Healing, in the anthropological sense, is a multi-sensorial process that carries an individual along the continuum from illness to wellness.  In the case of people living with HIV or AIDS, “wellness” cannot be defined as an absence of the virus or as the success of a “cure”.  Rather, a more holistic definition of “wellness” should be employed.  A person living with HIV or AIDS is in a state of “wellness” when he or she has embraced a whole sense of him or herself and moved from a state of despair and confusion to hope and self-reclamation.  The associations in the EFA network strive to create deeper, truer connectivity to self and others.  As such, the associations offer an opportunity for people infected with HIV or AIDS to come into a state of wellness.

‘Illness’ can be described as a state where the body, mind, and spirit are not aligned.  The discordance between body, mind, or spirit manifests itself physically in such a way that one’s orientation and engagement in and to the world is altered.  Illness is a call for spiritual meaning; however “spiritual” is understood.  For those associations who best tend to the spiritual and social needs of their members, the members become more engaged in their own treatment and have become better connected to what they value, which often manifests in community outreach and anti-stigma campaigns.

For many people, a diagnosis with HIV carries a tremendous amount of “baggage” related to sexuality and sexual behaviors, and a host of other socio-economic factors.  Depending on the circumstance, the anthropologist Victor Turner would deem the infection a “breach” in “cultural values” for infection is often assumed to occur in such a way that is deemed culturally inappropriate or offensive (Turner 20). “Human drives” for love, for a release, for pleasure “transgress cultural commandments” when satisfied with “promiscuity”, prostitution, or relations with someone of the same sex (Turner 20). Much of that “baggage” is either directly or indirectly classified as sinful or immoral by the dominant religious and cultural traditions and transgresses the dictates of the religious establishments and cultural norms.

For many HIV positive individuals, they live in a constant liminal state.  There is always possibility.  Optimistically, there is always the hope for improved therapies and even for a cure.  For some though, being “infected” and having to live with the virus means having to live with the possibility of imminent, unavoidable illness and death. The ‘illness’ makes it difficult to create connections if one feels that they are destined to be short-lived.  It is even more difficult to initiate relationships when there is the possibility for judgment and rejection.  As such, the possibility for interconnectivity between individual association members, collectively among the five associations has offered the greatest opportunity for healing.

Within the associations, the members are allowed to embrace the ambiguity and indeterminacy of the liminal state and the dissolution of their normal sense of identity.  The social status is changed from that of an outsider to that of an insider.  For the association members, the state of liminality, that serves to foster the “cure” and the eventual reentry into society, is a period of transition that can lead to new perspectives about themselves and their group identity. In this sense, the clients are also performing a social drama (Turner 20-21).  The clients move through parts or all of the social drama of
“breach-crisis-redress-outcome” together at their meetings (Turner 20).  As with any “performative healing event”, the events are not predetermined.  Each member of the group contributes to the outcome. Likewise, the effects of the performance are felt differently by each individual; “the participants may not all experience the same significance or efficacy” (Shieffelin 722).  Each person has a different perspective and something different to be healed.   People are given permission to stand together outside of the normal confines of society.  The group is strengthened and empowered because of the vulnerable connectivity and fraternity and the simultaneous value of confidentiality.  For some of the association members, group membership (in their communities, in their church, mosque, community, etc.) is something that they lost when their “illness” took hold.  For many HIV positive individuals, “life bec[ame] broken into a before and after of discontinuities and disruptions”; there is life before an HIV+ diagnosis and the life afterwards (Henry 382).   “Previously held referents [are] abruptly and violently dissociated and social conventions and identities unexpectedly flounder” (Henry 382).    The “breach-crisis” stage threatened or even broke the stability of their earlier social units.  The “redress” stage that takes place at the meetings allows for a creation of a new social unit.  At the meetings, association members can find kinship with people who understand what it was like to manage a life-long illness and all that is associated with it, managing medicines, managing finances, managing the stigma and the social isolation.

It is clear that some associations are closer to reaching or have reached already the wellness state.  Those associations are marked with a remarkable fraternity, social outreach efforts, and a remarkable collective efficacy—they care for each other and carry each member towards healing and wellness.

-Caitlyn Bradburn, Peace Corps Volunteer

Works Cited:

Henry, Doug.  2006.  ”Violence and the Body: Somatic Expression of Trauma and Vulnerability during War.”  Medical Anthropology Quarterly, 20:3. 379-398.

Schieffelin, Edward.  “Performance and the Cultural Construction of Reality”.   American Ethnologist, v 12, p 707-724: 1985.

Turner, Victor.  “Liminality and the Performative Rites”.  Rite,
Drama, Spectacle, Festival.  Philadelphia, Institute for the Study of Human Issue: 1984.

Tags: illness, News from Cameroon, peace corps, stigma, wellness