In humanitarian aid there is often a strong focus on the biomedical angle of disease, as we can see right now in the Ebola crisis in West Africa. However, the role of religion should not be underestimated, as scholarly research and media indicate that religious beliefs and practices can have a positive influence on prevention and treatment of disease. Barnet and Stein have argued that humanitarian aid is becoming increasingly secular. Bartelink and Wilkinson have both reflected on how this impacted on the humanitarian sector in its engagements with human rights and disaster risk reduction, in two posts on this blog before. In today’s post, Esther Loonstra argues that it is important to reflect on personal narratives of how religion can form mechanisms of coping and resilience during illness and disaster.

Ada Ignoh is a Nigerian nurse who survived Ebola after an outbreak in Lagos. She used various strategies to get emotional comfort and support from religion during her hospitalization in the Ebola clinic. For example, she would read Psalm 91 every morning:

The Lord will keep you safe from secret traps and deadly diseases. He will spread his wings over you and keep you secure. His faithfulness is like a shield or a city wall. … And you won’t fear diseases that strike in the dark or sudden disaster at noon. You will not be harmed, though thousands fall all around you.

As a nurse in the First Consultants Hospital Ada Igonoh cared for Patrick Sawyer, also known as ‘the man who brought Ebola to Nigeria’. She was one of the eight out of twelve directly infected by Sawyer that survived. Igonoh has written an extensive account of how she experienced having Ebola and the ways in which she used religion as a coping mechanism – through prayer, conversations with her pastor, seeking communion with other women in the clinic, reading the Bible, listening to messages of faith and healing (‘I continued listening to my healing messages. They gave me life’) and praising the greatness of God.

Igonoh’s story is not unique. Numerous studies have identified and significance of faith in healing and resilience and the different functions it can fulfil. Pargament and Cummings (2010) identify four major religious/spiritual functions that are important in resilience: (1) the search for meaning, (2) the quest for emotional comfort or anxiety reduction, (3) promotion of a sense of interconnectedness and (4) communion with the sacred. These elements can be seen as faith functions in the process of resilience and are not mutually exclusive, one or more may be used when coping with crises. The four faith functions can be seen as destinations or ends, which can be achieved through various ‘spiritual pathways’ such as beliefs, practices, relationships and emotions. The story of Ada Igonoh illustrates the spiritual pathways that can be taken as means towards the ends and can consist of various beliefs, emotions, practices and relationships. In the very detailed account of Igonoh we can see that she uses different pathways to fulfil the functions of resilience that are relevant to major functions of religion.

An example of a faith function such as the search for interconnectedness is when Igonoh describes herself as being tested in her faith. When a friend succumbed to Ebola ‘it was a great blow and my faith was greatly shaken as a result’. But she started a Bible study with the other female patients, she promoted her sense of social connectedness by forming relationships: ‘my communion sessions with the other women were very special moments for us all’. By actively engaging in religion, Igonoh built emotional resilience. She had ongoing contact with her pastor, also a doctor, who motivated her to do research about the illness (on her iPad) and to monitor very closely how many times she stooled and vomited. ‘My research, my faith, my positive view of life, the extended times of prayer, study and listening to encouraging messages boosted my belief that I would survive the Ebola scourge’.

From these ways of dealing with Ebola in relation to her faith and spirituality, Igonoh gained the mental strength to stay positive and to have faith in her process of recovery. Although people around her died, she managed to cope with the illness and stay positive.

In addition, religion can play a major role in emotional comfort. Empirical data also shows that religion can motivate people to take direct measures to solve problems such as disease. Various studies show that religion has a positive effect on health and has the potential to promote healthy prevention and treatment strategies. Research among seropositive African American mothers has for example shown that religious involvement reduced psychological distress. The authors also suggest that involvement in religious practices can be beneficial in the promotion of resilience. Thus, research shows that religious people do not ‘bury their heads in the sand’ when they appeal to spirituality in difficult times, but may be more engaged in actively resolving their problems.

While downplayed or ignored when looking through a biomedical lens, the story of Igonoh shows various strategies to cope with Ebola. It also raises a more practical point. Medics from contexts such as Nigeria or Liberia might more easily recognize that religion can be a motivator to be as proactive as possible in carrying out self-protective and healing measures. The pastor of Igonoh who also had a medical background is an example. Igonoh explains: ‘My pastor, who also happens to be a medical doctor, encouraged me to monitor how many times I had stooled and vomited each day and how many bottles of ORS I had consumed. We would then discuss the disease and pray together’. This example suggests that religious coping with the disease and medical approaches of prevention and cure can be complementary and acknowledged within their own roles and qualities.

Illnesses like Ebola or HIV/AIDS are often seen primarily through a biomedical lens, neglecting social, cultural or religious frameworks. Research suggests, however, that religion can promote practices that benefit patient’s recovery. In the practical reality of Ebola, as we can see in the story of Igonoh, this can mean consistently drinking ORS when infected, or seeking help a.s.a.p. when the illness is suspected. Thus, religion can play positive and motivational roles in coping with Ebola and contribute to the resilience of people in the face of adversity. Consequently, religion should not be overlooked in the sense that it can play a positive role in prevention, detection and healing the disease.

Yet, while religion’s contribution to promoting healthy behaviours that fit within a medical paradigm are becoming more widely recognised, religion’s effect on a patient’s emotional, spiritual and psychological wellbeing while coping with a deadly virus such as Ebola continues to be downplayed or ignored. While this is problematic in itself, it has the added consequence that the complementarity of religion and biomedical approaches to healing is lost and along with it an important and effective strategy for dealing with disease. The two fields should not be regarded as mutually exclusive. There should be room for religious practices because they can be beneficial for the recovery and resilience of the patient.

Coming back to the four major functions of religion relevant to resilience (search for meaning, emotional comfort and anxiety reduction, social interconnectedness and communion with the sacred), we can see the importance of spiritual guidance in the Ebola crisis as it can promote the way to recovery. Religious practices and beliefs can contribute to the wellbeing of patients and increase the legitimacy of healthcare. Humanitarian aid organisations responding to the Ebola crisis should therefore pay greater attention to the potentially powerful role that religion plays and support patients in meeting their religious and spiritual needs, as well as their physical needs.

Esther Loonstra is an intern at the Knowledge Centre Religion and Development in Utrecht and in the final phase of her master’s Religion and Globalisation at the University of Groningen. Her research focusses mainly on the (interconnectedness of the) fields of religion, gender, sexuality and health on the level of both policy and research. 

Sources

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Koenig, H., King, D. & Carson, V.B. (2012). Handbook of Religion and Health. Oxford: Oxford University

Barnett, M. & Stein, J.G. (2012). Sacred Aid: Faith and Humanitarianism. Oxford: Oxford University Press.

Verses 3,4,6 and 7 of Psalm 91. Bible Society. Available: http://www.biblesociety.org.uk/the-bible/search-the-bible/CEV/Ps/91/

Pargament, K.I. & Cummings, J. (2010). Anchored by Faith: Religion as a Resilience Factor. In J.W. Reich, A. Zautra, J.S. Hall (eds,). Handbook of Adult Resilience. New York: Guilford Press, 193-211. Available: http://books.google.nl/books?id=lyRc8ZshU98C&pg=PA193&hl=nl&source=gbs_toc_r&cad=4#v=onepage&q&f=false

Ai, A.L., Peterson, C., Tice, T.N., Huang, B. & Bolling, S.F. (2007). The Influence of Prayer Coping on Mental Health among Cardiac Surgery Patients: The Role of Optimism and Acute Distress. Journal of Health Psychology 12:4, 580-596. Access: http://www.ncbi.nlm.nih.gov/pubmed/17584810

Walker, P., Mazurana, D., Warren, A., Scarlett, G. & Louis, H. (2012). The Role of Spirituality in Humanitarian Crisis Survival and Recovery. In: Barnett, M. & Stein, J.G. (2012). Sacred Aid: Faith and Humanitarianism. Oxford: Oxford University Press.

Prado, G., Feaster, D.J., Schwartz, S.J., Pratt, I.A., Smith, L. & Szapocznik, J. (2004). Religious Involvement, Coping, Social Support, and Psychological Distress in HIV-Seropositive African American Mothers. AIDS Behavior 8 (3), 221-235. Available: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1480649/

Online article: Must Read! Through the valley of the Shadow of Death… Dr. Ada Igonoh survived Ebola – This is her story. http://www.bellanaija.com/2014/09/15/must-read-through-the-valley-of-the-shadow-of-death-dr-ada-igonoh-survived-ebola-this-is-her-story/