Traditional healer (Sangoma) medical certificates – a sensitive issue where employers need to tread carefully

Traditional healer (Sangoma) medical certificates

The issue of medical certificates that come from traditional healers is a sensitive issue that needs employers to tread carefully.


  • Traditional Health Practitioners Act 22 of 2007
  • Basic Conditions of Employment Act 75 of 1997


Resource: Traditional Health Practitioners Act


Let’s first determine who can issue out a valid medical certificate:

  • A Medical practitioner can issue out a valid medical if they are registered with the health professions councils of South Africa
  • A Dentist can issue out a valid medical certificate if they are registered with the health professions councils of South Africa
  • A Psychologist (Clinical, Educational and Counseling with Masters Degree) can issue out a valid medical certificate if they are registered with the health professions councils of South Africa
  • A Traditional healer can issue out a valid medical certificate if they are registered with the Traditional Health Practitioners Council of South Africa.

So it is clear that traditional healers are recognised as health practitioners in the eyes of the South African law, thus resulting in employers having no leg to really stand on when refusing to accept medical certificates issued by a Sangoma/ Igqirha /Ngake.

So to ensure that the medical certificate is valid, let us determine what must be included in it:

  • Health practitioner’s name, address and qualifications
  • Employee name and surname
  • Date and time of examination
  • Whether the certificate is based on the health practitioner’s personal observations or just according to the employee’s observation and that could still be based on suitable medical grounds
  • Illness description, with the employee’s consent, should the employee not agree, and then the health practitioner just states that it’s his/her opinion that the employee is not fit for work.
  • Time period that the employee is booked off.
  • If the employee is completely or only partially unable to do his duties.
  • The health practitioner must personally sign or initial the original and print his name next to it in capital letters
  • The health practitioner must give the patient a short factual report if he asks for one.


Below is a CCMA case that is commonly used in traditional medical certificates case studies:

Kievits Kroon Country Estate (Pty) Ltd v Mmoledi and Others [2014] 1 All SA 636 (SCA). In this case, Ms Mmoledi, who was employed as a chef de partie at Kievits Kroon Country Estate, requested five week’s unpaid leave in order to become a traditional healer. Her request was declined by Kievits for the reason that she worked in a high-pressure environment as the estate had three kitchens which can, in total, accommodate up to 610 guests making her attendance imperative. In support of her application for the leave, she submitted two letters. The first letter was from her traditional healer, Mrs Agnes Mamoreroa Masilo, stating as follows:

“This serves to certify that Johanna Mmoledi was seen by me on 13-01-07 and diagnosed to have premonitions of ancestors. He/she under my treatment from 13-01 to 8th July 2007. He/she will be ready to assume work on 8-07-2007.”

The second letter was also from Mrs Masilo, which read:

“I hereby inform you of the graduation of the abovementioned patient. I am asking you to please give her days from the 4th of June to the 8th of July 2007 to complete her initiation school final ceremony to become a traditional healer.”

These letters were not accepted on the basis that they were not from a medical doctor.  She, however, took time off despite the refusal of the leave. She was invited to a disciplinary hearing and dismissed.

She referred the matter to the CCMA for unfair dismissal where the arbitrator held that her absence from work was justified. Kievits applied to the Labour Court to have the award reviewed and set aside, but the Labour Court held that the award was within reason, and therefore dismissed the application.  They then appealed to the Labour Appeal Court but the Court held that the Labour Court’s conclusions were supported by valid reasons and dismissed the appeal.  Kievits then went further by appealing to the Supreme Court of Appeal (SCA). The SCA held that the employer should not have regarded the traditional healer’s letters as “meaningless” simply because they were not issued by a health practitioner in the Western sense and should have seen the importance of the letters or the matter and attempted to understand what they meant instead of summarily rejecting them.  Had the employer done that, then the employer may have been able to accommodate the employee’s request. The appeal was accordingly dismissed with costs.

In conclusion, based on the labour appeal court’s decision, one should deduce that the constitution recognises traditional beliefs and practices, so employers should also accept these beliefs or better yet be open-minded about the beliefs, practices and traditions of their employees.


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