Death, Ancestors, and HIV/AIDS among the Akan of Ghana

This is a study of crises caused by HIV/AIDS among the Akan of Ghana. It creates more awareness about the epidemic and has indicated other possible paths for campaign strategies. The pandemic has many devastating consequences; yet new infections are recorded daily despite campaigns against the disease. The search for therapy often sees the use of multiple outlets, which expresses Ghana's pluralistic medical system based on Kleinman's sector analytical model involving Western medicine, self-therapy, and folk healing. But it also leaves individuals and kin members in financial quandary. The fieldwork for this study is mainly through participant observation lasting 13 months (February 2003 to March 2004) among the Akan; in addition, some archival materials have been used. The Akan people live in the coastal south and forest zone of Ghana. Every Akan village or town is made up of corporate lineages, and social organisation is based on matrilineal descent. The society is holistic because the matrilineages seek the welfare of all their members. Meyer Fortes, R. S. Rattray and others on the Akan noticed this encompassing nature in the lineage organisation; but they did not make it salient (or failed to notice it) during illness, efforts for healing, and the care of the sick member. HIV/AIDS is an illness which shows the encompassing nature of the Akan matrilineage. It also reveals many contradictions in the group, viz. stigmatisation, abandonment, and attitudes that do not express altruism in a group expected to be closely-knit based on members' belief that they are of the 'same blood'. The crises have been analyzed in the total social system because the disease creates breaches at various levels of social interaction. An analysis of crises in a group is not far-fetched; Victor Turner has shown the way among the Ndembu and has revealed the contraditions in the seemingly uneventful life in the group. This study has identified that in dealing with HIV/AIDS patients and crises about the disease we are dealing with 'holistic' patients. Their cases produce many changes in the matrilineal structure--many orphans are being created and the care of patients is increasingly falling on the elderly. HIV/AIDS also challenges Akan cosmology because, for example, an AIDS death in local notions is a 'bad' demise which fails to produce ancestors who reproduce the society through reincarnation. Campaigns could emphasize this notion. The study begins with a description of the holistic nature of Akan matriliny, and the patients have been described as 'holistic' because their crises affect other people in the holistic society. Chapter 2 discusses the importance of ancestors as the starting points for social order who are constantly revered (in rites invoving the chief, Chapter 4). Chapter 3 focuses on funerals as an important social performance for the welfare of the dead and the living. Chapter 5 concentrates on HIV/AIDS as an illness threat marked by dominant discourses such as poverty, sexuality, migration, and condom use. Chapter 6 analyzes the attempts for therapy, and traditional healers' claims to have a cure. The efforts for therapy continues with spiritual church healing in Chapter 7, and chapter 8 is devoted to care of the patients and its inherent crises. Chapter 9 analyzes the effects of HIV/AIDS afflictions and AIDS deaths on the matrilineal group and in society. The study ends with a short part, devoted to Recommendations based on the findings in this investigation.

Tutkimus käsittelee HIV/AIDS-kriisiä Ghanan akanien keskuudessa ja tarkastelee vaihtoehtoisia strategioita, joilla kriisin terveydelle ja yhteiskunnalle edustamaa uhkaa yritetään hallita. Laajalle levinneellä sairaudella on monia tuhoisia vaikutuksia ja uusia infektioita kirjataan päivittäin huolimatta epidemian vastaisista toimista. Terveysriskien lisäksi epidemia aiheuttaa vakavia taloudellisia ongelmia kokonaisille suvuille. Erilaiset hoitomuodot kuvastavat Ghanan pluralistista lääketieteellistä järjestelmää. Tutkimuksessa tätä järjestelmää analysoidaan Kleinmanin sektorianalyyttisen mallin pohjalta, jossa yhdistyvät länsimainen lääketiede, itsehoito ja kansanparannus. Tutkimus perustuu 13 kuukautta (helmikuusta 2003 maaliskuuhun 2004) kestäneeseen osallistuvaan havainnointiin akanien parissa sekä arkistolähteisiin. HIV/AIDS-epidemia ja sen tuottamat paikalliset reaktiot kuvastavat matrilineaalisuuden kattavaa merkitystä akan-yhteiskunnassa. Äidinpuoleiseen polveutumiseen perustuvat ryhmät ovat sisäisesti kiinteitä ja niiden jäseniltä odotetaan altruismia toisiaan kohtaan sillä perusteella, että he ovat "sama verta". HIV/AIDS-potilaiden leimaaminen ja hylkääminen paljastaa kuitenkin myös ristiriitaisuuksia ja altruismista poikkeavia asenteita ryhmien sisällä. Tutkimuksessa HIV/AIDS- kriisiä analysoidaan osana koko sosiaalisen järjestelmän toimintaa ja identifioidaan niitä kanssakäymisen tasoja, joilla sairastuminen altistaa ihmisten väliset suhteet jännitteille ja rikkoutumiselle.