High-res version

The case

Over the past week or so, South African news outlets have been reporting on a case of cannibalism in Estcourt, KwaZulu-Natal.  There seems to be consensus that five men have been arrested.  Two of the detainees are said to be nyangas (or traditional healers), and some articles suggest that one of these traditional healers masterminded rape, murder, cannibalism and the illegal exhumation of remains.  It also appears that he then encouraged about 300 members of the community, who sought his counsel as a traditional healer, to eat human flesh.  There are many different types of traditional healers and traditional medical practitioners in South Africa, and they have different methods of practice.  It’s a bit unclear from the reports exactly what the scope of the traditional healers implicated in this case is.

Distrust and suspicion

Many aspects of this case are deeply tragic, and it has sparked discussion about xenophobia, rape, murder and death.  For me though (as a bioethicist with a PhD in organ transplantation ethics under my belt) a secondary concern is that it is exactly this kind of behaviour that creates mistrust and suspicion amongst the population, and discourages people from willingly donating the organs of a loved-one after they die.

The reason for this, as I found in my doctoral research, is that distrust about the way in which human remains are managed is usually bubbling away under the surface.  Most of the time, we’re able to keep a lid on it, but sometimes cases like this serve to bring this distrust into sharp focus.  Of course, I was really looking at the management of human remains in a biomedical setting, not a traditional medicine environment.  However, the two go hand-in-hand, with patients often seeking counsel from both western and traditional medical practitioners at any given time.  Moreover, the SA government has tried to integrate traditional healers into our medical system, and viewed holistically, the actions of one group could well have consequences for the other.

In this case, the actions of an irresponsible few seem almost to confirm some of the most deep-seated fears in the public eye, such as grave-robbing, killing people for body parts and an inability to account for the whereabouts of remains of a loved one.  In my research, I found that it is exactly these fears which prevented people from agreeing to organ donation.  It’s unfortunate that traditional healers have been implicated in this type of behaviour, because they are often viewed as leaders in their communities, and as such they are trusted and have the power to influence public perceptions for better or worse.

Challenges

These challenges make the work of donation advocacy groups, whose activities are geared towards increasing the number of organ donors in this country, all the more complicated.  Yet another hurdle which must be overcome in the quest to raise awareness and promote public engagement in organ donation activities.  Busting organ donation myths in the biomedical setting, which a colleague and I discussed in this newspaper article, proves a complex task when individuals who may have some association with medicine or the medical community perpetuate these atrocities themselves.

The views published in this blog are entirely my own (informed) opinions.  They are open to debate, discussion and disagreement.