John Iliffe states in his book, “A History of the African AIDS Epidemic”, that “Africa had the worst epidemic because it had the first epidemic” (Iliffe, pp.158). HIV became an epidemic during the late 1970’s and early 1980’s in sub- Saharan countries. Reasons for its epidemic outbreak include increased urbanization that began in the later colonial period and the increased mobility of young urban immigrants. Also poverty was a growing problem all over parts of sub- Saharan Africa, which led to large amounts of women “to depend on sexual relationships with men either for survival or for otherwise unobtainable goods” ( Iliffe, pp.16). Steps have been take to fight this devastating illness in Africa, however there are many hurdles that must be overcome if the world is to rid itself of HIV/Aids. The three main themes surrounding HIV/Aids and how it is being dealt with in African countries are indigenous conceptions of health and illness tied to a disease that began in the 1950’s, effectiveness of western biomedicine, and social and economic problems against health knowledge to fight aids.
Traditional healers are the preferred and most accessible care providers in Africa. Their status as healers has been rooted for decades, well before western medical techniques were known in Africa. Indigenous healers claim to have special curing powers given to them by a higher deity, and therefore some Africans declare, “Traditional healers know cures for diseases that Western medicine cannot heal…They even know cures for diseases that Western medicine has not yet diagnosed” (West, pp. 1). However western medical practitioners believe traditional medicine has little physical or medical evidence for treating patients with HIV/Aids. The best solution is to try and combine forces to help HIV/Aids sufferers live as comfortable as possible with this disease and help provide the main source of care, the Aids victim’s family, with better resources “to relieve the acute pain that many terminal Aids patients suffered” (Iliffe, pp 102). The AIDS epidemic in sub-Saharan Africa has stimulated interest on the part of modern biomedical health practitioners in collaboration with these traditional healers. Traditional healers have started to be trained as educators and counselors to disseminate HIV/AIDS information and prevention practices among their peers and communities. Overall the traditional healers are capable of performing just as well as their biomedical counterparts as AIDS educators and counselors. The only main concern of western doctors is the failure of many projects providing healers with counseling training to give organized follow-up classes to healers after their initial training. Such follow-up is essential to support healers in dealing with unfamiliar issues such as condom use and death and dying. The most important thing to be aware of is neither western biomedicine nor traditional healing have provided the world with a cure for HIV/Aids. So it is wrong to assume one is better than the other and it is vital for the two health systems to work together.
Another problem is how well biomedicine is accepted in Africa and how effective it really is in the environment. It wasn’t more than thirty years before the Aids epidemic began that African countries were finally ridding themselves of western colonial rule and oppression, it must have been a little difficult to ask and receive help from former governing nations. Also, one of most effective ways to prevent sexual transmission of HIV was to use condoms during any sexual activity was very problematic for those who were most susceptible to HIV infection, married women. “Condom use is problematic for these married couples for two main reasons. First couples who want to have children cannot both accomplish this goal and consistently use condoms. Second, undercurrent connotations of condom use, asking one’s spouse to use a condom may show distrust or raise suspicion about one’s own behavior” (Schatz, pp.483). Then there is antiretroviral drugs. Antiretroviral therapy is not a cure for Aids; however, it suppresses the replication of the HIV virus in the body. A combination of several antiretroviral agents has been highly effective in reducing the number of HIV particles in the blood stream, as measured how much virus is found in the blood. Preventing the virus from replicating can help the immune system recover from the HIV infection and improve T-cell counts. Though this drug is very helpful in extending the longevity of an Aids victim’s life, the cost of using it is well above that which the average African could afford, “ and means of distributing the ARV drugs are very difficult and very unequal, “today, hundreds of thousands of people with this disease in the industrialized world lead full, healthy lives, thanks to ARV drugs. In the developing world, perhaps only one in a hundred of those needing treatment have full access to ARVs” (Thomas, pp. 252).
The third problem faced in Africa is the social and economic difficulties with presenting health knowledge about HIV/Aids. The stigma of the Aids epidemic spans not only the African continent but developed nations with resources to help. The stigma is the same as it was during the colonial period in the early 1990’s, that Africans are synonymous with disease, death, and uncontrolled sexuality. It seems that the world has portrayed Africans as receiving Aids for being an immoral group of people and had it coming to them. The African governments responded to this by stating Aids is a ‘western’ problem that was placed on Africa by Western countries, “the initial response to HIV/Aids was commonly to blame Others. “Indignant at suggestions that the virus had originated in Africa, intellectuals insisted that it was rather ‘the white man’s burden’, a disease of American and Europenan homosexuals” (Iliffe, pp. 80). This however leads to denial of the existence of Aids as a serious medical problem in Africa. Also, developing nations don’t see the benefits of helping to fight HIV/Aids in the developing world, but in the reading, “Nothing to Gain”, written by Alexander Irwin, Joyce Millen and Dorothy Fallows in the book Global AIDS: Myths and Facts: Tools for Fighting the AIDS Pandemic, it states that this belief is a misleading conception, “helping to check the global spread of HIV/Aids will bring long-term gains for the US in three major areas: public health, the economy, and security” (Irwin, pp. 153). Aids should not be seen as only a problem in Africa but a global crisis.
The HIV/AIDS epidemic in Africa that began in the early 1980s is a new and confusing health problem that should be treated differently than anything that has come before it because it is a new disease that not only has no cure but has an incubation period up to ten years before there are any signs that a person is infected. And it is important to focus on fighting HIV/Aids with both Western and traditional health systems. As Aids is a sexually related disease it is important to produce a new discussion of sexuality and how to protest oneself that is not based on Western or European ideals of African sexuality but based on real experiences of men and women living in Africa with certain stigmas against condom use and safe sex practices, “It would be better to die of Aids from someone you love than lose a loving guy for the sake of a condom” (Varga, pp. 81). Also, it is important to understand that there is no longer a separate Western and African health practice. Biomedicine is practiced by Africans, and biomedical research is being carried out by Africans. So it is safe to say that since the late twentieth century, biomedicine has become a part of African traditional healing.
Work Cited
Enid Schatz. ‘“Take Your Mat and Go!”: Rural Malawian Women’s Strategies in the
HIV/AIDS Era. Culture, Health, and Sexuality 7, no. 5 (2005): 479-92 (JSTOR)
Caroline Thomas. ‘Trade Policy and the Politics of Access to Drugs.’ Third World
Quarterly 23, no. 2 (2002): 251-64. (JSTOR)
Alexander Irwin, Joyce Millen and Dorothy Fallows. ‘Nothing to Gain.’ In Global AIDS: Myths and Facts: Tools for Fighting the AIDS Pandemic, pp. 152-67. Cambridge: South End Press, 2003.
Harry G. West. ‘Working the Borders to Beneficial Effect: The Not-So-Indigenous
Knowledge of Not-So-Traditional Healers in Northern Mozambique.’ In Borders and Healers: Brokering Therapeutic Resources in Southeast Africa. Ed. Tracy J. Luedke and Harry G. West, pp. 21-42. Bloomington: Indiana University Press, 2006.
Christine A. Varga. ‘The Condom Conundrum: Barriers to Condom Use among Commercial Sex Workers in Durban, South Africa.’ African Journal of Reproductive Health 1, no. 1 (1997): 74-88. (JSTOR)
John Iliffe. A History: The African Aids Epidemic. Oxford: James Currey, 2006.
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