Raphael Dwamena passed away on November 11^th, 2023. A 28-year-old footballer from Ghana, he collapsed on the pitch during a match in Europe, and died. His former club in Albania announced last month that they will honor the player by naming a stadium stand after him.

His death shook the global football community, but also raised difficult questions about the relationship between medicine and religion.

Dwamena struggled with heart problems throughout his football career in Europe. He had cardiac arrythmia, a potentially deadly condition that was exacerbated by exercise. In January 2020, he had a defibrillator fitted in his chest, which saved his life on at least one occasion. But his problems continued, and contracts with football clubs came and went.

Notably, Dwamena was a devoted Christian. He grew up in Ghana, in humble circumstances, with a deeply religious grandmother. Having become born-again in 2015, he used every chance he had to spread the word of God. He explained his predicament in a 2022 interview with an Austrian newspaper: “I went to many doctors, they all say different things. But only the Lord can tell me when it’s time to stop. It’s God’s will if I die… I believe that God is the one who takes care of my heart… I am never afraid.”

He was determined to continue playing professionally, and in early 2022 decided to have the defibrillator removed. He defied doctors’ advice, believing that the device was holding him back. His former cardiologist commented that his death was, unfortunately, predictable. Former teammates and agents reported that Dwamena resisted medical interventions in order to follow “God’s plan” and “God’s desire.”

Christianity certainly played an important role in Dwamena’s decision-making. However, it is too simplistic to reduce his story to one of religious zeal and fatalist rejection of secular medicine. Doing so risks misunderstanding how spiritually inclined people make decisions in challenging situations. It also risks underestimating the impact of highly competitive and profit-driven industries on people’s lives and worldviews.

Since 2014 I have been conducting anthropological research on football and Christianity in western Cameroon. Cameroon is obviously different from Ghana, but there are many similarities. In both countries, countless young men join football clubs and academies with hopes of signing contracts abroad and fulfilling dreams of migration and sports stardom. And both in southern Ghana and in western Cameroon, charismatic Pentecostalism – a global evangelical movement that emphasizes miracles, prophecies, and healing – has gained many followers.

In Cameroon, I did not find that religion discouraged aspiring footballers from medical interventions. Prayer was important, but it was one more tool in their arsenal of healing. For instance, a groin injury would include visits to the hospital, injections, many hours of rest and stretching, and prayers. When faced with injuries and illnesses, the aspiring footballers did not avoid medical assistance, at least not when they could afford it. Those steeped in charismatic Pentecostalism instead used prayers as an additional – but very important – tool for healing, especially when the medications seemingly did not work, or when they were prohibitively expensive.

Contrasting secular medicine to religious doctrine is clearly not very useful. In practice, the spiritually inclined athletes use both when recovering and making hard decisions, just like Dwamena did when consulting numerous doctors and a Christian God.

I also found that Pentecostalism served the footballers as an engine of hope. Football is highly competitive, and while many aspire, very few succeed in playing professionally. Migration from West Africa, especially to Europe – the footballers’ preferred destination – is highly restricted, and applying for a visa can feel like playing the lottery. Sporting talent is valued, but it is not enough – one needs connections, and a lot of luck. An injury can end a career before it has taken off.

In this highly precarious context, I was often struck by the fervor and the optimism expressed by my Pentecostal interlocutors. “I will travel, by God’s grace!”, they would say about their migration aspirations. “I will play on this professional level!”, they asserted, pointing to posters of football superstars on their walls. “I have dominion over you, you cannot stop me,” they would whisper to themselves while marking opponents in challenging matches. These were not statements of fact, but rather confidence boosters designed to bring a desire into reality.

In this way, the footballers could resort to counting on a “God’s plan” or “God’s desire”, while also taking control of their lives and making active and bold decisions. A far cry from a fatalist acceptance of one’s destiny.

It is notable that Dwamena was also quoted as saying “you cannot really trust anyone” when discussing the ups and downs of his upbringing in Ghana. Trust is indeed a scarce commodity in African football and migration. The aspiring athletes need to decide which agents and migration brokers are trustworthy, as many have been known to exploit the footballers’ dreams and mislead them for profit. The footballers are also often wary of so-called spiritual attacks from uncles, aunts, and neighbors envious of their potential success, or from competing footballers who also strive to be scouted for professional contracts. The attacks are not just theoretical – many believe that they can cause serious injuries and disrupt migration plans.

African football migration is competitive, and even potentially dangerous. In this context, trust in a Christian God serves as a form of protection from envious others, and a rare harbor of stability and certainty.

Finally, singling out religious fervor can effectively obscure other important factors. Dwamena seemed to have difficulties imagining life beyond football. His decision to continue playing despite heart problems was surely grounded in personal faith. But we should keep in mind that professional football is also a dream machine, a global multi-billion dollar industry propped up by heroic stories of men (and women) overcoming small odds, realizing their talents through dedication, and lifting themselves and others out of poverty.

These are powerful stories that attract many hopefuls, especially those from humble backgrounds. Personal faith – Christian or otherwise – is only one piece of a complex puzzle that includes profit, resolve, high expectations, and love for the beautiful game.