Desperate Ethiopians, flocking to an ancient mountain north of the capital, Addis Ababa, seeking a "holy water" cure for AIDS have been belatedly warned by the church to keep taking their antiretroviral (ARV) medication.
"Both are gifts of God, they neither contradict nor resist each other," the Archbishop of the Ethiopian Orthodox Church, Abune Paulos, said this week. "You can swallow your drugs with the holy water," he added.
Thousands of HIV-positive people from all corners of Ethiopia have visited Entoto mountain, on the northern outskirts of the capital, after local priests promised they could cure the virus.
"I found out my HIV status seven months back and packed my bags for Entoto - many people have been healed,” Tesfaye Belete*, a former soldier seeking treatment, told PlusNews.
Ethiopia’s Orthodox church has several deeply-rooted beliefs among its adherents. One of these is the power of Entoto's 'tsebel', or 'holy water', to heal the sick and cast out demons. The water, which comes from a spring on the mountain, is poured onto the patients or drunk as a healing tonic.
Until Archbishop Abune's clarification, the Church's position on the use of ARVs had been unclear and many patients believed so strongly in the power of the holy water that they stopped their ARV regimens altogether.
"A majority of holy water users believe that either HIV/AIDS is caused by an evil spirit or it is a demon by itself," said Ato Zena Berhanu, a PhD student in Addis Ababa who has researched the issue. "There are people who believe that the only solution to HIV/AIDS is the holy water and they do not want to use the antiretroviral drugs."
A recent report by the UK's satellite broadcaster Sky News on Entoto's exorcisms has drawn widespread criticism of the Church for its failure to advise patients to continue with their ARV medication.
Entoto has long been a safe heaven for community outcasts and those looking for spiritual help. "Approximately 4,000 people currently reside at Entoto in search of a miracle," said Haimanot, one of the priests who performs the ceremonies.
He said patients came from all social backgrounds and lived there until they were "cured''. Healing, he added, could take anywhere from one day to several years, and supposedly manifested itself in the form of a dark discharge in the patient's saliva.
Zewdi Zuriah came to Entoto after being abandoned by her husband when she tested HIV-positive. "If one is too sick to cook or wash, the neighbour pitches in as the primary care giver... we also talk openly about our disease and share our fears."
Zeinab Tsehay, a former sex worker who joined the community four months ago, says she will stay in Entoto "as long as it takes" for her to be cured.
Alem Bekele, who came all the way from Gonder, in the north of the country, said: "As soon as I received the bad report about the virus in my blood, I took the bus to Entoto." She was willing to try conventional drug therapy, but said she did not have enough money to return home for her ID card, which she would need to access free, government-provided ARVs.
A typical day at Entoto starts at dawn, when the patients descend to the bottom of a steep ravine and line up naked. The clergy then stand on the edge of the cliff and shower them with the holy water.
Residents in Entoto put up with very poor living conditions where ‘patients’ can rent a tiny room without a bathroom for between US$5 and US$7 per month.
Several patients are crammed into each room and with the unavailability of toilets and poor hygiene, other health problems like tuberculosis are commonplace. Especially since the 'healing' requires patients to drink up to six litres of holy water every day.
But few complain about the conditions; they believe that this suffering only makes them stronger candidates for healing.
According to Berhanu, a concerted effort was needed to ensure people remained on their drug regimens, even if they used the holy water. "Entoto and other holy water sites in other parts of the country are attracting thousands of people living with HIV/AIDS - there should be some organised effort to address the problems of these citizens in a culturally sensitive manner; this includes encouraging people to combine holy water and ARV drugs, and designing and implementing a care programme for the patients."
There is still no known evidence-based cure for AIDS.
When contacted, an official of the Ministry of Health said the ministry did not have a position on the exorcisms at Entoto, but continued to advise patients to stay on their ARVs.
Ethiopia's HIV prevalence is estimated at about 3.5 percent, with more than one million people living with the virus - just seven percent of these are currently on antiretroviral medication.