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Samuel Muriisa was not my first witch doctor.
I interviewed Mr. Muriisa, a healer in rural Uganda, for an article profiling him in light of the Ebola epidemic in the nearby Democratic Republic of Congo.
Over the last 20 years of covering global health and infectious diseases, I have interviewed several traditional healers. You can’t really understand medicine in Africa without them.
In 2001, when we were working on a series about how AIDS had affected one small South African town, Joao Silva, a Times photographer, and I spent the night in the compound of Martha Shokwakhe Mtshali, a prominent Zulu healer.
“Mama Mtshali” gathered several colleagues to meet us. (South African sangomas like her are easy to spot — they dress in red and white and their apprentices must wear inflated goat bladders in their hair, which I wish all medical students did.)
They showed us how they did diagnoses: Although it involved drumming and chanting, it amounted to taking the patient’s history and checking a long list of symptoms.
We talked about H.I.V.; they were especially interested in how long it lingered on razor blades or porcupine quills, which were their syringes — they cut patients’ scalps and rubbed herbs in.
Then we had a feast of beef liver and sorghum beer and spent the rest of the evening dancing. I could still kick over my head then — that’s how Zulu dances end — but Joao was much better than me.
Mrs. Mtshali and Mr. Muriisa are part of a huge parallel medical system. The World Health Organization estimates the continent has 80 healers for every doctor. (Even in hospitals, it is rare to see an actual M.D. — most care is delivered by nurses.)
The term “witch doctor” is pejorative, but it captures something that “traditional healer” conceals. There are actually two schools of African medicine: those who rely on herbs and those who remove spells. Or who, if they have evil hearts, will cast them for money.
(Spell-casters don’t advertise and covens are not trendy in Africa. Belief in witchcraft is no joke. People accused of it may be beaten or burned to death. But bewitchers definitely exist: witness the horrible spate of murders of albino children to get body parts for magic.)
Mr. Muriisa and Mrs. Mtshali straddle both worlds.
They use herbs medically. That’s centuries old. Willow bark, for example, helps with headaches because it contains salicylic acid, which is aspirin. (I once expressed surprise to see an aspirin packet in a healer’s cave in Lesotho. She shrugged and said, “It cures headaches.”)
But they also fight curses. Mr. Muriisa says he can prevent lightning strikes. Mrs. Mtshali had a patient who complained that her hut was overrun by mice.
She was told to burn certain herbs and sprinkle the ashes.
Why, I asked, would someone consult a healer about a mouse problem?
The woman’s neighbors envied her, Mrs. Mtshali explained, and sent the mice to make her life miserable.
You can see the appeal: if only psychiatrists could cure one’s neighbors.
I once asked a sleeping sickness patient what she thought had made her sick.
She blamed her husband’s family, thinking they had cursed her because they had paid three cows for her and she had produced only three children in return.
The scientific answer: a parasite injected by a tsetse fly.
Western doctors working in Africa need to understand how differently their patients view disease.
That was how I met Mama Mtshali. An astute Zulu H.I.V. specialist, Dr. Smangaliso Hlengwa, had realized that his patients taking antiretroviral drugs were also seeing sangomas and being given emetics and enemas to purge evil influences (not unlike bloodletting in Western medicine 200 years ago).
That negated his treatment, so he befriended the local sangomas, treating them with respect instead of disdain, asking if they could work together. He could teach them safe “injection” techniques, for example, if they could treat his patients without purgatives.
With Africans facing everything from AIDS to Ebola to diabetes, if only all doctors working there could be that farsighted.
