HIV illness meanings and collaborative healing strategies in South Africa

Traditional health care practices were formally recognised and advocated by the World Health Organisation (WHO) in 1978. The implications of the WHO’s directive have been diverse, and have shifted over the subsequent three decades of international health care. Similarly, the landscape of disease and illness, within and beyond South Africa, has been significantly influenced by the burgeoning international and regional HIV-epidemic. In South Africa the move to democracy was coupled with a decentralisation of the National Health System (NHS), increasing rates of HIV-infection, and a political desire to recast traditional healing as an African cultural practice deserving of state endorsement. This paper considers the multiple illness meanings and treatment strategies employed by HIV-positive people and traditional healers living in Cape Town, South Africa. In order to offer an understanding of treatment strategies that move between the biomedical and traditional healing, this paper draws on the distinction between the psychosocial aspects of illness and the biological disorder of disease. The first section of the paper presents a case study of an HIV-positive woman’s experiences of the illness and the disease of HIV, and explores her concomitant health care strategies based on her shifting conceptions and experiences of HIV. The subsequent section moves into a detailed analysis of interviews conducted with a sample of traditional healers. This section highlights the traditional healers’ overlapping and also divergent views on the causation and treatment of HIV and AIDS-related illnesses amongst their HIV-positive clientele. Finally, this paper places traditional healing practices and practitioners within the context of South Africa’s NHS in order to suggest some of the potential benefits and limitations around collaboration between biomedical and traditional health care paradigms