Who Gets to Call Themselves a Healer? Licensing, Gatekeeping, and Traditional Medicine

“She has been healing this neighborhood for forty years. She is not licensed. The people are still healed.”

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The Question Behind the Question

When we ask who gets to call themselves a healer, we are really asking: whose knowledge systems are considered real? A physician who completed a residency in a teaching hospital in London or Lagos is recognized by law as a healer. An elder herbalist who trained for twenty years in the Yoruba tradition of Osain plant medicine, or a Kenyan traditional birth attendant who has guided hundreds of safe deliveries, is not — at least not in the eyes of any formal health system.

This is not a judgment about effectiveness. It is a judgment about origin. Modern medical licensing structures were built inside a specific epistemological tradition — Western, biomedical, reductionist — and codified at a specific historical moment: the late 19th and early 20th century, when colonial governments were actively dismantling indigenous governance, land tenure, and knowledge systems across Africa. The exclusion of traditional healers from formal medicine was not an oversight. It was part of the architecture.

The World Health Organization has estimated that 80 percent of people in low- and middle-income countries rely on traditional medicine for their primary health care.¹ This is not a figure about people who cannot access “real” healthcare. It is a figure about who people trust, who has been there, and what actually works in the communities where they live.

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How Traditional Healers Licensing Became a Gatekeeping Tool

Medical licensing in its current form has colonial roots. In British-administered territories across East and West Africa, colonial health ordinances of the early 20th century systematically designated indigenous healing practices as “witchcraft” or “native medicine” — categories designed to discredit and criminalize, not to assess safety. The same governments that built formal health systems for colonizers built almost nothing for colonized communities, and then told those communities their own healers were the problem.

This is not ancient history. The legal frameworks that govern traditional healers in Kenya, Uganda, and Nigeria today are largely inherited from those colonial-era statutes, updated but not reimagined. Traditional healers in many countries operate in a legal grey zone — neither formally recognized nor clearly prohibited, which means they cannot be regulated, cannot be funded, and cannot be integrated into national health systems, even when they are the primary care providers for millions of people.²

In communities of the African diaspora, the pattern holds. Curanderas, Candombl;é healers, Haitian mambos, Black midwives — the history of the 20th century United States includes deliberate legal campaigns to suppress midwifery and herbalism that fell most heavily on Black and Indigenous practitioners.³ The tools were licensing laws, scope-of-practice restrictions, and prosecution. The outcome was the elimination from formal healthcare of the people most trusted by communities who could not access or afford biomedical care.

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What the Numbers Tell Us About Who Actually Heals

The numbers are not marginal. In sub-Saharan Africa, the ratio of traditional healers to population in many countries is approximately 1 per 500 people. The ratio of physicians to population is approximately 1 per 40,000.⁴ Traditional healers are not a supplement to the health system in these regions. They are the health system — or the majority of it. This is the operational reality that any honest discussion of traditional healers licensing must begin with.

Research on traditional birth attendants (TBAs) illustrates the stakes. In Uganda and Nigeria, TBAs attend a substantial proportion of all births, particularly in rural and peri-urban communities where skilled birth attendants may be hours away.⁵ Studies on TBA training and integration programs have shown that structured collaboration between TBAs and formal health facilities — rather than prohibition — reduces maternal and newborn mortality. The evidence points toward integration, not exclusion.

What would it mean to take this seriously? It would mean that credentialing systems would be built around what communities need and who is actually providing care — not around protecting a professional monopoly. It would mean that traditional healers licensing structures would be developed in genuine partnership with healer communities, not imposed on them. The question of how to ensure safety and accountability within traditional medicine practice is a real and important question. The answer to that question is not prohibition.

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What We Witness in Kenya, Uganda, and Nigeria

In the communities where Ubuntu Village works, traditional healers are not historical artifacts. They are active, trusted practitioners navigating a dual burden: they are essential to community health, and they are systematically excluded from the resources, recognition, and infrastructure that would make their work more sustainable. A traditional herbalist in western Kenya may have encyclopedic knowledge of indigenous plant medicines and decades of successful practice — and zero access to malpractice protection, supply chain support, or referral networks.

In Nigeria, traditional healers who practice Yoruba or Igbo medicine often operate in the same communities served by government health clinics — and community members move between them based on the specific nature of their illness, their trust relationships, and practical accessibility. This is medical pluralism in practice. It is not confusion or a lack of education. It is a sophisticated, community-determined healthcare navigation that the formal system rarely acknowledges and never supports.

What we see connects directly to our solar access work in Uganda: the infrastructure that makes healing possible matters. A traditional birth attendant who cannot sterilize instruments because there is no reliable electricity is not limited by her skill. She is limited by neglect. Electrification, clean water, and recognition of traditional healers are not separate issues. They are the same question: what does this community need to keep its people alive?

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What Gets Lost When Healers Cannot Work

When traditional healers are pushed out of the formal healthcare conversation, what is lost is not just a service. It is a knowledge system, an epistemology, a way of understanding the human body as embedded in community, land, and spirit rather than as a collection of biological systems to be optimized. This is not sentimentalism. The WHO’s own traditional medicine strategy has acknowledged that traditional healing systems offer resources for mental health, chronic disease management, and community-level prevention that biomedical systems cannot replicate at scale in the communities where they are most needed.¹

The mental health dimension is particularly acute. Chronic stress and its physical consequences fall heaviest on communities that have experienced colonization, displacement, and structural racism — and biomedical psychiatry has a documented history of pathologizing the spiritual and cultural frameworks those communities use to understand and process suffering. A spiritual counselor who holds grief in its ancestral context is doing something a clinical psychologist who has never encountered that framework cannot replicate. Both have a place. Only one is funded.

There is also a straightforward access argument. Formal healthcare is not equally accessible. Cost, geography, language, documentation, cultural competence — every one of these is a barrier that falls harder on communities of color, on rural communities, on communities in the global south. The traditional healer who has served a community for forty years is not a last resort. She is often the first resort, the most trusted contact, and the one who knows which biomedical referrals to make and when. Excluding her from the formal system does not make the community safer. It makes the community more alone.

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Toward a Medicine That Honors What Works

Several countries have attempted serious integration of traditional and biomedical medicine. Ghana’s Traditional Medicine Practice Act (2000) and South Africa’s Traditional Health Practitioners Act (2007) both created legal frameworks for recognition and regulation — with mixed results that researchers and practitioners have analyzed carefully. The lessons from those experiments matter. Recognition without resourcing does not work. Regulation without self-determination by healer communities produces frameworks that look like integration and function like control.

What genuine recognition requires is what Ubuntu Village understands as community power: the right of communities to define the terms of their own healthcare, to hold their healers accountable within their own systems, and to access resources without surrendering self-determination as the price. This is not a new idea. It is what communities have always demanded when outsiders arrived with frameworks that did not fit.

The woman who has been healing that neighborhood for forty years does not need a credential to prove what she knows. She needs a system that stops treating her knowledge as invisible — and starts building the infrastructure that lets her do the work she has always done, with the recognition and resources it has always deserved. What the baobab knows, the clinic does not always know. And that is not a deficiency in the baobab.

If this reached you, share it with someone who has been healed by a person the system refuses to name.

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Who in your community holds knowledge that the formal system does not recognize? What would it take for that knowledge to be treated as the public health resource it already is? Reach out.

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References

1. World Health Organization. (2019). WHO Global Report on Traditional and Complementary Medicine 2019. World Health Organization.
2. Homsy, J., et al. (2004). Evaluating herbal medicine for the management of Herpes zoster in human immunodeficiency virus-infected patients in Kampala, Uganda. Journal of Alternative and Complementary Medicine, 2(7).
3. Fraser, G. J. (1998). African American Midwifery in the South: Dialogues of Birth, Race, and Memory. Harvard University Press.
4. Peltzer, K., & Pengpid, S. (2018). The state of traditional and complementary medicine in health policy and plans: A survey of 24 countries in Africa. African Journal of Primary Health Care & Family Medicine, 10(1).
5. Byrne, A., et al. (2010). The effect of training traditional birth attendants on neonatal mortality in developing countries. BMC Pregnancy and Childbirth, 10(8).

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Related Reading

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