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DISEASES ETIOLOGY IN KEJOM KETINGUH - NORTH WEST CAMEROON:

MEDICAL ANTHROPOLOGICAL PERSPECTIVE

                                                   A paper written by written by:

MONJU CALASANCTIUS MATSIALE

Guidance Counsellor/Anthropologist

Email: monjucal@yahoo.com

Tel: (00237)22 17 20 94

Website: www.edudisciplines.com

                                                                  CONTENTS

I- GENERAL INTRODUCTION/BACKGRAOUND INFORMATION
i) The Geographical Background of Kejom Ketinguh
ii) Religion and Magic
iii) Social orgnaisation
iv) Definition of Concept

II- DISEASES ETIOLOGIES IN KEJOM KETINGUH
III- DIAGNOSES AND THERAPIES
IV- PREVENTIVE MEASURES
V- THE ROLE OF PERSONALISTIC THEORY TO THE KEJOM PEOPLE
IV- GENERAL CONCLUSION

I- GENERAL INTRODUCTION/BACKGRAOUND INFORMATION

          These notes on educational disciplines think that Disease is the problem of each and every society in the world at large. This problem is handled with respect to the societal cultural universe. Therefore every society must seek for ways to solve its health problems by identifying the causes hence providing necessary diagnoses and cure to its population. In western as well as in non-western societies, numerous medical illnesses exist. Some belief diseases are caused by germs while others belief spirits are found at the roots of every single misfortune.

            In Cameroon, despite the diffusion of biomedical system and recently Chinese modern Medicines, which seem to occupy a dominant position as far as our ethno medical system is concerned, indigenous ideas about illness causation seems to alter only a little. Most of the indigenes look at illness from a folk point of view. Therefore, these ideas or perceptions of illness determine necessary therapy and preventive measures propose by the culture itself. The object of this paper is to look at how indigenous ideas (in a non-western medical) system operate as far as etiology, diagnosis and techniques of appropriate therapy are concern. This centres in a village in Cameroon - Kedjom Ketinguh. It is organised into five parts.
            The first part grapples with geographical, religion and magic of the Kejom People and their social organisation and definition of concepts. Part two identifies the dominant theory as far as the Kejom cultural universe is concerned. Part three and four dive into the various diagnoses and therapeutic as well as appropriate preventives made available by the Kejom culture in the face of any diseases. Part five moves from ethnography and examines the function or contribution of such a system to the Kejom cultural universe, then follows the general conclusion.

i) The geographical background of Kejom Ketinguh
    Kejom Ketinguh, whose disease etiology we are going to investigate in this paper, is one of the grassland ethnic groups in Cameroon. This group makes up one of the five villages which constitute Tubah sub-division-Mezam division in the North West Region. This group is situated along Bamenda/Ndop highway. It is 15 miles away from Bamenda and bounded on the south by Bamessing, on the North by Bambili, Bambui and Banja, on the West by Bali-Kumbat on the North-West by Awing and East by Kejom Keku. The greater part of this land is covered with savannah, but its northern section is covered by forest. Of recent however, most of this forest has been devastated by agricultural activities. The climate is warm in the South but a little chilly in the northern part. This could be due to its elevated nature.

ii) Religion and Magic
    These people belief that there is a god that has made the whole universe. This god is called "Nyingong". Like most societies of the grass field, the Kejom people belief in a Supreme Being and this Supreme Being is likened to the spirit of ancestors, and other Greater Spirit that dwells with the Spirits of these ancestors in whirl pools, waterfalls, big tree, mountains, forests and great stones. This belief has a great implication on the lives of the people. The commonest of all is that this belief acts as a social control in this group as well as to other groups of the grass field.
    Magic which is often considered by Western religion as paganism plays a pivotal role as far as religion is concerned. The belief in fortune telling and other elements of the supernatural by this group is derived from the assumption that the supreme spirit has elements in the society in which it can transform itself to do good or bad among the members of this group.

This assumption makes disease, religion and magic a little inseparable. As George M. Foster quotes in his article, Disease Etiologies in Non-Western Medical Systems, some authors like Glick (1967:32) writes that “it is common knowledge that in many cultures, ideas and practices relating to illness are for the most part inseparable from the domain of religious belief and practices” This quotation applies to non-western medical systems where personalistic theory guides their views on disease etiologies. Jansen (1973:34) also makes this clear in writing about the Bomvana (Xhosa) “that religion, medicine and magic are closely interwoven … Waren (1973-74:27) remarked that “when curers are described as [priests] and [priestesses], it is clearly in the domain of religion.

            This is not however different in Western societies where the underlying theory is naturalistic. In Latin American societies, victims of illness sometimes place votive offerings on or near “miraculous” images of Christ, Virgin Mary or powerful Saints asking for help.

            In Kejom Ketinguh like in most societies, for the problem of health to be solved, such domains as magic and religion is viewed as an integral part for the reconstruction of health.

Social Organisation

            Kejom Ketinguh is a social group with a population of over 30,000 people (rough estimate). Like most tribal societies of the grass field, farming is their dominant occupation – Crude tools are still employed and mechanised system of farming is still far in the horizon. The fon (chief) occupies the upper stratum and his position is strengthened by the due respect paid to him and the different paraphernalia he puts on. The remaining strata are occupied by the indigenes depending on their respective positions.

            They are organised in such a manner that every member or indigene occupies a status position depending on the position held. For this reason, healers, diviners, cultural upholders are known and respected. Therefore social organisation within Kejom Ketinguh permits us to understand who leads, provide appropriate therapy or even diagnoses illness.

Definition of concept

            Before examining our principal concept, it is necessary to remark that response to disease through therapy is determined by the disease causation theory. Let us make a distinction between disease, illness and sickness here.

            Disease is the definition of a health problem by a medical expert; illness refers to the patient’s experience of his condition, whereas sickness is the social role attached to a health problem by society at large. Anita Hardo et als (1995:12) quoted by Ngambouk V. Permunta.

            According to Foster and Anderson (1978), here are two of these disease causation theories. According to the personalistic system, illness is caused by purposeful intervention of an agent, who may be human (a witch or sorcerer), non human (a ghost, an ancestor, an evil spirit), or supernatural (a deity or other very powerful being). The sick person literally is a victim, the object of aggression or punishment directed specifically against him for reasons that concern him alone.

            Under naturalistic system, illness results from disequilibrium of bodily elements. Illness is explained in impersonal, systemic terms. Disease is thought to stem not from the machinations of an angry being but rather from such natural forces or conditions as cold, heat, winds, dampness and above all by an upset in the balance of the basic body elements. Foster and Anderson (ibid).

            However, we know that disease etiologies cannot be neatly categorised under these two categories because there is the possibility of multiple causality which therefore may give rise to zig-zag recourse. A diarrhoea episode for example may be interpreted differently. A mother for instance may take it ‘normal’ because the child is teething meanwhile the case may be that the child has been given dirty water.

            In trying to look at disease etiologies in Kejom Ketinguh therefore, we will take the two systems into, consideration while bearing in mind that they are not absolute for the categorisation of disease causation.

II- DISEASE ETIOLOGIES

            According to George M. Foster’s article, it is but clear that the two etiologies already explained are rarely if ever mutually exclusive as far as their presence or absence in a particular society is concerned. Equally, that many, if not most, peoples are committed to one or the other of these explanatory principles to account for a majority of illness.

            In Kedjom Ketinguh, despite the obvious overlapping of naturalistic system (biomedicines) disease most often than not is still regarded as being the end product of personalistic system. In fact, most of the people interpret illness as being personal. Therapy is only resorted in the biomedical domain when all attempts to step within the folk medical domain have failed.

            Therefore illness and disease are attributed to envy, juju (fetish). Death is consequently caused by witchcraft, sorcery, actual assault or by the individual’s ill behaviour- stealing, adultery or by an ancestor – going against his will. In this society, a disease diagnosed by the medical practitioner and proven with laboratory test is most often not accepted, if it happens that the victim dies this or that person in the family or the neighbour who lives behind is held responsible.     

            Like in most personalistic medical etiologies, the Kejom Ketinguh people have adopted the “personal idiom” as the basis of their attempt to understand their world to account for almost everything that happens in the world, only incidentally including illness. As Foster in his article puts it, “In such societies, the same deities, ghosts, witches, and sorcerers that send illness may blight crops, cause financial reverses, sour husband-wife relationships, and produce all manner of other misfortune”.

            Following this, the Kejom Ketinguh people in the face of any illness, diseases or misfortunes, however small, always look for personalistic reasons to explain “why” and “who” is responsible. For instance most illness, death, miscarriages, sterility, difficult child births, poor crops are widely believed to be caused by witches.

            To summarise, among these people most cases of deaths are unnatural, they result from the intrusion of an outside force unusually directed by some magical means. Therefore the dominant theory in this non-western society is the personalistic theory. This leads us to the next part which grapples with diagnoses.

DIAGNOSES / THERAPIES

            Disease in Kejom Ketinguh is diagnosed by people with supernatural and/or magical skills. According to the personalistic system, the kinds of cures found in a particular society and the curing acts in which they engage, stem logically from the etiologies that are recognised hence personalistic systems with multiple levels of causation, logically require curers with supernatural or magical skills.

            Here, diagnoses are by means of divinatory techniques with the aim to find out who and why is responsible. In fact it is common in Kejom society to meet people very early in the morning returning from or going to the witch doctor’s residence with either a fowl or a goat or any other item demanded by the diviner. The witch doctor could begin his diagnoses by trying to speculate or search for the “who” or “why” such and such a diseases or misfortune has occurred.

            He could proceeds by prescribing therapy if he is capable to do so but if he is not, he could send the victim to another doctor who handles the situation. Even George M Foster in his paper exposes a graphical example of such a situation among the Nyima of the Kordofan Mountains in Sudan. “…the shaman goes into a trance and discovers the cause and cure of the disease. But he himself performs no therapeutic acts; this is the field of other healing experts, to whom the patient will be referred.

            In the society under study, there are people with powers who are well known not for their therapeutic performance, but for their ability and capacity to use divinatory techniques to discover the cause and cure for diseases that have proved fatal. I have witnessed the most learned of people resorted to such people after the biomedical system for so long has proved unworthy to handle instances of their indisposition. Most of them get well after cure and causes have been identified because they are advised to resort to new horizons of medical system or therapy.

            All these have laid a framework for the existence of personalistic system in this society. This leads us to the next part of our paper which seeks to expose therapeutic measures taken by a society dominated by a personalistic medical system.

            Even though, George M. Foster reduces the primary role of the shaman or witch doctor to be diagnostic, this is far more beyond that in Kejom Society. There are some specialised therapeutic practices. The numerous tradi-pratictioners (commonly referred to as doctors) explain the dominant personalistic theory in Kejom society. Most of them set up “consultation clinics” and “wards” in their compounds where people with indisposition resulting from witchcraft, devils or ancestors are placed under surveillance while administering therapy.

            Therapy in most cases includes a mixture of concoctions which are either applied on the body or taken through the mouth. Indisposition belief to result from devils or even ancestors are taken care of by employing appropriate magical procedures or propitiating rituals as a positive demonstration to ancestors that they have not been forgotten and to friendly acts to neighbours and fellow villagers that remind them that their good will is valued.

            What ever the case, the therapy employed depends on the active agent believed to be at the root cause. Therefore, an indisposition believed to be caused by witch or sorcerer have a different therapy and that orchestrated by nonhuman (a ghost, an ancestor an evil spirit) or supernatural (a deity or other very powerful being all have differential treatments altogether).

            Though personalistic is far more complex than naturalistic causality since there are no absolute rules to avoid arousing the envy of others, for doing just the right amount of ritual to satisfy an ancestor for knowing how far one can shad a taboo without actually breaching it. The people of Kejom Ketinguh have at least preventive measures which are believed to stabilise health. This opens a new but short part on our discussion on preventive measures.

PREVENTIVE MEASURES

            The measures taken are believed to prevent a victim from any active agent who may be human, nonhuman or even supernatural. These measures could take place after the victim has been cured or a person could consult the diviners for prevention. From a general point of view, Foster in his article writes “…in personalistic systems the basic personal health strategy seems to emphasize the “dos” (contrasted to the “don’t” in naturalistic systems) and especially the need to make sure that one’s social networks, with fellow human beings, with ancestors and with deities are maintained in good working order…”

            In Kejom Ketinguh, it would not take long for a stranger to know the “witch doctor” who is more efficient to prevent active agents – human, nonhuman or even supernatural being. I have witnessed a ritual where magic is employed to prevent someone from evil eyes, witchcraft, sorcerer or even deities. The victim is rapped with a white piece of cloth (to keep devils away); a white young cock is used. The feet of the cock are wetted with concoctions mixed in a black clay pot and the individual is asked to suck the feet. In the course of this, the witch doctor murmurs to himself invoking spirits to cleans and prevent the victim from evil eyes. After this process, two spears are fixed in the ground to form a pyramidal arc. The victim is then asked to pass through. A stone with a hollow is used, to touch his head with. After, the white cloth is removed and the victim is told he is now prevented from witchcraft, devils, deities and that accidents and even bullets could not do away with his life.

            Equally, a razor bled is used to inflict wounds on the body in order to apply some blank concoctions which are believed to penetrate the body and act as a sort of immunisation against evil eyes.

            As already mentioned, preventive measures depend on the type of agent believed to cause illness. From here, we grapple with the last part which speculates on the role of such a system of disease causality.

THE ROLE OF PERSONALISTIC MEDICAL SYSTEM TO THE KEJOM PEOPLE

            In the first place, such a medical system permits us to present understand the world view of the Kejom people. The diseases existing within Kejom cultural universe have an explanation as far as cause, diagnoses are concerned. Almost all diseases in our cultural universe – cancer, frontal headache, gonorrhoea, syphilis, epilepsy, goitre rashes to mention but a few have explanations for cause, appropriate diagnoses and cure. One could conclude that the world view of the Kejom people is more of super naturalistic rather than naturalistic as far as explaining and reconstructing ill health is concerned.

            Such a medical system could also be used to understand social stratification in our society. The question of who occupies this or that position is quite obvious to answer. To diagnose, cure and provide preventive measures is not the responsibility of any person within the society. Persons who are believed to possess some supernatural powers are highly responsible for such jobs. Because they jealously guide their knowledge, they acquire prestige and thus occupy a different social stratum. They are looked upon as “restorers” of life or “doctors” within the society. They preserve such a prestige/position by putting on distinctive paraphernalia on their necks, legs or simply hanging them on their clothes. Some go as fare as refusing to share foods with people using the same dish or prefer to use only traditional utensils for their food dish.

            Equally, this medical system exposes some of the taboos in the Kejom society. To prevent ill health, victims are prohibited from entering into some social relationships which are believed to cause illness. Also victims or individuals are prohibited from performing acts against ancestors which may render them angry. As known, if an ancestor is angry, it could take off the preventive powers from the person concern and there by exposing him to evil or witchcraft. This contributes to a check for people to be able to know how and when to behave in order to maintain health.  

GENERAL CONCLUSION

            In this paper, we have been exposing diseases etiologies in Kejom Ketinguh dwelling attention mainly on personalistic theory. However, as mentioned on earlier, many ethno medical systems have attributes of both naturalistic and personalistic etiologies. This could be the case with Kejom society where the presence of biomedical system (naturalistic) has placed the indigenes in a state of anomy. Imbedded with personalistic behaviour, indigenes find themselves within the naturalistic sector only after the questions of “who” and “why is responsible are far from explanation. These two go hand in hand for health to be reconstructed in Kejom society.

References

Foster, George, M & Barbara G Anderson. 1978. Medical Anthropology.

            New York: John Willey and Sons 

Foster, George, M. Disease Etiologies in Non-Western Medical system, an article