Abstract #47  -  Driving the devil away - Holy water, prayers, and other miraculous cures for AIDS in a semi-rural Tanzanian ward
Authors:   Presenting Author:   Mr Benjamin Nhandi - National Institute For Medical Research
Additional Authors:  Mr Ray Nsigaye , Mr Benjamin Nhandi, Mr Mark Urassa, Mrs Basia Zaba, Mr Jim Todd,
Aim: The role of religious beliefs in the prevention of HIV and attitudes towards the infected has received considerable attention. However little is known about Faith Leaders’ perceptions of antiretroviral therapy (ART) in the developing world. This study investigates religious leaders’ attitudes towards different “HIV treatments” available in a rural Tanzanian ward (traditional, modern and spiritual).
Method / Issue: In-depth interviews with 21 Faith Leaders (FLs) purposively selected to account for all the denominations present in the area and content analysis conducted with NVIVO-7 software.
Results / Comments: Misfortune was often attributed to the “work of the devil” and villagers resorted to FLs seeking success in business, reproduction and love. Praying for the sick was an extended practice. Inter-denominations mobility was high and guided by pragmatism. Traditional healers (THs) and FLs were often reported as antagonist (“as oil and water”) and some healers were categorised as “agents of evil”. However, duality prevailed and many “church goers” and FLs resorted to traditional healing (“he is double-minded: he believes in this and in that too”). Some FLs from both mainstream and emergent churches believed in witchcraft-induced Aids-like diseases and a few reported that “bad spirits” could be cast away using prayers or “holy water” (“we pray and the spirit runs away leaving the person free”). The rituals of new denominations were occasionally described as “a certain kind of sorcery“, rumours circulated about a FL who had learnt “tricks from the witches”, and “praying to God” was mentioned as a diagnosis method used by some THs. Being HIV-positive was seen as “a punishment from God” but could be due to the “instigations of Satan”. Forgiveness was thus possible and a “reconciliation with God” essential for a favourable disease progression. Some FLs believed that prayers could cure HIV “completely” but ART use was generally not discouraged as God had “only a part to play” and prayers were ineffective for those “doubtful” and “half hearted”.
Discussion: Spiritual healing seemed to be promoted more as a complement than as a substitute for ART. This contributes to explain the lack of association found in other parts of Tanzania between the belief that a prayer can cure HIV and the hypothetical willingness to initiate ART. Still, some FLs thought that “real” or “witchcraft-induced” AIDS could be “completely cured” through spiritual means and evidence points to the belief in miraculous cures as a factor contributing to ART interruption. The documented tendency to turn to religion after an HIV+ diagnosis situates FLs in a privileged position to promote ART initiation and adherence. By delivering ART education to their communities FLs could also contribute to increase the local acceptability of the drugs. The impact of banning TH’s activities on the demand of spiritual services deserves further attention as THs and FLs are consulted for similar reasons and share an economic context of severe deprivation as well as a common system of beliefs based in the fight between God and Evil. Leaders from both mainstream and emergent denominations should be further involved in the roll-out of ART.
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