spirit and healing in africa - University of the Free State

personnel with all kinds of specializations, the pharmaceutical industry, medical insurances, and
international organizations like Medicins sans Frontiers. The biomedical model reflects a
scientific approach to health, based on reductionist logic combined with a preference for
scientific neutrality pertaining to health. This means that all kinds of subjectivities and
contingencies are left out in the acquisition of medical knowledge and in the treatment of a
patient. Not surprisingly, one of the features of the biomedical model is the focus on disease. The
idea that the incidence of disease implies the absence of health, sharpened biomedicine’s focus
on the abnormal condition of health, with the result that representatives of the biomedical model
are more concerned with the aberrations of health (that is, disease) than with manifestations of
health. Expressions like ‘conquering the disease’ and ‘the battle against AIDS’ are typical for the
biomedical model since it reveals modern thinking about development, human progress and
control.
The social constructivism model
Towards the end of the 1970’s a new perspective on how to define health emerged, for the
reductionist model of health and its focus on disease and the body did not do justice to other
dimensions of health. Factors like political, social, economic and personal circumstances were
generally not taken into consideration in the efforts to halt the disease. Things started to change
radically under the influence of the work of Michel Foucault, and the social constructivist
approach entered the health disciplines. This approach cast new light on the perception of health
by addressing the very processes of distributing health knowledge. The implication of the social
constructivist model is that the perception of health (and illness) is continuously being
constructed in the words, thoughts and experiences of people. Thus, health is not something
objective that is understood by everyone in the same way, and illness is not something that is
being treated the same way everywhere in the world; health is constructed by the individual as
well as by the group, who affirm and sustain that specific construct. In the social constructivist
model it is not possible to understand ‘health’ by one definition or broad description, because
health is seen as a complex collection of perceptions that are produced within specific
discourses. According to the social constructivist approach, for example, the biomedical model is
just one culturally determined discourse among many other health discourses. The exact
definition of health, is not fixed in a particular objective idea, but comes into existence when the
role of culture, power relations and dominant knowledge are considered as, and linked with, the
ideas and practices of those who seek health.
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