spirit and healing in africa - University of the Free State
spirit and healing in africa - University of the Free State spirit and healing in africa - University of the Free State
never be developed in a vacuum. Health ideas and practices are influenced by external and foreign discourses (institutions, practices, experiences, language). This hybridity does not decrease the uniqueness of health in Africa, but it explains that African health ideas can also be found in another geographical setting, and be developed in the encounter with other health discourses. 1.5 CONCLUSIONS Although health issues dominate daily life and nearly everyone has something to say about health or illness, ‘health’ itself remains difficult to define. We lack a universal definition of health despite the efforts of the World Health Organization to come up with a description of what health ought to be. Health research, and thus the understanding of what ‘health’ is, is steered by two basic approaches to health: the biomedical model and the social constructivism model. These two models are direct opposites, since the biomedical frame of reference is determined by a focus on disease, reductionist logic, scientific neutrality and modernistic ideas of development, human progress and control of disease, while the social constructivism approach presumes the idea that health is determined by the group. Health, therefore, is not something autonomous that can be approached and examined, but instead is seen as a social construct to which meaning is attached by the social group. The perspective of health as a social construct implies that an understanding of ‘health’ is entirely determined by the social context. Social structures play a crucial role in the creation of ideas and practices pertaining to health, illness and healing. In addition, health as a social construct also implies that social context creates and sustains (in all kinds of ways) a discourse of those ideas and practices of health. The existence of multiple and different health discourses also implies the inevitability that some concepts or practices belonging to one discourse will find access to another discourse. Globalization processes play an influential role in the hybridity of health ideas, which has become a basic feature of ‘health’. Related to this hybridity of health ideas is active participation of the patient or the lay person. The perspective of the patient reveals that it is the patient who determines what ‘health’ means to him or her, and who decides on whether to integrate several discourses or not. All in all, one could say that health as a social construct basically has to do with conferring meaning in an active way: the fabric of health in the Southern African context shows that people are actively and deliberately involved in the (continuous) generation of ideas and practices of health, illness and healing. The core supposition in this study is that all health ideas and practices are by definition individual and collective constructions which are influenced by, and rooted in, individual and 42
collective experiences, codes of the kinship group, socio-cultural traditions, economic circumstances, scientific research information, the way information is distributed and political influence (Feierman & Janzen 1992:1; Janzen 2002:52; Helman 2007:126; Louw 2008:44). It means that the conceptions of health that people have produced, and the responses to health situations that they have developed, are provided and molded by the context in which they exist. ‘Health’ is contextual: it is entrenched in particular socio-cultural traditions that vary from place to place. Health ideas can only be articulated meaningfully, and health practices only be experienced as relevant, when the patient, the relatives, the medical practitioner, the pastor and all others involved, share the same culturally-specific health tradition. Within every sociocultural context there are multiple and different health codes and practices present, but it is possible to discern basic or dominant ideas in the amalgamation of health theories in one specific context. The perspective of health as social construct offers the opportunity to explore ways in which health is understood in the Southern African context. It is possible, in accordance with Foucauldean discourse theory, to discern four distinct health discourses in the Southern African context. These are: (1) the African traditional healing discourse; (2) the missionary medicine discourse; (3) the HIV/AIDS discourse; and (4) the church-based healing discourse. These discourses will be addressed extensively in the following chapters, with the aim of clarifying the four distinct approaches to health. The theoretical framework of this research is the social constructivism approach, because all the above-mentioned features of health as a social construct provide the scope for theological reflection on health, illness and healing in the Southern African context. This theoretical framework sheds light on the fact that health always has numerous dimensions, and that health can never be approached in one single way. This insight can be regarded as a stepping stone in an exploration of the potential of Reformed theology in matters of health, illness and healing, since the perspective of health as a social construct provides the opportunity to understand health in other (or new) ways. 43
- Page 1 and 2: SPIRIT AND HEALING IN AFRICA: A REF
- Page 3 and 4: ACKNOWLEDGEMENTS It feels like this
- Page 5 and 6: I would like to believe that my chi
- Page 7 and 8: TABLE OF CONTENTS INTRODUCTION 11 1
- Page 9 and 10: PART II. EXPLORING A REFORMED PNEUM
- Page 11 and 12: INTRODUCTION 1. Research background
- Page 13 and 14: and her status? Does the Bible not
- Page 15 and 16: traditional healing, the HIV/AIDS c
- Page 17 and 18: This thesis centralizes the proper,
- Page 19 and 20: subject of health within the variou
- Page 21 and 22: 7. Research outline This research c
- Page 23 and 24: and materiality. The answers to thi
- Page 25 and 26: physical affliction, and it points
- Page 27 and 28: 1.2 MEANING OF SOCIAL CONSTRUCTIVIS
- Page 29 and 30: trust) that can influence health an
- Page 31 and 32: 1.3.2 Discourse When one follows th
- Page 33 and 34: still resists a clear definition an
- Page 35 and 36: the study of African healing starte
- Page 37 and 38: industrialized world” (Helman 200
- Page 39 and 40: produced, that a certain gesture re
- Page 41: influence in Southern Africa. The a
- Page 45 and 46: However, despite many attempts to a
- Page 47 and 48: impact on African indigenous cultur
- Page 49 and 50: Suffering as a relational matter
- Page 51 and 52: situation in which one is actively
- Page 53 and 54: particular rituals are subject to c
- Page 55 and 56: Ngoma’s ability to recreate socie
- Page 57 and 58: 2.4 BORDERS OF AFRICAN TRADITIONAL
- Page 59 and 60: carefully balance their practices a
- Page 61 and 62: connection with the human beings wh
- Page 63 and 64: ancestors and other spirits is impo
- Page 65 and 66: a network of vessels through which
- Page 67 and 68: healing, because relationships are
- Page 69 and 70: esistance. Without denying that mis
- Page 71 and 72: century it turned out that the medi
- Page 73 and 74: scientific insights. The rigid Enli
- Page 75 and 76: determined the course of missionary
- Page 77 and 78: exclusive and divergent therapy, th
- Page 79 and 80: merely regarded as the mirror of th
- Page 81 and 82: esearch starts (as it is in convent
- Page 83 and 84: a given society), but it should be
- Page 85 and 86: eliefs and deeds were reproduced th
- Page 87 and 88: missionary discourse focuses not on
- Page 89 and 90: The notion of transformation result
- Page 91 and 92: 3.5.3 Transformation without superi
collective experiences, codes <strong>of</strong> <strong>the</strong> k<strong>in</strong>ship group, socio-cultural traditions, economic<br />
circumstances, scientific research <strong>in</strong>formation, <strong>the</strong> way <strong>in</strong>formation is distributed <strong>and</strong> political<br />
<strong>in</strong>fluence (Feierman & Janzen 1992:1; Janzen 2002:52; Helman 2007:126; Louw 2008:44). It<br />
means that <strong>the</strong> conceptions <strong>of</strong> health that people have produced, <strong>and</strong> <strong>the</strong> responses to health<br />
situations that <strong>the</strong>y have developed, are provided <strong>and</strong> molded by <strong>the</strong> context <strong>in</strong> which <strong>the</strong>y exist.<br />
‘Health’ is contextual: it is entrenched <strong>in</strong> particular socio-cultural traditions that vary from place<br />
to place. Health ideas can only be articulated mean<strong>in</strong>gfully, <strong>and</strong> health practices only be<br />
experienced as relevant, when <strong>the</strong> patient, <strong>the</strong> relatives, <strong>the</strong> medical practitioner, <strong>the</strong> pastor <strong>and</strong><br />
all o<strong>the</strong>rs <strong>in</strong>volved, share <strong>the</strong> same culturally-specific health tradition. With<strong>in</strong> every sociocultural<br />
context <strong>the</strong>re are multiple <strong>and</strong> different health codes <strong>and</strong> practices present, but it is<br />
possible to discern basic or dom<strong>in</strong>ant ideas <strong>in</strong> <strong>the</strong> amalgamation <strong>of</strong> health <strong>the</strong>ories <strong>in</strong> one specific<br />
context.<br />
The perspective <strong>of</strong> health as social construct <strong>of</strong>fers <strong>the</strong> opportunity to explore ways <strong>in</strong> which<br />
health is understood <strong>in</strong> <strong>the</strong> Sou<strong>the</strong>rn African context. It is possible, <strong>in</strong> accordance with<br />
Foucauldean discourse <strong>the</strong>ory, to discern four dist<strong>in</strong>ct health discourses <strong>in</strong> <strong>the</strong> Sou<strong>the</strong>rn African<br />
context. These are: (1) <strong>the</strong> African traditional <strong>heal<strong>in</strong>g</strong> discourse; (2) <strong>the</strong> missionary medic<strong>in</strong>e<br />
discourse; (3) <strong>the</strong> HIV/AIDS discourse; <strong>and</strong> (4) <strong>the</strong> church-based <strong>heal<strong>in</strong>g</strong> discourse. These<br />
discourses will be addressed extensively <strong>in</strong> <strong>the</strong> follow<strong>in</strong>g chapters, with <strong>the</strong> aim <strong>of</strong> clarify<strong>in</strong>g <strong>the</strong><br />
four dist<strong>in</strong>ct approaches to health.<br />
The <strong>the</strong>oretical framework <strong>of</strong> this research is <strong>the</strong> social constructivism approach, because all <strong>the</strong><br />
above-mentioned features <strong>of</strong> health as a social construct provide <strong>the</strong> scope for <strong>the</strong>ological<br />
reflection on health, illness <strong>and</strong> <strong>heal<strong>in</strong>g</strong> <strong>in</strong> <strong>the</strong> Sou<strong>the</strong>rn African context. This <strong>the</strong>oretical<br />
framework sheds light on <strong>the</strong> fact that health always has numerous dimensions, <strong>and</strong> that health<br />
can never be approached <strong>in</strong> one s<strong>in</strong>gle way. This <strong>in</strong>sight can be regarded as a stepp<strong>in</strong>g stone <strong>in</strong><br />
an exploration <strong>of</strong> <strong>the</strong> potential <strong>of</strong> Reformed <strong>the</strong>ology <strong>in</strong> matters <strong>of</strong> health, illness <strong>and</strong> <strong>heal<strong>in</strong>g</strong>,<br />
s<strong>in</strong>ce <strong>the</strong> perspective <strong>of</strong> health as a social construct provides <strong>the</strong> opportunity to underst<strong>and</strong> health<br />
<strong>in</strong> o<strong>the</strong>r (or new) ways.<br />
43
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