A sangoma's goal in healing is to establish a balanced and harmless relationship between the afflicted
patient and the spirits that are causing their illness or problem.
The healer intercedes between the patient and the world of the dead in order to make restitution.[5] This is generally performed through divination (throwing the bones or ancestral channeling), purification rituals, or animal sacrifice to appease the spirits through atonement.
Throwing the bones to access the advice of ancestors is an alternative practice to the exhausting ritual
of possession by the ancestor. In a typical session, a patient will visit the sangoma and the sangoma
must determine what the affliction is or the reason the patient has come to them for help.
The patient or diviner throws bones on the floor, which may include animal vertebrae, dominoes, dice, coins, shells and stones, 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.
The sangoma then interprets this metaphor in relation to the patient's afflictions, what the ancestors of the patient require, and how to resolve the disharmony.
In the same way, sangomas will interpret metaphors present in dreams, either their own or their
patients.
When the diviner comes to an acceptable understanding of the problem and the patient agrees, she will
instruct the patient on a course of medicine which may include the use of ngoma, referral to a herbalist,
inyanga (if the sangoma does not have the knowledge themselves), or recommend a Western medicine
regimen.
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