Babalú-Ayé is an Orisha strongly associated with infectious disease, and healing. The name Babalú-Ayé translates as “Father, lord of the Earth” and points to the authority this orisha exercises on all things earthly, including the body, wealth, and physical possessions. In West Africa, he was strongly associated with epidemics of smallpox, leprosy, influenza, ebola, and HIV/AIDS. Although strongly associated with illness and disease, Babalú-Ayé is also the spirit that cures these ailments. Both feared and loved, Babalú-Ayé is sometimes referred to as the “Wrath of the supreme god” because he punishes people for their transgressions. People hold Babalú-Ayé in great respect and avoid calling his actual name, because they do not wish to invoke epidemics.
His worship is widely associated with the Earth itself, and his shrines are often separated from commonly travelled areas. His ritual tools include a ritual broom for purification, a covered terra-cotta vessel, and abundant cowry shells. Usually considered hobbled by disease, he universally takes grains as offerings.
Venerated by the Yoruba, he is usually called Shopona and said to have dominion over the Earth and smallpox. He demands respect and even gratitude when he claims a victim, and so people sometimes honor him with the praise name Alápa-dúpé, meaning “One who kills and is thanked for it”. In one commonly recounted story, Shopona was old and lame. He attended a celebration at the palace of Obatala, the father of the orishas. When Shopona tried to dance, he stumbled and fell. All the other orishas laughed at him, and he in turn tried to infect them with smallpox. Obatala stopped him and drove him into the bush, where he has lived as an outcast ever since.
Venerated by the Fon, the spirit is most commonly called Sagbata. He owns the Earth and has strong associations with smallpox and other infections. His worship is very diverse in Fon communities, where many distinct manifestations of the spirit are venerated. Because the dead are buried in the Earth, the manifestation called Avimadye is considered the chief of the ancestors.
Venerated by the Ewe, there is a similar figure with the praise name Anyigbato who is closely associated with sickness  and displaced peoples. He is believed to wander the land at night, wearing a garment of rattling snail shells; the snail shells are also a key feature of his fetish.
In Latin America
Omolu, in candomblé of "Ile Ase Ijino Ilu Orossi".
In Santería, Babalú-Ayé is among the most popular orishas. Syncretized with Saint Lazarus, and regarded as particularly miraculous, Babalú-Ayé is publicly honored with a pilgrimage on December 17, when tens of thousands of devoteess gather at the Church and Leprosorium of Saint Lazarus in El Rincón, in the outskirts of Santiago de Las Vegas, Havana. Arará communities in Cuba and its diaspora honor the spirit as Asojano. Both traditions use sack cloth in rituals to evoke his humility. The spirit also appears in Palo as Pata en Llaga.
In Candomblé, Obaluaiê's face is thought to be so scarred by disease and so terrifying that he appears covered with a raffia masquerade that covers his whole body. He also manifests in Umbanda and Macumba.
In Ifá and Dilogun divination
Through divination, he often speaks to his devotees through the Ifá signs (Odu Ifá) Ojuani Meyi and Irete Meyi, though as a sickness, he can manifest in any divination sign. In cowrie-shell divination (Dilogun), he is also strongly also associated with the sign called Metanlá (13 cowries).
Relationship to other Orisha
There are several, sometimes contradictory, accounts of Babalú-Ayé's genealogical relationships to other orisha. Babalú-Ayé is often considered the son of Yemoja and the brother of Shango. However, some religious lineages maintain that he is the son of Nana Burukú, while others assert that he is her husband.
Some lineages of Candomblé relate myths that justify Babalú-Ayé being the child of both Yemoja and Nana Burukú. In these myths, Nana Burukú is Babalú-Ayé's true mother who abandons him to die of exposure on the beach where he is badly scarred by crabs. Yemoja discovers him there, takes him under her protection, nurses him back to health, and educates him in many secrets.
Because of his knowledge of the forest and the healing power of plants, Babalú-Ayé is strongly associated with Osain, the orisha of herbs. Oba Ecun (an oriate in La Regla de Ocha) describes the two orisha as two aspects of a single being, while William Bascom noted that some connect the two through their mutual close relationship with the spirits of the forest called ijimere.
Themes in the worship of Babalú
The narratives and rituals that carry important cultural information about Babalú-Ayé include various recurring and interrelated themes.
Earth: Babalú-Ayé’s worship is frequently linked to the Earth itself, and even his name identifies him with the Earth itself.
Illness and Suffering: Long referred to as the “god of smallpox,” Babalú-Ayé certainly links back to disease in the body and the changes it brings. Because Babalú-Ayé both punishes people with illness and rewards them with health, his stories and ceremonies often deal with the body as a central locus of experience for both human limitations and divine power. Similarly, his mythical lameness evokes the idea of living in a constant state of limitation and physical pain, while people appeal to him to protect them from disease.
The Permeable Nature of Things: In the Americas, Babalú-Ayé vessels always have various holes in their lids, allowing offerings to enter but also symbolizing the difficulty in containing illness completely. These holes are often explicitly compared to sores that pock the orisha’s skin. This permeability also appears in the sack cloth and raffia fringe called mariwó used to dress the orisha.
Secrecy and Revelation: The contrast between silence and speech, darkness, and light, and secrecy and revelation permeate the worship of Babalú-Ayé. According to the tradition, certain things must remain secret to sustain their ritual power or their healthy function. In turn inappropriate revelation leads to illness and other negative manifestations. Conversely the appropriate revelation of information can provide important teaching and guidance.
Wickedness and Righteousness: Represented in sacred narratives as a transgressor in some instances, Babalú-Ayé himself is condemned to exile because he breaks the social contract. The physical pain of his lame leg transforms into the emotional pain of exile. Only after spending much time in isolation does he return to society. In other contexts, he is lauded as the most righteous of all the orishas. Similarly he is often referred to as punishing the offense of human beings.
Exile and Movement: Strongly associated with the forest and the road itself, the key stories and ceremonies related to Babalú-Ayé involve movement as an antidote to stagnation. In Lucumí and Arará ceremonies in Cuba, his vessel is ritually moved from place to place in important initiations. But through this movement through different spaces, Babalú-Ayé regularly appears as a complex, even liminal, figure who unites various realms. Strongly associated with powerful herbs used for poisons and panaceas, he is sometimes associated with Osain and the powerful acts of magicians. Strongly associated with the Earth and the ancestors buried within it, he is sometimes ritually honored with the dead. At the same time, he is widely included as an orisha or a fodun, as the Arará traditionally call their deities in Cuba. Similarly the dogs strongly associated with Babalú-Ayé move from the house, to the street, to the forest, and back with relative facility.
Death and Resurrection: Last but not least, Babalú-Ayé's own journey of exile, debilitation, and finally restoration addresses the cyclic nature of all life. While this theme of transcendence plays a much more prominent role in the Americas than in West Africa, it is also present there in narratives about epidemics befalling kings and kingdoms, only to find relief and remedy in Babalú-Ayé.
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