When the voices of her ancestors called on Makhosi Tholakele Memela to become a sangoma, or Zulu healer, she said yes.

Her traditional healer training included “birthing, respecting ancestors, healing people and communities, and suggesting herbal medicines,” but not treating the deadly disease that started killing her patients more than two decades into her practice.

Memela says her mission is to save lives, and that is what led her to the Ragon Institute-affiliated ITEACH program, which certifies traditional health practitioners like Memela to perform HIV tests, counsel and educate patients about HIV, and prepare them to initiate and adhere to lifesaving treatment.

One of the aims of ITEACH is to strengthen HIV and tuberculosis (TB) care and treatment delivered at government hospitals and clinics in KwaZulu-Natal, South Africa, a hotbed of this deadly dual infection. A resurgence in TB coincided with the onset of the HIV pandemic, making it the leading cause of death in persons who were dually infected with HIV.

In 2009, when Memela was 50, she and 15 other healers completed the HIV counseling certification course offered by ITEACH. It was the first graduating class for the program, which Memela would eventually join as a trainer herself. She and the ITEACH team have certified more than 400 traditional healers to provide HIV testing and support services.

Sangomas are addressed as makhosi, which, similar to “doctor” for a physician or “father” for a priest, shows respect for a person’s position. Makhosi is also an acknowledgement of the healers’ ancestors.

Many patients will consult traditional healers before they consult doctors trained in Western medicine at a clinic or hospital, which can delay the start of lifesaving treatment for patients who are unaware of their HIV status. Early treatment of HIV with antiretroviral (ARV) drugs not only preserves the immune system and prevents progression to AIDS, but it also prevents transmission of the virus to intimate partners.

With a chronic shortage of doctors and nurses in the public health sector, overcrowded clinics, and long wait times, a network of knowledgeable healers like Memela fills an important gap. As trusted community leaders, they can promote early HIV and TB testing and treatment adherence at the grassroots level. They are uniquely able to guide those who follow traditional practices in using both traditional and Western health systems to their advantage. And they explain that patients can take ARV drugs safely without abandoning their traditional beliefs.

“Sometimes patients come to me with what they think is a traditional problem,” Memela says. “But if I see signs of HIV infection, I test them.”

Because her ITEACH training included time working in a government clinic, Memela can prepare patients who test positive for what they can expect when they go to their local clinic for treatment. The services she and her colleagues provide, especially HIV testing and referral within the community, are aligned with the UNAIDS global 90-90-90 campaign to end the HIV pandemic by testing 90% of those living with HIV, linking 90% of HIV-positive individuals to treatment, and ensuring 90% of those receiving antiviral therapy adhere to it and suppress the virus.

Memela says the training she received from ITEACH has been invaluable, and she wishes that all sangomas could be taught how to fight the disease as she was.

“There should be funding to provide this training in all districts,” she says. “Traditional healers who are not yet trained will be unable to do the right things in their communities.”