spirit and healing in africa - University of the Free State

that they establish networks and new organizations, look for new methods of treatment, go into
business in order to sell medicine, market their healing activities, and combine different avenues
of health information, knowledge and practices. So there is a dimension of active creation by the
people involved in the search for healing: by receiving and subsequently reforming knowledge
and activities, people respond to health conceptualizations and practices in such a way that they
are able to come to terms with their own health situation 8 .
Thus, in every context people define ‘health’ in relation to their specific life setting, time, place
and circumstances. Their social and cultural (and, in many contexts, religious) frame of life
provides for the health ideas and practices that are not just occurring, but are actively produced
and created. The essential point being made here is that health conceptualizations are
purposefully made by people, and that these constructions are always contextual. This is what
the fabric of health 9 refers to. ‘Fabric’ is derived from the Latin verb faber which means ‘to
make’ or ‘to create’, and it has become a useful metaphor for the manmade patterns in relation to
health. One can speak, for example, of the social fabric, economic fabric, cultural fabric and
moral fabric of health, thereby referring to the practices, social arrangements, words, values,
resources, facilities, tangible and intangible assets, and related concepts that people use in order
to express ‘health’. Based on the different (and always dynamic) fabrics of health, one can say
that health codes and traditions (with their health concepts and practices) are socio-cultural
constructions. They are created by people who, in a particular context, try to make sense of what
is happening in specific life situations.
Understanding ‘health’ by looking at the fabric of health is a generally accepted approach in
health studies. However, holding on to the notion of health as a socio-cultural creativity often
raises difficulties in relation to biomedicine. The issue at stake is biomedicine’s claim of
objectivity and validity that has its origins in science. Biomedicine is labeled as a discipline of
modern research producing knowledge based on experiences that can be observed, repeated,
measured and generalized. This scientific objectivity is difficult to match with the idea that
health conceptualizations and actions are culturally specific. Despite biomedicine’s own claim of
objectivity, it is asserted here that biomedicine is a socio-cultural construction just as other health
traditions are, and that “biomedicine can be regarded as the ethnomedicine of the Western,
8. In the same way, Feierman & Janzen emphasize the importance of describing African therapeutics in the active
voice (1992:12) in order to avoid or otherwise deconstruct the image of health and healing in Africa as a static,
stagnant and un-self-conscious tradition.
9. The concept of ‘fabric of health’ is developed by Janzen (2002).
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