Ritual, as an experimental technology intended to affect the flow of power in the universe, is an especially likely response to contradictions created and (literally) engendered by processes of social, material and cultural transformation, processes re-presented, rationalized and authorized in the name of modernity and its various alibis (‘civilisation,’
‘social progress,’ ‘economic development,’ ‘conversion’ and the like). For modernity, a Eurocentric vision of universal teleology carries its own historical irony, its own cosmic oxymoron: the more rationalistic and disenchanted the terms in which it is presented to
‘others’, the more magical, impenetrable, inscrutable, uncontrollable, darkly dangerous seem its signs, commodities, and practices. It is in this fissure between assertive rationalities, and perceived magicalities that malcontent gathers, giving rise to ritual efforts to penetrate the impenetrable, to unscrew the inscrutable, to recapture the forces suspected of redirecting the flow of power in the world. In these circumstances, ritual practice typically appears to its practitioners as an entirely pragmatic, secular means to bridge those chasms, to plumb the magicalities of modernity. (1993: xxx).
1.3 Ritual Healing and Traditional African Medicine.
In this section I describe the logic that informs traditional healing practices17 with the aim of showing why and how rituals form an inextricable part of traditional African medicine. All ritual healing takes place within a cosmological setting, which Comaroff (1980) refers to as the manifest perceptions of the world as they inhere in the context of action and experience.
In traditional African medical practices, perceptions about cause and effect and the nature of the world are always couched in a set of cultural expressions that determine the nature of affliction and the manner of its management (amelioration). It is important right from the outset to show the central importance of rituals in traditional healing, because as I will be arguing later, it is this connection to healing and to other spheres of life that has made ritual healing continue to flourish. Traditional African medicine has been defined and described in different ways in various ethnographies on health and illness in Africa. Banermann et. al have defined it as ‘the total body of knowledge, techniques for the preparation and use of substances, measures and practices in use, whether explicable or not, that are based on personal experience and observations handed down from generation to generation, either verbally or in writing and which are used for the diagnosis, prevention and elimination of imbalances in physical, mental or social well-being (1983:25). Good (1987) clarified that
17 In this dissertation I use traditional African healing in the singular sense even though one could argue that the singular form is misleading since each region or ethnic group in Africa had its own traditional healing system. As I use it here, I refer to the general principles that govern traditional healing in Africa which as Good (1987) argued , and I agree with him, have wide distribution throughout Sub Saharan Africa. The concept of underlying course which I address in the next paragraphs, for instance, is found in all regions in Africa in similar form.
32
African traditional medicine is an all-embracing system of healing that is deeply embedded in religious and socio-cultural institutions and reflecting values and practices, both local and foreign which have been incorporated and adapted over the centuries.
A discussion on the centrality of rituals in illness control and prevention in Traditional African medicine boils down to what Foster referred to as the ‘underlying cause’ (1976:
178), or its etiology. Foster observed that in all accounts of ethnomedical literature, beliefs about aetiology determined the kinds of curers, the mode of diagnosis, curing techniques, preventive acts, and the relationship of all these variables to the wider society of which they are part. Most ethnographies of illness and misfortune in Africa have always sort as their starting point, two of the most famous ethnographies on Africa, the one by, Evans-Pritchard, Witchcraft Oracles and Magic among the Azande (1937), and the other by W.H.R. Rivers, Medicine Magic and Religion (1924). Since the publication of these two famous ethnographies, scholars have argued over whether the two writers (Evans-Pritchard and W.H.R Rivers) and their followers placed too much emphasis on supernatural causation at the expense of natural causation and practical medical behaviour (Pool 1994). The debate on Evans-Pritchard’s famous ethnography among the Azande has over the years become more complex and moved beyond the discussion of whether he was right or wrong, to a level of discussing whether those who criticise him misunderstood his main argument. Based on these debates, a number of ethnographies appeared between the mid 1970s and mid 1980s, which sought to show that Africans traditionally recognised a separate medical domain in which they interpreted illnesses primarily in empirical and practical rather than in social and moral terms.18
It is not my intention to enter the debate on Evans-Pritchard and his critics although much ethnography on Africa has been written against this background. Part of what is at stake here is the notion of causality in illness or even more importantly the notion of affliction and misfortune. Based on this underlying assumption on the importance of etiology, scholars have attempted to categorize medical systems using various schemes. I provide two examples of such categorization.
18 Such ethnographies as cited by Pool include, Fortes 1976, Loudon 1976, Gillies 1976, Prins 1981; Warren 1982, Yoder, 1981.
33
The first is that of G.M Foster who came up with the two categories, i.e ‘personalistic’ and
‘naturalistic’. Foster defines a personalistic medical system as
one in which disease is explained as due to the active, purposive intervention of an agent, who may be human (a witch or a sorcerer), non human (a ghost, an ancestor, an evil spirit), or supernatural (a deity or powerful being) The sick person is merely a victim, the object of aggression or punishment directed specifically to him and for reasons that concern him alone. Personalistic causality allows no room for accident or chance. In contrast to personalistic systems, naturalistic systems, explain illnesses in impersonal systemic terms.
Disease is thought to stem, not from machinations of an angry being, but rather from such natural forces or conditions as cold, heat winds, dampness but above all, by an upset in the balance of basic body elements (1976:775).
The second scheme though similar to the first one, is that between ‘externalising’ and
‘internalising’ medical belief systems associated with Allen Young. Young explains that internalising systems
encapsulate sickness within the sick person’s body and concentrate effort on decoding the symptomatic expressions of intrasomatic events. In externalising systems on the other hand, episodes of serious sickness implicate categories or groups of people and sickness is itself a symptom of disrupted relations not between organs but between people and between people and anthropomorphized spirits who mirror or invert the moral order of society. Externalising systems have a low degree of conceptual autonomy in the sense of constituting a phenomenological domain which people can distinguish from coordinate jurral and cosmological systems. (1976:148).
Both Foster and Young agree that the two systems of classification, whether labelled externalising/internalising or Personalistic/naturalistic are not mutually exclusive and that most medical belief systems employ both kinds of explanations. The principle determining variable is the notion of causality, which yields either personalistic or naturalistic explanations to an illness. A useful clarification is provided by Young (1976) who explained that even as the two systems are polarized, there are certain systems that fall in between the two – systems where therapeutic strategies emphasize naturalistic or personalistic explanations or a combination of the two. In these case Young observes that ‘even when physiological explanations are used they are often weakened by the emphasis given to the motives and purposiveness (i.e personalisation) of causal agencies’ (1976:148) while Foster agrees that in such mixed systems, ‘illness is just but a special case in the explanation of all misfortune (1976:776). Medical beliefs persist as parts of larger cultural systems and the strategy of medical action, which they organize and rationalize, imply coordinate action in economic, kinship and even politico-jural domains (Young 1976).
34
Although the distinctions made by both Foster and Young are useful as organising rubrics within which several ethnographies can and have been written on traditional African medicine, it is difficult to state how such distinctions between systems can remain applicable in rapidly modernising societies where medical systems borrow ideas and techniques from each other and remain neither autonomous nor puritan. The notion of underlying cause which both categorizations reckon, is very necessary to an understanding of the organisation of healing is important not just to these categorizations, but to an understanding of why ritual healing has persisted in the community under study. It is important to state here initially a part of my conclusion: that ritual healing has continued to flourish principally because medical beliefs are linked to other parts of the larger cultural system and to cosmology.
While recognising the importance of the underlying cause, researchers and writers on health in Africa also agree that is more useful to use the term ‘affliction’ than ‘disease’ and/or
‘illnesses’. The title of Turner’s famous book, The Drums of Affliction’ is one of the most eloquent in the use of the term. The preference for the affliction as opposed to illnesses or disease is due to the recognition that frames of reference for health and disease are wide since African medical systems espouse a comprehensive etiology (Foster, 1976). The use of the term affliction enables the discussions on health in Africa to go beyond the limiting biomedical framework that perceives illnesses as isolated or simply probabilistic occurrences and allows the location of symptoms and manifestation of dis-ease beyond the ill persons physical being, to reflect discord in his or her social body or a rupture in life’s harmony (Mbiti 1969). Perceptions of affliction are linked to a people’s cosmology.
Comaroff (1980) described cosmology as the manifest perceptions of the world as they inhere in the context of action and experience. Affliction and its amelioration were thus best understood within a people’s cosmology. In discussions on affliction, Comaroff’s (1980) article based on her research amongst the Barolong boo Ratshidi of South Africa is quite relevant here since Tsidi cosmology is similar or shared by many other African communities. Comaroff states that the Tshidi spontaneously expressed a set of perceptions about cause and effect and the nature of the world which comprised a relatively inclusive cosmology. This cosmology was however an etiology, a set of causal notions which was articulated most clearly in the identification and management of affliction. The set of notions though shared for the most part were only relevant in the specific contexts of
35
practical experience where they served to impose meaning upon everyday events. The frame of reference for discussions of affliction revolved around the self and its social, spiritual and material existence (Comaroff 1980, Mbiti 1969). Selfhood (health in its encompassing sense) in this principle connotes a positive existence, an assertion over the natural and social environment, which otherwise threatens to swamp identity. Selfhood is conceived then as being in a region of positive valence. Affliction on the other hand is the lack of self-determination; it is a state of vulnerability, of being overshadowed by external sources or being eaten away by a hostile environment (Comaroff 1980). Misfortune or illness implies a disruption of the delicate balance between the subjective and objective points of being, characteristically perceived as an intrusion into the self. It is the movement of a person from a region of positive valence to that of a negative valence – to vulnerability. It is important however to note that the self is not perceived as confined within the visible limits of the body; it extends to encompass the more general sphere of personal influence upon the environment, inhering in words, footprints, and personal possessions, such as land with its crops and cattle. The self is also lodged in all those persons who (literally) share its substance- those who give it life, those to whom it has given life, and those with whom it has regular contact, including but not limited to sexual contact.
Affliction in such a context is the dislocation of person from the positive valence sphere, and is identified in terms of disruptions within the categorical relationships between man and man, man and spirit and man and nature (Comaroff 1980). Healing is the objectification and restructuring of such dislocation. Mbiti (1969) corroborates this position when he comments that in popular culture, the root causes of many illnesses and misfortunes are directly attributed to conflicts and tensions in interpersonal relationships which feature both horizontal (kinfolk, neighbours, co-workers) and vertical dimensions (relations with the
‘living dead’ ancestral spirits). In this context Foster (1976) avers that individuals adopt a personal idiom as the basis for the attempt to understand the world, to account for everything that happens in the world, only incidentally including illness. In these societies, the same deities, ghosts, sorcerers and witches that send illnesses may blight crops, cause financial reverse, sour husband-wife relationships, and produce all manner of misfortune.
Quimby (1971) showed that in Bobo-Dioulaso (Cameroon) the principle source of conflict within the social structure was the socially induced conflict between loyalty and aggressive competition for scarce resources including wives. Jealousy by itself did not cause illnesses.
However, in societies where belief in magic, witchcraft and other forms of ritual
36
manipulation was universal, fears of jealousy fostered a belief that the jealous ones would and could easily exact revenge (ibid, see also Handloff, 1982). Writing about the notions of health and disease among Abaluyia of western Kenya, Wandibba (1995) points to the fact that they attributed illnesses to multiple causes, which included human factors, transgression against taboos, spiritual factors and environmental pollution.
Other writers who have written about illness notions in Kenya, including those of communities whose members constituted the ritual clientele referred to in this study, include Sindiga (1995) Nyamwaya (1995, 1987), and Good (1987). I mention these scholars in relation to the healing rituals conducted by my two main healers, and especially by Mtumishi Barasa, and deliberately avoid giving a thorough description of his nosological categories because, as far as I have observed, his clientele represent a cross-section of all ethnic groups in Kenya and occasionally from neighbouring countries. In response to this growing clientele and supported, as we shall see later by notions and ‘(mis)-conceptions about modernity’, Mtumishi Barasa appropriates general principles of nosology from throughout African traditional healing, rather than exclusively using notions and expressions from his own ethnic group. It is however important to note that when dealing with clientele from his own ethnic group (the Luyia), he uses the specific cosmological notions, rationale, and language of affliction and reconstruction that he shares with them.
Many scholars agree that in the consciously elaborated world of everyday experience, cosmological logic is implicit and not always self-consciously articulated. It cannot be elucidated systematically by ritual specialists or by non-specialists. The concepts embodied in it are not the subjects of self-conscious elaboration but are axiomatic dimensions of reality (Comaroff, (1980). And so the diagnostic categories in African illnesses are observable primarily within the practical management of affliction. These categories are always composites of both cause and symptom (ibid., cf. Mbiti 1969). And as Good (1987) and Mbiti (1969) observe, these categories of affliction do not differentiate between ‘how’,
‘what’, and ‘why’. Symptoms and causes are not logically separated; the former are merely tangible expressions of the latter deriving their meaning from the dominant metaphor of causality (Comaroff 1980). A broken leg, or any other physical injury is both a fracture and sorcery and both components are part of an adequate description. Furthermore the meaning of both is encoded in terms of the disrupted relation of the sufferer to his overall context.
Several of the cases that I illustrate in this dissertation clarify this notion. In chapter 5 for
37
instance, I provide the case of Karama case whose swollen stomach was interpreted by Mtumishi Barasa, one of the healers described in this study, as sorcery as well as an instance of stomach distension and thereby required recourse both to a ritual healer and a biomedical facility. Both explanations are seen as complementary and not exclusive.
In the all encompassing understanding of affliction, there is no categorical distinction made between physical sensations and such disturbing occurrences as terrifying dreams, perceptions of personal failure, illnesses of one’s livestock, failure to be promoted at work place or in business, family discord or run away spouses and children. Indeed an observation of what transpires at a healer’s practice, as we shall see in the subsequent chapters, confirms that affliction or the types of problems handled by the healer had more to do with afflictions or misfortunes than with illness or disease.
The perception and classification of afflictions derives from notions of causality, and since similar afflictions could be attributed to different causes at varying times, the task of the healer was crucial in translating specific symptoms and contextual indicators into the patient’s idiomatic language of causality. This was often done through divination. Comaroff argued, that ‘the crux of the healing process and the defining rite of the healers’ role is the act of divination, which brings the cosmological repertoire to bear upon specific instances of affliction and in so doing, it involves the reduction of apparent chaos to order by legitimately allocating responsibility in terms of available causal metaphors’(1980: 646).
Writers on African medical systems have observed that there is no known community in which divination or diviners did not play a crucial role in the management of affliction.
Throughout Africa, whether in the city or in the country side, no matter the religion, sex or status of the individuals - questions, problems emerge for which every day knowledge is insufficient and yet action must be taken: the information necessary to respond effectively is available, but often through a diviner’ (Peek 1991: 2). Many of the ritual healers in Western Kenya employed divination as a vital source of knowledge that enabled them diagnose the clients’ problems and suggest ameliorative strategies. Their techniques will be described in great detail in this dissertation especially the way they responded to changed circumstances of the clients and their needs.
38 1.4 Methodology.
This study was conducted among ritual healers in western Kenya although their clients hailed from all over the Kenya and at times from neighbouring countries like Uganda and Tanzania. On the next page I provide a map of Kenya showing the Western province as well as two other maps of two districts to show the location of the two healers with whom I conducted extensive observations. My respondents were mainly the healers and their clients who I encountered in the course of their consultations with the ritual healers. This kind of study populations is what Pelto and Pelto have referred to as a ‘Clinical Population’, which they define as ‘any group of patients, clients or cases selected from the persons found at a particular health centre, hospital or individual healer’s location (1990:276).
This study was conducted among ritual healers in western Kenya although their clients hailed from all over the Kenya and at times from neighbouring countries like Uganda and Tanzania. On the next page I provide a map of Kenya showing the Western province as well as two other maps of two districts to show the location of the two healers with whom I conducted extensive observations. My respondents were mainly the healers and their clients who I encountered in the course of their consultations with the ritual healers. This kind of study populations is what Pelto and Pelto have referred to as a ‘Clinical Population’, which they define as ‘any group of patients, clients or cases selected from the persons found at a particular health centre, hospital or individual healer’s location (1990:276).