The people of the Kandoka village, located in Papua New Guinea, have quite a unique way of life that differs from that of Western civilization in several ways. They are essentially a simple society based on subsistence horticulture and occasional hunting. With a population of approximately four hundred people, the Kandoka village is “the largest of the five coastal villages of Lusi-Kaliai speakers. Travel between these different communities is achieved by foot or sea and usually requires a substantial amount of time. This can be quite problematic in cases of medical emergency. Although a registered nurse is located at an Aid Post a few miles from the village, more serious cases are often referred to hospitals quite far away. The Kaliai have now been in contact with Western culture for over a century and with Western medicine for almost fifty years. They have still managed to maintain their strong cultural beliefs and practices while at the same time integrating certain aspects of Western culture into theirs. In this essay I will discuss how the availability of Western medicine has affected how the Kaliai perceive and explain causes of illness and methods of treatment, when they seek this type of treatment, and how they explain and deal with it’s failure. I will then proceed to comment on how and when traditional treatment is exercised and what happens if this method fails. The information used in the discussions is provided in a series of case histories documented by Drs. Dorothy and David Counts. It is from these cases we find that the people of the Kandoka village have generally accepted Western medicine and use it in varying combinations with traditional practices.
Western Medicine’s Impact on Perceptions of Illness
With the introduction of Western medicine into the Kandoka village came new ways of explaining illness and providing treatment. Contact with Western missionaries had established a great deal of respect for their culture through both their kindness and their exciting different way of life. When Western medicine became available near by at a relatively low cost the Kaliai experimented with these new methods of treatment. This new system of health care differs from traditional Kaliai care in that it is based more so on scientific facts and discoveries. Illness and disease are diagnosed according to what symptoms the victim possesses. Once the diagnosis is established the associated treatment is administered. From the information presented in the case histories it does not appear that the Kaliai were unwilling to seek aid from Western medical care providers.
Several of the victims mentioned in the cases sought advice and treatment provided by Westerners. In the majority of situations this was even the first avenue explored by them. Such was the case with Paul, Tina, Nathan, Bruno and Christy.
It generally appeared that this method of treatment was selected over traditional medicine especially when symptoms were recognized as being similar to ones that had been cured through Western medicine in the past. Examples of this involve the infection of Paul’s thumb, Tina’s high fever, and Nathan’s swollen face. Shortly after the symptoms appeared, Paul approached the Counts for first-aid treatment. With this infection continuing to worsen, his next action was to travel to the mission clinic to see if they could heal him. In Tina’s case her parents wanted to take her to the Health Centre but bad weather prevented them from travelling there. They, like Paul, then approached the anthropologists for help. In Nathan’s situation he was administered treatment at the Kaliai Health Centre and was then paid a visit by the Counts. “The anthropologists, and their pills, were credited with predicting the time of his recovery and with his cure.” These cases suggest a high level of confidence in Western medicine’s ability to heal. Unfortunately, in Paul’s case he was unable to get to a better medical facility in time and ended up needing to have his thumb amputated. Drs. Dorothy and David Counts were often consulted both because of their close proximity and because they were highly respected by the villagers. The other common place travelled to for treatment was the Kaliai Health Centre staffed by trained nurses.
Although the people of the Kandoka village hold a generally positive opinion of Western medicine there were some instances in which this type of treatment was perceived to have failed. The most obvious example indicating this relates to Bruno’s sudden death. The boy’s family took him to the medical centre where he was diagnosed with symptoms consistent with malaria. The nurse there did everything she could to try and save him but his body was unable to fight the illness. This was perceived a failure not only because he died but also because his family was unable to accept that Bruno could have contracted the disease and were unfamiliar with the treatment he received. A similar conclusion was drawn in Christy’s case. The nurse claimed that her retardation was the result of cerebral meningitis as a child. The Kaliai could not understand this and therefore looked for an alternative way of explaining what had happened to her. What was found in both cases was discovered to relate to traditional medical explanations.
The Kaliai’s traditional beliefs relating to illness and healing have been culturally embedded into every member of society over countless generations. The Kaliai are highly spiritual people who believe in the presence of “powerful extra-human intelligent spirits.” Certain members within the village are known to practice sorcery and witchcraft. These people have the ability to cast spells and inflict harm on others. The reverse is also true for they are often approached by the ill or injured seeking a cure for their ailment.
The Kaliai hold enormous respect for the spiritual world. An example of this relates to the case of Michael and Melissa and their disrespect to the ‘masalai’ (bush spirit) in their garden. The villagers unanimously agree that their child, Wanlek, was born deformed as a direct result of them cutting down the tree and enraging the spirit within. No thought was given to the fact that the malformation may have been the result of any number of other variables. Insufficient data is provided in the cases, but it is possible the birth defect was caused by inbreeding due to the small population of the village, random mutation, or the use of alcohol or some other harmful substance during Melissa’s pregnancy.
Another case relating to the spiritual world involved the young infant Tina. The child’s sudden and mysterious illness seemed unaffected by Western medicine, which prompted her mother to take her to another woman in the village for traditional treatment. The woman, Cookie, decided it was necessary to contact the spirit of ginger to determine what was wrong with Tina. With the assistance of Leo, “who was known to be on good terms with the spirit,” they concluded that her recently deceased uncle had possession of her spirit and was unwilling to give it back. This conclusion allowed Cookie to perform a ritual to pull Tina’s spirit back to her body. Miraculously, the child made a full recovery shortly thereafter. This case further reinforces the Kaliai’s great respect for powerful spirits and the supernatural and their ability the inflict harm upon or heal somebody.
In addition to the spiritual world, the people of Kandoka also use sorcery and witchcraft as a way of explaining why people become ill. The case histories of Christy and Paul provide evidence of this. The following discusses how Christy’s condition was ultimately explained according to the Kaliai. It is believed that when she was two years old her spirit became trapped in the kisinga (protective spell) of a well-known sorcerer. Her spirit’s prolonged entrapment is said to be what caused her retardation. Villagers accused Christy’s parents of thoughtlessly allowing her to come to close to this powerful sorcerer in the first place and then again by not approaching Bou and asking him to release her spirit sooner.
A similar explanation was used to account for Paul’s injury and subsequent severe infection. Western medical attempts to heal his thumb had not appeared to have any effect on his condition. He is believed to have been a victim of the iha aimata ‘fish eye’ magical lock placed upon a house under which he sought shelter during a storm. His inability to recognize this cause and seek the owner of the house’s aid in breaking the spell quickly are the reasons used to justify him still requiring amputation.
As mentioned earlier, Bruno’s family searched for another way of explaining the young boy’s tragic death. Sorcery was the explanation they found. A ritual ceremony was performed in which the ghost of Bruno appeared to “identify the person who had brought him his poison.” It was discovered that his father was responsible because Bruno had come into contact with some material that his father had sorcerized.
Bertha, another resident of the Kandoka village, and her husband Lawrence were suspected to be the victims of witchcraft. Another woman, furious that she could not marry Lawrence, maliciously contaminated him by mixing her menstrual blood with something he ingested. This is said to be the cause of his tuberculosis and subsequently Bertha’s through her contact with her husband.
The information discussed above deals with how and when traditional methods are used to define and cure illness. Although there is only a limited number of cases in question, a pattern seems to have developed. It appears that the Kaliai will in most cases attempt using Western medicine first and resort to traditional beliefs of the spiritual world or sorcery when the Western methods fail to cure them or provide an acceptable cause of an illness, deformity, or death. Not enough information exists, so I can only tentatively state that when the circumstances surrounding the time and location of the illness seem suspicious, the Kaliai are more likely to turn to traditional sources of explaining events. Wanlek and Christy’s parents, as well as Paul, were all aware in advance of the presence of powerful spirits and sorcerers, which likely made it easier to find an explanation as to what happened after the fact.
It is because traditional medicine is generally approached after Western medicine that it is harder for the Kaliai to explain what happened when it fails. One explanation for why their traditional method did not work involves Paul. Loa’s attempt to cure him was unsuccessful therefore it was claimed that he had waited too long to seek her assistance. Similarly, Christy’s retardation is said not to have been the result of her spirit being caught in Bou’s kisinga but because it remained inside for so long.
The people of the Kandoka village have accepted Western medicine into their way of life. This new form of medical treatment is founded on a much more rigid foundation of diagnosis and scientific cure than their traditional practices. From the case histories provided it appears the Kaliai seek Western medical care first, especially when the symptoms of illness look familiar to ones that have been previously cured by this method. Western medicine, however, is not always able to explain sickness in a manner the Kaliai can understand or accept. It is in these situations that they are likely to revert to traditional medical beliefs involving sorcerers and the spiritual world to form a conclusion as to the cause of illness. Even these long-standing traditional beliefs are occasionally challenged when they fail. In instances like this excuses are often made, such as too much time was wasted before treatment was sought, or the person was foolish to disrespect the spirits. The people of the Kandoka village use Western medicine to compliment traditional practices and vice versa. Different cultures have different sets of values and beliefs that make up who they are as a culture. The medical beliefs and perceptions of illness are just a small part what make up the Kaliai.