spirit and healing in africa - University of the Free State

these, but all of them include, implicitly or explicitly, an account of how they relate to the
Western system of biomedical thinking about health, illness and healing.
4.2.1 Colonial medicine
One crucial phase in the development and the transformation of biomedicine in the African
context, particularly in relation to the HIV/AIDS pandemic, is the colonial era. Although only a
few studies on HIV/AIDS in Africa mention the colonial history of biomedicine, the magnitude
of colonial medicine in the discourse on HIV/AIDS in Africa cannot be missed: colonial
medicine generated a specific frame of pathologies that was projected on African patients. This
means that categories of race and of otherness started to become influential in the colonial health
discourse as well as in the health discourses that emerged after the colonial era.
In general, and especially compared to missionary medicine, colonial biomedicine can be
characterized as more or less secular in its medical practices. The religious notion of conversion
linked with healing is basically absent in colonial medicine. Consequently, colonial medicine
was less contrastive among African patients themselves. Whereas missionary medicine aimed at
drawing the patient-convert closer to the inner circle of saved people and further away from the
heathen kin, colonial medicine was more focused on creating subjects compliant with colonial
rule. And whereas missionary medicine developed at the intersection of health and religion,
colonial medicine was ruled by a more or less secular perspective, with health, socio-economics
and politics as its center.
This intermingling of health, socio-economics and politics within the discourse on colonial
biomedicine provided colonial rulers with a framework of ideological-medical avenues for
further control of African subjects. European colonial powers, for example, substantiated their
perceptions of poverty and African governmental incompetence on the basis of biomedicine’s
preoccupation with the African body, and they concluded that such pitiful conditions were
causally linked with the African racial type. Colonial medicine thus created a firm link between
physical (and at a later stage, environmental) characteristics and socio-political conditions,
resulting in a specific pathology unique to Africans. This ‘Bantu anatomy’ (Tobias 1947:18; see
also Butchart 1998:155) created ‘the’ African patient or subject as an individual body that was so
different from European patients that a new interpretation framework of diseases had to be
developed, whereby factors like skin color, physiognomy, physiques, new diseases and sexuality
determined the way colonial medical practitioners examined their African patients. Thus, as
Vaughan (1991:25) contends, “the power of colonial medicine lay not so much in its direct
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