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A sangoma is a highly respected healer among the Zulu who diagnoses, prescribes, and often performs the rituals to heal a person physically, mentally, emotionally, or spiritually. Often the sangoma addresses all of these realms in the healing process, which usually involves divination, herbal medicine, and specific, customized rituals to cure the illness and restore well-being.

God, being rarely involved in human affairs, is not a common cause of illness (isifo). However, God delegated much of its administrative functions to the ancestors (Amadlozi). The latter, therefore, are actively and constantly involved in the world of the living. As a result, they are frequently suspected of being responsible for sending isifo to the living. They do this not out of wickedness or caprice, but to punish the living for not abiding by the ethical standards of the community and to remind them of their imperative duty to live a moral life. Failure, for instance, to conduct certain important rituals or violation of a taboo may result in the ancestors' wrath, manifested in the form of sickness. One is then in a state of spiritual pollution and imbalance, which must be redressed. Once divination has established the exact cause of illness, certain rituals will be conducted to appease the ancestors, thus restoring health. The behavior that angered the ancestors will also, of course, not be engaged in again.

In addition to the ancestors, witches and sorcerers have the ability and desire to harm others. They may house evil spirits, use medicines, take on animal (or other) forms, and, generally speaking, resort to several possible agents to hurt other people. Witchcraft is taken quite seriously and is dreaded, given the devastation it may cause in a person's life. As a result, people often take precautionary measures to circumvent evil attempts at harming them. They may engage in rituals whose express purpose is to appeal to the ancestors for protection against witchcraft. They may also choose to wear protective devices—amulets. The latter are known as Ama-kbubalo and are often fragments of barks or roots tied around the neck and sucked on. When witchcraft has already struck, specific ngoma rituals, relying heavily on the use of medicinal plants known for their spiritual cleansing powers, will be conducted to neutralize the malevolent forces unleashed by the witch or sorcerer. The expected result is the return of harmony, peace, and health in the life of the person affected.

The sangoma is the most senior of the various traditional healers in South Africa. These healers can inherit or choose their professions. However, the sangoma must be called by Spirit. Because san-gomas are called, there are no restrictions on gender imposed by society; however, approximately 90% of sangomas are female. Sangomas, unlike other healers, or malevolent sorcerers, must learn ethnic and communal history and mythology. In this way, they are healers as well as keepers of sacred knowledge. The calling denotes an ancestral and cultural responsibility and is initiated usually by an illness, ukutwasa, which is accompanied by strange dreams and visions. This disruption in the daily life of the person causes him or her to seek the services of various healers. Because of the availability of Western medicine in South Africa, many twasa, or “apprentices touched by illness,” often try in vain to be cured by modern medicine before ending up with a sangoma who can correctly diagnose ukutwasa. This begins their initiation period which can last from months to years depending on the circumstances.

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