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  • Title: Cosmology and change in Rwanda.
    Author: Taylor C.
    Journal: Soc Afr SIDA; 1994 Jan; (3):7. PubMed ID: 12179367.
    Abstract:
    Quantitative research methods and epidemiological models dominate research into the understanding of risk behaviors related to HIV/AIDS. While clearly important to understanding AIDS and finding some answers for its prevention and control, quantitative and epidemiologic approaches do not shed much light on how people think. One must also try to understand the thought patterns behind behaviors which we are trying to influence. The author became aware of a mode of thought after 18 months of anthropological fieldwork with traditional healers in Rwanda which has implications for the prevention and control of HIV/AIDS. He described in a previous article a cosmological system based upon the flows and/or interruptions in the movement of liquid substances. Pathological states are provoked or characterized by perceived abnormalities in fluid movement, either excessive flows or blockages. Hypotheses concerning this system were later reinforced when he returned to the culturo-historical literature on Rwanda and discovered that the rituals of kingship were also a rich example of flow/blockage imagery. Tens years after his first fieldwork in Rwanda, the author reports finding ongoing evidence of that cosmological system. While some people in Rwanda who ascribe to the fluid flow/blockage ideology may understand condom use to be a necessary preventive measure against AIDS, they are concerned about the overall effect of condoms upon individual health. Mechanically, concern is expressed that the condom may remain lodged in the vagina and harm the woman or that it will interfere with a Rwandan form of lovemaking called kunyaza. With regard to the prevailing ideology, however, condoms block the flow of fluid. As such, concern also exists that blocking the release of semen from the penis will negatively affect male health. A notion also exists that a gas exits the penis at the moment of ejaculation. Interfering with the escape of such gas, condom use may cause the gas to re-enter the man's body and harm his kidneys. Rwanda is not the only place in sub-Saharan Africa where these beliefs are held. It is important that program planners and implementers understand how Rwandans think about the body and sickness, and tailor communication messages and interventions accordingly.
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