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Wisdom and counselling: A note on advising people with HIV/AIDS in Ghana

Sjaak van der Geest


This article raises the question of whether the practice of HIV/AIDS counselling in Ghana can be linked to the wisdom that older people are said to have and use when they give advice to younger family members. Older people believe they have wisdom and life experience that young people should listen to; counsellors hold an opposite view about their work, insisting that it is they who listen to people with HIV/AIDS to help them make their own decisions. In actual practice, however, HIV/AIDS counsellors predominantly give information and advice, for at least three reasons. Firstly, clients urgently need a substantial amount of medical information about the causes and prevention of HIV in order to assess their situation and make decisions. Secondly, the traditional hierarchy between nurse and patient is difficult to reverse when the two meet during counselling. Thirdly, encouraging the client not to lose hope often takes the form of a pep-talk, which leaves little room for listening by the counsellor. This paper pleads for peer counselling, as a format that combines a relative equality between counselling partners with the authoritative knowledge of the counsellor. This article is based on anthropological fieldwork among older people in a rural community and counsellors in a hospital in the Kwahu region of southern Ghana.

Keywords: anthropology, peer counselling, traditional advice-giving, elders, stigma, trust, hospital