In West Africa, he was strongly associated with epidemics of smallpox, but in the contemporary Americas, he is more commonly thought of as the patron of leprosy, influenza, and AIDS. Although strongly associated with illness and disease, Babalú-Ayé is also the deity 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.