What Ebola can teach us about the complexities of religion and health in Africa
More than 8,200 reported Ebola deaths in Guinea, Liberia and Sierra Leone. A mortality rate above 50 percent for people contracting the virus. Searing images of individuals being turned away at medical centers, and children about to be orphaned ministering to dying mothers and fathers.
It is no wonder that so many individuals in sub-Saharan Africa have turned to religion to seek hope and some form of understanding in the face of the Ebola crisis.
Religion permeates all aspects of African society and culture; roughly nine in 10 people or more in nations such as Liberia and Nigeria and many other countries in West Africa reported that religion is very important in their lives, a Pew Research survey found.
In the area of public health, discussion about the role of religion in combating Ebola has become imperative given the overarching influence of religion in the lives of people in the most infected areas.
For starters, faith-based organizations have a critical role to play in the Ebola prevention effort.
They already have an established loyal following and existing infrastructure to reach people. They have access to resources, especially social capital and networks that can be used for Ebola outreach and preventive efforts. The leadership can also use their influence and pulpits to draw attention to the way the disease is transmitted.
Similar to the HIV/AIDS pandemic, Ebola is also producing new populations of stigmatized individuals who find themselves abandoned by the side of the road, including widows and orphans who often have few places to seek help other than faith-based organizations.
At their best, faith-based organizations and religious communities have embraced victims with loving care, heedless of their own safety in treating the suffering and working with public health officials in education and prevention efforts.
Still, amid the uncertainty that has gripped governments, world health officials and religious groups alike, responses have been varied over religious rituals such as Muslim and traditional African burial practices encouraging the washing of the dead, Christian practices such as exchanging hugs and handshakes and receiving Communion orally and the reliance on traditional healers that provide sources of comfort and hope to believers but also pose public health risks.
So we ask: How have African religious institutions, leaders, practitioners, activists, and theologians responded to the crisis?
The answers are complex.
Religion and health
Several studies in the rapidly growing field of religion and health have indicated that belief in a loving God, along with the support of being part of a social network whose members care for one another, leads to positive physical and mental health outcomes, including lower rates of depression and anxiety and greater overall happiness.
Spiritual resources offering hope, optimism and connection can be especially helpful to those suffering from Ebola, a potentially fatal disease with no known effective cure that is transmitted through direct contact with the blood or body fluids of an infected person. The fear and uncertainty surrounding Ebola has led to levels of stigmatization somewhat similar to those faced by people with HIV/AIDS during the initial years of that pandemic.
Yet, just as in the medical world, where inadequate infrastructures in many nations forced care workers to turn some people away or offer only minimal services, so too have many religious groups struggled to come to terms with how best to comfort and support their members without taking risks that may lead to the spread of the disease.
The considerations begin with practices as elemental as gathering for worship, whether it be for Friday afternoon prayers in mosques or Sunday services in churches. Deciding who should be asked to stay home, including family members and caregivers, presents difficult choices for religious communities committed to providing compassionate public support for already stigmatized victims.
This is particularly challenging for faith groups, such as Pentecostal and Catholic communities, accustomed to caring for the sick in large charismatic healing services. But it also surfaces in questions over more common expressions of communal devotion such as the exchange of hugs and handshakes before, during and after services.
Other issues of religion and health are more particular to different religious groups. Consider these cases:
- Communion: The Catholic Church, as do some other churches, offers the option of receiving the host believed to the body and blood of Christ by hand or by mouth. But the concern of spreading Ebola through saliva led some religious leaders to ban the option of distributing Communion orally.
- Washing of the dead: African religious practices and Islamic customs calling for the washing of the dead are being reconsidered since the virus can be transmitted through direct contact with an infected individual who is deceased. In a letter to the medical journal The Lancet, two Saudi Arabian scholars noted that under
the Principle of Injury and Harm, one of the five grand principles of Islamic Law, it is permissible not to wash corpses if washing them would expose washers to harm.
Health and wealththeology: There are thousands of different expressions of Christianity in Africa, including some that place a particular emphasis on the temporal benefits and punishments associated with religion. Where it can become a public health concern is when some Christian leaders take theology to such an extreme that they make explicit promises of healing that can discourage individuals from seeing doctors, or claim the virus is a punishment from God, further stigmatizing victims.
- Traditional healers: Throughout highly religious West Africa, Christianity and Islam co-exist side by side with African belief systems. Unfortunately though, in addition to healers who work in concert with the medical profession, the West African region abounds with individuals who go around peddling all sorts of spiritual healings, ointments and anointing oils that are supposed to cure Ebola and several other diseases to some of the most vulnerable and marginalized populations in the region.
The experiences of religion’s role in addressing the AIDS epidemic and decades of research in the field of religion and health in Africa in general conclude the most effective care and prevention outcomes occur when religious groups, medical officials and governments work together.
Faith groups not only need to continue offering hope, compassionate care, and outreach to the most vulnerable segments of Africans hit hardest by Ebola. They also have a responsibility to use their influence to educate their members about how Ebola is transmitted and to seek professional care, being bold in preaching against false religious claims and untested medications.
There are gratifying reports from West Africa that many religious leaders are actively involved in education and prevention efforts.
For example, Catholic and Anglican leaders in Nigeria told priests to deliver communion elements into the cupped palms of worshippers, and some discouraged parishioners shaking hands during services. Muslim and Christian leaders in Liberia have appeared on the radio encouraging safe mortuary practices. And while some Christian and Muslim leaders expressed concern that the Sierra Leone government was insensitive in imposing a three-day quarantine during the worship days of Friday through Sunday, they cooperated with the national shutdown to allow health workers to conduct home visits throughout the country.
Faith matters to the people of sub-Saharan Africa. And so it will matter in providing effective care for all those impacted by the Ebola crisis, from being a source of social support and connection for all those suffering from the disease to enlisting an international humanitarian response that calms fears, encourages the sharing of scarce medical resources and lifts West Africa out from under a pariah status that has created economic losses and instability throughout the region.
The good news at the beginning of this New Year is that the Ebola crisis has been contained somewhat. The improved outlook can make many African countries complacent. However, it’s not over yet so there is the need for sustained and increased efforts in stopping the spread of Ebola in West Africa. This effort requires a holistic approach. The efforts of religious social groupings would come in handy in any attempts at curtaining the spread of the disease.
- ARDA National Profiles: View religious, demographic, and socio-economic information for all sub-Saharan African nations with populations of more than 2 million.
- ARDA Compare Nations: Compare detailed measures on topics from religious freedom to religious demographics for Liberia, Sierra Leone, Guinea and Nigeria.
- International Religious Health Assets Programme: The South African-based organization develops research to help religious health leaders, public policy decision-makers and other health workers in their collaborative efforts to meet the challenges of disease, to strengthen health and community systems, and to promote sustainable health.
- World Health Organization: Ebola Virus Disease: The site provides the latest information on the Ebola outbreak.
- Pew Research Center: Tolerance and Tension: Islam and Christianity in Sub-Saharan Africa. The report offers results from a public opinion survey involving more than 25,000 face-to-face interviews in 19 countries, representing 75% of the total population of sub-Saharan Africa.
- Chikwendu, Eudora, Faith-Based Organizations in Anti-HIV/AIDS Work Among African Youth and Women
Due to their proximity to the rural poor, church health institutions are able to deliver rapid and efficient assistance to HIV/AIDS sufferers, and to bring quick relief to AIDS victims. Victims of HIV/AIDS are now receiving hope, humane treatment and dignity instead of hopelessness and stigma.
- Essien, Essien D., Notions of Healing and Transcendence in the Trajectory of African Traditional Religion: Paradigm and Strategies
This article draws attention to the practice of several healing activities in African traditional religion in its attempts to restore health, exploring the indigenization of health care procedures and the role and function of God in African medicine and healing.
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Our findings show that religion has the ability to modulate preventative behaviours and suggest that there is a need to intensify the efforts to involve religious leaders at the local level.
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The review of research on religion and health has a particular emphasis on literature addressing sub-Saharan Africa.
- OnIslam and news agencies, Muslims urged not to wash Ebola’s dead
Muslims in Liberia have been cautioned against washing the bodies of people who died of Ebola to avoid spreading the virus.
- Parkhurst, Justin, The Response to HIV/AIDS and the Construction of National Legitimacy: Lessons from Uganda
The article discusses the importance for non-state actors such as religious organizations to partner with health care professionals to help check the spread of the disease as happened during the peak of the HIV/AIDS pandemic.
- Takyi, Baffour K., Religion and women’s health in Ghana: insights into HIV/AIDs preventive and protective behavior
This article contributes to the discourse on religion and health in Africa by analyzing the interrelationship between religion and AIDS behavior in Ghana, a West African country where religious activities are more pronounced.
- Eds: Adogame, Afe, Chitando, Ezra, and Bateye, Bolaji, African Traditions in the Study of Religion in Africa
This book presents a unique multidisciplinary exploration of African traditions in the study of religion in Africa and the new African diaspora.
- Mbiti, John S., Introduction to African Religion (African Writers Series)
One of the leading experts of African religion offers a strong overview of the topic.
- Trinatapoli, Jenny, and Weinreb, Alexander, Religion & AIDS in Africa
Drawing on hundreds of interviews in Malawi and survey data from 26 other sub-Saharan African nations, the book explores the importance of religious narratives and institutions in everything related to AIDS in Africa.