Turning mirrors into windows : Knowledge transfer among indigenous healers in Limpopo province of South Africa

The title of the article was inspired by a quote from Sydney J. Harris (1917–1986) that ‘the main purpose of learning is to turn mirrors into windows’. This implies that when one looks into a mirror, the only thing they see is their reflection and the area around them, but when they look through a window, the view is endless. Learning enables us to look beyond ourselves and to see more clearly. Learning is usually done through knowledge transfer and knowledge sharing. In this study, knowledge transfer among indigenous healers in the Limpopo province of South Africa is investigated.


Introduction and background to the study
The title of the article was inspired by a quote from Sydney J. Harris (1917Harris ( -1986) ) that 'the main purpose of learning is to turn mirrors into windows'.This implies that when one looks into a mirror, the only thing they see is their reflection and the area around them, but when they look through a window, the view is endless.Learning enables us to look beyond ourselves and to see more clearly.Learning is usually done through knowledge transfer and knowledge sharing.In this study, knowledge transfer among indigenous healers in the Limpopo province of South Africa is investigated.
Knowledge transfer by definition is the process by which knowledge is transmitted to, and absorbed by, a user (Garavelli, Gorgoglione & Scozzi 2002).Faust (2007) explains knowledge transfer as a component of knowledge management that involves the transmission of explicit, implicit and tacit knowledge from a person or organisation to one or several people.Kamal, Manjit and Gurvinder (2007) are of the view that the value of knowledge increases when it is shared.The review of literature further suggests that the transfer of indigenous knowledge hinges on the effective transfer of tacit knowledge (Nonaka 1994;Polanyi 1966;Szulanski, Ringov & Jensen 2016).The proper handling of tacit knowledge lies at the very heart of the creation and transfer of knowledge in organisations (Szulanski et al. 2016).When it comes to the transfer of indigenous knowledge which is known to be oral in nature, Adekannbi, Olatokun and Ajiferuke (2014) highlight that elders are considered to be the legitimate custodians of this knowledge which is handed down to them by their ancestors, and they are in turn expected to pass it on to others for this knowledge to survive.
According to Szulanski et al. (2016), tacit knowledge may be transferred through observations, imitation and practice.For tacit knowledge to be transferred through observation, there should be Background: Knowledge transfer is an unavoidable process when it comes to indigenous knowledge especially in Africa, the continent known for its oral tradition.Such knowledge is in danger of being obliterated as a result of a number of factors, including lack of interest from younger generations and low life expectancy whereby knowledgeable people die before transferring it to the next generation as it is mostly not documented.
interaction between source and recipient, communication should be very personal, the recipient should observe the knowledge in use and the recipient should keep practising.Although all transfers of knowledge require some degree of effort and may experience some difficulty, some transfers experience significantly more difficulties than others, whereas some of the transfer-related problems will be diagnosed easily and resolved routinely (Szulanski et al. 2016).
Studies by Ijumba and Barron (2005), Denis (2006) as well as Truter (2007) suggest that the majority of the population in Africa consults traditional healers and depend on indigenous medical knowledge for survival, yet there is limited understanding of how this knowledge is transferred among healers.This is because knowledge of traditional healing survived over the years without being documented.Furthermore, knowledge of traditional healers is rarely integrated in the mainstream government health system (Maluleka 2017;Mathibela et al. 2015).As a result, understanding how this knowledge has been transferred among healers is of great importance.This study utilised the organisational knowledge conversion theory to investigate knowledge transfer among traditional healers in Limpopo province of South Africa.

Theoretical framework
This study was guided by the theory of organisational knowledge conversion, which explains the interaction processes of tacit and explicit knowledge.This theory identifies the four modes of interaction that may facilitate knowledge management, including knowledge transfer among healers.The organisational knowledge conversion theory (see Figure 1), with its four constructs reflected below and abbreviated as the SECI (Socialisation, Externalisation, Combination, Internalisation) model was originally proposed by Nonaka (1991) and further developed by Nonaka and Takeuchi (1995).The four modes of knowledge conversion theory are the following: • socialisation (from tacit knowledge to tacit knowledge); • externalisation (from tacit knowledge to explicit knowledge); • combination (from explicit knowledge to explicit knowledge); • internalisation (from explicit knowledge to tacit knowledge).
Even though this theory was created in the Japanese context, it was found to be relevant to the South African context, especially in the process of managing traditional medical knowledge.This is because the four modes of knowledge management explain how more knowledge is transferred through conversion between tacit and explicit knowledge.

Contextual setting
The study focused on the Sepedi-, Tsonga-and Vendaspeaking healers in the Limpopo province of South Africa.
The province is divided into five regions, namely Waterberg, Capricorn, Vhembe, Mopani and Sekhukhune (see Figure 2).Truter (2007) notes that traditional healers are known by different names in the different South African cultures (e.g.amagqira in Xhosa, ngaka in Northern Sotho, selaoli in Southern Sotho and mungome in Venda and Tsonga).This study focused on traditional healers in the Limpopo province.These healers mainly spoke Sepedi, Tsonga and Venda, as these are the three main languages spoken in Limpopo.

Statement of the problem
The World Health Organization (WHO 1998) and Poorna, Mymoon and Hariharan (2014) reported that an estimated 70% -80% of the population in developing countries are dependent on traditional medicines for their primary healthcare needs.Despite these high numbers, knowledge of traditional healing is in danger of being lost entirely.By its nature, knowledge of traditional healing is known to be transferred from one generation to the next through oral tradition (Mokgobi 2014;Ngulube 2002).The death of a senior citizen may have devastating implications for a community that depends on the expertise of that particular citizen; more so if the knowledge was not imparted in any way (Maluleka & Ngulube 2017).The danger that has always been associated with indigenous knowledge is that it might be obliterated as a result of a number of factors such as it not being documented or the death of a senior or the most experienced person before such knowledge could be passed on to the next generations.Mathibela et al. (2015) supported by Maluleka and Ngulube (2017) suggest that traditional healing is usually the first choice for primary healthcare by rural communities in developing countries, yet there is little understanding of how this knowledge is transferred among healers.As highlighted in the background to this study, elders were considered to be the legitimate custodians of indigenous knowledge.Despite facing extinction, knowledge of traditional healing survived over hundreds of years without being a formally recorded source of information.This knowledge, however, passed the test of time and survived over generations despite the threads that it faced over the years.

Objectives of the study
This study aims to investigate how knowledge of traditional healing in the Limpopo province is transferred among healers.The specific objectives were to: • determine the methodology employed by traditional healers in transferring knowledge; • identify the process of transferring knowledge by traditional healers.

Research methodology
This study adopted a qualitative research approach and further employed hermeneutic phenomenology as a method because lived experiences of traditional healers who share similar experiences in their practice of traditional healing were investigated.Data were collected through interviews, observations as well as an analysis of notes, records and other forms of documents that were held by healers.
Snowball sampling technique was employed because of the nature of the population being investigated.South Africa had approximately 200 000 traditional healers practising in 1995 and around 300 000 in 2005 (Denis 2006;Truter 2007).It is, however, very difficult to give the exact figure when it comes to practising healers because many are not registered with the Traditional Health Practitioners Council of South Africa, which is tasked with registering persons who engage in traditional health practice in South Africa (Parliament of South Africa 2005).For qualitative studies, sample representation is not of great importance because the results are not generalised.Data were collected until saturation was reached.To ensure authenticity, the investigators went back to some of the healers and shared with them what was captured and allowed them to make further comments.This allowed the investigators to have continuous discussions with healers and that gave the investigator some leverage to interpret what the traditional healers have contributed.
In total, 27 participants were interviewed, of the 27, 19 were women and only 8 were men.Of the 27 participants, 2 were trainees, 6 were new graduates and 19 were experienced healers.
Interviews were recorded using a voice recorder, supplemented by the notes taken by research assistants.The investigator listened to the recorded tapes from the interviews and transcribed them from tape to paper.The notes taken by the research assistants during interviews were compared to the data obtained from tapes and necessary adjustments were made where necessary.The data were organised according to each theme emanating from the objectives of the study.

Ethical considerations
Ethical clearance was obtained from the University of South Africa.Furthermore, participants were given consent forms to read and sign if they agreed to participate in the study.Each interview participant was informed about the person who was conducting the research, why the respondents were invited to participate, that participation is voluntary and are free to withdraw anytime and that anonymity and confidentiality will be maintained at all times.Even though participants had no problem with being mentioned in the study, the investigators decided to keep all responses anonymous assigning alphabet letters to participants, for example, Participant A.
For data collected through observation, the senior healer and the trainees agreed in granting us permission.The investigator informed them that anonymity and confidentiality will be ensured and they were free to withdraw at any time.That was in line with the University of South Africa's policy on research ethics (2007) which explains that all studies must be conducted ethically at all times and the rights and interests of all participants must be protected.All pictures taken during this study were shown to the healers and they agreed that they may be included in the document; however, the investigator protected their identities by severing off their faces from the pictures where necessary.

Findings
This section presents the findings of the study based on the objectives of the study, which are understanding how knowledge of traditional healing is transferred and the methodologies employed to transfer this knowledge.In cases where participants gave similar answers, only one answer was captured to avoid recording the same answer multiple times.

Knowledge transfer among traditional healers
The transfer of knowledge of traditional healing is an unavoidable process, especially in Africa because of its oral tradition.In an effort to understand how knowledge is transferred among traditional healers in Limpopo, traditional healers were asked to share their experiences on how knowledge transfer generally occurs among them.The following responses were given (see Table 1).
When trying to understand how tacit knowledge gets to be externalised by knowledge holders, senior healers were asked how they transferred their skills and experiences to their trainees.The key answers recorded are listed in Table 2.
It was observed that the senior healers, as the knowledge holders, were the ones giving instructions, guidance and leading the way during knowledge sharing and transfer.In addition to that, former students who were graduated by the same senior healer constantly visited the senior healer when there are events where a number of duties have to be performed.During those visits, former students spent a lot of time with the trainees sharing experiences, what they (former students) enjoyed and what they found hard to do.During those meetings, a lot was shared between the experienced healers and the trainees.
The other form of knowledge transfer that was occurring was between the inexperienced healers and the experienced healers who have been in the business for many years.
During those events, the experienced healers work closely with the inexperienced healers showing them how certain functions are performed so that they may be able to do them independently when they start training their own students.
To supplement the data obtained during observation, the investigator asked the participants during interviews to explain the type of relationship they have with other healers.This was done in an effort to determine if there is some level of working together which may promote knowledge sharing.
The responses given are listed in Table 3.

Methodologies employed to transfer knowledge
The second objective of this study was to identify the methodologies employed by traditional healers to transfer knowledge.During interviews, participants were asked to share the type of methodologies they employed to transfer knowledge and the following were some of the main responses recorded: • Trainees are mostly advised to observe what the experienced healers are doing and learn from them.• We mostly tell our trainees what to do and make sure they repeat until they can do things on their own.• I tell my students what to do and observe as they do to see how well they do.• My master just showed me the way, but I am the one who walks it through the help of the spirits, they tell me everything I need to do.
The investigator also wanted to know how common was knowledge sharing among healers because knowledge sharing goes hand in hand with knowledge transfer.The responses recorded are shown in Table 4.
In an effort to determine which methods were used by senior and experienced healers to transfer their knowledge of traditional healing with the new inexperienced healers, some of the key responses were recorded and are listed in Table 5.
Discussions Szulanski et al. (2016) are of the view that for tacit knowledge to be transferred there should be interaction between source and recipient, at a social level and communication should be very personal.Traditional healers share personal experiences among themselves during socialisation.During those interactions, experienced healers patiently share their experiences with trainees.The experienced healers are sometimes required to repeat the same thing several times to ensure that the trainees learn the correct thing.Dedicated trainees get to get the most out of their masters while those with the wrong attitude end up knowing very little.
The findings further revealed that during training trainees constantly get to learn from healers who were graduated by their master.This knowledge transfer process occurs during informal discussions when these graduates visit their master.The transfer of knowledge also occurs between experienced healers every time there is a meeting or a gathering of some sort.During these interactions, tacit knowledge is mostly transferred because such discussions are personal.Traditional healers in Limpopo can safeguard this knowledge and ensure the survival of the knowledge for future generations by sharing their tacit knowledge through initiation and mentoring.
Methodologies employed to share knowledge included the exchanging of notes, labelling herbs and using different recipes for different concoctions.Those methods encouraged collaboration among healers where different illnesses were discussed or ideas on how to deal with different issues related to traditional healing were shared.Furthermore, herbs that healers use are mostly found from trees that grow in different areas.Some of these trees can only be found in specific parts of the country.To that effect, healers have developed their own networks where there is some level of working together.There are herbs that are known to grow only in mountainous areas and healers who live in areas without mountains will get help from those in those areas and return the favour by sharing knowledge of herbs that grow in their area.This allows healers to the knowledge they gained from their colleagues to their knowledge base to form new knowledge.Traditional healers who dealt with a particular problem may exchange ideas and share their experiences and in this way combine their ideas and experiences to create the best solutions for particular problems.
The findings further suggest that the methodologies mostly employed by trainees to acquire knowledge included observations, practically doing things, imitations, following orders from the ancestors and constantly shadowing their masters.This supports the argument made earlier by Szulanski et al. (2016) that tacit knowledge may be transferred through observations, imitation and practice.Even though the drumming and dancing occur almost every day, trainees spend most of their time collecting and grinding herbs, learning how to read the bones and also participating in the practical healing of patients until they fully acquire the necessary knowledge.In addition to the methodologies discussed, healers mentioned continuous learning and the contribution of their ancestors as key methodologies employed to transfer knowledge.

Conclusion
Arthur Danto (1924Danto ( -2013) ) is quoted when saying 'when I transfer my knowledge I teach, but when I transfer my belief, I indoctrinate'.Transferring knowledge of traditional healing goes beyond just transferring knowledge, it is also a belief in many African communities.The interactions between healers make it possible for knowledge to be transferred from one individual to the other.In addition to the tacit knowledge that is transferred during training, the study established that collaboration which encourages knowledge transfer is very common among healers.
Healers share and transfer knowledge informally and spontaneously during externalisation.During externalisation, healer's tacit knowledge is externalised, made ready and it becomes easier to share and acquire knowledge.The results suggest that experienced healers share what resides in their minds and at the same time convert their tacit knowledge into explicit knowledge, which is easier to share and acquire.
The findings suggest that the methodologies mostly employed by trainees to acquire knowledge included observations, practically doing things, imitations, following orders from the ancestors and constantly shadowing their masters.The study further established that knowledge transfer happens during collaborations, formal and informal discussions, meetings between healers and when there are events like the trainee's examinations as well as during gatherings.A broader study on the development of a framework to integrate indigenous knowledge of traditional healers into mainstream health system is recommended.

TABLE 5 :
Methods used by experienced healers to share their experiences.the same way we got the information from those who trained us.' Participant B 'I show them herbs then send them to another area to find the same herbs on their own.'Participant C 'They should do everything on their own, I just give guidance.'Participant D 'My ancestors were mostly guiding me on things to which may come in a form of a dream, I will tell my dreams to my mentor and she will give me interpretations telling me what it means and what I should do.My students get guidance from their ancestors; my job is to help them carry out those duties.'Participant E 'I was told to do things in a particular way and will look at how my mentor did things and try to imitate what he did.The same principle works for my students and I won't change that.I will stick to it.'Participant F 'The ancestors decide when and what you should know.They mostly give directions through dreams.'Participant G 'There are different levels during training.The first step is the calling of the ancestors where you take herbs and keep others under your pillow when you sleep.As soon as the ancestors shows their presence, you will start having dreams where you are shown different herbs, when you now ready to heal people the ancestors will show you which herbs to mix to heal a particular illness.'

TABLE 2 :
How experienced healers transferred their skills and experiences to their trainees.
'This is like in a normal school; if you don't listen you will never know anything.Your attitude will determine how much you end up knowing.'ParticipantB'Itmostlydepends on the student and how dedicated they are.But with me we learn how to read the bones every day and involve my trainees in everything I do.I show my trainees how different herbs are prepared and for what purpose, then when there are patients I just tell them to prepare a particular herb.

TABLE 4 :
Knowledge sharing among healers.Healers always share information and ideas about different illnesses and how they handled them but there are healers who are secretive who don't want to show others what they using but mostly they are the ones who are left behind because as a healer there is no way you can know all herbs.As healers as we are together in the wild when one shares what a particular herb is used for, the next will mention uses of another herb we come across and by the end of the day we would have discussed a lot of herbs and some of which you never knew.'We sometimes have a traditional healer's conference organised by our leaders and in that conference we share a lot of information.At the conference there are always herbalists from faraway places selling different types of herbs.They mostly explain what each herb is and what each herb is used for which adds on the knowledge we have.'

TABLE 3 :
Knowledge sharing among healers.When one of the healers I work with comes across a bit of information in relation to what we do, we sit down and share the information to improve on what we already do.' http://www.sajim.co.zaOpenAccess