Illness transmission and proximity: local theories of causation among the Bissa in Burkina Faso.

Anthropological studies of African conceptions of illness have often worked with a division between the natural and the supernatural, with the focus being on the efficient, or final, causes of an illness. This approach tends to maintain local African explanations of sickness within a framework of exoticism. Based on a study among the Bissa in southeastern Burkina Faso, this paper offers an alternative analysis, with the main focus being on how the process of transmission is conceived. Four different modes of illness transmission are identified: (1) ingestion of improper substances, (2) breaking of social taboos, (3) sorcery, and (4) improper interaction with spirits. Notions of proximity and improper sharing of space play a role in all four types of illness transmission. I demonstrate how local theories of illness transmission indicate a dynamic interaction between spatial domains and social relationships. Such a focus may well be more useful for health planners than the one that emphasizes the differences between African and biomedical notions of causation.