I've just finished an excellent book about the AIDS epidemic in SA, Three-Letter Plague by Jonny Steinberg - this was recommended to me by my friend Charles who runs a wonderful blog over here (and who is himself a brilliant fiction writer - do buy his books!)
Steinberg's book is about a Medecins Sans Frontieres attempt to set up an antiretroviral treatment programme in a poor village in rural Transkei - but it's even more about a local man's reluctance to be tested for HIV and Steinberg's attempts to understand this reluctance. It'd be pointless to try to summarise the whole book here - I suggest you read it - but it goes a long way to explaining the gap between African traditions and what people like me take for granted about modern health care. There's a tension in the fact that the author is white and the protagonist is black - but this is addressed directly at various points, and perhaps it's helpful in some ways for a white South African to act as an interpreter of African culture for an ignorant white Englishman like me.
I found much of the book very uncomfortable reading - the narrative about the AIDS epidemic itself (one in eight people in SA are HIV positive; 800 South Africans die of AIDS every day) and the various obstacles that health workers have to overcome or fail to overcome; but also the accounts of magic and witchcraft which are an integral part of rural culture in SA. I have almost no tolerance towards religion and mysticism in any form at all, and I'd willingly go ten rounds with any Christian, so there's no reason for me to expect myself to tolerate superstition any more in African culture - but then this clashes with a willingness to try to respect the beliefs of people whose views are different from mine - shouldn't I suspend my cynicism towards a culture I know very little about, at least initially? However this sort of thing astounds and repels me:
- babies sleep badly because they're sensitive to evil spirits; the dead can visit you in your dreams and ask you to perform rituals for them; envious neighbours can cast spells to make demons visit you while you're asleep and force you to eat raw meat or have sex with them; epilepsy is caused by demons who attack their victims from within their bodies; the tikoloshe demon is a foot tall, has an old man's face and a long beard, and his penis is so long he carries it over his shoulder - he is visible to children and the adults he has sex with - he's willing to murder the enemies of his human lovers; the impundulu appears as a handsome young man and seduces women when they're alone; and so forth.
Steinberg writes, "I was struck for the first time by the full weight of what it means to live in a magical world... in which the gap between ill wishes and the means to fulfill them closes. Those who wish to ruin you can do so by little more than wanting it."
My own reaction is: what nonsense, what ignorance. But my response is certainly very limited, as these beliefs are apparently still central to the social and psychological reality of people in rural areas here - astonished rejection isn't going to help understanding. The relation between a belief in witchcraft and attitudes towards AIDS is complex and indirect and again I won't attempt to summarise it here - but Steinberg's book challenges all sorts of (Western) assumptions on all sorts of levels - which is a rare and worthwhile achievement for any book.