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AFRO-NETS> Traditional health contributions to health education (2)
- Subject: AFRO-NETS> Traditional health contributions to health education (2)
- From: "P.R. Gwatirisa" <gwatirpr@mcmail.CIS.McMaster.CA>
- Date: Fri, 21 Nov 1997 12:48:59 -0500 (EST)
Traditional health contributions to health education (2)
Maurice Eisenbruch, Co Chief Investigator, CNRS-CACSPI project on
AIDS, France, wrote:
> Our group at CNRS-CACSPI have been working on the anthropology of
> STI and AIDS in Lao PDR, Cambodia and Thailand, and a paper describing
> some of this work in progress was presented in Manila. It identifies
> the social and structural and economic barriers to access to Western
> health. We agree that the role of traditional healer should be given
> more prominence. Why? The key issue, in our view, is not the healer as
> a mainstay of treatment. Rather, it is the healer as a window onto the
> local perceptions of all illnesses related to sex - including AIDS. It
> may well include other illnesses, such as leprosy, for example, which
> are biomedically not related to sex. It may open up thorny gender is-
> sues such as the perceived differences, for example, that 'women cre-
> ate AIDS, men catch it'. The key issue is how to overcome the cultural
> road-blocks to the acceptance of the AIDS campaigns. Here, the healers
> can act as key informants.
> At the Manila Conference, there were many papers of KAP studies of
> AIDS. These showed how important cultural factors can be. In our opin-
> ion, the KAP studies suffer the limitations that, as questionnaires
> fashioned by Western questions, they simply repeat the well-known
> 'category fallacy' of Kleinman. To be realistic, few involved in the
> emergency of AIDS have the time or luxury to wait for full-blown eth-
> nographic studies carried out country by country in Southeast Asia.
> Nevertheless, a compromise is needed, in which the KAP and the ethno-
> graphic approaches complement one another.
> In our opinion, the issue of traditional beliefs and practices to do
> with sex, and sexually transmitted illness, should be given greater
> prominence in Geneva and at future conferences. Traditional healing is
> a necessary part of such a focus. We hope that this posting will
> stimulate further discussion.
I read with interest Maurice's contribution on the need to consider
traditional beliefs and practices around sex, particularly when dealing
with HIV/AIDS issues. Studies on the socio-cultural construction of AIDS
that have been conducted in different settings shows how a contextual
analysis and understanding of sexually related issues can pave way to
culturally appropriate interventions. If I can speak more specifically
about Zimbabwe:- given the economic upheaval the country is going through,
there is need to identify workable solutions to the problem of HIV/AIDS,
so that financial resources are appropriately directed. In some parts of
Zimbabwe, AIDS is construed as an indigenous folk disease called Runyoka,
a form of witchcraft intended to punish men engaging in extra-marital
relations (refer to Willms et al. 1995) [(AIDS is construed also as
"Meila" in parts of Botswana (Ingstad) and "Kahungo" in parts of Zambia
(Mogernsen)] - I am sure there are a few other examples - I remember
reading Edward Green's article on Swaziland a year ago and I think it
speaks to that too - I have to read it again.
My point is that, where there are such conflicting conceptual categories,
there is no way we can sideline indigenous KAP on HIV/AIDS and other
sexually transmitted diseases. Ignoring the traditional aspect of
therapeutic care only turns out to be more expensive in the long term,
as those who espouse it continue to do so, and at the end of the day we
look back to assess our efforts in combating the spread of HIV, and
nothing has worked.
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