“The Impact of Conflicting African and

Western Medical Values, Beliefs, and

Practices on HIV/AIDS Prevention”

2009 SAHARA ConferenceJohannesburg, South Africa

Presented by:

David Baronov,Associate Professor of SociologySt. John Fisher CollegeRochester, NY USA

1.) All HIV prevention interventions represent a potential clash between two or more

sets of cultural beliefs and practices.

2.) Effective HIV prevention interventions require the incorporation of cultural

beliefs and practices in a manner that respects and learns from local cultures and

peoples.

3.) The willingness to openly question one’s own cultural beliefs and practices is a

minimal prerequisite for effective HIV prevention work.

4.) We should always assume that we will learn as much about another culture’s

beliefs and practices as we will teach.

BASIC ORGANIZING THEMES

Western efforts to conduct HIV prevention in Africa reveal sharp cultural differences that reflect contrasting worldviews and medical beliefs and practices.

However:

Neither Africa nor the West represent monolithic cultural perspectives.

Western enlightenment traditions assume distinction between natural and supernatural worlds:

- separate and distinct realms

- knowable vs. unknowablenatural world is tangible, material, observable, measurablesupernatural world is mystical, spiritual, invisible

- dualistic frameworks of explanation (physical versus metaphysical)

- causal relationships limited to phenomena in the natural world

Many African traditions assume overlapping natural, supernatural, and social worlds:

-fluid interaction between realms

- holistic frameworks of explanation

- each is equally present in one’s life

- ability of people to command supernatural forces

- causal relationships ascribed to phenomena in all three worlds

Basic Elements of Western Medical Beliefs and Practices:

- body as machine

- body/mind division

- reductionist/atomistic

- narrow materialism/empiricism

- highly judgmental of other beliefs

Common Elements of African medical beliefs and practices:

- role of natural explanations

- role of supernatural explanations

- role of social network explanations

- holistic frameworks of explanation

- pragmatic attitude toward “foreign” medicine

- empirical-rational premises

NEED FOR COLLABORATION

In 2000, the World Health Organization (WHO) estimated that for 80 to 85 percent of the African population, African healers were the primary source of health education and health care. This marked little or no improvement from two decades earlier when Bichman (1979:176) estimated that 70 to 90 percent of African rural populations lacked access to public health.

UNAIDS AND COLLABORATION

“[African healers] make a unique contribution that is complementary to other

approaches. They also tend to be the entry point for care in many African

communities, and even more so for the complex HIV-related diseases that

frequently jolt family dynamics and shake community stability. [African healers]

often have high credibility and deep respect among the population they serve.

They are knowledgeable about local treatment options, as well as the physical,

emotional and spiritual lives of the people and are able to influence behaviors.

Thus, it is imperative and practical to consider [African healers] partners in the

expanded response to HIV/AIDS, and to maximize the potential contribution

that can be made towards meeting the magnitude of needs for the solution to

HIV/AIDS in the African context” (UNAIDS, 2002:5).

Assuming that collaboration between African healers and Western medicine is essential for HIV prevention what are the bases for this collaboration?

- must be mutually respectful

- cannot be purely instrumental

- must be genuinely reciprocal