spirit and healing in africa - University of the Free State

include the dismissal of the assumed clear connection between sin and illness (or infection), and
the affirmation of quality of life for all people, especially people living with HIV/AIDS
(Frederiks 2008:22).
4.4 QUALITY OF LIFE
In this sub-chapter, the lines set out in the previous sub-chapters will be drawn together in order
to gain an overview of existing health concepts within the discourse of HIV/AIDS in Africa.
This will be difficult to do considering the paradigm shift that is now taking place within the
discourse. From the onset, Western medical health constructions have dominated information
distribution, policies and prevention programs, but current social science research shows that
something has changed in the past ten years: biomedical health constructions are not taken for
granted anymore, and are being complemented by health concepts that are constructed by
various groups in African societies. It would not be true to say that the top-down model (health
as constructed by a few people who have full access to information, media and money) is
substituted by a structure in which the majority decides what ‘health’ is. Rather, the paradigm
shift in the HIV/AIDS discourse shows that health/illness conceptualization processes cannot be
dictated by just one perspective.
When studying the discourse on HIV/AIDS in Africa, and when observing the various ways in
which individuals, social groups and institutions try to make sense of HIV/AIDS, it is possible to
discern ‘quality of life’ as a key notion that permeates the whole HIV/AIDS discourse. Even
though this might not be obvious at first, the many different constructions of HIV/AIDS do have
a common denominator in the sense that they all play a role in the search for quality of life for
HIV-infected people. ‘Quality of life’ can be defined as individuals’ perception of their “position
in life in the context of the culture and value systems in which they live and in relation to their
goals, expectations, standards and concerns” (WHO Quality of Life Group 1995). As will be
substantiated in the following paragraphs, this multi-dimensional construct has become an
important aspect in biomedical, social and spiritual responses to HIV/AIDS. The initial focus on
biomedicine halting the spread of the virus has altered into a focus on retrieving functional
ability and control over symptom intensity by means of antiretroviral treatment (ART); the social
dimension of the pandemic evokes questions about how an HIV-infected person can live
meaningfully despite stigmatization, and the spiritual dimension of the HIV/AIDS threat
addresses one’s well-being in relation to God. Basically, all the different responses to HIV/AIDS
are related to the issue of quality of HIV-infected life. It must be emphasized, however, that the
identification of quality of life as a central element of the HIV/AIDS discourse does not
necessarily exclude other notions as significant in this discourse.
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