Responsible healing in a world of HIV/AIDS

Address to a conference of Catholic AIDS activists and theologians

St Augustine College of South Africa

February 2003

Stuart C Bate

(“Responsible healing in a world of HIV/AIDS”. Public lecture given during the conference Responsibility in a time of AIDS held at St Augustine College of South Africa. Johannesburg, February 2003.)

 A. The medical model. AIDS is an incurable disease

 In our modern Western world, sickness and health are mainly understood in terms of the scientific medical model. In this model, sickness must be diagnosed and the appropriate remedy prescribed. A diagnosis is achieved when the entity causing the sickness is identified. Identifying this cause follows a rigorous and time tested process which involves the use of the scientific method of experimentation. Two principal criteria must be satisfied: verifiability and repeatability. The criterion of verifiability requires that the cause of the sickness can be verified by empirical, objective observation. The criterion of repeatability requires that the results obtained by one observer can be repeated by another. Researchers conduct experiments and when an agent has been identified which causes a sickness then the experiments are repeated by others. If the same results are received then the experiments are said to have satisfied the criteria of verifiability and repeatability and the cause of the sickness has been identified. This method has led to a revolution in the identification of bacteria, viruses, and physical and chemical causes of sickness such as high blood pressure and high cholesterol in heart attacks and sugar in diabetes.

In applying this method to the AIDS pandemic, the scientific community has determined that the HI virus is directly causative of AIDS (NIAID 1). The reasons given for this by scientists are that the virus satisfies Koch’s postulates required for substantive evidence that a specific microorganism causes a particular disease. These postulates are (NIAID 1):¹

1.         Epidemiological association:            the suspected cause must be strongly associated with the disease.

2.         Isolation:                                the suspected pathogen can be isolated - and propagated - outside the host.

3.         Transmission pathogenesis:   transfer of the suspected pathogen to an uninfected host, man or animal, produces the disease in that host.

Once the cause of a disease has been identified then the remedy must be sought. In this case the obvious remedy is the elimination of the Human immunodeficiency virus (HIV) from the person. Unfortunately no remedy has been devised which can achieve this purpose and so from the scientific perspective HIV is an incurable disease (Brundtland 2000).

Faced with this impasse, medical treatment of the illness has focussed on finding ways to control the condition and,  in particular, to reduce the concentration of HIV within the body in order to minimise its effects. Current treatments involve the use of “antiretroviral agents”. These therapies are effective in reducing HIV concentration in the blood but are problematic since they are toxic to the body and are also not effective if the treatment is not taken following exact guidelines as to quantities and times of medication.

B Healing in human life and consciousness.

The scientific community considers questions about the causes and solutions to HIV and AIDS to be relatively clear. But elsewhere in society, these questions are the source of great debate and controversy. People from all kinds of groups, cultures and religions have a whole series of different views, values and beliefs about HIV and AIDS. Some deny that HIV causes AIDS. Some deny that AIDS is incurable and claim to have cured it. Some say that there is no such thing as AIDS calling it an invention of scientists and pharmaceutical companies.²  Some say that AIDS is God’s punishment for evil.³ Why should there be this controversy about AIDS which does not seem to apply to other sicknesses?

The main reason is that AIDS has become something that affects many different aspects of our human life. This pandemic has become a matter of life and death, of sickness and health, of medicines and no medicines, of jobs and unemployment, of wealth and poverty, of politics and power, of spirits and witches, of sin and evil and of ethics and morality. In order to make more sense of why AIDS is such a powerful human issue we will need to look a little more into what it means to be human. This will require a brief excursus into anthropology.

All human beings have to make sense out of the world in which they live so that they can function within it. The way we do this is through culture. Culture governs how we perceive and understand the world. And it motivates and justifies our behaviour within it. Culture provides us with patterns of understanding which allow us to recognise and relate to what is happening around us. An easy example of this is given by language which is a major aspect of culture. Our language provides us with a way to label, think about, understand and make judgements about what we experience every day. In matters of sickness and health, sozo, curing and ukuphilisa are words which mean healing in Greek, English and Zulu. They are used in the bible for what Jesus does when he heals. But sozo, curing and ukuphilisa do not mean exactly the same thing. The Greek word also means to save, the Zulu word also means to give life, whilst the English word is very much linked to the medical model of organic disease. The way in which the category “healing” operates in these three languages contains both a measure of similarity from one to the other as well as  a measure of difference between them. Without understanding this vital point we will never see why different groups of people operate somewhat similarly AND somewhat differently when they respond to sickness and health.

But language is only one manifestation of the way in which culture affects us. Our culture determines the way we see the world, the way we think about the world and the way we live in our world. It also operates on more subtle and deeper levels. It gives us our beliefs and values and helps us to identify the important symbols and rituals in our life.

Almost all cultures have religious symbols and systems within them. According to Clifford Geertz (1973:100-108)  religious symbols play a particularly important  role in cultures. This is because they respond to the limit conditions of human life. The limit areas of life are those  which are not easily dealt with using the normal set of beliefs, values and understandings which get us through daily life. There are three principal types of limit areas: the unexplainable, the unendurable and the immoral. On the analytical level, religious symbols kick in when we are unable to make sense of things that occur in our world, like for example, why the universe exists. On the level of endurance, religious symbols respond to situations of overpowering suffering, like, for example, the death of a loved one. On the ethical level, religion helps us to respond to the situations which go beyond our normal moral insight like, for example, the suffering of an innocent child, and we are called to face the problem of evil.

When certain human experiences touch upon all the limit conditions of human life they become powerful experiences in that society. It should be quite clear that HIV/AIDS is such a human issue in our society today. It challenges our ordinary understanding of the world, our ordinary understanding of good and evil and our ordinary understanding of sickness and death. Why are babies born into our world HIV+ only to die as children? How can we deal with the reality of hundreds of thousands of AIDS orphans left alone as their parents fall victim to the pandemic? Why can’t our world of modern technology and science deal with these problems? With Albert Camus in his book The Plague, we ask why a good God allows innocent people to suffer and die in this way.

Our moral understanding is enraged by the behaviour of some people go out and rape babies to be cleansed of the virus in a country whose value systems include Christianity, Ubuntu/botho  and respect for individual human rights. We cannot understand how women with HIV/AIDS are left destitute by husbands or boyfriends. In many squatter camps close to mining areas, women have no other choice than to sell their body to the miners. When the woman is seen to be sick, then the man will strip the shack of all its belongings claiming they are bought by his money and must return to him for the woman is no longer of use to him. In many rural areas, AIDS patients are hidden away in huts and often die quickly for lack of proper care or nourishment. In the same communities people often deny that there is a problem with AIDS. And in funerals people are never said to have died from AIDS  yet people whisper the truth amongst themselves quietly.

What is the value system of a person who, whilst knowing HIV causes AIDS, continues with high risk behaviour? What is the religion of a church community that asks people to leave because of their HIV status in the belief that this renders them unclean: unworthy sinners who are not part of God’s elect? What makes someone, on discovering they have the virus, set out to infect as many people as he can before he dies? Why does a man, knowing he is HIV+, refuse to tell his wife, continue to sleep with her and end up infecting her as well? All of these are common behaviours in our society today. They are behaviours which challenge the limits of our understanding, our beliefs and our values. The suffering they describe is unendurable and often we prefer not to know. Issues around HIV/AIDS go beyond our analytical limits, our endurance limits and our moral limits. For this reason issues around HIV/AIDS are profoundly religious and cultural issues. They can only, in fact, be effectively tackled within the framework of culture and religion.

Whilst HIV is a virus, the issues around HIV/AIDS are far wider than the medical ones. The plague of AIDS reveals who we are as human beings in the way we respond to it. And this response reveals the real truths, beliefs and values of our society. And this revelation demonstrates that we are sicker than we first thought and that our sickness is far more profound than we realised. Responsibility in a world of HIV/AIDS must be a response to these revealed truths about our humanity and not just a response to the virus. Healing AIDS means curing the virus and this of course is the primary goal but it also involves healing our humanity. The healing that heals our humanity is cultural and religious healing.

C. Religious and Cultural Sickness and Health.

Medical therapies operate on the organic level and concern themselves more with  material and impersonal entities. Religious and cultural healing therapies have a different approach. They operate on the human level concerning themselves with the personal, interpersonal and social aspects of human life.

Religious and cultural healing always includes aspects of human identity.  This is because sickness on the human level always affects who I am as a person and who we are as family, community, culture, church or society. The experience of illness is a human experience. The first step in this experience usually happens when someone begins to “feel sick”. This feeling is not just an emotion but also a perception and an understanding that something is not quite right. Now this perception is also fed from the person’s own resources of knowledge and previous experiences. These resources are conditioned by the culture she grew up in which socialised her into a worldview, a set of beliefs and a value system. For this reason the experience of illness is always cultural. Culture provides her with labels for the illness which allow her to identify the illness within her own identity as a human being. In this way the feeling can be identified as headache, cold, umkhuhlane, possession by evil spirits, sin, being bewitched or thakatha’d, false consciousness or whatever other label the culture may prescribe.

This labelling process is also important because it allows the illness to move from the unknown which can exert enormous power to the known where it can be dealt with. Once an illness has been labelled or culturally identified then the healing system of the culture will provide a remedy. In the culture of medical science, the remedy for the illness “headache” is “two aspirin”. In Zulu traditional culture the remedy for umkhuhlane is umuthi. In Catholic and Pentecostal cultures the remedy for “possession by evil spirits” is prayer or “casting out demons”. In Catholic cultures the remedy for sin is confession and absolution.

We always use the easiest remedy that will work. As a first step we look for healing within our own knowledge and understanding or within our immediate family circle which often provides some effective folk remedies. If that doesn’t work, and the illness continues, we will go onto the next level: the local cultural healing centre. These are healing experts who are close at hand. For Westerners they will be the clinic, nurse or doctor. For traditional Africans they are the nyanga, sangoma or ngaka. For urban Blacks they are likely to be the umkhokeli, umprofeti, or umthandazi: the township prophet healers. For Catholics, Pentecostals, Hindus or other religious persons it might be the priest, pastor or guru.

If the local healer fails and the illness continues, then we are likely to look for a more powerful cultural healer or cultural healing institution to help us. On this next level Westerners might go to the hospital whilst those belonging to African Traditional culture might embark on a journey to a distant or wellknown nyanga/nganga/ngaka. Those belonging to a township culture might go to a distant wellknown umkhokeli, umprofeti, umthandazi like Ma Radebe of Cancele who was very popular in the 1980s. For the Christians it may be a specially powerful healing person or healing place like Archbishop Milingo, Benny Hinn or Lourdes.

If the illness is still not healed then I may conclude that my culture cannot heal it and I will look for other healers outside my own group. This is a journey which takes me across the cultural healing boundary. A westerner who feels ill but is told by the doctor that “there’s nothing wrong with you” will go elsewhere: to holistic healers, or homeopaths or even to Eastern gurus. People of African Traditional cultures eventually took a similar journey as they discovered the healing power of clinics, nurses and doctors in the Western system whilst continuing to interpret these within their own categories of sickness and health. It is also why some Christians make us of traditional healers nyanga/nganga/ngaka without necessarily acknowledging the fact. It is why non Pentecostals may go to the “miracle tent crusade” and  why Springbok rugby player Wium Basson went to the Nigerian faith healer, Prophet Temitope in 2001 (The Star (South Africa), Apr. 22, 2001). When a person takes a step like this they begin the process of culture change. Some individuals convert to another world-view if the healers of that culture or religion are effective. Whole cultures may change as a community lets aspects of another cultural healing system into their own. This is what happened in traditional African culture as it incorporated the western healing system.

In all of this human behaviour it is important to remember that the aim is always to feel well. This is because illness and healing is an unwellness-wellness paradigm on the level of human perception and feeling. 

Sometimes the locus of the experience of illness may not be the ill persons themselves, but the community where they live. A person may feel fine herself whilst those around are very aware that something is not right. They may then ascribe cultural labels of sickness to her and prescribe cultural remedies of healing.  This is the kind of thing that happens when a community labels someone as “mad” and institutionalises him even though he feels fine himself. Psychopaths may believe that there’s nothing wrong with them even as they destroy the lives of others who get in their way. Some secular communities or schools of psychology often see “religious” behaviour as sickness resulting from various degrees of neurosis or psychosis (cf Ellis nd; Ellis 1962). It is also what happens when a community identifies a witch amongst them and deals with the person according to cultural prescriptions. Finally, someone who is HIV positive may feel just fine but once the community has labelled him as HIV+ then all the categories of illness ascribed to such a person will be placed upon him. He will be considered a sinner, a promiscuous person, a dangerous person, a fearful person, someone living with death, someone who is polluted and so on. All of these sicknesses will describe his new human identity within his society. This is why many fear to go for HIV testing.

Religious and cultural healing therapies try to look at all aspects of what can cause human unwellness and what is required to become well. They are thus concerned with holistic approaches to the problem. All religions and cultures prescribe the meaning and purpose of human life. They also link health to the fullness of human life and to all the different aspects of what human life is about. Health may include notions of salvation, as in the Christian religion, or enlightenment as in eastern religions or of a good life lived in harmonious relationship with others as in African traditional culture. It may include notions of correct human social living as in the Marxist, Christian, Muslim, and Western systems. It may also include a moral or ethical system which allows people to live in mutual trust and respect rather than in social chaos. Sickness within a religious and cultural system can be ascribed to a breakdown of any, or all, of these aspects of human life and wellness. It should also be noted that in a cosmopolitan society like South Africa most people participate in a number of cultural paradigms. This means that the somewhat contrived cultural models presented above are more fused together in the reality of human life. In other words South Africa is multicultural and a lot of symbol borrowing and cultural system sharing goes on. It should also be noted that AIDS affects all strata of society and all races within the country.

“Faith” describes the relationship of adherence that people have with their religion or culture. It implies an acceptance of the teachings, values and world view. Some faith in the cultural or religious health system is a necessary prerequisite to using it. If I don’t believe in the system I wont use it. It is in faith that I use the labels and symbols which help me identify what is wrong and the rituals and therapies which will help me to put it right. Faith is an important component of the sickness/healing paradigm, and this includes the medical model. Once I believe in a particular human system of sickness and health then the culture out of which the system emerges will provide the categories of understanding, categories of knowledge and the labels and symbols of well-ness and unwellness.

Faith also implies that sick people expect the remedies offered by the religion or culture to be effective for them. This is the power and importance of religious and cultural healing and also its particular importance in situations of crisis and confusion. The pandemic of HIV/AIDS is such a situation.

D         Religious and cultural healing in a world of HIV/AIDS

When we look at the HIV/AIDS pandemic we quickly realise that here is a sickness which affects many different aspects of human life and identity.

It is a sickness which affects individuals, turning young, effective, vibrant persons into living  skeletons walking to an early grave.

It is a sickness which affects families and communities, leaving a legacy of AIDS babies and orphans to be cared for by grannies and strangers.

It is a sickness which affects society and religion, making people into sinners and lepers, rejected by families, friends, churches and communities.

It is a sickness which distorts human identity and cultural notions of the truth, as people pretend that there is no sickness, refusing to identify its presence amongst them.

It is a sickness which creates and feeds off poverty. It reduces those who previously managed to survive because they had jobs, into wretchedness, hunger and a living death. It devastates the extended families they were supporting. It spreads with the ferocity of a bush fire amongst the poor who have no way to protect themselves, found, as they are, only on the margins of a full human life, in their daily experience of limitation in knowledge, resources, morality and extended suffering.

It is a sickness which thrives on social chaos, affecting, far more powerfully, those communities deprived of the institutions and structures of social cohesion which allow for effective social life built on mutual respect and trust in the rule of law. Without such institutions, drunkenness, lawlessness and licentiousness remain unpunished and the weak and defenceless are at the mercy of the powerful. When a society degenerates into social chaos then the cultural and religious restraints are no longer able to exert the moral force they previously had on people and so taboos about killing, rape, violence and respect are gradually eroded. It is in such a context that prostitution may become the only means of survival and the risk of infection a risk that has to be taken. In such a context men may feel that the rape of a child to be cleansed of the virus is a good path of action to take.

It is a sickness which has political consequences for a society. Governments like South Africa, Zambia, Botswana, Uganda and the USA have debated the issues around HIV/AIDS and come to their own conclusions regarding the truth of the epidemic and the way to deal with it. President Mbeki, and the South African Minister of Health, Manto Tshabalala Msimang, whether they still holds the position or not, are generally considered to belong to the group of AIDS skeptics who question the relationship between the virus and the epidemic and who consider what is now called AIDS to be a re-labelling of previous sicknesses which have decimated African populations for many years. Political leaders are responsible to create health systems which improve the common good in society. Citizens are responsible for political action in advocacy, lobbying and struggle to ensure that leaders follow the will of the people.

Religious and cultural healing has to respond to the complexity of this sickness as a human reality. This is because religious and cultural healing is concerned with all of humanity and human identity. The goal of religious and cultural healing is the restoration of the fullness of humanity and human life to the many strata of human life where the sickness penetrates. The way in which these strata are understood will, of course, depend on the categories of understanding of human life within the particular religion or culture. And so in the final part of this talk we will have to make some choices about religion and culture for there is no time to deal with them all. The choices I make are within the Catholic Christian Religion in Southern Africa. My goal is to identify some important areas for responsible healing strategies that we should be developing.

E. Responsible Catholic Christian healing of HIV/AIDS in the Southern African context

1. Therapies in the medical culture

Strictly speaking, of course, one could even identify medical therapies as a form of cultural healing, operating, as they do, within the parameters of modern western culture and the scientific paradigm. The Church would consider acceptable, all those forms of medical therapy which are not destructive of human life. The toxicity of antiretrovirals is, in this way, acceptable in terms of the principal of the double effect (Peschke 1991:273-281) since the principal effect is to enhance the quality and extend the length of human life. For this reason many Catholic AIDS care centres are actively seeking ways to provide these drugs to their patients.

2. Therapies based on care

One of the most powerful forms of healing that we can mediate to people is caring for them in their suffering. Thousands of volunteers have been mobilised by Catholic AIDs projects to help in Home based care programmes, Orphan care programmes and other forms of caring projects. Care for people, especially the very poor, includes the search for ways to help them survive. In this regard the development of income generating projects has become a vital aspect of healing care. People who care for others bring them hope, support, joy and the opportunity to live in human conditions and to die with human dignity. All of these are aspects of religious and cultural health.

3. Therapies for psychic wellness

Psychological therapies can be summarised as all those therapies whose goal is the psychic well being of the patient. There are many different kinds. Therapies which restore emotional wellness help a person to feel better. Therapies which restore cognitive well-being allow people to understand and accept their situation more realistically. Therapies which allow psychic integration of beliefs, values and behaviour, promote a lifestyle which reinforces self identity and self esteem (May in Buhrmann note 42).

Psychological therapeutic methods also have religious and cultural dimensions. The various approaches to psychotherapy have emerged out of different schools and are based on different sets of beliefs and values. Many authors (Dow 1986, Moerman 1979, Buhrmann 1986 and Edwards 1985)  have  emphasised the importance of cultural factors in psychotherapy. Buhrman (1986), who studied traditional Xhosa healing, was able to make clear links between what she does as a Jungian therapist and what the igqira does with his/her own patients. In psychotherapy the cultural factor is so important that Mandura wrote: “unwillingness to consider a patient’s culture is tantamount to treating him as a fragment rather than a whole person; this attitude is antitherapeutic.” (In Burhrmann 1986:93). 

4. Therapies based on cultural symbols 

Rituals are one of the main ways in which culture mediates healing to people. Ritual healing has the ability to effect psychic and social healing for those people who accept the worldview and symbol system of the culture. In a healing ritual the factors which cause sickness and those which have the power to heal are attached to cultural symbols. During the ritual process these symbols are manipulated by the cultural healer in order to effect the healing. How does this work in practice? Within a traditional African culture, the principal symbols of sickness are angry ancestors, pollution or dirt, and witchcraft. Healing symbols include the drums, dance, music, umuthi and the healer who heals through an ancestor. In the ritual process, all of these symbols are brought together in a symbolic routine as healer, patient and affected community go through the ritual. The effective healer is able to overpower the symbols of sickness by the symbols of healing and in this way make the healing present in the hearts and minds of those present. This means that the healing is experienced or felt by those present through the emotional power of the ritual itself. They feel better! A similar process occurs in the miracle tent crusade of the Pentecostal healer where the symbols of sickness are sins and demons and those of healing are the Holy Spirit, the casting out of demons and the laying on of hands. Ritual therapies are also effective in places like Lourdes with its processions, healing baths, candles and prayer at the grotto. The so-called placebo effect in the medical model probably works through the operation of the same ritual process.

Ritual healing processes effect cultural healing by restoring wholeness within the community. When a community has been through a prescribed ritual, one effect is the  promotion of relationships within the community and the restoration of broken ties. This is because people have done the right thing together.  Ritual healing processes also promote a sense of well-being within the community because they articulate the belief system and value system of the community. Catholics have to examine themselves to see whether ritual healing solutions are being effectively applied to the healing of those infected and affected by HIV/AIDS. The Catholic Church is a Church which recognises the role of rituals in Christian life. Are Catholic AIDS projects doing enough to develop and adapt these rituals for use with patients and communities affected by the illness?

5. Therapies responding to social and political factors

In one sense the greatest healer in South Africa is not a Pentecostal pastor or a powerful sangoma or a great doctor like Chris Barnard but a politician. I am thinking of the Minister of Water affairs who has been responsible since 1994 for the provision of clean running water to some  7 million people who did not have it before.⁴   Issues of healing are issues of society and of politics. It is society’s leaders who determine the acceptable healing structures of society and the resources which they receive. Issues of HIV/AIDS in South Africa have been fraught with political ramifications. The South African Government’s HIV/AIDS policy has been disastrous, leading to South Africa having the highest number of AIDS patients of any country in the world. Organisations like the Treatment Action Campaign have had to continually lobby for a greater government response to HIV/AIDS as well as to fight the pharmaceutical companies in the courts on the issue of greater accessibility to cheaper AIDS drugs. Healing on this level takes on dimensions of political struggle as in the Apartheid era and it is interesting to see the same kind of social activists involved in both. Problems with government were reported as the third more serious difficulty that Catholic AIDS projects have to deal with. These problems include bureaucratic ineptitude and counter-productivity an anti religion or anti-Catholic bias and just plain prejudice (Bate 2002: 34-38). The Church must continue to play a role within civil society on the level of advocating for more effective structures of healing to deal with the pandemic and to promoting effective Christian solutions for prevention.

6. Spiritual therapies

Spiritual therapies recognise the importance of supernatural factors in both illness etiology and healing remedies. Illness etiologies may be ascribed to the activity of spirits, demons or other malevolent spiritual beings as well as to immoral human behaviour usually understood as sin. Healing therapies include the casting out of demons or evil spirits, the confession and forgiveness of sin,  anointing with oil, laying on of hands and prayer for the sick person. In the Catholic tradition there are two sacraments of healing: Penance and the Anointing of the sick. Receiving communion also has a healing effect.

In the scriptures we cannot find hard and fast rules about healing but nevertheless some misunderstood notions need correcting. When Jesus or the apostles heal in the scriptures, the main words used are sozo (σæζω) and therapeuo (θεραπεύω). These words are usually translated as “cure” in English. But they absolutely do not mean cure in the medical sense. There is another Greek word for that (iasthai). Sozo  means to heal, save, rescue or maintain integrity. It always refer to the whole person and not to individual members of the body (Foerster 1973: 990). Therapeuo is used in the New Testament  in the  “sense of to heal and always in such a way that the reference is not to medical treatment which might fail but to real healing” (Beyer 1973: 129). When it comes to the act whereby Jesus heals, the word that is primarily used is dunamis  (δυναμις). Dunamis is a powerful or marvellous force which originates in God (Grundman 1973:301-302). We get our English word dynamic from the same Greek word. Unfortunately dunamis has often been translated “miracle” in English translations and the current Western understanding of this word is an event which is outside the normal rules of nature. This restrictive usage is not really what the original text wishes to communicate. Dunamis gives Jesus control of all powers and spirits and in this way he is able to work signs and wonders.

As Christians we believe in the power of God to heal the sick. Indeed the church was given a specific mandate to heal the sick and to cast out demons (Cf James, 5, Matt 10). One of the surprising discoveries in the study of the work of Catholic AIDS projects in Southern Africa was the seeming absence of this form of healing strategy in the Church’s work. I would suggest that the value of prayer, spiritual healing and other specifically religious pastoral services will enhance this effort. Scientific studies have shown that religious factors have a positive effect on healing.  Harvard Medical School’s conference on “Spirituality in Healing” provided studies showing the clinical benefit of religious practices like prayer and worship.⁵  These studies and others like them allow us to venture that medical science is also now beginning to recognise the operation of clinical factors in religious healing. If we do not provide resources for this kind of healing, we run the risk of becoming too secular in our approach and people may come to us for their material well-being and go to the healing churches such as African Independent Churches and Pentecostals for their religious needs. It is essential that we provide more spiritual therapies like prayer, worship, healing services and other forms of Christian spiritual healing as part of our response to the pandemic.

F.         Conclusion

Religious and cultural healing focus on the healing of a person as a human being. We are concerned with the restoration of human life on the personal, familial, communal and societal levels. This is a project that involves the whole of society because the whole of society is affected by HIV. Responsibility means, in the first place, coming to the awareness that I am involved because we are involved and that all of us need to take responsibility for our actions in society. This responsibility includes providing the best treatment for those suffering infection by the virus and an effective response to its human consequences. It means dealing with the other effects of the pandemic in our society such as promoting values based, sexual behaviour, fighting the stigma of AIDS within our society and lobbying government for better policies and practices to fight the disease. It also means an involvement by Christians in civil society to work for the promotion of Christian values within it.

Responsibility in religious and cultural healing should open us up to the value of providing therapies on many different levels and not just the medical. It should help us to value and promote a multiplicity of therapeutic approaches including psychological approaches, ritual approaches and socio-political solutions. Finally, it should help us to see the value of religious healing approaches, since religious categories respond to the limit areas of human power, where our ordinary ability to be on top of the situation is compromised. Since the current state of HIV/AIDS as a massive plague puts all of us in such a situation, the religious therapies become very important. Responsibility here means recognising this and making use of them. We believe that God can heal us on many levels for he is the Lord of life and will save his people.

References

Bate, S C 1999. Inculturation of the Christian Mission to Heal in the South African Context. NY:Edwin Mellen

Bate, S C 2002.  Independent evaluation of HIV/AIDS projects funded through SACBC. Report to SACBC AIDS desk, Johannesburg August 2002..

Beyer 1973: s v therapeuo ktl ThWNT

Brundtland 2000.  Address of Dr. Gro Harlem Brundtland, Director-General, World Health Organization to UNAIDS Programme Coordinating Board 25 May 2000.

Bührmann , M.V. 1986. Living in two worlds (communication between a white healer and her black counterparts). Illinois: Chiron Publications.

Dow, J. 1986. "Universal Aspects of Symbolic Healing: A Theoretical Synthesis." American Anthropologist 88,1:56-69

Edwards, S.D., ed. 1985. Some Indigenous South African Views on Illness and Healing. n.p.: University of Zululand.

Ellis, Albert. 1962.  Reason and Emotion in Psychotherapy. New York: Lyle Stuart.

Ellis, A nd The case against religion. Online <http://www.matriarch.com/case.htm>

Foerster 1973: s v sozo ktl ThWNT

Geertz, G 1973. The Interpretation of Cultures. N.Y.: Basic Books

Grundman 1973 s v dunamis ktl ThWNT

Holmes, U 1981 A History of Christian Spirituality . NY:Seabury Press.

Moerman, D E 1979. Anthropology of Symbolic healing. Current Anthropology 20,1:59-80.

NIAID 1  The Evidence That HIV Causes AIDS. Created November 1994. Last updated November 29, 2000. National Institute of Allergy and Infectious diseases Bethesda, Maryland. http://www.niaid.nih.gov/factsheets/evidhiv.htm.

NIAID 2 HIV Treatment Guidelines Updated for Adults and Adolescents. National Institute of Allergy and Infectious diseases Bethesda, MarylandFeb. 5, 2001

http://www.niaid.nih.gov/newsroom/releases/hivguidelines.htm.

White, A.1988.  “AIDS as divine judgement”. Journal of Biblical Ethics in Medicine Vol 2 No4.online http://bmei.org/jbem/volume2/num4/white.htm
           

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