by Ruby Mikulencak
One of the greatest hindrances to the improvement of health and living conditions in developing African countries is the conflict between the Western scientific world view and the African’s traditional world view.
One of the greatest hindrances to the improvement of health and living conditions in developing African countries is the conflict between the Western scientific world view and the African’s traditional world view. Many Western medical missionaries come to Africa with a preconceived agenda on the causes of illness. Their medicine is based on science. Scientific medicine believes in the "chance theory" that germs enter people and cause sickness. Westerners are so convinced they are right that they find it difficult to think in the categories and logic of the African’s world view.
The traditional African world view, on the other hand, emphasizes invisible powers operating in ordinary, everyday living. One of these beliefs is dynamism, wherein all thingsâ€”whether animals, people, or natureâ€”exercise a continuous, mystical influence over all other things. This is why traditional Africans worship the sun, moon, trees, and other natural objects so ardently.
Belief in a spirit world composed of dead ancestors also strongly influences how Africans regard health care. Traditional Africans believe the spirits of the dead possess great power and force. They constantly observe the living to make sure the traditional ways are followed. If the spirits are displeased, they show their anger by causing illness, or other calamities to befall the living. Their power helps to maintain the hold that traditional ways have over many Africans. Fear of disaster prevents people from rebelling against age-old social structures. That’s why there is often much resistance on the part of traditional Africans to the scientific ways of Western medicine.
Western doctors and nurses patiently explain the logic of their "germ theory," declaring it the sole cause of illness. They fully expect the Africans to believe them. When they don’t, often they are dumbfounded.
In discussing the traditional African mind-set, George Foster states in Medical Anthropology, "The sick person is literally a victim, the object of punishment directed specifically against him for reasons that concern him alone." Treatment, therefore, must include not only traditional herbs, but also making amends to whoever has caused the illness. The Western idea of becoming sick because of invisible germs does not answer the deeper question of why. The role of the traditional healer becomes clearer when we take into account the traditional African’s belief in cosmic and spiritual forces.
Arden Almquist writes in Practical Anthropology, "He (the traditional healer) is sought out because the patient feels he himself lacks power to deal with his illness and seeks to add power by established contact with powers outside and around him which he can influence in his favor through a skilled intermediary."
The rational, scientific thinking of Western doctors and nurses prevents them from taking a more wholistic approach to health. It inhibits their understanding of the way traditional Africans think. Likewise, Africans misunderstand the Western approach to health care. Therefore, we must try to bridge the gap by accepting the existence and reality of the traditional African’s beliefs, while using the "miracle drugs" of modern medicine.
BIBLICAL TEACHING IS CLEAR
Biblical passages such as 1 John 5:19, 1 Corinthians 10:20 and 2 Corinthians 4:4 speak of Satan and his kingdom working on earth. The African’s thinking on the reality of the spirit world is much closer to the biblical data than Western scientific thinking.
Jesus frequently encountered the demonic world (e.g., Matt. 8:24-34; Mark 5:1-20; Luke 8:26-39). Satan and his army work not only among unbelievers. Satan also accuses God’s people (Job 1:6-12; Luke 8:26-39); he opposes them (Zech. 3:1); he tempts them (1 Thes. 3:5); and he causes weak Christians to stumble (Acts 3:5). Over and over again the Scripture affirms this supra-cultural presence of demonic cosmic powers.
Perhaps one of the strongest verses is Ephesians 6:12: "For we are not fighting against people made of flesh and blood, but against persons without bodiesâ€”the evil rulers of the unseen world, those mighty satanic beings and great evil princes of darkness who rule this world; and against huge numbers of wicked spirits in the spirit world" (TLB).
As believers in Christ ministering in a context that admits to the reality of the spirit world, what should be our attitude?
First, we must recognize the existence of demonic powers. Peter tells us, "Be carefulâ€”watch out for attacks from Satan, your great enemy. He prowls around like a hungry, roaring lion, looking for some victim to tear apart" (1 Pet. 5:8, TLB).
Second, we must acknowledge the cosmic struggle between God and Satan, which engages humans as well. We must recognize our position of authority in Christ and our strength through his name. By the Word of God and the blood of the Lamb we can be victorious over Satan and his army. We need not be paralyzed by fear of Satan, but we are to "be strong in the Lord and in the strength of his might" (Eph. 6:10). Through the full armor of God, we can withstand Satan and his attacks.
What does this mean to medical missionaries from the West working in Africa? Five things must be considered. The first two will be mentioned only briefly, because they have been the primary focus of medical work down through the years. The other three have been neglected in the past.
For the Western scientific mind this "germ theory" poses no problems because it is empirically based. For the traditional African, however, disease has both natural and spiritual causes. However, because of the African’s world view, it is difficult for him to relate to germs as the ultimate cause of disease. The traditional African needs further understanding and clarification to fully comprehend the natural causes of disease.
THE NATURAL MEANS TO HEAL CERTAIN DISEASES
Long before Paul told Timothy to take a little wine for his stomach’s sake, people used local remedies to combat illness. R. H. Harrison writes in Healing Herbs in the Bible, "The act of the herbalist is one of the oldest forms of professional healing known to man."
Almost all physicians are aware of the limitations of drugs and medicines. Often doctors and nurses can’t explain why medicine does not always heal. In the Western way of thinking, we accepted this as an unknown. But in Africa the question of why is not so easily dismissed. This desire to know has given rise to many magical practices. When local preparations and drags fail, Africans use magic to control the mysterious forces in the world.
The Apostle Paul offers one explanation of how magic arose (Rom. 1). When men no longer recognized God as God, they turned to worshipping created things, rather than the Creator. If God is not viewed as the Supreme Ruler, then it seems logical that things beyond the grasp of man’s mind must be explained in other ways. This could be one reason why traditional healers began using magic as well as herbal medicine to cure illnesses.
Leith Mulling, in his unpublished Ph.D. dissertation, writes, "In Ghana the task of healing is performed by several different categories of specialists: (1) herbalists who are versed in the knowledge of herbs; (2) medicine men who possess ju-ju (magic) and whose clients generally seek success; (3) Muslim healers; (4) fetish priests who divine through a particular god; (5) soothsayers who are only concerned with divination."
Traditional healers as a group have been avoided by Western medical missionaries because of the magical and supernatural powers they seem to have. However, perhaps those who deal strictly with herbs might be incorporated into health programs. We need further research.
WITCHCRAFT AND SORCERY
The Bible tells us to refuse to cooperate with people who delve into the spirit world. Leviticus 19 and 20 and Deuteronomy 18 clearly show God’s rejection of such practices. Again and again God speaks out against sorcery, witchcraft, and diviners (often called soothsayers).
Although the Bible graphically shows that God hates these practices, it is the practices themselves and not the person using them that God hates. Can we not also begin to accept these healers as human beings who have dignity and worth, but who have arranged their world differently than ours? Should we not recognize their right to consider a different alternative? Rather than condemn them, perhaps we should try to fit the message of Jesus Christ particularly to them.
While there is obviously too much biblical evidence against their approach to healing for us to include them in our medical work, we should at least accept them as human beings and not as mere objects of foolish understanding.
The last two matters point to new dimensions that should be part of today’s medical practice.
THE REALITY OF SPIRITUAL INFLUENCE IN THE WORLD
The scientific world view, which sees the world as a closed mechanistic system operating on the basis of impersonal laws of nature, has caused many Westerners to question the reality of spiritual influence in everyday life. On the other hand, our African brethren are completely aware of this truth.
The Western cultural ideal has been elevated to a supra-cultural level, while all the time the African has understood God’s truth about these matters. No wonder medical practice all too often has not met the real need of traditional Africans.
John Gration, professor of missiology at Wheaton College Graduate School, has written, "During an in-depth discussion of the reality of the spirit world and some of its ‘strange’ manifestations, such as lights and sounds experienced by some Africans, one African professor stated, ‘We never share these things with missionaries; they would only laugh.’ At that moment I could not help but ask myself how many insights into African life and heart needs we missionaries had forfeited because of a condescending smile born of our ultimately secular, Western scientific view of reality."
CHRIST IS OUR CO-WORKER IN MEDICINE
Our world is not a closed system, but rather a battlefield between the kingdom of God and the kingdom of Satan. Brace Nicholls writes in Contextualization: A Theology of Gospel and Culture, "This battle is not an eternal dualism, for the decisive victory has already been won on the cross. Satan is dethroned and Christ is Lord, but this victory is still in the process of being actualized in human history and culture and is moving to a culmination at the return of Christ in his glory to establish his reign on earth."
Since Jesus Christ is the conqueror, he is able to save in all situations and to protect us from all enemies. Jesus prayed to keep and protect his followers from the evil one (John 17:9-19). What comfort it would bring if we presented Christ as the victor and protector against these spiritual forces and powers.
In passages like Matthew 4:24 and 8:16 there is a distinction between possession by spirits and other forms of illness, something that Africans have realized for centuries. Jesus miraculously healed in both situations.
It is time for medical missionaries also to consider themselves as members of the church of Jesus Christ that has been charged to heal the sick. It is time to bring God’s intervention back into our medical work.
The current dichotomized approach to medical work has arisen because curing is regarded as an event. A man falls and breaks his leg. After treatment he becomes well again. However, it is possible for a man to be cured of an illness, yet to remain unhealed. Curing is usually the work of man, whether by doctor or traditional healer.
Healing, on the other hand, includes interactions with both people and God. Kofi Appiah-Kubi writes in Man Cures, God Heals, "Healing then implies restoring the equilibrium in the otherwise strained relationship between man, his fellow men, environment, ecology, and God. This includes physical, emotional, social, and spiritual dimensions."
Such a wholistic approach to health care can take the supra-cultural truth of the spiritual world and make the message of Jesus Christ more compelling to the traditional African. By accepting the reality of the spirit world perhaps our message will satisfy more of the spiritual, emotional, and social needs of the people.
Medical missionaries have always desired to help people come to know God and to know him more completely. Health work can be a wonderful bridge to help people to grow and develop in their faith. However, first we must be aware of our own prejudices and cultural biases. As we talk with our African brethren, together we can learn how to fit the truths of the Bible to the African’s world view of health.
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