Michael Ortiz Hill

May 8, 2001

Dear Editor:

As a traditional healer (nganga) among the Shona and Ndebele people in Zimbabwe and a registered nurse (UCLA Medical Center), one might say that much of my life involves moving between two very different medical modalities. Why, then, did I find myself irritated with Matthew Steinglass's survey of the attempts of Westerners to ally themselves with traditional practitioners in facing the AIDS crisis?

African people have had their traditional cultures trivialized and sometimes demonized by Christianity and Islam and their political and economic institutions buried under foreign forms. Western medicine has its own way of condescending to the intelligence and vitality of African ways of knowing, and many of Steinglass's informants display their variations on this tired theme. While they present various windows of opportunity for Westerners to influence traditional healers' points of view (yes, the tiny insects in the blood certainly dovetails nicely with the germ theory of disease), there is very little sense of dialogue in which there are two credible partners. Has it occurred to no one to communicate between epistemologies? Why is it only the African who is required to alter his or her limited or dangerous ways of perceiving?

Western allopathy is an ethnomedical traditions with its own virtues, lacunae and superstitions, not to mention its indigenous forms of brutality. When I return from Africa and have to shift into the logic of a modern hospital, I am struck first by the institutionalized superficiality of its medical praxis. Impressive in emergencies and diagnostics and sometimes pharmaceutical intervention, it tends towards both the heroic and the bureaucratic, and thus lacks a coherent relationship to incurability and the simple fact of mortality. When it comes to psychological distress and madness, there is no doubt in my mind that African medicine carries a more sophisticated and effective understanding.

African medicine, as Steinglass points out, also has its lacunae and superstitions and its brutalities. In response to the AIDS crisis, its virtues include its radical pluralism and remarkable inclusivity of whatever works from whatever direction. The vibrancy of its medical understanding is at its root community based, for every true healing is nested in the community of the living and the ancestors. Questions of meaning, so critical to anyone with a life threatening illness, are at the core of African healing whereas in the West they are not, fundamentally, a medical concern.

Between the West and Africa, there is rich ground for collaboration regarding AIDS, but until the West can meet the traditional healer as a peer, the gifts of biomedicine will be received with the ambivalence one might receive a gift from a missionary.

Michael Ortiz Hill, R.N.
African Studies
Eranos Institute
Ascona, Switzerland