Beyond Biomedicine: Exploring Religion As an Alternative Health System in Men's Engagement for Tuberculosis Diagnosis

This paper explores how religious beliefs influence the health-seeking behaviors of Black working-class men diagnosed with tuberculosis (TB) in a South African township. While biomedicine is the dominant health system, religious practices remain deeply rooted in Southern Africa. Through ethnographic fieldwork conducted between 2020 and 2021, this article investigates how local interpretations of TB affect men’s engagement with both religious and biomedical health systems. Key research questions include: “How do men’s religious beliefs impact their health-seeking behaviors regarding TB?” and “How do these beliefs shape their interaction with healthcare systems?” Interviews with 30 men revealed that they often attributed TB symptoms, such as unexplained weight loss, to supernatural causes like witchcraft (sejeso) or sexual encounters with “polluted women.” As a result, men frequently consulted faith-based healers, particularly those associated with the Zion Christian Church, as part of their health-seeking process. These healers, closely aligned with African traditional religion, provide men with a framework for understanding illness that biomedicine alone does not offer. The engagement with religious healers reflects the cultural importance of the supernatural in shaping African men’s understanding of health and identity. Men often navigate both biomedical and religious health systems, relying on religion for initial interpretation of symptoms and turning to biomedicine for formal TB diagnosis. This cross-referral strategy highlights the pluralistic medical landscape in South Africa, where men’s health-seeking behaviors are shaped by cultural and religious frameworks. The article argues that men’s engagement with religious systems is deeply connected to their identities and perceptions of masculinity, with religion serving as both a source of health and a means of asserting their identity.