A sangoma is a practitioner of herbal medicine, divination and counselling in traditional Nguni (Zulu, Xhosa, Ndebele and Swazi) societies of Southern Africa (effectively an African shaman).

The philosophy is based on a belief in ancestral spirits. Both men and women can be called by the ancestors (a consequence of refusing the calling is usually ongoing physical or mental illness). A trainee sangoma (or twaza) trains under another sangoma, usually for a period of years, usually performing humbling service in the community.

At times in the training, and for the graduation, a ritual sacrifice of an animal is performed (usually a chicken, a goat or a cow). The spilling of this blood is meant to seal the bond between the ancestors and the sangoma.

Sangomas are the traditional healers in the Zulu, Swazi, Xhosa and Ndebele traditions in southern Africa. They perform a holistic and symbolic form of healing, embedded in the beliefs of their culture that ancestors in the afterlife guide and protect the living. Sangomas are called to heal, and through them ancestors from the spirit world can give instruction and advice to heal illness, social disharmony and spiritual difficulties.

Sangomas have many different social and political roles in the community: divination, healing, directing rituals, finding lost cattle, protecting warriors, counteracting witches, and narrating the history, cosmology, and myths of their tradition. They are highly revered and respected in their society, where illness is thought to be caused by witchcraft, pollution (contact with impure objects or occurrences) or by the ancestors themselves, either malevolently, or through neglect if they are not respected, or to show an individual her calling to be a Sangoma. For harmony between the living and the dead, vital for a trouble-free life, the ancestors must be shown respect through ritual and animal sacrifice.

A Sangoma is called to heal by an initiation illness, often psychosis, headache, intractable stomach pain, shoulder or neck complaints. She will undergo Thwasa, a period of training including learning humility to the ancestors, purification through steaming, washing in the blood of sacrificed animals, and the use of Muti, medicines with spiritual significance. At the end of Thwasa, a goat is sacrificed to call to the ancestors and appease them.

Sangomas are steeped in ritual. They work in a sacred healing hut or Ndumba, where their ancestors reside. They have specific coloured cloths to wear to please each ancestor, and often wear the gallbladder of the goat sacrificed at their graduation ceremony in their hair. They summon the ancestors by burning a plant called Imphepho, dancing, chanting, and most importantly playing drums.

Sangomas are able to access advice and guidance from the ancestors for their patients in three ways: possession by an ancestor, or channelling; throwing bones; and interpreting dreams. In possession states the Sangoma works herself into a trance, through drumming, dancing and chanting, and allows her ego to step aside so an ancestor possesses her body and communicates directly with the patient, providing specific information about his problems. It can be very dramatic, with the Sangoma speaking in tongues, or foreign languages according to the specific ancestor, or dancing fervently beyond her normal ability.

Accessing the ancestors´ advice through the bones is an alternative to the exhausting possession states. The Sangoma possesses a collection of small bones and other small objects like seeds, shells etc, each with a specific significance to human life. For example a hyena bone signifies a thief and will provide information about stolen objects. The Sangoma or the patient throws the bones but the ancestors control how they lie, and the Sangoma then interprets this metaphor in relation to the patient´s life. In the same way, Sangomas will interpret the metaphors present in dreams, either their own or patients´.

Sangomas will give their patients Muti, medications of plant and animal origin imbued with spiritual significance, often with powerful symbolism - lion fat is given to promote courage. There are medicines for everything from physical and mental illness, social disharmony and spiritual difficulties to potions for love and luck. Muti can be drunk, smoked, inhaled, used for washing, smeared on the body, given as enemas, or rubbed into an incision.

Sangomas function as the social workers and psychologists in their community. They know the local dynamics and can counsel appropriately with this background knowledge.[1]

The formal health sector has shown continued interest in the role of sangomas and the efficacy of their herbal remedies. Western-style scientists continue to study the ingredients of traditional medicines in use by sangomas. Public health specialists are now enlisting sangomas in the fight against the spread of HIV/AIDS.[2] In the past decade, the role of all types of traditional healers have become important in the fighting the impact of the virus and treating people infected with the virus before they advance to a point where they require (or can obtain) anti-retroviral drugs.

Sangomas far outnumber western-style doctors in Southern Africa, and are consulted first (or exclusively) by approximately 80% of the indigenous population. Whilst for many they provide the healing needed, there are some causes for concern. Charlatans who haven´t undergone Thwasa charge exorbitant prices for fraudulent service, and not all countries in southern Africa have effective regulatory bodies to prevent this practice. Some Sangomas have been known to abuse the charismatic power they have over their patients by sexually assaulting them, sometimes dressed up as ritual. Repeated use of the same razor blade to make incisions for Muti carries HIV transmission risks in regions where the disease is rife. Western-style doctors have seen a number of cases of patients with serious gastrointestinal problems through the use of Muti, especially in enema form, and have even coined the phrase "ritual enema induced colitis". Zulu children may have up to three enemas a week.

One of the most famous and well respected sangomas worldwide is Vusamazulu Credo Mutwa also known as the Zulu Shaman

Nganga is a bantu term for herbalist or spiritual healer in many African societies and also in many societies of the African diaspora such as those in Haiti, Brazil and Cuba. In Haiti the term for voodoo high priest Houngan is derived from the word Nganga. In Cuba the term Nganga refers to a certain creation made with an iron pot into which several items are placed. It also refers to the spirit of the dead that resides there. In South Africa, the Nganga has a medicinal role in contrast to the Sangoma who deals with the spirits. In swahili Mganga refer to a qualified physician or traditional healer.