“HIV is a punishment from God.”

“The Bible says those who go against God’s will by sin will be punished through diseases.”

“The source of this disease is prostitution.”

“HIV is a punishment for sin.”

My colleague Mr. Masalu and I stood on the grounds of a local church, surrounded by five church elders. They talked in a mixture of Swahili and English, and Mr. Masalu translated for me deliberately. What had been a simple chat against the setting sun had turned quickly into a fascinating discussion about religion and HIV in Tanzania. They were eager to talk. And we were eager to listen, having traveled in Tanzania for six weeks now, trying to pin down these very same issues. The most recent journey had taken us along two hundred kilometers of bumpy dirt road into Babati, an agricultural town by Lake Minera, the famous natural park.

One of the church deacons was particularly talkative. He claimed that he would not advise those who are infected with HIV to seek medicine. His reasoning was that medicine strengthens the body of those who are HIV positive, misleading others into thinking that they are healthy and thus increasing the likelihood of HIV transmission through sex. I was stunned by this logic. So what should HIV positive people do instead?

“Pray. The Bible promises to provide cure for those who confess and seek help from God.”

HIV bounces off the walls of prayer rooms and churches like no other disease. Take malaria, for example. It kills many more people every year than HIV, but it is rarely discussed in religious settings; it is secular—we know that it is spread by mosquitoes that more or less strike at random, and it can be effectively treated. The religious fervor surrounding HIV stems from two factors: it is primarily spread through sexual intercourse and there is presently no medical cure. The lack of understanding about HIV/AIDS has led to many alternative theories concerning its origin; these theories range from the dubious: AIDS is not caused by HIV but through build up of toxicity in human - to the outrageous: it is conceived in labs and unleashed by the U.S. government to kill off Africans and homosexuals. Many pastors preach that the disease is a punishment from God for those who commit adultery.

As HIV spreads, the perceived connection between HIV and religion has erupted into dangerous incidents. In Malawi, a pastor recently made headlines for telling five HIV positive people in his church to stop taking medication because they had been cured through prayer. ‘Televangelism’ has also become increasingly popular in this conservative country where the HIV prevalence is about 14 percent. Churches regularly broadcast programmes on Television Malawi, with pastors preaching messages of healing miracles. Some openly say to viewers, “all those who are sick should touch their television set and, using the other hand, touch where they are feeling unwell.”

The situation is much more extreme in Entoto, Ethiopia, where legends have spread of a divine-healing river. Approximately 4,000 people have migrated to Entoto and paid $5-7 per month for the privilege of cramming into tiny rooms without toilet. Entoto has became a safe haven for the outcasts and the ill looking for spiritual help. Every morning the priests of the Ethiopian Orthodox Church in Entoto bring the patients up the hill to perform healing rites, a component of which involves drinking up to six litres of holy water. Healing could take anywhere from one day to several years, a priest claimed, and more than a thousand people have been cured in the past two years. “We don’t allow patients to take medication if they want to receive holy water.” Poor hygiene has made commonplace a host of other health problems like tuberculosis. But few complain about the conditions, believing that suffering increases their chances of healing.
Many factors contribute to the proliferation of the spiritual healing industry. Despite recent international efforts to provide free HIV/AIDS medication, access to treatment remains problematic due to transportation difficulties in getting to the clinics, the stigmatization of HIV and medication, and simple ignorance of these programs. In Ethiopia, there are over one million people infected with HIV, but only seven percent of these are currently on anti-retroviral medication. Spiritual healing meets the important needs of people living at a grass-roots level. At best it provides moral support, physical care and sympathetic guidance on how to cope with HIV. But it is also becoming a tremendous money-making industry. Pastors who claim to have healing powers stand to gain large followings in their congregation and consequently make more money at the offertory. Less delicate pastors would charge patients directly for performing healing rites.

Seldom does a pastor claim to possess divine healing power himself; this would be too outrageous for any patient with even a passing knowledge of the Bible. Instead the persuasion usually runs along thelines of “God can heal any disease, even HIV, but he listens only to some prayer requests and not others. Mr X has a special ability to communicate with God. If he prays for you and if you become a good Christian, then you will be healed.” ‘A good Christian’ is an important caveat, for it dissolves any responsibility from the healer in cases where the patients do not improve, or, worse still, die. The blame for failure would be shouldered by the patient for not having strong enough faith.

Recently-sprung churches now dot the landscape in several African countries. They are mostly of Pentecostal creed, though often operating as independent churches with congregations numbering in the tens, and, sometimes, in the thousands. Spiritual healing is often the central tenet of such churches. The pastors—most are self-taught and have not gone through any seminar or bible college. The churches—typically an open air meeting ground. The members—new converts to Christianity mix with Catholics and Lutherans, all drawn by the promises of healing.

Amosi Mlaki was the pastor of International Assembly of God Tanzania Church, a small church with 25-30 members that he started on his property. Cheerful and friendly, he talked with me while waiting for the start of a weekly meeting of Pentecostal pastors in Arusha, Tanzania. Pastor Mlaki claimed that God uses HIV as a punishment for sin, but acknowledged that HIV can be transmitted through non-sexual means—mother to child, blood transmission. He had a prayer that he used in cases of healing and said, “ the faith of the pastor when combined with the faith of the sick people” allowed healing to take place.

But who gets healed and who does not?

“Even in our churches there are people working properly in faith and others working slowly. So others are too small,” explained Pastor Mlaki. “If they have not enough faith, then I allow them to use medicine. I can’t let them to die because when they can’t use that medicine they can die because they don’t have faith.”

“And if they have enough faith?”

“Yes they can receive the power of Jesus.”

Answers from a 43-question survey collected from about 600 churchgoers in Tanzania reveal some stunning facts:

• More than half of all participants claimed that HIV is a punishment from God.
• Over 70% believed that prayers can cure HIV; this included every congregant at one rural Pentecostal church.
• More than half claimed that they know people who have been cured of HIV through prayer.
• Five percent said they would refuse medical treatment if found to be HIV positive.
• Most people also believed that God works through medicine and doctors.

Cases of prayer healing make for sensational news articles, but much more damaging to the plight of people living with HIV is the stigma that they have to face day to day, a stigma founded on ignorance: “I wouldn’t sit next to you because I could catch HIV through your breath,” and superstition: “you have HIV so you must be a bad person and possessed by a demon.” It is important to recognize that the important role that religious groups play in providing health care. In Tanzania, hospitals affiliated with Catholic and Lutheran churches account for almost half of all health service in the country. Much of HIV medication and counseling is disseminated through such hospitals, so religion is a force to be reckoned with in consideration of global health.