A Discussion with Gwendolyn Heaner, Social Research Consultant

With: Gwendolyn Heaner Berkley Center Profile

November 25, 2015

Background: When faced with illness, people often don’t know where to turn for healing. During the Ebola crisis in West Africa, this was particularly challenging, as people were both fearful of the strange disease and often suspicious of doctors and messages coming from government officials. Gwendolyn Heaner studied Pentecostalism in Liberia and was invited to attend the consultation on religion and Ebola, sponsored by the Berkley Center and WFDD, held October 6, 2014. This interview with her, conducted by Crystal Corman by phone on November 25, 2015, follows up to better understand how she came to focus on this section of religious actors in the country, as well as her perspective on the religious response during the Ebola crisis. On her journey to becoming a doctor, she was captivated by how many people prefer spiritual healing over modern medicine. Her research on Pentecostal churches in Liberia demonstrates the difficulties of understanding this fluid group, but also highlights the central importance of spirituality for explaining phenomena and offering hope.
How did you become interested in the role of religion in development, and especially in medicine?

In my first few years of college, I was planning to go to medical school. I loved science. Interestingly enough, the book Hot Zone [Richard Preston, published 1994], the one about Ebola, was extremely interesting to me when I was younger. So, as a 19-year-old I wanted to go abroad and help people—work for Doctors Without Borders or something. In the meantime, I was taking classes in the study of religions, just because I found the topic interesting.

I had a year-abroad opportunity so I went to the School of Oriental and African Studies my junior year. I also took a class on Indian religions; I studied Sanskrit and Jewish mysticism. I also took Professor Paul Gifford’s classes on Christian Fundamentalism and then on Pentecostalism Worldwide. Particularly with the second class, it blew my mind as he was showing us how far everything that goes on in developing countries where the Pentecostalism movement is taking over cannot be understood without understanding the religious aspect.

I began thinking in terms of how this would apply to my being a doctor in developing countries. I needed to know where people were coming from if I wanted to treat them. If we just arrived in some village and tried to give them medicine, is that really going to work? It seemed to me that external health interventions needed to be based on knowledge about how locals understand healing. In the class, we discussed how illness and misfortune are often not explained by Western science to most people; they explain illness and misfortune by the spirit world. That was so interesting to me!

How were you able to take this curiosity out of the classroom?

That summer I had the opportunity to do an internship through Smith College. I ended up in rural northern India in a hospital through one of those voluntourism programs. Just a few weeks into it, I felt that nothing I was doing was helping anybody. My placement was in a hospital where I essentially shadowed doctors. It was a government hospital with allopathic medicine, but it was an extremely rural, poor area. People would come into the clinics and leave with some pills, without proper care or clear communication from the doctors. It seemed the patients would walk away having no idea what just happened. I decided to follow up to ask them what they had learned about their illness from that visit; they would say, “Nothing.” And so they would next go to either the Ayurvedic doctor, which is the traditional medicine, or the religious healer, which was more around dealing with the spirits.

Instead of staying in the hospital where I was just getting in the way, I turned the rest of my time into a study on medical practices. For the next eight weeks, I interviewed many traditional and religious healers in the village. I found that the best health care
—in terms of actual outcomes for people—came from those that dealt with the religion side of things. Patients actually listened to the person treating them and did what he or she said. For example, instead of merely taking a pill every so often, a religious healer may give some elaborate series of activities. Though more complicated than taking a pill, the reasons underlying the activities were valued—and believed. It was very complex. There were whole worlds of rationality behind what they were being told to do.

Did this experience change your career path?

After my time in India, I went back to Smith College and quit pre-med. I just said, “Forget it. This is not what I’m going to do. That’s not where I’m going to be able to do what I want, which is to go abroad and help people.” But at the same time, I had had my first glimpse of development work, which seemed to me to be about bringing foreign, often white (and young and inexperienced in many cases), people into remote villages to help even if they didn’t know the local context or have the right skills.

I took a step back and realized that I wanted to understand the religious worldview of people, applying those insights into whatever intervention might come later—whether it was medical, educational, poverty reduction, etc. The first step was to study religion, because so often religious worldviews determine or are determined by what people think and how they act. In my opinion, it is a disservice to people to not take their religion seriously. To make a long story short, as soon as I graduated from Smith I went on to complete my master’s degree and then my Ph.D. under the same professor (Paul Gifford) who blew my mind with the first classes.

How did this all bring you to Liberia?

During my Ph.D. studies, I chose to focus on charismatic Christianity/Pentecostalism because it was growing everywhere around the world. Based on much of the literature that I’d read, it was clear that a big thrust behind much of modern Pentecostalism is the power of positive thinking. Birgit Meyer’s book Translating the Devil [1999] was particularly interesting. She demonstrated how mainline Christian missionaries in Ghana’s Volta Region had tried to stop traditional religious practices such as veneration of ancestors or appeasing spirits by saying that such practices and belief in such spirits were demonic. This didn’t eliminate people’s belief in those spirits, but rather those spirits went from ambivalent
—could cause good things or bad things to happen to you based on how you treated them—to evil. The spirits would only do bad things to you because they were essentially agents of the devil. As a result, what’s left are a whole lot of evil spirits roaming around, so one needs something to fight them. That’s where Jesus Christ comes in. He can fight any spirit if you just use his power correctly. The power of positive thinking is that when you are born-again, you have an incredible amount of power to fight evil spirits and also attract blessings from God; you will have a better life if you are just doing things right. I wanted to see if this would apply in a place where so many bad things have just happened and not much looks positive these days.

Liberia was a very clear case study, where civil war had ended four years earlier. I knew there had been a very strong Pentecostal presence before the war because my advisor, Paul Gifford, had done a study on Christianity in Liberia during the end of Samuel Doe’s regime, around the time the war began in 1989. I knew that Pentecostalism was strong and growing in 1989, but no one had looked at it in any depth since then. I wanted to go in and see: did Pentecostalism survive the war? Was the power of positive thinking maintained when all these horrific things were happening to literally everybody in the country?

Another source of inspiration was a book by the late Stephen Ellis, The Mask of Anarchy: The Destruction of Liberia and the Religious Dimension of an African Civil War [1999]. A main point of his thesis is that a Liberian’s understanding of the spirit world, which is that it is in total disarray, reflects in the way that the war is playing out. There is a lot of emphasis on masking, for example; when fighters would dress in costumes as a version of traditional Liberian masking rituals. The belief is that when you put on a different costume, you become a different person (and in some cases can tap into power), and you can do these certain things because you aren’t yourself anymore.

To put it another way, I thought, there is so much going on in the spirit world in Liberia, and I wanted to understand what Pentecostalism had to do with it—so that’s why I went to Liberia.

Are Pentecostal churches in Liberia networked or are they independent?

They are both. In Liberia when I was working there (2007-2009), I would distinguish three types of Pentecostal or charismatic churches (there’s a difference between charismatic and Pentecostal that I won’t get into here—but the common emphasis is on the power of the Holy Spirit, and its ability to bring about healing, miracles, deliverance, etc. in a person’s life today). There are megachurches, which were at that time for the most part planted in Liberia. The best example is Winners’ Chapel, which came in from Nigeria. They are massive; they come with a ton of money from Nigeria. They bring funding and Nigerian pastors to plant churches in really beautiful, newly constructed structures. This served as one of my case studies in Liberia. When I arrived, it was just getting started, an empty shell of a massive building. By the time I left, it had air conditioning and the best music, and they started planting other little Winners’ Chapels around the country. There was definitely a network of Winners’ Chapel members, and it was a very distinct type of Pentecostalism, very motivated around the power of positive thinking and the faith gospel (also known as the prosperity gospel).

The second category is Pentecostal churches that originate from the United States where the Pentecostal movement began in the early twentieth century, what’s known as a classical Pentecostal Church. United Pentecostal Church is one example. They had one central church in Monrovia but around 50 satellite churches around the country, all closely linked with the U.S.-based church. American pastors would visit from time to time, and there were newsletters that had letters from so-and-so in Kenya, or so-and-so in Illinois.

Thirdly, there were the very homegrown Pentecostal/charismatic churches. These are the ones that would adapt certain bits and pieces of classical Pentecostal (e.g. speaking in tongues, healing) and charismatic beliefs and practices (e.g. the power of positive thinking, singing and dancing) to meet their congregation’s needs, and very often they have a particularly strong emphasis on deliverance (casting out evil spirits and reversing generational curses that result from years of living an un-Christian life/involved in traditional religious practices). An example of this type of church in my thesis was the Christian Evangelistic Pentecostal Church (CEPC). The pastor had been inspired by books on demonology—the science of casting out demons—that were produced in the United States, Kenya, Nigeria, or Cameroon.

These local homegrown congregations are very much their own thing, so their networks don’t extend too far beyond. Before a crusade event (a multi-night praise and worship event for which a primary purpose is to attract new followers by demonstrating the power of the Holy Spirit), they will invite everyone in the community, and they all come (it is a legitimately fun affair
singing, dancing, bright lights, and the promise of healing/good fortune), but that’s the extent of their network. If they were having financial trouble, for example, they would have to raise money from within their own church. That’s for the most part how they sustain themselves. Sometimes, the pastors try to become connected with churches in the United States in order to get funding; they’ll write letters or become acquainted with NGO workers in town; quite a few, including CEPC, have been successful and with just a bit of money can continue.

How do Pentecostals in Liberia work with other religious traditions? Do they collaborate?

It was such a pivotal time when I was doing research. The Liberian Council of Churches (LCC) had a liaison of sorts with the government. For example, if there was something going on, the government would go talk to the LCC to ask, “What is the Christian message?” At the time that I was there, LCC was composed of mainline Christians: Catholics, Methodists, and Lutherans. Pentecostals were on the fringe, though they were trying to be a part of the LCC. There was a lot of internal reluctance to do bring them in because so many of them were viewed as not truly Bible-believing
too focused on demons and being wealthy (power of positive thinking). They did not use any sort of mainline liturgy in their worship services, and those dealing with demonology were often seen as religious charlatans. This was interesting to see coming from the LCC because in so many cases, the congregants who were visiting the deliverance clinics or mid-week prayer services at Pentecostal/charismatic churches were regular members of these mainline denominations, and they wished that their church focused more on the healing aspect of Jesus Christ.

But given the influence and reach of Pentecostals, others were definitely trying to get them more involved with LCC. One Pentecostal minister ended up becoming a part of the LCC, and they would consult with him regularly. I know for a fact that during the Ebola crisis, they would meet with him regularly about what to do with it. But there are also so many small churches that are just considered off-the-wall, unregulated, borderline African traditional religion with Jesus thrown in; these probably wouldn’t be accepted. The general view of mainline churches to Pentecostals is very suspicious largely due to an emphasis on the faith gospel, which is the belief that if you donate money to the church, then you will get a blessing in return (the more you give, the more you get). This sustains most of these churches because this ideology is extremely strong, some more than others.

During the Ebola crisis did people talk about Ebola as a demon or a curse?

Yes, definitely. At one point the LCC released a statement saying that Ebola was a punishment from God; when the LCC says that, it’s kind of scary. They organized a national prayer and fast. If LCC has so much power to convince people to fast, why not also tell them to wash their hands?! There was much critique from outsiders observing the Ebola situation, but for many Liberians, this explanation and method of dealing with the problem made perfect sense.

The Pentecostal churches definitely saw Ebola as either demons targeting people for their individual sins or as punishment for Liberia not being a godly country. The range of reasons why people thought that Ebola was happening was vast, but without a doubt there was a spiritual element to it. Therefore, there needed to be a spiritual response to it.

How did churches or spiritual leaders respond to Ebola, in efforts to prevent it?

Initially, there was so much fasting and praying, and not much use of religious radio shows for public service messages, and based on reports from my Liberian Pentecostal friends, pastors didn’t really address the problem beyond its spiritual components. This is why I came to the meeting you helped organize in Washington, DC and participated in the Ebola Anthropology Initiative that Sharon Abramowitz was leading. We needed a more conscious effort to reach out to these leaders in hopes of getting them to say something more.

It was hard to get the full grasp of what was happening on the ground. I did hear from two pastors with whom I regularly talk. In their congregations, they were teaching very obvious things that health professionals were asking people to do, like about using bleach to wash hands. They had heard such public health messages on the radio, understood its importance, and then told their congregations that in additional to prayer, washing hands with bleach could help keep their families safe.

Information given by public health officials wasn’t necessarily contrary to their beliefs, but it needed to be supplemented and for people in congregations, being told what to do by a pastor whom they trusted arguably more than any other leader in the country was extremely important. One example is when Pastor Moses, one of my best friends in Liberia, referred to 1 Timothy 5:22, “Do not be hasty in the laying on of hands, and do not share in the sins of others. Keep yourself pure.” This is to say that you shouldn’t always try to cast out a demon if you aren’t sure it’s a demon—and that really resonated with people. And of course, if followed, it meant that people were touching sick people less.

So you saw that there was space for people to have “both / and,” the science facts coming from doctors, but imbue it with spiritual elements? People were able to hold those together?

Yes, exactly. To me, the key was that the people delivering the science were the pastors: the ones that the people saw had the legitimacy. The challenge was, of course, getting the religious leaders to see that the message was important. From what I know, for the pastors who did that, it worked for people. “Don’t stop praying, but wash your hands before you come in here.”

How did you see church leaders distributing messages or information through their networks in a way that was useful?

One contact would physically visit his satellite churches. They were in such rural areas that didn’t have radios, so he would go to transmit the messages. Cell phones were used a lot, but those were sort of limited; there is only so much you can do through a text message.

The successes I saw were the ones that required a lot of nurturing, which is not necessarily easiest. If there were unlimited financial resources, instead of sensitization teams going to individual communities, I would tell them to go to churches. The first point of contact is the village chief, but don’t let that conversation happen without the church leaders across all the communities. Through that, you could reach everyone and it might be a more effective approach. It would need to be a one-on-one visit with a lot of care and attention because a text message approach just isn’t going to resonate with people in the same way.

Pastors already gather at different events across the country, and those could be very useful for communication strategies. Since they are already happening, use these places to educate religious leaders, urging them to take messages back home. These things might have been done and I just don’t know about them.

Can you talk about some of the risks involved because of spiritual practices in infecting others?

See the Ebola Anthropology Initiative’s work on burial practices, because one of the biggest risks involved the washing of the bodies.

For Pentecostals, there were obvious risks because of the laying-on of hands that is often required for deliverance. During deliverance services in Liberia, people are touched a lot! During these events, particularly during crusades, not only are people typically sweaty and in close proximity to others, but also when demons are cast out during deliverance, they usually “manifest” in some external way. This can be in the form of a hiccup or a cough, but many times, it manifests as vomit, or urine, or feces. If someone is convulsing, this is an obvious sign that person is undergoing deliverance. At crusades where there are hundreds of people, the spiritual warriors (a specific role in some churches) see this and go pick that person up out of the crowd, carry them off to the side, and place them on a tarp. They are left there to continue convulsing and often times, throwing up. There is bodily fluid all over the place. Because I had seen so much of that in my time researching Pentecostals, I was extremely nervous because I knew similar deliverance services must still be happening. They’re important!

I can imagine people being scared and a bit desperate, especially if the modern medicine wasn’t working.

The idea of demonic possession often is that if you are in close proximity to someone who has a demon, and your heart is not full of the Holy Spirit (you aren’t truly born-again), then you are very vulnerable to contracting that demon. Using that logic, the demon of Ebola could come to you if you are next to someone that has it.

At the same time, Ebola was so mysterious to people: it was this little hidden enemy that would just hit people, very much in the ways that demons would hit people. The natural response is certainly to look at the spiritual side of things. When it was first creeping up, I imagine that most people were not even thinking about medicine. Even with cases of malaria, many people in Liberia don’t get treatment for it because they can’t afford it or can’t take the time to go to the clinic (which in rural areas could be very far away), so they just deal with it and ask for healing. So, at least in the early stages, when people didn’t know what Ebola looked like, I would guess spiritual healing was sought.

When you were doing research in Liberia, were you paying attention to the way that people were relating to medical care in hospitals and clinics?

It was not my primary focus, but I can offer some powerful examples. I spent a lot of time at the CEPC Deliverance Clinic next to JFK Hospital, the government hospital. Deliverance went from Wednesday to Friday every week, but a good portion of people’s time on the Wednesday was to wait outside for their one-on-one consultation with the head pastor or on Friday waiting for their personalized deliverance session (Thursday was for a class where everyone learned about demonic risk). I would go and talk to people about what they had. Or course, many people were there for issues like inability to find a job, spouse, or had bad dreams. But some were physically ill, and at the church instead of the hospital because they believed that the issues that they had were spiritual. And they had very medical issues—but they just didn’t bother with the doctor. I found that in fact, they would pay more at the Deliverance Clinic (US$3 to $5 compared to US$1 at the clinic to see a doctor).

I couldn’t really see the specific reasons why this happened—if it was mistrust of doctors, if they were ineffective, or it was too long to wait around—but without a doubt there were people who would choose the Deliverance Clinic over medicine, where it would have been a pretty quick fix for medicine, like malaria, for example.

This is a bit troubling to hear. How do others working in medicine or development react to this story?

My main take-away from all my fieldwork in Liberia is that religion is there. It exists, and that is how people think. Rather than demonizing it as a thing that is hurting people, we need to look at it as an opportunity to work with people, taking into account the spiritual realities.

The one thing about religiosity in Liberia, and, I would say, most of West Africa, is that religion is extremely flexible based on worldly events. I hate to say it, but it is easily manipulated to achieve certain purposes. This goes both ways, so if development actors want to work with the people, they can use it too. It won’t work if you just say, “This is stupid.” It’s the same in the United States. You have to find and use the same language, meeting people where they are.

Would you mind reflecting on the role that anthropology plays in thinking about and understanding health systems?

Anthropology’s first role is to help understand the way people see causality. There is very often more to people’s understanding of cause and effect than science, and, in fact, there may be no science at all. In contexts were education is sub par, people might lack basic science education that often explains how things work in the way that you and I understand it. Instead, that knowledge is replaced with religious or spiritual education, which can be extremely clear about how things happen. This is the spiritual dialogue around such things as healing. It’s extremely rich and extremely rational for many perspectives. Anthropology can understand this thought process, and then work within it to integrate other messages—not to compete with it, but to enhance or re-shift it.

Anthropology’s second role relates to legitimacy, which is a huge problem in many of these places. Just think of government legitimacy and donor legitimacy, especially in Liberia. People are getting exhausted because so many promises have been made, and there hasn’t been a lot of progress. In fact, many things are getting worse in the wake of these promises. Instead, working within existing networks where people see legitimacy is far more powerful, and the churches are those places, more than anywhere else. Anthropology can understand those networks far better.

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