HIV/AIDS and Traditional Medicine

 Overview of HIV/AIDS (Stats)

Stacey Links PhD Researcher Receptor Approach

The HIV/AIDS pandemic, which broke out during the early 1980s has become an issue that has gained increased attention in all fields within a short amount of time.  The explosion of cases of the virus has had enormous effects not only medically speaking, but additionally across legal, social and particularly economic aspects of society.  To give a brief overview of the degree of the pandemic and its enormity: In 2011, there were approximately 34 million people living with HIV/AIDS worldwide. With this, Sub-Saharan Africa (Hereafter SSA) has been the worst affected accounting for more than two-thirds of all HIV/AIDS cases while South and South East Asia come in as the second most affected region.  In 2010, 69% of all HIV cases were in SSA, while 66% of all deaths related to HIV/AIDS were from SSA.  Globally speaking, South Africa is home to the largest population with HIV/AIDS.  To give some insight into the gravity of the problem by way of comparison, in South and South-East Asia in 2011 there were approximately 5million people recorded as living with HIV/AIDS.  South Africa, as a single country alone has 5.9million people living with HIV/AIDS.  This is of course merely a statistical insight into the enormity of the problem but nevertheless concisely indicates the gravity and depth of the pandemic.

HIV/AIDS as a virus is of course not geographically contained nor does it solely affect the developing world.  With that being said, there nevertheless exists a clear divergence in factors present in the developed and developing world.  These factors have affected the virus’s growth and path of development in distinct ways within these two regions. 

What has remained problematic in the developing world, however, are the discrepancies between the public and private domains regarding discussions on HIV/AIDS. In SSA the issue of HIV/AIDS has been relatively visible in the public sphere.  Publically speaking, by way of the dissemination of information, campaigns, rallies, and overall visibility, the issue of HIV/AIDS has been seemingly, albeit surprising to some, at the forefront of medical and social debate.  In the private sphere however, a very different story unfolds.  It is here in the private sphere that the ills and dangers of stigmatization and secrecy emerge. This stigma exists in a variety of forms, and is useful to deal with as a distinct phenomenon in its existence and functioning within society.  But first I will briefly lay out the issues surrounding traditional medicine and conventional biomedicine before getting to the issue of stigmatization. 

Dialogue in the Receptor Approach to human rights model: some lessons from Theatre for Development (TfD).

In this article I will first present briefly the idea of the receptor approach to human rights and the important role that dialogue as part of an effective communication strategy plays within it. I will then consider Theatre for Development as practiced in East Africa with a view to highlighting aspects in its process that I believe could be useful in strengthening of effective dialogue within the Receptor Approach to human rights.

The Receptor Approach to human rights is a practical and functional approach for the promotion of international human rights obligations in local contexts, according to which international human rights norms and local cultural practices could and should mutually reinforce each other. The Receptor approach borrows its name from the field of biomedicine, where receptor molecules residing on the cell surface or nucleus receive and transmit external chemical signals. These signals are usually loaded with specific instructions for the cell, controlling such vital functions as cell division, extinction, as well as entry and exit of substances to the cell membrane. For the communication to be effective, the signaling molecules (carried for examples in hormones, drugs and neurotransmitters) have to lock onto specific receptor molecules which then translate the signals into the desired actions.

The Receptor Approach analogously makes use of human rights receptors within cultural societies that provide a path through which both cultural and social institutions and treaty obligations can be received, analyzed, understood, translated and delivered for enjoyment by right holders. This approach therefore considers that international human rights will be most effective if they are able to lock onto social and cultural receptors. As such, it is a two way communication process to which effective dialogue is crucial.

The Receptor Approach is a two-step process that involves matching and amplification. Using established approaches from ethnography, it identifies the core elements of the international human rights regime and looks for analogous phenomena in the societies of the state party concerned. Consequently, the duty to implement a particular right may be matched by social institutions other than law, such as kinship, religion, custom, customary law, pledge societies, social support networks or group-help. If there is a full match, the state is living up to its international human rights obligations despite not relying solely on legislation. If there is no match or only a partial one, then amplification is required and the state has to extend existing social arrangements to bring it in line with its obligations.

Such amplification may involve reforms, and the Receptor Approach promotes the idea that reforms should be indigenous and add to but not replace existing social arrangements. It opposes the introduction of foreign notions into local contexts if local remedies can be found which, while undoing the violation, remain loyal to the social structure existing in that particular society. This position is informed by the belief that changes that add to the existing arrangements stand a far better chance of being supported and carried out by the community than those enforced top-down. For this process to be effective, it is imperative that honest, genuine and mutually respectful dialogue that results in a transfer of knowledge to both parties be at its heart, and this is where the experience of Theatre for Development TfD provides valuable lessons.

It is recognized from the outset that no unified methodology or ethical standard in TfD exists at the moment. Joseph describes TfD as operating in an extremely discursive and eclectic context, and finds the lack of a guiding ethical standard as seriously hampering the effective practice of TfD. The attraction of TfD to the Receptor Approach, however, lies in its stated intentions, founding ideas and ethos, rather than as a robust model of unqualified success.