Bringing Back Ubuntu.

Abstract

I awoke to the sound of drums at 6:30 a.m. Despite an exhausting journey of over 10,000 miles, I had not slept well. Countless stray dogs had howled back and forth to each other long into the night. Unfortunately, the prospect of getting more sleep was out of the question; the drums were even more persistent than the barking. I rolled out of bed, threw on another sweatshirt, replaced my pajama bottoms with a pair of jeans, and grabbed an apple as I headed for the door. I could hear a faint swell of voices begin to join the drums in rhythmic song. As I hurried along the well-worn path between the banana field and the compound wall, I heard shrill, exuberant ululations periodically pierce the growing chorus and felt the sun begin to push back the chill of night. I turned a final corner and joined the stream of people making their way to the outdoor auditorium for the morning devotional. I found an open seat and began to clap along. My fatigue was replaced by anticipation of what the day might bring as I was swept along by the energy of the song. A smile crept over my face. Ayear had passed since my last visit, and it felt good to be back. I was at Kafakumba Training Center (Kafakumba) in the Copperbelt Region of northern Zambia, just south of the border with the Democratic Republic of the Congo (DRC) and west of Tanzania. Prior to boarding the plane 2 days earlier, my role as an academic psychiatrist had focused primarily on medical education and community engagement at an academic health center in the USA. Once I set foot on the tarmac in Zambia, however, my role transitioned to a visiting faculty member for the annual Kafakumba Pastors’ School. Sincemoving to Zambia from the DRC in the late 1990s, Kafakumba has hosted pastors for 6 weeks annually to complete a curriculum that spans 8 years. They travel from the DRC, Tanzania, and throughout Zambia to study theology and learn skills related to leadership, communication, economic development, and health. During the remaining 46 weeks, they serve as trusted leaders who, due to their positions as faith leaders and the limited access to local health care, are often approached by individuals seeking guidance about both spiritual and physical health in their communities [1]. Explanatory models of ill health in many of the region’s rural communities are commonly rooted in traditional beliefs that involve evil spirits, conflict between the physical and spiritual realms, and failure to appease one’s ancestors [2]. The pastors straddle worldviews shaped by traditional beliefs and Christianity, the latter providing an opportunity to understand disease and illness in a manner that does not rely solely on spiritual and magical causes. In the late 1990s, many people were succumbing to AIDS despite the advice of traditional healers and the prayers of the Christian community. In this context, the Director of Kafakumba invited me in 2001 to provide a different perspective on the health issues confronting the pastors, thereby offering an alternative explanatory model through which to understand disease, illness, and death. That visit was the first of many. Cultural humility and mutual respect guide my interactions with these faith leaders, with most of their worldviews differing significantly from mine. Upon arriving each year, I spend the first couple of classes listening to them share their pressing health education needs. We then prioritize these topics and create a curricular framework to focus our sessions. During my first few years, basic education regarding HIV/AIDS dominated the curriculum.More recently, however, neglected tropical diseases, mental illness, gender-based violence, and the * Mary Kay Smith marykay.smith@utoledo.edu