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Why many visit the mganga before the doctor

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Mudu Mohammad Nuru is a traditional healer in the eastern part of Zanzibar. Photo: Anne Kidmose

The traditional healer – mganga in Kiswahili – is more popular than the conventional physician in most African countries, and there are several good reasons why.

When one falls ill in in some parts of rural East Africa, the immediate solution is often not to rush to the doctor’s office or the hospital, but to cross to the outskirts of the village and seek help from the local traditional healer, in Kiswahili simply mganga. According to scholars, 80 percent of ailments in East Africa are treated first and foremost by traditional healers.

This number exposes more than a gap in health care services as some might point out. While Western medicine has come to define and dominate health systems across the world, there is still more to health care than white shirts and clinical hallways. Across Africa, the number of traditional healers is about 100 times the number of conventional practitioners, researchers have estimated.

Why this overwhelming disparity? Seeing as healers never seem to run out of work – why is the healer the first choice for so many?


The first reason comes down to logistics. If the hospital is 30 kilometers away – or often much more than that – and the traditional healer’s office is a short walk away, the choice is self-evident.

A traditional healer’s collection of herbal medicine, powdered roots, and branches as well as oils. Photo: Anne Kidmose

While this might be among the most cited explanations, it is far from the only one. According to Mudu Mohammad Nuru who is himself a traditional healer in eastern Zanzibar, the popularity of waganga (healers) is a matter of trust.

“People here believe more in waganga than in the hospital because the hospital doesn’t help them,” he says, referring to villagers who have trailed back and forth from the village to the district hospital without visible improvements.

Nuru’s father taught him to treat people using herbal medicine, holy scriptures and incantations, and this kind of apprenticeship among traditional healers is part of what secures high trust among patients. 37-year-old Nuru proudly carries on his father’s tradition and legacy.

Test of time

This leads us to the next reason. According to researcher and director at the Nairobi-based Africa Mental Health Research and Training Foundation (AMHRTF) Dr. Victoria Mutiso, the healers have something hospital workers do not – time.

“We realized that people seek psycho-social support from the healers because primary health care workers do not always have the time to sit down and talk,” she says, pointing out that people suffering from mental health issues are even more likely than people with physical ailments to seek help from healers.


Finally, an overarching reason that people turn to traditional healers is to be found in the very conception of illness. In the semi-autonomous archipelago of Zanzibar, superstition shapes the way people view illnesses. Ailments are often explained with reference to curses or possession of evil spirits, and when this is the case, who else to exorcise the evil than the mganga?

According to mental health coordinator at the charity Health Improvement Project Zanzibar (HIPZ), Haji Fatawi, people choose healers because of their success in exorcism.

One of the widespread methods used by traditional healers in Zanzibar is called Kombe. Using saffron ink, the healer writes holy scriptures on a blank piece of paper, then submerges it in water for it to dissolve. The patient should then drink or bathe in the water to remove evil spirits. Photo: Anne Kidmose

This is what 33-year-old Dume, who requested to use his middle name only, did when he experienced hallucinations in early October. Dume was certain that he had been bewitched, and his parents called for the nearby traditional healer. The healer however realized that Dume needed psychiatric support and referred him to the nearest hospital. Still, Dume is not convinced by the effects of Western medicine.

“Now, I am torn between the hospital and witchcraft,” he says.