spirit and healing in africa - University of the Free State

One major element that contributed to this growing awareness and to a more critical evaluation
of the Western biomedical paradigm regarding HIV/AIDS in Africa is the so-called critical
discourse analysis (CDA). Generally speaking, CDA is a tool for acquiring sharper insights into
particular matters within a specific discourse that have to do with social constructions of power,
domination and marginalization. It is presupposed by CDA that spoken and written words
(discourse) are subjective by definition. Words can never be neutral, for they acquire their
meaning within a specific historical, social and political context. The objective of CDA is to
identify, clarify, and challenge the relationships that exist between the use of language and the
exercise of power, in the sense of domination of the marginalized by the elite within a discourse
(see Van Dijk 1993).
Within the discourse on HIV/AIDS in Africa, critical discourse analysts have contributed
significantly to the voicing of the unheard and marginalized people involved in the fight against
HIV/AIDS. Focusing on the HIV/AIDS discourse, the CDA “analyzes the calculus of economic
and symbolic power in medical rituals, critiquing the systems upon which medical exchange and
meanings are built” (Jain n.d.:1). This means that CDA does not only play an important role in
identifying the limitations of mainstream biomedical programs within HIV/AIDS prevention
programs, but also aims to resist the social inequality produced and maintained by those who
dominate the HIV/AIDS discourse financially, politically and socially. CDA research has, for
example, brought to attention how the power relations within the HIV/AIDS discourse facilitate
the dominant perspective by highlighting themes such as stigma, blame, racism and moralism
(cf. Stillwaggon 2003; Schoepf 2004; Jain n.y.).
4.3 BEYOND EPIDEMIOLOGY
‘Beyond epidemiology’ is a term coined by Kalipeni et.al., who published an important work on
HIV/AIDS in Africa from perspectives that had been largely unnoticed until then. Beyond
Epidemiology (2004) is a rich collection of perspectives and research findings forming a critical
addition to mainstream opinions within the discourse. The publication was instigated by the
realization that the biomedical paradigm has dominated the HIV/AIDS discourse, without
succeeding to stop the spread of the virus. In response to this, the trend now is to open the
discourse, and to move beyond epidemiology as the determining factor to understand HIV/AIDS.
By moving beyond epidemiological models of HIV/AIDS, researchers have pushed the
HIV/AIDS discourse in a new direction so that it is no longer a mainly epidemiological matter;
the roots of the disease are more numerous and deeper than the virus itself. ‘Beyond
epidemiology’ is an expression that refers to the complex network of factors linked to each other
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