The document discusses the clash between African and Western medical values and practices in HIV/AIDS prevention. It notes that effective prevention requires incorporating local cultural beliefs in a respectful way while also questioning one's own culture. Western medicine views the body mechanistically while African traditions see overlapping natural, supernatural and social worlds. The WHO found African healers provide most health services in Africa. UNAIDS advocates collaboration with healers who have community credibility and influence behaviors, making them essential HIV prevention partners. Any collaboration must be mutually respectful, not purely instrumental, and genuinely reciprocal.

1. “The Impact of Conflicting African and
Western Medical Values, Beliefs, and
Practices on HIV/AIDS Prevention”
2009 SAHARA Conference
Johannesburg, South Africa
Presented by:
David Baronov,
Associate Professor of Sociology
St. John Fisher College
Rochester, NY USA

2. BASIC ORGANIZING THEMES
1.) All HIV prevention interventions represent a potential clash between two or more
sets of cultural beliefs and practices.
2.) Effective HIV prevention interventions require the incorporation of cultural
beliefs and practices in a manner that respects and learns from local cultures and
peoples.
3.) The willingness to openly question one’s own cultural beliefs and practices is a
minimal prerequisite for effective HIV prevention work.
4.) We should always assume that we will learn as much about another culture’s
beliefs and practices as we will teach.

3. Western efforts to conduct HIV prevention in Africa reveal sharp cultural differences
that reflect contrasting worldviews and medical beliefs and practices.
However:
Neither Africa nor the West represent monolithic cultural perspectives.

4. Western enlightenment traditions assume distinction between natural and supernatural
worlds:
- separate and distinct realms
- knowable vs. unknowable
natural world is tangible, material, observable, measurable
supernatural world is mystical, spiritual, invisible
- dualistic frameworks of explanation (physical versus metaphysical)
- causal relationships limited to phenomena in the natural world

5. Many African traditions assume overlapping natural, supernatural, and social worlds:
-fluid interaction between realms
- holistic frameworks of explanation
- each is equally present in one’s life
- ability of people to command supernatural forces
- causal relationships ascribed to phenomena in all three worlds

6. Basic Elements of Western Medical Beliefs and Practices:
- body as machine
- body/mind division
- reductionist/atomistic
- narrow materialism/empiricism
- highly judgmental of other beliefs

7. Common Elements of African medical beliefs and practices:
- role of natural explanations
- role of supernatural explanations
- role of social network explanations
- holistic frameworks of explanation
- pragmatic attitude toward “foreign” medicine
- empirical-rational premises

8. NEED FOR COLLABORATION
In 2000, the World Health Organization (WHO) estimated that for 80 to 85 percent
of the African population, African healers were the primary source of health education
and health care. This marked little or no improvement from two decades earlier when
Bichman (1979:176) estimated that 70 to 90 percent of African rural populations
lacked access to public health.

9. UNAIDS AND COLLABORATION
“[African healers] make a unique contribution that is complementary to other
approaches. They also tend to be the entry point for care in many African
communities, and even more so for the complex HIV-related diseases that
frequently jolt family dynamics and shake community stability. [African healers]
often have high credibility and deep respect among the population they serve.
They are knowledgeable about local treatment options, as well as the physical,
emotional and spiritual lives of the people and are able to influence behaviors.
Thus, it is imperative and practical to consider [African healers] partners in the
expanded response to HIV/AIDS, and to maximize the potential contribution
that can be made towards meeting the magnitude of needs for the solution to
HIV/AIDS in the African context” (UNAIDS, 2002:5).

10. Assuming that collaboration between African healers and Western
medicine is essential for HIV prevention what are the bases for this
collaboration?
- must be mutually respectful
- cannot be purely instrumental
- must be genuinely reciprocal