditional healers particularly diviners when confronted with a pandemic when they
are still in denial.
Mr. Khalema: Consumer Association of Lesotho
The core mandate of the Association is to protect the rights of the consumers in Lesotho.
They represent them in various forums to ensure that decisions taken do not compromise
their rights.
Asked whether they are also involved in protecting human health against misuse of drugs,
especially traditional medicines; he showed that they do not have a direct involvementwith both the traditional healers or those who sell them along the streets, but in forums
where they are involved concerning health matters such as Protecting hawkers on HIV
and AIDS matters, they do voice their concern about the display of traditional medicine
directly exposed to sunlight and laid on dusty, dirty places. Furthermore, they also advice
those in authority in terms of health to be aware that some of the people involved in theact of selling these medicines might completely lack the technical-know-how of the herbs

ATPS (2013): Analysis of Traditional Healers in Lesotho: Implications on Intellectual Property Systems. ATPS Working paper No. 68

45and poison the civilians.
Regarding the way these drugs are bottled, they pointed out that they do not believe thatthese people are able to mix the right ingredients as some are not licensed traditional
healers. There is a high possibility of over-dosing which might be a source to some
unexplained deaths. As the consumer association, they recommend that people sellingthese herbs should be in one hygienic place, and should have licenses allowing themto sell the indigenous herbs. On the impact of this exercise on the environment, he said
that this put our indigenous medicinal plants and animals in danger hence appropriate
measures have to be taken concurrently.

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46

ISBN: 978-9966-030-52-8
ATPS (2013): Analysis of Traditional Healers in Lesotho: Implications on Intellectual Property Systems. ATPS Working paper No. 68

47