As the gaily coloured bus lurched down a Kenyan dirt road from town to the villages, a self-professed 'doctor' in a grey suit clung on to the seats while standing in the aisle. He yelled in Swahinglish about the magical properties of the green ointment in his other hand. The ointment cured AIDS, he said. Baldness. Impotence, in men and women. It also cured eczema, foot rot, and tuberculosis. Hands rose up from among the seats to claim their sample of this cure-all, and the 'doctor' administered his wares with a flurry of cash and promises.
I was at the tipping point of rage as he approached my seat. I couldn't hold back my fury and yelled over the hubbub that he had blood on his hands for selling fake treatments to poor people. Losing my temper at the display of hocus pocus in Kenya was becoming a bit of a theme.
Witchcraft, misguided religious advice and clashes between tradition and science were common experiences during my time in Uganda and Kenya. Undertaking health education at a local church my lesson to the assembled was subsequently undermined by the pastor. He stood up after me and announced that all condoms were made in cold countries, and when they were brought to Kenya they simply broke in the heat.
I had it explained to me that everything from homosexuality to yoga were attributed to the devil. Alcohol turned women to lesbians. Malaria was caused by infidelity. Even the motorbike accident that left a dear colleague in a wheelchair was caused by a curse the neighbour placed on him. Maybe worst of all, it was rumoured that the foundations of all the major buildings in Kampala contained the body of a new born; a sacrifice to the spirits to ensure the building didn't fall down.
The mystic, the religious and the scientific lived in daily competition and conciliation in the minds and hearts of those around me. Tradition and spirituality were by no means discarded mechanisms for explaining the universe. If they clashed with more scientific explanations, explanatory compromises arose, whereby the two could exist in some sort of harmony.
One woman I knew, a Ugandan health volunteer named Mary, had done amazing things working alongside our organization to educate people about HIV. Living an HIV positive life she had done a great deal to dispel misunderstandings about how the disease worked, and promoted the use of anti-retroviral medication which protected not only the person with HIV, but also their children and partner. With the right treatment, the risk of transmitting HIV to a child during birth could be reduced by 80%. She worked hard to embed this knowledge in the village.
That was, until Mary went for routine testing and received a false negative reading on her HIV test. Her church celebrated the miracle of her cure. They celebrated her in the chapel as one touched by God's blessing. She stopped taking the anti-retrovirals. Within months she started getting sick as her immune system crumpled. Those in her local church told her this was because her faith was weakening. To pray harder would bring her back to health. Mary continued on praying and believing she was cured. She died in hospital of cerebral malaria and meningitis. Mary, with all the information and medication available to her, still fell victim to the battle between science, religion and culture, which she had been unable to navigate.
Every culture finds a way for explaining the universe around them. And I felt regret for those in Uganda who have suffered waves of interference from outside countries. I knew that where I stood in the village preaching the existence of microbes someone had stood only decades before preaching the existence of God. Both were equally invisible to the naked eye, but God at least made some sort of moral sense, by rewarding the good and punishing those with evil in their hearts.
I craved often during this time to return home to the scientific-minded world of home. There, in the Australia of my mind, people required evidence before they believed something. People would look to research before concluding on the appropriate medication or treatment for an illness. We delicately lay culture aside in favour of clear-cut rationality, right?
It's true, health literacy has increased considerably in our society in the past few decades. People expect explanations, options, and evidence from their doctor. The gap between practitioners and the public has shrunk, and amazing publications such as the British Medical Journal, PubMed, the Cochrane collaboration and JAMA have made it easier to access scientific knowledge than ever before. Science communication is on the up and up; 'I Fucking Love Science' has over nine and a half million followers on Facebook. Tim Minchin and others artists have worked key scientific concepts into their works. We see science everywhere.
Many of us declare an allegiance to science as the primary tool to inform our understanding of the universe. Though science is not an outcome, or a finding – it's a process. One involving the selection of a hypothesis and identifying the evidence that exists both for and against it. It involves identifying and removing bias from experimentation. It's about being able to reproduce the same results under the same conditions. It's based exclusively on what can be observed. It's a process of understanding why a systematic review which collates the results of hundreds of clinical trials testing the same hypothesis is better evidence than what your auntie swears by as a cure for her bunions. It involves understanding the distinction between correlation and causation. It requires understanding the difference between anecdote and data. It involves knowing how tremendously powerful placebo and nocebo are. At the heart of science is an understanding that we, as feeling, social creatures, are not instinctively scientific.
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