spirit and healing in africa - University of the Free State

Epidemiological constructions of AIDS in Africa
It is worthwhile taking a deeper look at epidemiological explanations of AIDS in Africa, because
they continue to form the framework of certain concepts of health, illness and healing that are
very prominent in the African context.
The aim of epidemiology is to gain an understanding of viruses and their disease profiles. Linked
to the viral trajectory of AIDS is the focus on factors relating to host that facilitate the
transmission of the virus. And the main factors that have been identified as contributing to the
spread of HIV in Africa range from biological (malnutrition, parasite load) and economic factors
(poverty, unemployment, no access to health care) to social factors (migration, broken family).
Obviously, all these host factors are so interrelated that they create an epidemic that seems to be
without end. This epidemiological perspective has fed the view point that the host factor that can
be controlled (in order to bring the epidemic to an end) is the factor of human (sexual) behavior.
The combination of health risk management, the individual and the location of health has been
viewed as the proper tool for assessing and evaluating an epidemic (see Jain n.y. 28 ). In other
words, epidemiological constructions presume that the health (and the illness, for that matter) of
an individual are located in the body of that individual. The organic body is seen as the
framework in which biological factors are at play, resulting in health or illness of the individual.
Just as health, from an epidemiological point of view, is bound to the temporal body, so are the
processes of health narrowed down to the individual: the social influences are played down and
simplified due to the focus on the individual and his or her body. Linked to the focus on the
individual’s body is the element of risk assessment. In the epidemiological discipline, the health
risk assessment of an individual is a crucial part of constructing an epidemic, since it will
provide a means to intervene and prevent the virus’ spread.
Behavioral paradigm
Epidemiological constructions on the rapid spread of HIV in sub-Saharan Africa consider a
variety of host factors, but the main components of epidemiology (risk, the individual and the
28. Jain’s research aims at analyzing and deconstructing mainstream intervention programs based on the dominant
Western medical system of medicine. His main point is that the underlying ideologies and theories of the biomedical
discourse on HIV carry three culturally-specific notions that are fundamental to epidemiological approaches to
HIV/AIDS. These three notions (risk, the individual and the location of health) are specifically Western notions,
although they are often perceived (by Westerners) as immutable, incontestable truths. Based on critical discourse
analysis (CDA), Jain shows that HIV intervention programs assume these three notions to be universal and acultural,
when they actually echo Western ideologies.
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