Some thoughts on inculturation and AIDS

So the other day I wrote some incomplete thoughts on the issue of AIDS. I don’t know if any of you out there heard about the AIDS conference in Canada. South Africa has repeatedly been criticized for its response to the crisis. At their table at the conference in Canada, their table had on it garlic and lemons, which represent one of the indigenous responses to AIDS. Later during the conference ARVs were added to the table. The director of health in South Africa (Manto) has constantly been criticized as well. Stephen Lewis of the UN stated that her views were “more worthy of a lunatic fringe than of a concerned and compassionate state.” (From the mail and guardian, mg.co.za). I do think that Manto might have a point, just as my friend did when he said that stress caused you to get sick. Manto is claiming that we have to look at issues of malnutrition and poverty. Yet the government has really been lacking in issues of public health and in particular to the response to AIDS. I was reading in the paper the other day that the government was being held in contempt of court for not providing ARVs to certain men in prisons. Hospitals are understaffed because of the decision to shut down nursing schools 10 yrs ago in order to save money…

All in all though, there is a disjoint even between the head leader of health in the government and the biomedical approach. Who can blame people the people suffering from this disease for not having faith in the biomedical response? Most of them have not even had a decent chance to use the ARVs that the biomedical solution proposes.

I wrote the other day about rethinking this in terms of the African Worldview. In effect, our understanding of AIDS has to be inculturated. It is easy to forget that our science, our biomedical solution itself is embedded in a culture. Our view of the human person is that of the individual. Within the traditional African viewpoint (a generalization of course) the individual exist in relation with those around him or her. In one of the examples that I read, a man stopped taking ARVs because if he did, then people would see that he was ill. Not only would this cause grief among his family, but also should others find out from the community, the household would be shunned. So how does one inculturate our understanding of AIDS.

The traditional African worldview (which does not seem as universally present here in south Africa as it might be in other countries that I will be visiting) is often governed by strict rules or taboos. These taboos would, as I understand them, govern the relationships between people and try to keep a village or clan in a state of harmony. One of these was a strong taboo against premarital relations. I expressed a concern the other day about rethinking the issue of AIDS into the wrong area of African traditional thought, because in my mind it has the potential to perpetuate some of the unjust taboos that used to rule and oppress. The problem with inculturation our understanding of HIV-AIDS through the vehicle of taboos is that it creates a community ethic that is imposed on others. Thus a shame driven ethic could lead to the exclusion of others who violate taboos. They could become stigmatized. I think we saw this in the states with the early conception of AIDS as being the “gay plague.” Rev. Falwell preached that it was God’s judgment coming down on sinners. Granted, he is an extremist, but one can see how in our own society the imposition of an external ethic on people lead to the conclusion that people merited this disease who suffered from it, because they violated our own taboos.

So what can one do? The article I was reading actually took the approach of the witch. Sounds impossible huh? Well, let me explain a little better. Often the traditional viewpoint in Africa is suffused with ideas of external causation. This is often from either spirits or curses from witches or what not. One would then go to a diviner (a sangoma here the Zulu tradition in South Africa) who would either determine the cause from some spirit or would sniff out the witch. This can actually be quite horrendous in practice, since a person could be falsely accused of causing someone’s misfortune or illness. There is attached to this notion the idea that each person has the potential to be a witch.

One might relate this to the Middle Eastern idea of the evil eye. Within the ancient Middle East they believed that just as sound comes out of the mouth, light came out of the eyes. This light, however, had the ability to effect others. If one had an envious heart than one could cause misfortune for others by just looking at them.

So, the author states that if we could spread the notion that, through our actions, we would in effect, be witching ourselves, we could spread the notion that through a behavior change one could keep oneself from contracting HIV. Now that clearly is not a comprehensive solution to the AIDS issue, but it will help people to begin to face in some respects the actions that can lead to AIDS. If I can find the name of the author I will put it up here.
Well, that was quite a long blog and my description of the author’s solution was probably inadequate.


On a side note, there is also the very important idea of interculturation. Inculturation can mean how can we reinterpret an idea within a different cultural framework. Interculturation would imply that this process of inculturation is actually a dynamic and mutual exchange. It would not be a translation of our notion of AIDS for example into the traditional worldview of Africa, but we would in fact have something to learn. I think that this is true. A prime example of this would be the understanding that illness is not merely an individual phenomenon, but also a community phenomenon. While we have fragments of this notion in our society, in my mind it has not deeply impacted our medicinal practices. It’s funny, when we do see people addressing illness in a social manner, it is often a remnant or a reinterpretation of a pre-enlightenment practice. Take for example faith healings, which claim their foundations in the post-Pentecost church. Look at the anointing of the sick, in which a priest anoints a person with blessed oils. He is both a representative of God as well as a representative of the church community. This is not really present however in our medical practices. As Christians, it is because of this social element, because of this sense of a human community and thus an obligation to the sick, the poor and the needy that Catholic charities do indeed create hospitals to nurse others back to health. Churches then become refuge of healing and friendship. In the medical world, illness only effects the individual. In my mind this is just one way in which the western view could learn from the African traditional view.