Skin and Sorcery a Medico-Anthropological Study of Traditional Healing and the Conceptualization of Kisigo in Kigoma

Ghent University

African Languages and Cultures Academic year of 2012-2013

Skin and Sorcery A Medico-Anthropological study of Traditional Healing and the Conceptualization of Kisigo in Kigoma

Promotor: Prof. Dr. K. Stroeken

Master thesis, submitted to achieve the grade of Master in the African Languages and Cultures by EVA BLEYENBERG

Nederlandstalige Samenvatting

Mijn thesis is opgebouwd volgens het verloop van mijn onderzoek. De thesis begint dan ook vanuit een brede en algemene invalshoek en werkt langzamerhand toe naar het specifieke. Het hoofdstuk volgend op de inleiding handelt over de literatuur die ik heb doorgenomen voor, tijdens en na mijn veldwerk. In een derde hoofdstuk presenteer ik mijn theoretisch kader. De methodologie en de onderzoeksvragen waarrond deze thesis zijn opgebouwd staan uitgeschreven in respectievelijk hoofdstuk vier en vijf. De resultaten van mijn onderzoek zijn weergeven in hoofdstuk zes. De thesis eindigt met ruimte voor discussie en het bespreken van een aantal probleemstellingen in hoofdstuk zeven.

Deze verhandeling is gebaseerd op 27 interviews afgenomen tijdens twee maanden veldwerk in Kigoma, een havenstad in het Noordwesten van Tanzania. Door de belangrijke economische ligging en de vele migratiegolven als gevolg van verschillende onlusten in buurlanden, is Kigoma een stad waar vele culturen samenvloeien. De originele opzet van het veldwerk was dan ook om de variëteit aan traditionele genezingspraktijken die aanwezig zijn in Kigoma te onderzoeken en weer te geven. De resultaten hiervan zijn weergegeven aan de hand van uitgewerkte case studies in de eerste en tweede sectie van het zesde hoofdstuk ‘Results’. Omdat in Kigoma (en elders) traditionele genezing onlosmakelijk verbonden is met hekserij, wordt dit fenomeen ook uitgebreid besproken.

Gedurende de verschillende interviews kwam steeds eenzelfde huidaandoening ter sprake, pese of kisigo genaamd. Elie Wamba, de Congolese man die mij in contact gebracht heeft met een aantal genezers en die mij ook telkens geholpen heeft met vertalingen tijdens het afnemen van interviews, had me voor het eerst gewezen op het bestaan van deze aandoening. Na een volle maand veldwerk verschoof de focus steeds meer naar de conceptualisatie van deze huidaandoening die gelinkt wordt aan hekserij. De resultaten van mijn zoektocht naar het begrijpen van deze aandoening zijn weergegeven in een derde sectie van het zesde hoofdstuk. Hierbij wordt speciale aandacht besteed aan de relatie tussen de huid en hekserij.

Door de velddata te combineren met de theorie van Scheper-Hughes en Lock (1987) over de ‘three bodies’ en de 7 facetten van emotie van Schweder en Haidt (2000), is het mogelijk een conceptualisatie van pese en kisigo op te stellen die niet enkel focust op de individuele fysische en psychische aspecten van de aandoening maar ook oog heeft voor de bredere sociale context. Niet alleen de huid, de fysische buitengrens van de mens die gebruikt wordt om iemands sociale status binnen de maatschappij te duiden en te affirmeren, wordt aangetast door pese en kisigo. De sociale positie van de patiënt in de maatschappij verandert er ook grondig door. Wanneer men van een persoon denkt dat hij behekst is, wordt er binnen de gemeenschap duchtig gespeculeerd over mogelijke morele oorzaken van de bezwering. Die morele oorzaken worden gezocht bij de patiënt zelf. De aandoening wordt een moeilijk bespreekbaar thema voor de patiënt. Dit is mentaal zwaar om dragen voor de patiënt, die vaak in een sociaal isolement terecht komt ten gevolge van het stigma. Bovendien slaagt het ziekenhuis er niet in de aandoening te traceren, te diagnosticeren of te behandelen. Daardoor zijn de patiënten aangewezen op de kennis en de behandeling van traditionele genezers, die dergelijke complexe aandoeningen wel de baas kunnen.

Deze verhandeling is een exploratief werk. Hoewel deze thesis een aantal interessante zaken behandelt, belooft verder onderzoek nog meer interessante inzichten te bieden op onderwerpen die in deze thesis worden aangesneden.

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Acknowledgements

This thesis would not have been possible without the help of a number of people, beginning with the traditional healers and practitioners who made time for the interviews and for my research and gave me very interesting and valuable information. I am especially grateful to my promotor Koenraad Stroeken for his support and guidance during my fieldwork and during the writing process of this thesis. Special thanks go to Deo Baribwegure for his support, dedication and his help in the search of social contacts during my fieldwork in Kigoma. I want to thank my two translators Elie Mwamba and Alan Matafwali for their time, their knowledge, their company and their patience. I want to thank the staff of the Maweni Hospital in Kigoma. Special thanks to Aimée Binja for sharing her illness experiences. I wish to thank the Brothers of Charity for their support in search for accommodation during my stay in Kigoma. Special thanks go to Ernest Nshemezimana for his excellent work as transcriber. Finally, I want to thank my parents and friends for support and assistance.

Contents

Nederlandstalige Samenvatting ...... iii Acknowledgements ...... v Skin and Sorcery: A Medico-Anthropological study of Traditional Healing and the Conceptualization of Kisigo in Kigoma ...... 1 1. Introduction ...... 1 2. Background Review ...... 5 2.1. From armchair anthropology towards a fieldwork based anthropology ...... 5 2.2. Phenomenology and the birth of medical anthropology ...... 6 2.3. Witchcraft and healing practices in the light of modernity and globalization ...... 7 2.4. The biomedical monopoly on truth ...... 9 3. Theoretical Framework ...... 11 3.1. The Mindful Body ...... 11 3.2. Anthropology of the Senses ...... 12 3.3. Language and Magic ...... 15 3.3.1. Symbols and meaning ...... 15 3.3.2. Symbolic classification ...... 17 3.4. Health, Illness and Disease: important terminological issues ...... 19 3.4.1. Health, Illness and disease...... 19 3.4.2. Three meanings of Illness ...... 20 3.4.3. Uncertainty: Matters of Life and Death ...... 22 3.5. The Illness narrative ...... 23 3.6. Framework: the conceptualization of the condition of Pese and Kisigo ...... 24 4. Hypothesis and Research Questions ...... 27 5. Methodology ...... 29 5.1. Qualitative explorative fieldwork ...... 29 5.2. Kigoma: geographical and socio-cultural setting ...... 32 5.3. The course of my fieldwork ...... 37 6. Results ...... 41 6.1. A short introduction to some cosmological ideas in Kigoma ...... 41 6.2. Traditional Healing and the image of the witch in Kigoma ...... 43 6.2.1. Traditional healing: a Variety of Practices ...... 46 6.2.2. Popularity and Succes of traditional healing ...... 61

VII

6.2.3. Witchcraft and Morality: social or anti-social acts? ...... 64 6.2.4. Image of the witch ...... 67 6.2.5. The government of Tanzania and its witchcraft policies ...... 69 6.3. The importance of skin in sorcery: a conceptualization of a condition called Kisigo ...... 72 6.3.1. Pese: the illness narrative of Aimée Binja ...... 74 6.3.2. Discourses on Pese: trying to define a mysterious condition ...... 77 6.3.3. Treating Pese ...... 81 6.3.4. Pese and Kisigo: “Je, pese ni tofauti na kisigo au la?”...... 83 6.3.5. A conceptualization of Kisigo ...... 93 6.3.6. Skin and sorcery: skin as boundary of the social self...... 96 6.3.7. The Unspoken Third: Bembe People of the Western shore of Lake Tanganyika ...... 99 7. Discussion ...... 101 8. List of Interviews ...... 107 9. Bibliography ...... 109

VIII

Skin and Sorcery: A Medico-Anthropological study of Traditional Healing and the Conceptualization of Kisigo in Kigoma

1. Introduction

This master dissertation fits within the field of medical anthropology. Medical anthropology is to be situated within the subfield of social and cultural anthropology. This field is one of the four academic subfields of anthropology next to archeology, linguistic anthropology and biologic anthropology. Although, quite often medical anthropology is called ‘the fifth field’ because it cross-cuts the four different fields and interconnects body, mind, society, and environment to sickness and healing. The discipline of anthropology overcomes the arbitrary divide between nature/body and culture/mind that is so typical of the Cartesian dualism, the dominant framework in the West for over four centuries now. Overcoming this divide is important when one’s study object is the social, psychological and biological human in relation to sickness and healing.

Medical anthropology is a holistic discipline, in that it works interdisciplinary and has an analytic approach. Often in one and the same study qualitative methods - such as participatory observation, ethnographic fieldwork, illness narratives, focus groups and in-depth interviews – as well as quantitative methods - such as survey and epidemiological statistics - are used. The first pillar dominates in this master dissertation, in which explorative ethnographic fieldwork and interviews as well as a wide range of literature from different fields have constituted the process of information gathering.

The fieldwork that I have conducted in the Kigoma region in August and September 2012, focused on traditional healing practices. A big part of the chapter ‘Results’ is consequently dedicated to the diversity of traditional healing practices in Kigoma and three surrounding villages called Ujiji, Mwandige and Kasaka. Throughout the interviews with different healers of the region, I got especially intrigued by one specific condition which affects the skin and is coupled to witchcraft practices, namely pese. As I worked further on this one condition, I found out that another name is used in a closely situated village called Kasaka. There, the healers name it kisigo. However, it remains a matter of discussion whether these two names refer to the same condition. At the end of my fieldwork period, a female healer in Kasaka gave me a classification of four different types of kisigo. In this classification, one of the four

1 conditions had a striking resemblance to pese, as it had been described to me by healers from Kigoma, Ujiji and Mwandiga. The classification I received from the female healer has been the starting point for the present attempt to produce a wider conceptualization of kisigo. This conceptualization is of course explorative, needs further research and remains open to further discussion.

Pese and kisigo seem to be widely known among the traditional healers of Kigoma, Ujiji, Mwandiga and Kasaka. However, there is no knowledge about pese in the hospitals, there is no governmental action undertaken to research on this condition and there is no straight forward definition available of the condition. Apart from what I collected through my interviews with healers and patient, there is no information on which I can rely to describe this condition. This is a rather exceptional situation and it needs a just approach. That is the reason why I have put a lot of importance to the constitution of a just anthropological approach.

This explorative and qualitative study is based on 27 interviews with practitioners, patients and medical staff of the local hospital during my two months of fieldwork in the Kigoma region in West Tanzania on traditional healing practices. A list of these interviews is given at the end of this thesis, before the bibliography. Focus is put on one specific condition named pese (Bembe language) or kisigo (the local Kiha language). Attention is paid to the different explanatory models of practitioners on pese and kisigo and the experience of patients of this condition. I paid a lot of attention to the narrative dimension of the condition. I did so by interviewing healers and collecting illness narratives from patients, from which it is possible to reconstruct a conceptualization of the condition from different angles. The different discourses on pese and kisigo are synthesized into a handful of categories, as presented in the section ‘Results’ and further discussed. The findings presented in this paper are based on various research methods in order to attempt a holistic understanding and emphasize the existence of different discourses.

My research can be seen as a journey from general to the very specific. This thesis represents the quest I undertook during my research. The structure of my thesis resembles a funnel, starting very general and getting more and more specific towards the end. I started my research with a broad and general perspective on the phenomenon of traditional healing. The first thing I did was read the existing literature on medical anthropology. Accordingly this

2 thesis starts with a general introduction to medical anthropology in which I present the background reading on medical anthropology that I have studied before and after my fieldwork and served as the backbone for my own writings. In the following chapter I focus on my theoretical framework, which has served as guidance during the writing of my master dissertation. This is a quite long chapter since I have put a lot of importance to the development of a just anthropological approach towards the ethnographic data collected during my fieldwork. During my fieldwork in Kigoma, because of the input of ethnographic data, my originally fairly general research questions got more specific. I started my fieldwork focusing on the variety of traditional healing and narrowed my subject down to the conceptualization of one specific and unknown condition. I have distilled two main research questions that I work out here. These two questions focus on traditional healing practices in Kigoma and on the conditions of pese and kisigo. These questions are shown in chapter four. Chapter five explains the research methodology used in order to collect data and formulate answers on the posed questions. In this fifth chapter I also address the geographical site of my fieldwork and describe briefly the course of my fieldwork. Chapter six presents the results of the research. This chapter is divided in three smaller subchapters from which the first is a rather introductory one that sheds light on the cosmology that the people of Kigoma adhere. The two other subchapters correspond to the two main research questions presented in chapter four. I conclude this thesis with a discussion worked out in chapter seven. This discussion mentions a few problematic issues in the research on pese and kisigo.

2. Background Review

The position of cultural relativism is important within medical anthropology. Cultural relativism claims that the elements that constitute a culture are more or less coherent and logical within their own context. Through the history of anthropology, academics have given different interpretations to cultural relativism. Lévi-Strauss (1964, 1973) focused on the structures of cultural production by humans, thus on the human mind in general, while Geertz’s interpretivism limited the logics to specific cultures. In any case, focus on the logics or internal structures have been a way to counter 19th century cultural evolutionism with its hierarchy of superior/inferior societies. On the basis of cultural relativism anthropologists value ‘the integrity and worthiness’ of every culture. In this chapter I give a small, chronological overview of some of the different angles anthropologists have proposed as framework when studying another culture.

2.1. From armchair anthropology towards a fieldwork based anthropology

From the moment Evans-Pritchard appeared on stage, anthropology moved away from the armchair anthropology of the 19th century towards a fieldwork-based anthropology. Evans Pritchard was a student of the praxis-oriented anthropologist Malinowski and built on the structuralism of Radcliffe-Brown, although he was convinced that anthropology was a social and not a biological science like Radcliffe-Brown suggested (Evans-Pritchard 1969).

Politics and alliance are the motor of society according to Evans Pritchard. Segmentation is the mechanism to keep the social structure intact. Conflict is thus seen as temporal. This conception is largely influenced by the famous work of Mauss titled Le Don in which alliance is central (Mauss 1970 [1954]). Evans Pritchard paid attention to the contextual and experience-oriented dimension of anthropology in his work, for example in stating that there exists a distinction between legal and criminal use of witchcraft in the Zande society (Evans Pritchard 1937). He described the interrelation between these phenomena, namely witchcraft, sorcery and oracle, as forming a coherent knowledge system with the possibility of secondary elaborations. Likewise, diviners will respond to illness in reference to the broad field of social and ancestral relations that surround the victim.

In 1947 Max Gluckman founded the Department of Social Anthropology at the University of Manchester, which became known among anthropologists and other social scientists as the

Manchester School. Notable features of the Manchester School are the emphasis on empirical information gathering and the extended case method. The extended case method involves detailed analysis of particular instances of social interaction to infer rules and assumptions. The social reality is seen as a dynamic whole in which change and social conflict are normal and in which social change is the result of conflict situations. Changing alliances through conflicts ensures social cohesion and stability. Rituals are overarching values and practices that exceed the morally complex conflicts in society. Recurring themes of the Manchester School included issues of conflict and reconciliation in small-scale societies and organizations, and the tension between individual agency and social structure (Gluckman 1966).

The Bridge paper, in which Gluckman gives a detailed description on an inauguration of a bridge, gives insight on the social situation of the whole society (Gluckman 1940). Every society consists of internal contradiction according to Gluckman. That is why it is important not to start from one’s own culture when studying another society. A way to do so is starting from a micro-event to study structures of the macro-society. During my fieldwork in Kigoma, I followed this inductive manner of looking at society. Since my stay in the region was rather short, I focused on micro-events, on individual interviews, on specific forest visits to learn something more about general structures in healing practices.

2.2. Phenomenology and the birth of medical anthropology

In the mid-sixties, Victor Turner wrote his doctorate dissertation on social conflict, witchcraft accusation and internal contradictions within the social structure of the Ndembu of Zambia (V. Turner 1977 [1967]). The work on the Ndembu was the result of intensive ethnographic fieldwork and participant observation. Thereby, Turner focused on what the people appointed as important and developed a theory of symbols coming from the Ndembu experience. He can thus be classified a phenomenologist who works with an interpretative method to search for the culture specific meaning of social practices. His term ‘social drama’ refers to an internal tension in every social process.

In his book The Drums of Affliction, Turner reopens the discussion on the meaning of symbols (V. Turner 1968). His symbolic anthropology reacts on the reductionist views which attribute ritual, religion and belief to a lack of rationality. Evans Pritchard already reacted on the evolutionists earlier by defending the rationality of every culture (Evans Pritchard 1937,

1954). Turner and the symbolic-interpretative school saw rationality as irrelevant within the study of rituals. The meaning of symbols related to the cosmology, the cultural code and the society-maintaining function is central to the work of Turner. Victor Turner was the first to recognize the therapeutic importance of medicines. His openness to local epistemology and cosmology in terms of healing make him the precursor of medical anthropology.

In contradiction to his predecessors who worked on social structure, Turner worked on anti- structure. He started from the tripartite model of rites of passages of Van Gennep (1909), and stated that the third phase of reincorporation into society is only possible by undergoing a passage of liminality, an ambiguous stateless in-between. Liminality as a moment of friction, of being freed from structure, creates a re-birth and symbolizes the death of the previous status of the subject. Every passage ritual has its dominants symbols. These symbols have multilayered meanings which consist of a normative pole in opposition to an experience pole to prepare the person for a new stage in life (V. Turner 1968: 15-45).

2.3. Witchcraft and healing practices in the light of modernity and globalization

The couple Jean en John Comaroff wrote an interesting article on colonization and globalization in South Africa in 1989. In Colonization of Consciousness they investigate the connection between structure and agency. Agency is not purely structural in that it stands for the actions of a subject and his interpretation of the world, which is unique. The actor can change structure and even escape from it. The Comaroffs claim there is a certain tension in the dialectic of social structure and human agency. They want to demonstrate that the colonization was not a one-way process. Actors can react against structure. People change the received culture and shape it into a new form instead of totally adjusting to it (Comaroff&Comaroff 1989). In their book Modernity and its Malcontents, they repeat this stream of thought by stating that new political structures emerge from coupling of local and global worlds in modernity (Comaroff & Comaroff 1993). Because of that, modernity has its own magicalities and its own enchantment. Sanders gives a good example of this. He states that the structural adjustment program in Tanzania did not completely achieve the intended goal of development. Nowadays, alternative visions on the application of this adjustment programs from the IMF are gaining support. People are musing over the illogical conclusion of unbridled liberalization, a world where society, culture, history and humanity itself have fallen victim to the caprices of the Market and where people go very far to get rich. Sanders writes that there is more speculation about magic and witchcraft forces because of more envy

7 and suspicion on the market and in the daily life. Also, there is a growth in the variety of witchcraft practices. According to him, witchcraft is a part of modernity in that “modernizing forces in one particular time and place have generated the very enchantments they should in theory eliminate” (Sanders 2001: 177).

Peter Geschiere builds further on the ideas of the Comaroffs. In The Modernity of Witchcraft Geschiere writes that witchcraft and sorcery is not only about evil, it is also about power relations (Geschiere 1997). Witchcraft gets intertwined with modern changes by which new transformations of witchcraft occur. In many parts of Africa one can notice an intervention of occult forces in modern politics. This is what Geschiere means with the modernity of witchcraft, which he opposes to the stereotype of witchcraft as a set of traditional beliefs and practices. Modernity is a breeding ground for new transformations of witchcraft and globalization increases the heterogeneity of social relations, rather than that globalization and modernity are the herald of the end of witchcraft practices as is presumed by many others.

Janzen opens his in 1992 published book Ngoma by pointing to the irrelevance of distinguishing between ‘religion’ and ‘healing’ within the context of the study of traditional healing. Rather, he opts for the use of indigenous categories and terms instead of the (western) analytical models (Janzen 1992). He also makes an important point when he states that research needs to be positioned in a wider frame of relevance. A researcher has to actively search the relevance of his research within the region but also more globally. In the words of Hahn and Inhorn, one can state that cultures are globally linked and partake of larger social processes covering the planet so that the internal coherence making up a cultural context is linked with the global as well and eventually involves all societies including our own (Hahn & Inhorn 2009). In his book Ngoma, Janzen describes a relatively similar healing ritual in four different cities in different countries. By doing so he indeed positions this one ritual in a broader perspective, also historically.

Janzen is aware of the possibility of changes in cults of affliction due to the urban context, when studying a specific traditional healing ritual in four major cities in Africa. There can be adaptations to the changing environment. There may be question of professionalization or just the opposite, the rise of charlatanism in order to obtain an income. There may be a certain trend to mimic Western medicine and modify the own practice with technical items. Also, the city context can have a position influence on the spreading of knowledge concerning

8 traditional medicines. Equally important to note is what Janzen writes on state intervention in traditional healing.

“A resource such as ngoma, which may arise in response to a need, and which symbolically, socially and materially reproduces itself, attracts the state which seek to co-opt the power and legitimacy of these traditional healing unto itself (…) The effect of professionalization of health care is often the codification of methods and the regulation of access to the ranks of those who practice.” (Janzen 1992: 171-172)

This quote is surely relevant for the particular case of my fieldwork in Kigoma, since the Tanzanian government is conducting research on traditional medicines at the Insitute of Traditional Medicine of the Muhimbili University of Health and Allied Sciences in Dar es Salaam. Moreover, the stance towards traditional healing and witchcraft practices is expressed through law. Tanzania even has its own national association for traditional healers.

2.4. The biomedical monopoly on truth

Although one of the bases of medical anthropology is that the researcher wants to learn from the other culture and sees the people as being experts on their own culture, this is not evident in other disciplines. When one specifically looks at the field of medicine, there is a baffling unbalance on truth favoring the biomedical (Western) world. The monopoly on truth envisaged by biomedicine and science is the reason why medical practitioners usually have little respect for or interest in healing traditions that have not been biomedically validated. Angell and Kassirer (1998: 841) echo the dominant view in the medical profession:

“There cannot be two kinds of medicine - conventional and alternative. There is only medicine that has been adequately tested and medicine that has not, medicine that works and medicine that may or may not work. Once a treatment has been tested rigorously, it no longer matters whether it was considered alternative at the outset.”

Such a view on medicines is dangerous in that it carries the roots of medicalizing sociocultural processes. The focus on the material characteristics of the traditional medicines neglects the therapeutical dimension of the traditional healing (Singer & Baer 2007: 92-94).

One cannot test the socio-cultural and therapeutical validity of a treatment in a laboratory. In biomedical testing the holistic aspect of traditional healing is thus denied and thereby, this essence of traditional healing is totally neglected.

3. Theoretical Framework

I have based my thesis on a broad theoretical frame distilled from the existing academic literature. My theoretical framework consists of concepts and existing theories from different fields of study like linguistics, anthropology and sociology. I here present the interrelated theories which critically guided my research. I will conclude this third chapter by making a synthesis of these theories and presenting a framework which enables me to approach the variety of traditional healing practices and Kigoma and the condition of pese and kisigo in an appropriate, anthropological and holistic manner.

3.1. The Mindful Body

In The Mindful Body, Scheper-Hughes and Lock present an approach to bring forth the diversity and richness of different cultures by interrelating mind, body and society into a more holistic view (Scheper-Hughes & Lock 1987). They produced a theory, a heuristic tool based on three bodies that overcomes the Cartesian dualism of body/mind and fits within the field of phenomenology since it is experience-oriented. The three bodies are the body-self, the social body and the body politic. The body-self refers to the way an individual experiences his or her own body. This perception of the self is important in relation with how you perceive the world. When one conducts research, it is done through his or her body-self. The social body in turn refers to how the body is experienced in relationship with others and how the society reflects on the body.

“Symbolic and structuralist anthropologists have demonstrated the extent to which humans find the body “good to think with”. The human organism and its natural products may be used as a cognitive map to represent other natural, supernatural, social, and even spatial relations." (Scheper-Hughes & Lock 1987: 19).

Mary Douglas observed the same when stating that the body is one of the richest sources for metaphors (1970:65). Moreover, “cultural constructions of and about the body are useful in sustaining particular views of society and social relations” (Scheper-Hughes & Lock 1987: 20). Needham pointed out that the frequently occurring associations of the left and that which is inferior, and, between the right and that which is superior, can be a convenient means of justifying particular social values and social arrangements, such as the "natural" dominance of males over females (1973: 109). One of the best examples of the symbolic uses of the human

11 body in the embodied world are the domesticated spaces in which human resides. Marcel Griaule wrote in his study on the Dogon how the use of the body in native cosmology is reflected in the ground plan of a Dogon community (Griaule 1965).

The last body can be seen as the relationship between the former two bodies with the addition of power and control, leading to regulation in reproduction and sexuality. Body politic is about controlling sexual behavior and thought about the body. In this view, incest prohibition can be seen as state in the minimal sense and all polity starts with sexuality. This is what Foucault named bio-power (Foucault 1980).When a society experiences threat, the symbols of self-control become intensified along with harshened social control (Scheper-Hughes & Lock 1987: 24-25).

Many societies put forward a culturally and politically “correct” body. “Cultures are disciplines that provide codes and social scripts for the domestication of the individual body in conformity to the needs of the social and political order.” (Scheper-Hughes & Lock 1987: 26). This can be linked to what Janice Boddy writes in her article spirits and selves in Northern Sudan about the women of Hofriyat who are supposed to be morally fertile through socialization and consequently are overdetermined by their own culture (Boddy 1988).

When we put these three theories in one formula, one can state that the way individuals experience the body reflects the social body and the body politic (and vice versa). So, these three bodies work together. One has to look to all three to be able to understand the whole picture.

3.2. Anthropology of the Senses

With Paul Stollers’ book The Taste of Ethnographic Things, anthropology arrived in a stage where it again had attention to all senses. Therefore, Stoller is often mentioned together with the Sensual Turn in anthropology. He described fieldwork as an experience of a new spectrum of odors, flavours, sights and sounds. Space, he said, is not a static thing but can reify a social and cosmological order, and thus can influence the senses. Space and context thus contribute to what Stoller calls multiple realities (Stoller 1986).

Howes called senses “the shapers and bearers of cultures” and opted for a relational approach of the senses within one culture. Every culture has an own balance of the senses in which

12 always one sense is the dominant one (Howes 1991). Different perceptions of the world in the variety of cultures worldwide were thus interpreted as caused by the differences in how senses work together in different cultures. Howes was convinced that how society as a whole perceives the senses is of interest to the researcher, rather than perceptions of individuals.

Tim Ingold was also interested in the causes why people from different cultural backgrounds perceive the world in a completely different way. Ingold opposes what he has named the Building Perspective to the Dwelling Perspective. The Building Perspective means that one rebuilds the world in one’s consciousness before one can act in that world. The reality is thus formed through sensorial stimuli which create an image in our brain. Consequently, differences in perceptions of the world can be explained by assuming that different cultures possess different symbolic systems for organizing the sensorial data. But Ingold does not agree with this perspective, which treats the perceiving organism as a passive recipient. He joins the ideas of James Gibson in stating that one has to study organisms as being active agents (i.a. Gibson 1966) and writes that “… perceptual activity consists not in the operation of the mind upon the bodily data of sense, but in the intentional movement of the whole being (indissolubly body and mind) in its environment.” (Ingold 2000: 166) In the Dwelling Perspective the agent is an active agent in an environment. “From this perspective, the world continually comes into being around the inhabitant, and its manifold constituents take on significance through their incorporation into a regular pattern of life activity.” (Ingold 2000: 153). However, when something goes wrong, for example a person makes a fall, the person changes from the daily dwelling to building of the environment in order to determine where things went wrong.

In contrast to Howes, Ingold is convinced that not the way the whole society perceives the environment is important, but rather the individual act of dwelling in the world. A researcher thus has to pay attention to the individual body as a whole which perceives the world in order to find out how meaning is generated in the act of seeing, smelling and so on.

The ideas of Howes and Ingold both contain the risk of using sensotypes when describing cultures and to relapse in cultural essentialism by ignoring variety within a culture, stating that a culture has one more elaborated and thus dominant sense (Howes) or one dominant perspective (Ingold). Stroeken (2006) therefore introduced an analytic approach taking into account modes and codes of sensory perception.

“The two-dimensional approach to the senses in terms of sensory modes and sensory codes promises to be useful for medical anthropologists attempting to account for both the biological and the cultural in their study of therapeutic efficacy and in their search for cross-cultural continuities between culturally specific practices. It provides the basis for a new epistemology of magic according to which, provocatively put, matter is meaning.” (Stroeken 2006: 467).

Stroeken is aware that, as every Western ethnographer, he is “inevitably influenced by Euro- American conceptions in which Aristotle’s model of the five senses prevails” (2006: 469). This model is based on exteroceptive orientation. Like Geurts (2002: 8) notes, this model overlooks interoceptive sensations such as those pertaining the intestines. Geurts also talks about a third sensation being the proprioceptive sense, which relates neither to the inside nor to the outside of the body, but to the body itself. This proprioceptive sense has to focus to keep the body in balance, and in this, it is comparable to the humeral system of the Greek and the Chinese traditional healing system. Sensorial specialization does not merely elaborate certain skills, it also privileges the development of certain moral norms. By consequence, if the researcher is not enabled to orientate his senses in the way this is done by the people under research, it is extremely hard to develop certain skills and to understand the living moral norms in that society.

Although Stroeken does not deny that the Sukuma specialize in certain sensory modes, he suggests that a culture encodes sensory modes in different ways depending on the social situation in which it is felt (Stroeken 2006: 470). Moreover, distinguishing sensory modes and codes transcends the embodiment paradigm, which has presented the body as an unconscious repository. Stroeken refers to Csordas (1994) when he states that the body also stands for the “indeterminate, creative processes by which practice transforms the socio-symbolic order” (Stroeken 2006: 471). Also Bourdieu approached culture in dynamic terms. The socially structured habitus is at the same time structuring and generative (Bourdieu 1980).

As studies of the senses and personal experiences are an important part of conducting research on traditional healing, I paid much importance to what Stoller, Ingold and Stroeken wrote on this subject. Because of Stollers’ book The Taste of Ethnographic things, I listened carefully to what people explained me about the smell, taste, feeling of things and I looked my eyes out during my fieldwork. I agree with Ingold that it is important to look at individual experiences,

14 but putting his theory together with the one of Stroeken and the one of Scheper-Hughes and Lock, I also argue that it is important to link these individual experiences to a broader network of context and society, respectively comparable to what Stroeken called codes and Scheper- Hughes and Lock named the social body and the body politic (Scheper-Hughes & Lock 1987).

3.3. Language and Magic

In the previous chapters we already touched on the importance of language linked to symbolism. Mary Douglas and Needham wrote about the strong symbolism of metaphors. Language and symbolism are important features of practicing magic. In this chapter I present some interesting theories which concern the link between language and magic.

3.3.1. Symbols and meaning

“Contemporary anthropology has in recent years become aware of the relevance of linguistics for its theoretical advance.” (Tambiah 1968: 174).

In Magic, Science and Religion, Malinowski takes a look at a typical act of magic, name it witchcraft (Malinowski 1954 [1948]). He argues that there are innumerable descriptions on recipes of medicines or the action of throwing a bone, an arrow or something else, while the emotional setting and the gestures and expressions of the sorcerer have seldom been described. Within the performance of witchcraft, a sorcerer does not merely have to throw a bone, but also has to reproduce the act of violence, the hatred and passion which accompany the act. Malinowski thus concludes that the very essence of the act of magic is emotion. There are however also rites that are so simple that they can be described only as an immediate application of magical virtue, as when a man pronounces a spell over an object and afterwards uses this object to accomplish his act. This magical virtue is the power contained in the spell, which is the most important element in magic according to Malinowski. To name it is to get a grip on it. “Knowledge of magic means knowledge of spell” (Malinowski 1654: 73) in that the utterance or formula is the core of the magical performance. This element can be connected to Austin's theory of illocutionary acts in which illocution stands for the intention of the speaker. (Austin 1971 [1962]).

In the two volumes of Coral gardens and their magic, Malinowski made a similar statement when he argued that the potency of Trobriand magic was felt by the Trobrianders to lie in

15 words and spells (Malinowski 1935). Tambiah wrote that although Malinowski's immediate successors confirmed that the verbal component in ritual was important, the orthodox anthropological approach devalued the role of words in ritual. In this aspect, Tambiah refers to a statement by Leach (1966: 407): “Ritual as one observes it in primitive communities is a complex of words and actions ... it is not the case that words are one thing and the rite another. The uttering of the words itself is a ritual.” An example of the importance of spell and words in acts of sorcery and witchcraft is the preparation of pese. According to Jerome Mwakamo, a traditional healer and expert on treating pese, it is very important that the witch while preparing the powder which will make the victim sick, speaks out a formula that contains the words that state and command the desired aim of the mix.

The importance and quantity of words in rituals may vary between rituals in the same society and between different societies, however, when a researcher asks why a ritual is effective, the reply often takes the form of a formally expressed belief that the power is in the 'words' even though the words only become effective if uttered in a very special context of other action (Tambiah 1968: 174). Sequence of words is fundamental to the logic of the ritual, as Tambiah illustrates with an example of a Sinhalese healing ritual. The verbal forms and their sequence have two dimensions. One dimension corresponds to the theology it embodies and another dimension refers to the logic which relates to the craft of communication whereby patient and participants successfully experience the passage from illness to the promised cure (Tambiah 1968:176-178).

“If sacred words are thought to possess a special kind of power not normally associated with ordinary language, to what extent is this due to the fact that the sacred language as such may be exclusive and different from the secular or profane language?” (Tambiah 1968: 179).

In ritual, language appears to be used in ways that violate the communication function because the language used is not always supposed to be understood. The general feature of most religions shows the remarkable disjunction between religious and profane language. But the nature of the authority attached to the sacred language and its range of exclusiveness shows complex variations. Tambiah wishes to make a general statement about the widespread belief in the magical power of sacred words. He says that within any single religious system

16 multiple values are given to the character and role of the sacred language, and that these values taken together form a set of three postulates in mutual tension.

“Thus it is clear that we are dealing with three notions which form an interrelated set: deities or first ancestors or their equivalents instituted speech and the classifying activity; man himself is the creator and user of this propensity; finally, language as such has an independent existence and has the power to influence reality. I would suggest that it is the perception of these characteristics of language that has perhaps brought about the elevation of the word as supremely endowed with mystical power.” (Tambiah 1968: 184).

So Tambiah says, in respect to ritual, one every time meets three broad fields of language behavior. The first domain is the one of myth which relates stories about prophets or ancestors. The second field is the one of ritual or the magical system itself. The last field is the one of the priests or magicians, their sacred status, their links with the saviors or ancestors and their special behavior which make their ritual practices effective. Tambiah states that any exhaustive study of religion and ritual needs to study these levels and the functional relations between them. We already saw that a ritual consists of a complex of words and acts, but it is important to find out what the precise interconnection is between the two.

In the Drums of Affliction, Turner stated that the meaning of one symbol is subordinate to the configuration of meaning of more symbols (V. Turner 1968: 45). He presented a tripartite semantic structure of symbols, consisting of the name of a symbol referring to the semantic morphology of the treatment, the substance referring to the medicines that are used and the artifact (V. Turner 1968: 184) One can relate this artifact to the shingila or ‘access’ element in traditional medicines amongst the Sukuma of Northern Tanzania which Stroeken describes in his book Moral Power. When a victim has been intruded by the witch’s attack by ingestion of poisoned food or drink, the roots which compose the medicine are combined with a symbolic additive, shingila. This additive represents the medicine’s purpose. For example, a tiny piece of a broom is added to swap away the poison and clean your body. (Stroeken 2010: 49)

3.3.2. Symbolic classification

Since I try to make a classification of a certain condition named Kisigo, Needham’s book Symbolic Classification is a very helpful tool (Needham 1979). Quite often symbolic

17 classification seems arbitrary and there appears to be nothing that one can recognize as a real or significant connection among the things that are grouped into one symbolic class.

“It is the task of anthropology to bring out by careful analysis of each case what are in fact […] the indigenous criteria by which things are defined and classified.” (Needham 1979: 15).

Several reasons can be given as a base for classifying cultural products. Symbolism is not always involved in these classifications. In order to be able to think about to world and to act in the world, we need to divide phenomena in classes. All societies speculate and subscribe to metaphysical schemes and sustain a cosmology. Classifications can also be linked to right and duties. Next to these three regular conducts of social life, there are also more circumstantial occasions on which symbolic classification may be put to use (Needham 1979: 16-23).

An alternative approach to the understanding of symbolic classification is to concentrate on the relations which appear to serve as constants in their formation. Needham mentions the notion of transition. He refers to Van Gennep (1909) and his study of rites of passage, where this last one established a pattern in the way that transition might be made between one category or status and another. Van Gennep showed that the process of transition is itself classified symbolically and exists of a triadic pattern consisting out of separation, liminality and incorporation. A symbolic classification can be seen in social action. Performing prestations is not simply economic or legal, but also symbolic. In his essay on the gift, Mauss called them “total social phenomena” (Mauss 1970 [1954]).

Needham sums up some regular types of transformation to which the categories of symbolic classification can be subjected. Two of these are of particular importance for my research: inversion and boundaries. A good example of inversion can be found in the Sukuma spirit possession. The special character of the event lies within the fact that behavior which is conventional and perceived normal within the society, gets inverted during the performance of the ritual (Stroeken 2010: 214-234). Boundaries on their turn are exposed to danger from the outside and thus perceived as dangerous. Mary Douglas says that for a society the transitional stage means danger, since transition is neither one state nor the next (Douglas 1966). There is a need for symbolic rituals to control this danger.

It is important to keep in mind that my classification of pese and kisigo is based on a given classification that I received from a female healer in Kasaka. Thus, the classification that is presented later on in this work is not one that I formulated myself. However the interpretation and elaboration of this given classification are my own.

3.4. Health, Illness and Disease: important terminological issues

Some of the core questions of medical anthropology come to the fore when one wants to work out a conceptualization of a human condition, as I wish to do here with pese and kisigo. What does it mean to be healthy or sick and who determines a person’s health status? What can be understood when one speaks about complex ideas as health, illness and disease? It is important to develop some answers to these questions in order to work with clearly defined concepts and to deliver a transparent study. The definitions presented below are useful tools which help to approach particular conditions in an appropriate anthropological, holistic and respectful way. I make extensive use of the term condition to refer to pese and kisigo. I do so because this is a more general term, and it is not completely clear to me yet what pese and kisigo exactly stand for. However, the term illness when used as defined below can be adequate to refer to pese and kisigo, since it includes the wider cultural and social relations, the patient’s experience and emotions and the ways of explaining and searching for feasible treatment.

3.4.1. Health, Illness and disease

The World Health Organization (WHO) defines health as “not merely the absence of disease and infirmity but complete physical, mental and social wellbeing” (WHO 1978a). This definition is clearly based on a holistic vision towards health, while many people think of health in rather functional terms as the ability to perform. According to Singer and Baer, critical medical anthropologists define health “in terms of access to and control over the basic material and nonmaterial resources that sustain and promote life at a high level of satisfaction” (Singer & Baer 2007: 64). As is clear from the plural meanings that are ascribed to health, health is an elastic condition that must be considered within an encompassing sociocultural context.

Illness too, the way it is often used in medical anthropology, constitutes a cultural construction. Kleinman defines illness as “the innately human experience of symptoms and suffering”. He continues by stating that “the illness experience includes categorizing and

19 explaining, in common-sense ways accessible to all lay persons in the social group, the forms of distress caused by those pathophysiological processes” (Kleinman 1988: 3-4). When one speaks of illness, it is thus important to include the patient’s judgment, as well as the judgment of his relatives, about how best to cope with his condition and the consequences it has in his daily life. Illness experience is culturally shaped since local cultural views organize a common sense about how to understand and treat illness. Of course, illness experiences are also distinctive because experiences and expectations differ individually due to unique biographies (Kleinman 1988; Steffen, Jenkins & Jessen 2007).

The locally shared views on illness shape a common ground for patient and practitioner. Disease, then, is “what the practitioner creates in the recasting of illness in terms of theories of disorder” (Kleinman 1988: 5). In a way, the practitioner reconfigures the illness problems which the patient presents to him, as narrow technical issues being disease problems. The presence of a disease is thus established through a diagnosis by a professional healer, like a biomedical doctor or a traditional healer (Singer & Baer 2007).

3.4.2. Three meanings of Illness

From an anthropological perspective, illness is polysemic and multivocal. However, the materialistically oriented structure of health care has turned the clinical gaze away from decoding the salient meanings of illness for patient and relatives. The psychosocial concern is replaced by the quest for the control of symptoms. This is a sad evolution since examining the particular significance of a person’s condition can contribute to the provision of more effective care, can help to break vicious circles of distress and can liberate the health care from its dehumanizing system of treatment (Kleinman 1988: 8-9).

Kleinman describes several meanings of illness. The first one he puts forward is the surface denotation of symptom qua symptom. This stands for the conventional signification of the symptom as disability or distress, often regarded as natural and self-evident. What is experienced as natural is actually based on shared beliefs of a certain culture. The cultural idioms of doing everyday activities, influence illness idioms and how we communicate about and react on illness (Nichter 1982). Kleinman calls this “standardized truths in local cultural systems” which reflect the accepted forms of knowledge about the body, the self and their relationship to each other.

The body itself is an organic part of the communicative world involving exchanges with others, including the divine. (Kleinman 1988). It is not only a biological entity, but also a sociocultural construction (Singer & Baer 2007).This can be linked to what Bryan Turner stated about the embodiment of social experiences. Social experience is embodied in the way we feel and experience our bodily states and appear to others (B. Turner 1985). The significance of symptoms is embedded in the meanings and relationships that organize our everyday world. Again, the three body theory of Scheper-Hughes with its link between body proper, social body and body politic, comes to the fore when looking at the self, the body and the society.

Symbols also have a second meaning which Kleinman calls cultural significance. Particular symptoms and disorders are marked with cultural salience in different times, places and societies. These categories bring powerful cultural significance with them, sometimes even stigmatizing (Kleinman 1988). An example of culturally marked illness is witchcraft. In a lot of societies in Africa today, witchcraft is a major explanatory model of malignant illnesses that are unpredictable or random. It also offers a means to control seemingly unjust suffering. This is also the case in Kigoma, where the seemingly inexplicable condition of pese is explained as being the result of human evil and witchcraft.

It is not only the labels of disorders that are value laden, but often symptoms can carry cultural significance too (Kleinman 1988). Meanings of all symptoms are dependent on local knowledge about the body. Also this element is an important consideration. If one considers that in many contexts and societies the skin represents the border between inner and outer space, than it is interesting to note a condition caused by witchcraft that grafts on the skin of the victim, like is the case with pese. The witch attacks the symbolic border of the inner person and penetrates the person with its intrusive gaze.

The main argument here is that cultural meanings mark the sick person, often unwanted and neither easily warded off nor coped with. In extreme cases this can lead to stigmatization or social death (Singer & Baer 2007). These meanings are inescapable, although often ambiguous and flexible depending on the local cultural status of the afflicted person (Kleinman 1988).

A third kind of illness meaning is the struggle of the sick person, their families and practitioners to fashion explanations of the various aspects of illness and treatment (Kleinman 1988). In other words, the attempt to answer various questions like: what is the cause of this condition? Why did it have its onset? Why now? How can I control the illness? What does it do to my body? These questions are not just asked to obtain information, they are also deeply felt. The way difficult sentiments like anger and despair are expressed and dealt with, reveals how the sick person and his relatives are handling his illness. This struggle is also visible in the actions and facial expressions of the patient. Questions about cause, effect and effective ways of managing illness will arise. The answers to these questions do not only come from the sick person, but also from the relatives and anyone in the social network, the media or the orthodox or alternative therapeutic system.

3.4.3. Uncertainty: Matters of Life and Death

When illness is introduced in someone’s life, the person does not only have to cope with physical experiences of pain, but also with social and symbolic aspects of life and death (Steffen, Jenkins & Jessen 2005). Negotiation is a central process to health and illness. According to Foucault, control and negotiation are always discussed in social relationships (Foucault 1988). People everywhere struggle to influence, because they cannot completely control, their future situations. There is a diverse, heterogeneous set of options for treatment. Different substances or artifacts, medicines and techniques offer various means to cope with affliction and misfortune (Feierman & Janzen 1992). The possibilities, open to an individual and his relatives, to react upon a certain condition contributes to the dynamics of social and cultural life. Therefor it is important to look at how people other than the medical practitioners, foremost the sick and his relatives encounter, experience and deal with uncertainty (Steffen, Jenkins & Jessen 2005). In doing so, one needs to pay attention to the broadest possible panorama of illness related behaviors (Helman 2000). Interpretative and experience-near studies which are based on the illness narrative of the patient, discussed in detail below, can help to achieve these goals.

Health and cure seeking is an attempt by individuals and relatives to cope with illness, to try to change the circumstances and to make things more tolerable. Because the problem of suffering is, like Geertz formulated so well, “not how to avoid suffering but how to suffer, how to make of physical pain … something bearable, supportable, something, as we say sufferable” (Geertz 1966: 19). Suffering needs to be recognized, because it cannot be avoided.

There exists a diversity and heterogeneity of possible responses. When people fail in the process of attempting to control an uncertain outcome of an affliction, one may come to try out ideas about the spirits of ancestors or the vengeful dead and plan healing rituals as an effort to deal with the condition, assert control and achieve to get cured. Reynolds Whyte says one cannot neglect the element of situated concern and trying out alternatives. This would overlook the uncertainty that so often attends undertakings (Reynolds Whyte 2007). When the case of Aimée Binja is discussed below, it is very clear that she had big question marks about traditional healing, but tried it because she saw it as an alternative after the biomedical treatments failed. Even more fundamental elements when attempting to control illness are how to get hold of the means of control. Dealing with uncertainty requires drawing on social relationships to mobilize resources, like financial means and good contacts. People do not just undergo suffering; they act and undertake to steer through it (Reynolds Whyte 2007: 259).

As we have shortly discussed the many meanings of illness above, one can now understand that to be able to cure from a condition, the several levels or meanings of illness need to be treated. Daniel Moerman outlines three human responses to injury or illness. He names autonomous responses as “all the processes which the organism can invoke to gain health or equilibrium” and he talks about specific responses referring to the quest for different medical treatments. Meaning responses stand for the psychophysiological effects of meaning in treatment of illness (Moerman 2001: 14). This last element can be brought into comparison with the element of shingila ‘access’ which is important in Sukuma medicines as discussed earlier.

Illness or any suffering are not just narrow individual experiential experiences. The suffering, explaining and healing are experienced by patient and by relatives. Medical anthropologists use the term social suffering to link individual experience of pain and distress to the wider social events and structural conditions that often are the ultimate sources of human misery (Kleinman 1997; Singer & Baer 2007). In this sense, it is important that the relatives are supportive in the healing process, and that the social relations are good.

3.5. The Illness narrative

Personal accounts of illness experiences are called illness narratives and have become a very important subject of research in medical anthropology. The goal of using illness narratives in research is becoming an experience-near approach of an illness or condition. The emphasis in

23 these interpretative studies is put on the people and on illness and health as multi-facetted engagement with meaning and experience (Steffen, Jenkins & Jessen 2007). Expressing personal feelings and recalling actions around a particular condition form the core elements (Singer & Baer 2007). Kleinman defines illness narratives as follows.

“The patient structures his own emotions and experiences of illness as personal narratives. The illness narrative is a story the patient tells, and others retell, to give coherence to the distinctive events and long-term course of suffering. The plot lines, core metaphors, and rhetorical devices that structure the illness narrative are drawn from cultural and personal models for arranging experiences in meaningful ways and for effectively communicating those meanings” (Kleinman 1988: 49).

The Illness experience is thus shaped by different cultural symbols and metaphors. Also the way people react on another’s illness is culturally shaped. Murphy (1987) focuses on the insider’s experience and describes what it is like not being able to walk and to be stuck to a wheelchair. In addition to the loss of his legs, Murphy who was a patient himself, had the feeling that he was losing a part of his sense of self. Despite strong social support from his relatives, he felt alone and isolated. He had the feeling he began to socially vanish, since people did not look him in the eyes when passing him by. It raises questions about the ways in which cultural expectations shape social interactions and social relationships while challenging conventional ideas about what being normal means (Murphy 1987).

3.6. Framework: the conceptualization of the condition of Pese and Kisigo

A synthesis of all the information summed up above is necessary in order to construct a good anthropological but also clearly defined framework to work with and to capture the condition of pese and kisigo in its full social and cultural meaning. The following chapter aims to construct such a holistic perspective which involves the three bodies, the human senses and pays attention to language use.

“Much of what is important about African healing becomes clear only when healers and patients and their relatives are pictured as actively creating the particular healing gesture, reshaping healing institutions, and finding the meaning of misfortune” (Feierman & Janzen 1992: 12)

This citation from the book of Feierman and Janzen gives a clear synthesis of the above mentioned. Healing practice, society and culture are inextricably linked. The people involved in the healing process should be addressed as creative actors. The illness narrative is in this respect a very important source of information because it tells an individual story of a patient and his relatives. It zooms in on their feelings and emotions, negotiations and actions.

To be able to obtain all the possible information from an illness narrative, the three body perspective is a valuable theory. I concluded the chapter on the three body theory of Scheper- Hughes with the synthesis that the way individuals experience the body reflects the social body and the body politic (and vice versa). It is very interesting, in respect to putting these three bodies in practice and applying them to the experiences of the condition of pese and kisigo, to connect these bodies to the seven facets of emotions which Schweder puts forward in his article on the cultural psychology of emotions. The seven facets of emotions are the somatic element, the affective element or the subjective experience, causality, the personal consequences, the social element or collective perception, the reactive element and the communicative element (Schweder & Haidt 2000).

The somatic, affective and the communicative element can be seen as ingredients of the first body or the body proper in the theory of Scheper-Hughes and Lock. The physical symptoms of the condition are felt and dealt with by the person suffering from the condition. The affective element indicates the subjective experience of the person suffering from the condition, for example feeling empty, calm, anxious…. These two elements are probably the most obvious ingredients of the body proper. A third element I placed under this body, while also part of the social body, is the communicative element. How does the person communicate about his condition to others? This is affiliated to how the person perceives the self and the condition and expresses this in iconic or symbolic expression of emotions. An example could be a certain height of voice while speaking, facial expression or a certain body posture.

The personal consequences of having a certain condition, the collective perception and the speculation about causality are parts of the second body or the social body, in that they all relate to how people in a society perceive, talk about and react on a particular condition of somebody. Personal consequences can be a change of status, fame or loss of face, in the worst case scenario even exclusion from society. This is closely related to the collective perception

25 of the condition alive in society and in a way also to the speculation of causality. An obvious example in this respect is the fact that people with AIDS are often perceived as being responsible for their own health issues through their immoral sexual behavior that would have caused the illness (Singer & Baer 2007: 80-81).

Finally, the reactive element fits within the field of the body politic. The reactive element stands for the way people handle the condition with the goal to control or to heal. Like stated earlier, the body proper and the social body reflect the body politic. How a person with a certain condition is perceived socially in the society, is a reflection of how the idea of a ‘normal’ person is promoted in that society, which is part of the body politic. Again, I must emphasize that these divisions of facets within the scheme of the three bodies are, exactly like the distinction between the three bodies itself, not clear-cut and rather flexible.

These three bodies, extended with the seven facets of emotions and the importance of the active voice of health and medicine, form the central framework for my research. This framework is used to order the information on pese and kisigo which I collected from the interviews with traditional healers and patients during my fieldwork in Kigoma. The application is displayed in chapter six.

4. Hypothesis and Research Questions

The topic of this master dissertation is a central one to the discipline of medical anthropology, namely traditional healing in a Sub-Saharan African region. When leaving for my fieldwork in August 2012, my intention was to research on the various traditional healing practices found in Kigoma by doing interviews with healers and report on these practices in my thesis. However, when a condition called pese repeatedly came up in the interviews, I got quite interested in this condition and changed my focus to a deeper study of this one condition. It is striking that although pese seemed so widely known among the healers of Kigoma, Mwandiga and Ujiji, the condition is completely unexplored and no attention is given to it from government instances. Is it a condition that a lot of people suffer from, or is it a rather small phenomenon? What is this condition exactly? How is it perceived? A lot of questions kept me busy. My interest for pese only grew when I found out that the healers in Kasaka did not know the name of this condition. When I explained what I thought pese was, they answered me that the condition was called kisigo in Kiha, the local language of the people of Kigoma.

This master dissertation thus seeks to find an answer to the following two main questions. The first question is related to the practices of traditional healing in the Kigoma region. Which manifestations of traditional healing practices are found in Kigoma and which social- economical role do they play in society? I want to give a representation of the general environment of traditional healers in Kigoma while drawing attention to the diversity which is prominent in the region. I will describe the different methods of examination and treatment, the uses of traditional medicines, the way knowledge is brought onto others by initiation, the re-occurring illnesses and the socio-economical role of the traditional healers.

The second question refers to a specific condition, pese or kisigo, which seems to be very known by the majority of the traditional healers in the region. A lot of healers I interviewed talked about this condition. The ones that did not mention it themselves could explain the condition when I asked about it. However, the interesting fact about the condition is that outside of the region of Kigoma, it is fairly unknown. I did not find any written documents on this condition, no government documents at any level, no medical records and no research dissertations. I was told by the healers that it is a condition caused by Bembe witchcraft. All this mystery got me very interested in this condition. That is why I tried to find out what this condition is, where it comes from, how it is caused and so on. What is understood under the

27 condition of pese and kisigo? How are kisigo and pese conceptualized in Kigoma? Is it even possible for me to research on this? The information I have gathered is rather a conceptualization of the condition from the perspective of the healers than from the perspective of patients and broader society. I was so lucky to have been able to interview Aimée, a Congolese woman who got cured from pese. I also spoke to her husband about the condition of Aimée. But apart from these two interviews, the information I gathered on pese and kisigo comes from interviews with traditional healers in Kigoma, Mwandiga, Ujiji and Kasaka.

An elaboration on this second main question focuses on the skin. Why is the role of skin in relationship to witchcraft and healing also important in Kigoma? The answer on these last two questions will be a rather explorative one which is open for discussion, since my fieldwork period was quite short. I give the different narratives on pese and kisigo which I recorded from the healers during my fieldwork. I also present a classification which I obtained from a female healer in Kasaka, a village a bit outside of Kigoma. The goal of this second part of the chapter ‘Results’ is describing the condition of pese and kisigo, the relationship between the two and the conceptualization of the conditions.

5. Methodology

The next question is how I want to research on these topics and how I want to try to answer the previous research questions. I already presented my theoretical framework, which can guide me through the literature and help me to order the many data collected during my fieldwork. Now, I present the methodology by which I collected my data, namely qualitative fieldwork. This inductive method gives me the opportunity to collect data on a micro level, from which I can make some general hypotheses on a more macro oriented level.

5.1. Qualitative explorative fieldwork

The will to learn from the culture of others is central to anthropology. Anthropologists approach the local populations as experts on their own culture. The ethnographer goes into dialogue with his subjects of study and gives these people a voice in his discourse. An important source of information for the ethnographer is the cultural exchange and the personal transformation undergone through fieldwork.

Above all, anthropologists have to be aware of and have to combat the ethnocentrism possibly inherent in their own and others’ analyses of cultures. It is important that they question the cultures’ premises influencing their own thought and worldview. For this reason, research, as a cultural construct in itself, entails reflexivity. Taking into account the effect of one’s research on what is being researched is fundamental in the process of ethnographic fieldwork. An anthropologist has to display this dialogue between own and researched culture.

For this cause of reflexivity, it is important for an ethnographer to write a personal and fieldwork diary. Stoller discusses the epistemological questions on the nature of anthropology when asking whether a researcher has to include personal accounts in his written work (Stoller 1986). I opt not to omit but rather edit myself as a subject in my research, that is the reason I wrote a personal diary and a fieldwork oriented one. By describing the human interactions constituting the research I seek to join the call for ethnographic realism. The dialogue between ethnographer and subject as well as the needed reflexivity when conducting fieldwork not only need to be part of the researcher’s method but also need to be displayed in the written product of the research. Reflexivity is obviously important for medical anthropologists working in the domain of public health where assessments of local practices

29 will have impact on the perception of those cultures by outsiders as well as by insiders. Ethnographers are never invisible observers.

This position surely applies when one’s field research is based on interviews. Qualtitative in- depth interviews are the most rewarding way of gathering much information in a fast way. Also, the information you gather is topic oriented. But it is important to realize the snag of interviewing too. When asking a question, the formulation is extremely important. One can formulate a question, which already presents a certain orientation for the answer. People can also tell you what you want to hear, with good intentions and to please you. Unintentionally then, you get a distorted picture of reality. In my case, it was the best way of information gathering due to the topic of my research and my short stay in Kigoma. It gave me also the opportunity to ask further information on indigenous terms and categories, which I see as very important for my research. Traditional healing and the often related witchcraft practices are surely not practiced in full public, under the eye of everybody who wants to see it. The practices happen in certain houses, on certain locations and with a closed and limited group of people. It is an intimate happening. To be able to participate in these healing practices, a long initiation is needed and a stay that enables participant observation for minimum one year. This was never seen as being within the scope of my research for this master dissertation.

This description is based on 27 interviews with healers, hospital staff, patients and shop owners, and on observations made on the markets, in the forests and at the houses of healers during two months of fieldwork in Kigoma. My analysis of the qualitative data is inductive, identifying significant and recurring segments of text in the interviews. These segments are synthesized into a handful of categories, as presented and discussed in the following section ‘Results’. The findings presented in this paper are based on various research methods in order to attempt a holistic understanding and emphasize the existence of different discourses. My thesis is thus based on more than only qualitative interviews. The first part of this thesis was literature based and the second part comprises mostly field data collected from interviews and observational visits. The participant observation was sensory sensitive in that attention was paid to the non-verbal and the environmental factors during the course of the fieldwork. However, saturation was not achieved through the sampling because of the limited time constraint of the fieldwork period. New insights can and will still come forward through further research.

The 27 interviews, on which this thesis is based, are conducted during fieldwork in August and September 2012 in Kigoma, making use of a semi-structured topic list on knowledge and use of traditional healing practices. For the purpose of highlighting different discourses, my co-assistant Elie Wamba and I selected respondents with diverse backgrounds (health workers, traditional practicioners, divinational healers, herbalists, faith healers and patients) through different contacts. Respondents were recruited by ‘snowball sampling’ (Biernacki & Waldorf 1981). This means that study subjects recruted future subjects from among their acquaintances. We did so because of the fundamentally anecdotal character of the subject. Within the field of traditional medicine, there is no register summing up all possible medicines, treatments or local conditions. The interviewees were asked about their knowledge, attitudes and perceptions towards traditional healing practices and attention was paid to the labeling of a specific condition called pese or kisigo. The interviews were conducted in English or French, or - with help of a translator - in Swahili and Kiha. All the interviews were recorded with the respondents’ consent and supplemented with field notes. Each interview took between 75 and 180 minutes. Some were afterwards transcribed verbatim; others were summarized and used for prescriptive purposes. I am well aware of the fact that application of critical discourse analysis (CDA) on the conducted interviews could have provided access to further relevant and interesting information (Fairclough 1995 [1941]). CDA could have put me in a position where I could have gone deeper in my analysis of the local traditional healing practices and the conceptualization of pese and kisigo. However, I do not have the affinity with the Swahili language in order to make such an analysis.

In my interviews, I made use of a semi-structured topic list. My questions were based on a schema named IKAPE. It comprises questions on Identity, Knowledge, Attitude, Practice and Evolution. I had listed a couple of question in each of these categories, but these questions were not fixed. I started with some smooth questions on the person’s live. Not only because of the importance of the social context of the individual, but also to gain some trust and to start the interview in a relaxed and good atmosphere. The questions I prepared before starting my fieldwork were quite different from the ones that I asked in my interviews later on in my fieldwork. As in my preparation, the questions focused on traditional medicine and healing practices. In my actual research the focus switched from medicine to a focus on healing practices. I did so because it was quite hard to obtain information on the medicines. I did do some very interesting interviews on this topic, and two healers even invited me to the forest to collect ingredients for medicines with them. But through the interviews, I got more interested

31 in the different aspects and the variety of healing practices in the region. Because of the mystery around pese, the condition that kept coming up in the interviews, my interest in the condition grew. Consequently, I started focusing more on these two topics. That is why, towards the mid of my fieldwork, I abandoned my IKAPE scheme and worked more in themes. I still started with a few questions about the identity of the person. It is always interesting to ask where the person and his family come from in order to trace certain local traditions. After a kind of introductory round, I most often asked about how they enrolled in the profession of practitioner and if they were initiated and how. I asked them how they receive, examine and treat patients. I asked for the most occurring afflictions and conditions. If pese did not come up in the conversation so far, I asked for it.

As stated earlier, cultural relativism is one of the central principles of anthropology. But cultural relativism is not without danger and needs to be relativized by grounding it socially. Cultures are globally linked and partake of larger social processes covering the planet so that the internal coherence making up a cultural context is linked with the global as well and eventually involves all societies including our own. Any assessment of culture should therefore be positioned in a wider frame of relevance, meaning it has to be globally rather than just locally relevant. In this respect, I tried to refer where possible to the wider national and international context when describing healing practices in Kigoma. When I elaborate on the condition of pese, for example, I will do so in reference to the healing culture of the Bembe of the Democratic Republic of Congo. When describing the traditional healers I interviewed, I can refer to the national associations of healers in Tanzania.

5.2. Kigoma: geographical and socio-cultural setting

The United Republic of Tanzania is a country situated in East Africa. It is bordered by Kenya and Uganda in the north, by Rwanda, Burundi and the Democratic Republic of the Congo in the west and by Zambia, Malawi and Mozambique in the south. In the East, Tanzania is bordered by the Indian Ocean. It is the only country in Africa where all the four language phyla persistent in Africa are represented. However, one can say that Tanzania is an overwhelmingly Bantu speaking country with Swahili and English being the two official languages. The East African country is divided into thirteen different administrative regions, one of them being the Kigoma region.

The Kigoma region is situated in the Western part of Tanzania. In the East, the region is bordered by Lake Tanganyika, the second deepest fresh water lake in the world and the largest lake of Africa. The Kigoma region has four districts: Kigoma Urban, Kigoma Rural, Kibondo and Kasulu. The region covers 45 066 square kilometers, from which 8 029 square kilometers is water. It is one of the least developed regions in Tanzania. According to the socio-economic profile of Kigoma published by the National Bureau of Statistics and the Kigoma Regional Commissioner’s Office, various groups have originally habited the Kigoma Region. In the profile, the Goma, Rundi, Bwari, Manyema, Bemba, Jiji, Holoholo, Vinza, Nyakaramba, Hangaza, Tongwena and Waha people are mentioned. The Waha is considered to be the biggest ethnic group of the Region.

Figure 1: Map of the Kigoma region (source: NBS and Kigoma regional commissioner’s office 2008).

The Ha speakers form the majority of the population in the three of the four districts of Kigoma, more precisely in Kigoma Urban, Kasulu and Kibondo. The Ha language is a Bantu language closely related to Kirundi and Kinyarwanda, spoken in the neighboring countries Burundi and Rwanda. Presumably, the Ha people originally came from these neighboring countries, but settled in the Kigoma region, which traditionally got the name Buha. There are several stories about the origin of the Ha people. One is described by Harjula in the introduction of her description of the Ha language. According to this story, early colonists asked the people living close to the lake who they were, they answered Turi Abaha ‘we were born here’. That would be why they got the name Waha ‘the Ha people’, Ha meaning ‘born here, local’ (Harjula 2004: 1-2). Agriculture is the primary economic activity of the Waha. Sorghum, millet, maize, cassava, yams, peanuts and other crops were cultivated by hoe techniques until efforts were made by the Tanzanian government to introduce plow agriculture. Cattle are raised mostly in the southwestern grasslands of Buha because elsewhere is less water and problems with tsetse flies.

Various religious traditions are followed by the people living in the Kigoma region. Christianity and Islam are the two most represented religious traditions. In 1978, The Kigoma Region had a total population of 618,950, increasing to 854,817 in 1988. In 2002 the number of people already increased to 1,674,046. This is almost three times the number of 1978. This growth rate is high compared to other regions in Tanzania and has to be seen within the perspective of conflict in neighboring countries which has been accompanied by an influx of refugees into Tanzania. The influx of refugees started in 1994. The refugees came especially from Burundi and later also from the Democratic Republic of Congo. The repatriation of refugees to their respective countries started in 2000. But in 2003, still almost 400 000 Burundese refugees were staying in the region. The refugees of the early influxes have settled into communities where they founded own shops and little schools. (Harjula 2004: 1). It appears that the rate of repatriation has increased after negotiations with the neighboring countries. In July 2012, the president of Tanzania Kikwete had announced that “all refugee camps sheltering Burundian refugees would be closed down”. In December 2012, the Mtabila refugee camp of Kasulu was closed and 38 000 refguees had to return to Burundi after living in Tanzania for tens of years (International Refugee Rights Initiative & Rema Ministries 2012; Hovil & Mbazumutima 2012). Apart from the refugees, there are also those people who have moved to the region from abroad or from other parts of Tanzania.

The fieldwork that has been conducted by me in order to collect data for this dissertation is done in the capital city of the region which is also named Kigoma and in some neighboring villages like Ujiji, Mwandiga and Kasaka. The historical trading center of Ujiji is only six kilometers away from Kigoma. Mwandiga and Kasaka are two very small villages alongside the road from Kigoma to Kasulu on respectively 5 and 12 kilometers distance from Kigoma.

Nowadays, Kigoma has become a far more important economic center then Ujiji because of its lake port on the eastern shore of Lake Tanganyika. Kigoma is one of the busiest ports on Lake Tanganyika, since historically it was the only port that had a functioning railway connection and thus a direct link to the seaport at Dar Es Salaam. All these factors make Kigoma and its surrounding villages an extremely interesting field to conduct research, as it is a region where different cultures come into contact via migration, trade and travel.

The Lake is of major economic importance for the people of Kigoma and the surrounding villages. Lake Tanganyika has high potential for fishing as it boasts more than 2,000 species of flora and fauna and is among the richest fresh water ecosystems in the world. The main activity of the people living along and close to the shore of the lake is fishing. Agriculture is the mainstay of Kigoma residents with its activities accounting for about 80 percent of all sectors’ economic contribution in the region. The type of agriculture practiced in the region is peasant agriculture whereby smallholders who employ very limited capital in their production process are the most involved. The outcome of the farming is however constrained by poor technology, infrastructure and techniques (NBS & Kigoma Regional Commissioner’s Office 2008).

In the scope of the topic of this dissertation, it is interesting to take a look at the available health services and data on health in Kigoma. The surrounding and the socio-economic climate of people influence the health of individuals and the community. The dominance of Lake Tanganyika dictates the climate and the prevalence of various diseases in the region. This is compounded by poor communication system, poor water supplies, poverty and poorly run health services. According to NBS and Kigoma Regional Commissioner’s Office, the most commonly reported diseases in the Kigoma region between 2004 and 2005 were malaria, diarrhea and vomiting, eye infections, skin infections, ear infections, air transmitted diseases, anemia, intestinal worms, cholera, pneumonia, Upper Respiratory Tract Infection (UTI) and Acute Respiratory Infection (ARI). As is the case for many other regions in

Tanzania, malaria topped the list of morbidity in the Kigoma region (NBS & Kigoma Regional Commissioner’s Office 2008).

The figure presented above shows the number of hospital beds and the number of available doctors. Next to the hospitals in the Kigoma region, there are also alternatives where people can go for health issues. A recent development in the health sector in villages in the region includes the introduction of village health committees. These committees form a link between the villages and the higher health authorities in the region. They are meant to oversee the day to day running of health activities in the villages (NBS & Kigoma Regional Commissioner’s Office 2008). Traditional healers are many in the region. Kibondo and Kasulu have the

36 biggest numbers of traditional medicine practitioners, while Kigoma Urban lists on the third place when comparing the four districts, based on the socio-economic profile of Kigoma published by the National Bureau of Statistics and the Kigoma Regional Commissioner’s Office. The next chapter elaborates on traditional healing practices in Kigoma Urban, more precisely in the capital city Kigoma and in the three surrounding villages of Ujiji, Mwandiga and Kasaka.

5.3. The course of my fieldwork

I arrived in Kigoma on the 2nd of August 2012. It was four years ago that I had been there with the Brothers of Charity and I still had some old friends I wanted to see again. I had contacted the Brothers of Charity before my arrival for accommodation in Kigoma. The first two weeks I thus explored Kigoma and its surroundings. I took my time to get in contact with some locals and to build up a social network in Kigoma. My actual fieldwork started the second week of August, when Deo Baribwegure arrived in Kigoma. Short thereafter, he presented me to Elie Wamba who would help me translating my interviews from Swahili to French.

Deo Baribwegure is the chairman of KICORA or Kigoma Community College by Radio and a personal friend of mine. I met Deo in 2008 during a trip I was making with the Brothers of Charity in Kigoma. Deo and I kept contact the years thereafter. When I finally planned to come back to Kigoma, the first person to contact was Deo. Before, during and after my stay, he helped me with local contacts and administrative things. He accompanied me to the Migration Office of Kigoma, near the Maweni Hospital, the day after he arrived. It was important for me to be able to conduct my research without constraints. To be able to do so, I had to obtain a CTA or researcher’s visa. It took me two weeks, six visits, 200 USD and a lot of patience before I got my visa, but luckily I was already allowed to begin my interviews during this waiting period. Since he is the son of a Burundian traditional healer, Deo has a lot of insight and knowledge on the topic where I am working on. The conversations I had with Deo during my fieldwork have been very helpful for my understanding of the topic. When I got stuck with my data, Deo was the best address for an illuminative conversation.

Elie Wamba Kabange is a Congolese man living in Kigoma. He is a graduate in financial studies and experienced in translating interviews. He speaks French and Swahili, but no Kiha. He brought me into contact with a number of traditional healers which he knew via word of

37 mouth or via neighbors, friends and family. In their turn, these healers brought us into contact with other healers. Most of the interviews I conducted during my fieldwork are done together with Elie. We visited different villages around Kigoma like Ujiji and Mwandiga to interview healers, we explored the forests of Mwandiga and Kararangabo with two traditional healers and we visited the Arabic shops and traditional medicinal stalls on the markets of all these villages. We got along quite well. I learned a lot from him because of our long discussion on the way to or back from our interviews. He told me about the local cosmological beliefs, about his business, his friends and family and about how it is to live in Kigoma as a Congolese. Most importantly, he was the one who told me about pese for the first time. His wife Aimée Binja had suffered from pese two years ago. This enabled me to inverstigate the condition first-hand through her illness narrative. However, sometimes there occurred some struggles between Elie and me because of different views or working methods. It was not always easy for me to be able to follow during interviews, because Elie did not always translate what was literally said but often gave me his own interpretations, which are interesting to discuss later on, but not during the interviews. Also, it was not always easy for Elie to translate regularly enough during the interviews. That is one reason why I often missed a good opportunity to get real relevant and interesting information. Another reason why I often missed a moment to get more out of the interviews is the fact that knowledge and capacity of conducting good interviews is something that can only be acquired by doing interviews. The experience you build up from doing interviews for a couple of weeks, helps you to do interviews with better questions, without presupposing answers but with an open view.

At the end of August I interviewed Chantal. She is a Congolese doctor working for the Brothers of Charity in Kigoma. For the moment, she works at Kasaka where the Brothers are building a new hospital for psychiatric patients. After the interview she invited me in Kasaka. She told me there are many tradition healers in the village of Kasaka. She saw it often enough, that a child needs urgent medical care because the parents visited a traditional healer and waited too long to come to the hospital once the situation of the child worsened. Often, the children wear a little black bracelet around the wrist, the neck or the waist. The bracelet exists of a package of protective medicines, attached to a string. It is called hilizhi (Docteur Chantal, Kigoma, 29/08/2012).

I was very enthusiastic about doing research in Kasaka, but Elie was not really in for the plan. He did not understand what I expected to find there. To be honest, I did not see it either, but I really wanted to speak some healers there. Deo did not have the time to accompany me to Kasaka to do interviews there, because of his work at KICORA. I met Alan Matafwali, a colleague of Chantal at the psychiatric hospital near Kasaka, at the hospital and had a good conversation with him. Afterwards he proposed me to help me with some interviews in Kasaka, since he knew the people in the village. I accepted his offer. I already visited Kasaka three times by then and, because the village is so small and every visit did not go unnoticed, the villagers started to know my name. I got invited to make palm oil or to watch the local football tournament. I really liked the atmosphere in Kasaka. However, I only did two interviews with Alan there. It was not that easy to work with him because he did not have much time. He was working at the hospital till four, so we could only interview in the late afternoon. Also, he was far less professional then Elie. His English was not that good and that made the translations difficult to understand. After two interviews he told me he wanted to stop. He told me people started to talk behind his back and gossip about him because he was visiting these healers and witches. “People will start thinking something is wrong with me,” he said.

I was driven more than ever to continue my research in Kasaka. Mostly because of the fact that the healers in the village did not seem to know a condition named pese. And by then, this condition had become the central topic of my fieldwork and interviews. They said to me they called that condition kisigo, but still it did not seem exactly the same.

During the time I was trying to get my fieldwork in Kasaka running, I was also still doing interviews with Elie in the other villages. As the last week of my fieldwork started, I was running out of time. Koenraad Stroeken was in Kigoma for two days that last weekend of my stay in Kigoma. I talked to him about Kasaka and my fascination for pese and kisigo. We grabbed a taxi and drove to Kasaka. That day we did two very nice and interesting interviews which gave me much more clearance on what kisigo is and how it is related to pese. Especially, the interview with a father and a daughter called Mskitu gave interesting information on the relation between the two conditions. I visited the daughter once more with Deo on the 26th of September. 2 days later, after a lot of goodbyes and thanks, I left Kigoma and took the bus to Dar es Salaam to fly back to Brussels the day after.

6. Results

6.1. A short introduction to some cosmological ideas in Kigoma

Elie once referred to the first line of a poem written by the Senegalese poet Birago Diop: “Les morts ne sont pas morts” (1947). The spirits of the ones that died are still with us, he said. Many people in Kigoma believe the live world is divided into two different realms from which the first is the manifest world and the second is an unseen, parallel world of ancestral spirits, sorcery and gods. “Ancestors represent an extension of the human community as a major cause of misfortune and cure in many African societies.” (Janzen 1992: 66). Because of this, these two worlds are causally linked in that the former is partly steered by the unseen forces of the latter (Sanders 2001).

As the everyday live is partly formed by occult forces, power over and knowledge about these forces is crucial in the process of power gathering. There are several ways to get some control of these forces; one of them is using medicine. Here, medicine is a broad term representing concoctions made by diviners, as well as traditional, herbalist medicine and biomedicine (Geschiere 1997). Traditional and herbalist medicines can be used to cure someone from a certain illness or condition and even to increase someone’s own political and economic wealth. The World Health Organization has defined traditional medicines as “the sum total of all knowledge and practices, whether explicable or not, used in diagnosis, prevention and elimination of physical, mental or social imbalance and relying exclusively on practical experience and observation handed down from generation to generation” (WHO 1976: 3). As Devisch (1993: 24) notices correctly, traditional refers here to the rootedness in civilizational traditional and the predominantly oral means of transmitting knowledge and practices. These traditions are characterized by their capacity to invent by means of trial and error, to adapt to changing context and to incorporate elements from other cultures.

These medicines can also be put to more nefarious ends like is done by witches. Witches are people with evil intentions who use medicine to make others sick, make them suffer or even kill them. They may do so on request of others or because of own purposes on the base of negative feelings towards that person or to simply accumulate wealth. However, since no-one has direct access to the unseen realm of powers, the ultimate causes of worldly events can never be fully known (Sanders 2001). The relation between the two worlds thus remains

41 complex and ambivalent. This makes it impossible to pronounce absolute judgments about the worldly events as being the result of a moral or an immoral conduct. One can only ‘divine’.

During my fieldwork, I heard numerous stories about rich families in Ujiji that suddenly lost their fortune or from which the house burnt down or from which the family members suddenly got sick or go crazy. Some explain these happening as the outcome of a ndagu pact. This is a deal one can make with the witch. The person gets more powerful, rich, strong or loved but this happens at the expensive of others, mostly family relatives, causing them to get sick or go mad (Sanders 2001). Others speak about widespread jealousy by envious others who turn their witchcraft against the family. It is worth stressing that very often a moral element comes to the fore in these witchcraft rumors (Sanders 2001). Often these moral issues relate to the market: who gets what, how do they get it and at what expense. This is also described by Koenraad Stroeken in his book ‘Moral Power’ (2010: 119-139). The witch with her intrusive gaze keeps an eye on the actions of every single one in the village. A person, who is very rich and keeps enriching himself on behalf of the others, is breaking a moral code of the Sukuma society where solidarity is very important. When a witch attacks that person to punish him for his greediness and success, there is a certain moral legitimation to her actions.

The strong claim that Sanders put forward in his article from 2001 is that the advent of the free market in Tanzania has increased the speculation about the occult, and as such, also provided the very mechanism by which such ideas and practices are spread (Sanders 2001). He describes the rise of sellers of traditional medicines on the markets of the Ihanzu. Although I cannot state anything about a rise or fall of sellers of traditional medicines in Kigoma, since I cannot compare chronically, the market there does offer a lot of traditional medicine shopping. When one goes to the central market of Kigoma for example, or the big market of Mwanga, there are several Arabic shops who sell all kinds of traditional medicines, packed in plastic pots, placed on the highest shelf of their little shops. Also the streets of Ujiji are packed with these kinds of Arabic shops. When one goes to the smaller markets of Katonga, Kibirizi or Mwandiga, one finds the little temporary stalls of traditional medicine sellers. Several traditional healers send their patients to these shops with a prescription, but people also go there without visiting a healer beforehand. They put forward their complaints, as the patron of such an Arabic shop on Mwanga market told me, and the seller in the shop will try to help with the appropriate medicine and dosage. And although many traditional healers make their medicines themselves with the ingredients they extract from the nearby

42 forests, some of them also visit these shops for extra ingredients they were not able to find in the forest.

Elie Wamba posing in an Arab medicine shop at Mwanga Market, Kigoma (own photo, August 2012).

6.2. Traditional Healing and the image of the witch in Kigoma

Kigoma is a city with a great variety of cultures intersecting. This variety of people and cultures is also reflected within the various traditions of healing. There are many typologies available to refer to the medical pluralism in complex societies. Chrisman and Kleinman (1983) created a widely used model consisting out of three overlapping sectors in the health system in the world in general. The popular sector consists of health care as performed by the patients themselves along with their social networks. This self-treatment overlaps partly what Janzen called the ‘therapeutic management group’ (1978: 5). It includes a variety of therapies and rituals, such as baths, rest, teas, herbs, exercises, massage and so on (Singer & Baer 2007: 137). The second level of this typology is called the folk sector. This sector is discussed here for Kigoma. The folk sector encompasses the various healers who are self-trained or undergo an initiation and tend to practice independently, often from their home. This level thus includes practitioners, shamans, mediums, herbalists, bonesetters and faith healers. The third and last level of the typologies is the professional sector. The sector includes practitioners and bureaucratic structures as clinics and hospitals associated with biomedicine and

43 professionalized medical systems (Singer & Baer 2007: 138). In Kigoma as in many other African societies, all three levels are represented. However here, I will only focus on one of the three levels, being the folk sector. I wish to give a rudimentary sketch of the wider context of these traditional healing practices which are found in Kigoma. This wider context comprises the Bantu civilizational traditions and cults of affliction in which traditional medicines form an important part of these civilizational traditions (Devisch 1993).

Devisch mentions, as was also shown by Janzen in his book Ngoma, that those African healing traditions are less ethnically based and fragmentary than has been alleged by colonial discourse. Janzen (1992) gives an analysis of his comparison of a major healing cult in four different societies from the equator down to the Cape of Good Hope. These societies are grouped by linguists as Bantu societies because the population speaks the interrelated Bantu languages. The region comprises big parts of central, east and southern Africa as presented on the map on the left. It is a region of linguistic and cultural homogeneity alongside the local variations. “There is a common core of basic assumptions and behaviors in the field of etiology, diagnostics and therapy, which is often displayed in the context of elaborate ceremonies or cults” (Devisch 1993: 24). Ngoma is an example of such a healing cult known throughout the Bantu area. There are also cults that know a less widespread practice and are spread only within restricted areas within the Bantu area. Figure 4: Representation of the Bantu area. (source: Wikimedia Commons)

In order to understand and value the spectrum of Bantu healing practices in their own right, it is necessary to study their group ethics, religion and cosmology (Devisch 1993). In the previous chapter I presented a very short sketch of the cosmology of the people of Kigoma, which can be said to be shared by the whole Bantu community. Apart from the belief in a twofold world which consists of one visible and one invisible world which are intertwined and influence each other, the Bantu community shares a common concept of ethical notions.

In respect to healing practices, these shared conceptions are also reflected in the cognate terms that cover concepts like symptoms, etiologies, healer roles, medicines and ritual activities with the end-goal of health. For example, in the whole Bantu area different terms are used for the existential quality of suffering and the physical injury or sore (Janzen 1992: 63-64). The most prominent ethical notions within Bantu society are solidarity and the coherence between body, group and cosmos. This coherence can best be understood when looking at the community or micro-cosmos as a humoral system that needs to be in balance. Society thus is a humoral system with life fluids flowing through its veins. The manner in which the different substances balance within the societal body determines the atmosphere within society. When a blockage occurs and the balance is disrupted, the community struggles to return to a state of equilibrium. The society needs healing in order to restore the good balance. As the external environment is an important variable within the maintenance of equilibrium, treatment typically involves an effort to keep the body attuned to the various changes in climate (CMAJ 2010). Group rituals, that bring the community together and healing rituals which cure the sick and excluded, can heal the wounds of conflict and restore the lost balance (Devisch 1993). The well-being of a person is considered as a sign of good social functioning within the community. Solidarity is pivotal to this good fitting in society.

These general elements of the Bantu healing practices are found throughout the whole Bantu area, the area in which the Bantu speaking farmers have settled, comprising Central, East and Southern Africa. However, local variations of these traditions exist in the different subregions of this enormous area. In this dissertation, I discuss the local healing practices found in Kigoma. During the two months I have been in Kigoma, I have interviewed over twenty-five people to talk about the local traditional healing practices. In this short time span I managed to gather interesting information about the variety of healing traditions in Kigoma. Quite fast, it became clear to me that when talking about traditional healing, one easily starts talking about witchcraft practices too, since the results of witchcraft practices need extensive traditional treatment. I only interviewed one healer who claimed to be able to make people sick and to have the power to kill others. Only one admitted he is healer and witch at the same time. Is there a taboo in admitting being a witch? Can healers and witches be one and the same person? Or are they enemies?

6.2.1. Traditional healing: a Variety of Practices

As many Africans still depend on traditional healing practices for their health maintenance, the function and prestige of traditional healers are growing steadily in towns (Devisch 1993). In Kigoma, there is a whole range of traditional healing practices available: the Christian prayers, the diviners, the Islamic healers who work with the Quran, the herbalists and traditional practitioners (mostly Muslims). They all have their own way of examining and treating patients.

The traditional healers are known among the people of Kigoma, Ujiji, Mwandiga and Kasaka. Often even, these healers are known far beyond the boundaries of their own compound or village. There is no advertising visible on the street, and most of the time there is even no indication at the house of the practitioner, although sometimes a grass hut is visible which already points to the contact with ancestral spirits. How do people know where to go when in need for traditional treatment? Social networks like family, friends and neighbors are an important factor in this respect (Kleinman 1988). Word of mouth is the best advertising one can get. When people are satisfied because of the good treatment they got from a particular healer, the word is spread rapidly. Surely, when they hear about other’s illnesses, the name of this particular healer will come up as a solution to the suffering.

According to my data, one can distinguish different steps in traditional treatments. First of all, there is the examination of the patient in order to uncover what the patient is suffering from. The condition gets labeled. Often, also the cause of the illness or condition is researched in this stage of the treatment. Discussion with the patient is valued high by most healers. A second step in the healing process is the treatment. This treatment exists out of more than just the use of dawa ‘medicine’. There are psychological and socio-anthropological dimensions involved in the treatment. It is important to look at the total performance of the healer as constituting the treatment. A third step of the healing process endures the whole treatment. While the patient receives care and becomes better, he or she also emerges as a healer himself. It is important that he knows the medicines he takes, that he understands how they are made and that he knows what it does with him. This third step is a rather exceptional one in that by far not every patient emerges as a healer as a conclusion of the treatment. This is only the case for some individuals who suffer from specific conditions that indicate that a person is picked out by the ancestral spirits to become a healer (Mskitu, Kasaka, 26/09/2012).

The person will get sick, has to manage the illness as a kind of exercise and will get initiated by the healer the ancestors have directed him or her to. The fourth and final step is when the patient feels well again until finally, he is cured. When the condition of the patient or victim was caused by witchcraft or evil spirits, the patients often undergo a protection ritual to avoid more attacks of being effective.

I wish to discuss these steps in more detail below. I have done so with the data I have collected during my fieldwork, often steered by some of the literature on traditional healing. I have chosen to work with case studies in order to give detailed examples of the different steps of healing practices discussed above.

6.2.1.1. Examination: finding the cause and labeling the condition A central conception of the cosmological world of the people of Kigoma is that afflictions do not always have a natural cause such as bacteria or a failure of a certain organ; even so misfortune is never just accidental. Since the world is divided in a visible and on invisible world, many conditions, illnesses and other forms of misfortune are believed to be caused by evil spirits or bad intentioned individuals. Here we see a clear-cut link to witchcraft practices. Witchcraft can be linked to what is called black magic. Traditionally black magic is referred to as the use of supernatural powers for evil and selfish purposes as economic or political personal gain. White magic, in opposition to black magic, may then refer to using magic for good rather than evil. In this, one can see divinational healing as an example of white magic.

I encountered a rather dubious example of white magic when I was interviewing Rehema Shabani, a female healer and the neighbor of Elie Wamba. While interviewing her, she gets a phone call. From the moment the conversation ended, Rehema starts explaining what the phone call was about. She said it was a patient who called her in order to thank her for the good remedy she gave him, however he also advised her to diminish the dose. The patient visited Rehema a couple of weeks ago. He was having a very hard time then because he did not have enough money, he had family problems and he had bad luck on his work. He believed that angry ancestral spirits were blocking off his luck. Rehema gave the man medicine which she calls mwita. These medicine needs to be mixed with water. Rehema washed the man with that water in order to chase the bad spirits away and to open the access to his own luck. After the washing, she gave him two little cuts on his forehead in which she applied a powder called samba in order to attract the good luck. The patient phoned Rehema

47 to tell her that he earns too much money now, his boss loves him more than he loves his own wife and he has never been happier. Is this white magic then? Or should this be classified as a ndagu-pact by which a person makes a pact with a witch for his personal gain to the detriment of others? In that case, it would rather be black instead of white magic.

As conditions and illnesses can have a variety of causes, examination is a very important step in treatment. In my interviews, I met different ways of examining patients. In this chapter, I will present some of the different methods by presenting a number of case studies.

Mzee Mwaleka Omari Bakari (Ujiji, 03/09/2012 and 07/09/2012) is an old, experienced and wise man who made a big impression on me. He is a real storyteller. He used to work for TANU, but is now a consultant for all kind of things, also for healing practices. Mzee Mwaleka is an Islamic healer who uses the holy books of the Islam when examining patients. The books contain texts that are believed to be authored by God to various prophets throughout the history of mankind. He uses four books: the Tawrat, the Zabur, the Injil and the Quran. He examines and heals according to the names of God. According to Mzee Mwaleka, there are one hundred plants and trees that are able to heal. Each of these plants has a name. Likewise, the Islamic prayers beads have one hundred spheres for the one hundred names of God. Each of the names of God has a number which indicates the times one has to recite the name. This information is written down in certain extracts of the four books. Mzee Mwaleka gives me an example. Latwif is the name for God as peace. One has to recite this name 129 times to convince God to listen to your prayer. Shafi stand for God as healer. This name has to be said 391 times. When one does that, God knows that one needs healing.

Mzee Mwaleka in his house in Ujiji (own photo, September 2012).

Mzee Mwaleka heals and cures by reading the books. When a patient visits him, he asks for the name of the patient and the name of his or her parents. Every letter has a number. He has to make the total of the numbers and search for the reference of that number in the books, a process he calls buruji. Then he knows what is wrong with the patient. Everything he needs to know is written in the book, also the treatment. Every condition or illnesses is addressed, every cure or medicine too. He prays to Allah, waits for answers and looks for interpretations in the books. Then he can start treating.

The information in the books is not free to everyone. One has to be initiated to read through the books and understand all the information that is given. Everything is written in the book, but it is only fully accessible to a few such as the ones that really want to and the initiated healers and sorcerers. It is written in a secret and hidden way, a sort of code. Mzee Mwaleka himself is initiated by using the Quran. He tried to remember his dreams to discover afterwards what his dreams meant by reading the Quran. He was thus initiated through his own dreams. Three close friends helped him to be able to interpret his dreams in a right

way and to bring him in contact with a voice. The Quran writes about dreams and visions and how to interpret them. When one dreams he is imprisoned, that person will soon die. The books write about everything. They write about how to do good and how to do bad. God gives you the free choice to do good or to do bad.

Mzee Mwaleka was the only healer I met who used the four holy books of the Islam to examine and treat patients. However, many healers are Muslims and many of them sometimes read from the Quran or the other books in the frame of a healing or a protection ritual. An example of this practice is given when is talked about protection rituals later on. Just like Mzee Mwaleka works with the names of God, Jerome Mwakamo Abedi (Ujiji, 17/09/2012) prays to God when he receives patients.

Everybody is welcome in Jerome’s house for treatment. All get a chair and a listening ear. When the patient has told his experiences, Jerome applies oil to the forehead of the person. He puts his hands on the head or the shoulders of the patient and starts praying to God. When he prays, God emerges and Jerome gets a revelation. God shows him what has caused the suffering of the patient and what is needed in order to cure the patient. Jerome can advise treatment to the patients for a certain payment but he says that “many Christians just want me to pray for them.”

From the interviews I conducted I can conclude that many healers search for a correct diagnosis through divination. The kind of divination I encountered in Kigoma and surrounding villages is one of ‘mediumistic type’ (Stroeken 2010: 152). The diviner enters an altered state of consciousness after the spirit descended on him or her. Mostly, the spirit gets called upon after a short introductionary conversation with the patient. The question, on which an answer is sought through divination, is whether the affliction is caused by a natural cause or if evil forces are involved (Janzen 1992: 66). During the divination, the spirit descends into the diviner’s head, enters his consciousness and will reveal what the patient is suffering from, what the cause of the condition is and how this should be treated.

Shabani Husseni Saidi is a divinatory healer from Ujiji. Before he asks questions to his patients about the problems they experience, Shabani evocates the spirits. A spirit climbs into his head and starts submitting the problems of the patient. The

50 spirit literally talks through the mouth of Shabani, who basically lost consciousness. Because Shabani can’t remember afterwards what is said during the divination, there is a third person present apart from Shabani and the patient. Mzee Jean-Pierre, a 60 year old man who is completing his initiation by Shabani, writes everything down. The spirits address the condition, the cause and the needed treatment in their speech. The spirits with whom Shabani works are many. Shabani names the jinn, the mayimona and mister Mishelino. He says that he can see their appearance and he knows how they look. The spirit that is closest to Shabani on the moment of divination enters his head. Tabu, the man that initiated Shabani, gave him the connection with these spirits. After the spirits have analyzed the client’s condition, they leave the head of Shabani. When Shabani returns to his normal state, he and Mzee Jean-Pierre read and examine what has been written. Before starting the treatment, the price is discussed.

Shabani Husseni Saidi in the room where he receives his patients at his house in Ujiji (own photo, August 2012).

Shabani says it is visible from the eyes of the patient when a condition is caused by evil spirits. In that case, the first thing to do is to chase these evil spirit away. The client’s head is covered by a small blanket, he sits on hands and knees above an illuminated incense stick and a pot of damping dawa ‘medicines’. The spirits

go up to the head of the victim and talk through his mouth. Shabani on his turn will invocate his spirits. The spirits will talk to each other. The bad spirit will tell why it has come or who has sent it to the victim. At the end of the conversation, Shabani’s spirit will order the bad spirit to leave the body of the victim. In most of the cases, further treatment is needed to cure the patient from his physical condition. In the case of malicious intent, Shabani knows who has bewitched the victim. Although he knows, he will never tell it to the patient to avoid hot headed people to revenge on the culprit or on the witch. Moreover, it is forbidden by law.

Herbalists often diagnose on the basis of a little interrogation of the patient. However, it is not always very clear what one is suffering from and which treatment is needed from the conversation with the patient. Therefore, it happens that healers send their patients to the hospital in order for them to get examined there. After the hospital staff has diagnosed what causes the discomforts of the patient, the patient can return to the healer in order to get the just treatment. There are however conditions that the hospital cannot trace, because of their complexity and the supposed involvement of evil forces. In that case, the healer has to rely on his or her own experience and start the treatment that he or she thinks will have the best results.

Mzee Habibu is a man in his fifties living in Mwandiga. Some years ago his sister, who was also an herbalist and was specialized in uterine disorders, started initiating him. She died after the second week of initiation. Mzee Habibu inherited her booklets with the description of the different medicines and treatments. He makes the medicines he uses in the treatments himself according to the recipes of his sister. Also, he is working out his own medicines by trial and error. He often sends his patients to the hospital when he is not sure which condition the patient has. Mzee Habibu has a lot of confidence in the hospitals and its staff, however, he emphasizes, that some conditions cannot be examined or treated in the hospital. There are cases where the hospital does not succeed in healing the patient. Often these people go searching for treatment from traditional healers. Based on his knowledge and experience, Mzee Habibu tries to offer the patients the best treatment. The treatments he offers are based on plants and trees, without any further conditions, he emphasized. The medicines are the core of the treatment. They do the work.

Mzee Habibu showing medicines againststomach ache in his house in Mwandiga (own photo, August 2012).

6.2.1.2. Healing process: dawa and treatment Diagnosis of illness and the certainty that this brings forth, can have an important therapeutical effect. They put an end to the despair and uncertainty that the patient had to deal with before. This can already mean a big step towards recovering the initial health of a person. The relationship between healer and patient is even so therapeutically important in that it helps to overcome social stigmatization and isolation. Conditions that severely influence the appearance or behavior of a person, or that are highly stigmatized in the community because of the conceptual relation with immoral behavior, have a long lasting and nefarious effect on the social relations and status of the patient. Psychiatric patients often get casted out by their own friends and family. The care, acceptance and support they receive from the healer are experienced very strongly and can form the start towards rebuilding the lost self-esteem. This gives the patient the power to fight against the condition or illness and the social effects of it. If the healer in question has more patients staying over for a similar treatment, the shared understanding and connectedness among patients can have the effect of the forming of a supportive network, what again increases the courage of the patients.

Also words are important in treatments. They can have beneficiary effects on the patient, just like they can have nefarious effects. Janzen writes that “expressions of the social setting can affect health and illness” (1992: 66). He explains that just like sorcerers and witches use words and associated thought to afflict others, words and prayers can have healing effects on people. In words patients can also give expression to the pains and social problems, which can bring relief and rest. As I already emphasized in my theoretical framework, the senses are of particular importance in respect to healing processes. Traditional healers work with the human senses in their treatment. The laying of hands on the shoulders or the head of the patient while praying is an example of the stimulation of the sense of touch (Csordas 2008: 111-112), while burning incense stimulates the sense of smell. The stifling effect of hanging over a steaming pot of dawa, strengthens the feeling of liberation when the piece of cloth that covered the head during the ritual is removed (Shabani Husseni Saidi, Ujiji, 21/08/2012). Janzen describes how musical instruments like the drum are utilized in ritual therapy (Janzen 1992). A good example of the therapeutical effect of a healing ritual is the healing method which Margerit practices for her patients (Margerit, Kigoma, 31/08/2012).

Margerit is the wife of a personal friend of Elie. She is a very little and fragile woman in her early thirties. She gave birth to five children, but only two of them are still alive. Her second child was a very smart boy. He was reading the bible when he was just seven years old, without ever enjoying proper education. The year he got eight, his head swelled up and he started losing weight. After three months of suffering he predicted his own death. He washed himself for the last time, heard the cock crowing three times, went to bed and died that very night. Margerit told me she saw a white dove getting of that morning. She says the force of the boy has descended on her. Four years ago, after her boy died, she felt a certain power. She started praying for people who experienced problems with their health. Many people have visited her since then for her prayers. Margerit does not ask anything in return. She gives everybody the time they need to come to rest and the time to share their problems with her. When the patient is able to sit, he can sit on a chair. Margerit imposes her hands on him and starts praying to God. This physical touch stimulates the sensual sense of the patient and indicates the intimate relation between patient and healer. The listening ear Margerit offers and the power of God she intends to share, give the patients a renewed power and

zest for life. Margerit says it is the capacity of God that heals the patients that come to her.

While different traditional healers see the holistic treatment as the central key to the recovery of health, herbalists like Samwali foremost emphasize the healing effects of dawa ‘medicines’ (Bunyemu Samwali, Ujiji, 05/09/2012).

Bunyemu Samwali is a married man with seven children. He lives in his hometown Ujiji where he grew up with his grandfather, who initiated him into the traditional practice of healing. Mzee Samwali is an herbalist healer specialized in fractures of the human bones. He makes his own medicines by mixing different roots of plants and trees together. He has explained me the complexity of the treatment of fractures of the human bone. However, he has done so without naming any of the dawa ‘medicines’ he uses. Most healers are mysterious and rather taciturn about their treatments since these treatments are central to their profession which often constitutes the only income for a big family.

Medicines are boiled and cooled thereafter before they are applied on the broken leg. After this first massage, other medicines are applied on the leg. A wooden mat is attached around the leg with a bandage to give the leg extra support. This bandage has to stay on for five days. When the bandage is removed, the patient has to apply certain medicines on his leg on a daily basis. The patient also has to drink a medicine during the treatment which serves to lower the bone marrow and to enforce the bones.

Mzee Samwali is much known for his specialization. People come from far to visit him in order to receive a treatment for their fractured arm or leg. “The hospital has no medicines for fractures,” he says. “The hospital staffs plaster your leg or arm and make you immobile for several weeks or months. In the worst case, they amputate your arm or leg. Moreover, it is too expensive for most of the African families.” Though, it happens that patients arrive at Samwali’s house with photos taken in the hospital or with their arm or leg plastered. Mzee Samwali claims that his treatment only takes around twenty days for adults and ten to

fifteen days for children. People, who have traveled a long way to arrive in Ujiji, can stay at his home for the time of the treatment.

While Bunyemu Samwali puts a lot of emphasis on medicine, Christian prayers like Margerit rather emphasize the contact with God, diviners focus on the contact with ancestral spirits and traditional practitioners see the relationship between healer and patient as an important element in the healing process. However, almost all make use of dawa in their treatments. What do these dawa stand for? Where do they get them from? How do they extract them?

These dawa or medicines are mixes of leaves, branches or roots of different trees and plants with healing capacities. According to Deo, there are almost no plants that heal when used on their own (Deo Baribwegure, Kigoma, 18/09/2012). These leaves, branches and roots get mixed, dried and stamped or ground to powder. The medicinal powder has to be mixed with fluids like water, tea or oil in order to drink it or to apply it justly onto the body. According to my data, most traditional practitioners and healers extract the elements from the plants needed in the forest themselves. Most even claim to be able to find all elements in the forests nearby, though healers told me they have to travel further once in a while to be able to extract the needed elements from plants that are rather rare or not growing in the Kigoma area (Sharifu Idi, Kasaka, 13/09/2012 and Fabian Isaam Kunga, Ujiji, 18/08/2012). Also the Arabic shops and the medicinal stalls on the market are used as a source to obtain the medicines the healers need for the treatments. Most healers told me they do not buy their medicines on the market on a regular basis. Jerome Mwakamo Abedi said he only buys medicine at the market as an emergency solution. When the situation is urgent, time is short and the supplies are done, he buys the needed elements from the Arabic shops or markets nearby (Ujiji, 17/09/2012).

Mzee Habibu and Rehema Shabani each offered me to join them to the forest to extract roots and plants for medicines. The two forests I visited were both savannah like forests. Since my fieldwork was during the last two months of the dry season, they looked rather arid. They consisted mainly of low vegetation like bushes with groups of bigger bushes and trees in between. I walked with Mzee Habibu and Elie over the hills of the forest of Kararangabo, from which one has a splendid view over Kibirizi and Kigoma. Reheme Shabani took us to the forest near Mwandiga, on the road to Kasulu. She brought a hoe with her and a big linen bag. They walked us through the forest, and stopped at times to give us some information on the plants, to cut some branches and leaves or to dig for the roots of a certain tree. The ease

56 with which both healers moved through the forest shows they know the forest very well and they know exactly where to walk in order to find the needed plants and trees.

Mzee Habibu uses the marandura plant in a mix used as a remedy for different skin problems, also pese. He especially uses the roots of this plant since they are more effective and powerful. Witches also use this plant because of its strong capacity (own photo, August 2012).

(Below) Rehema Shabani digs out the roots of the subisubi tree with her hoe at the edge of the forest (own photo, September 2012).

6.2.1.3. Well-being and Protection When a person is attacked by evil spirits, witches or sorcerers, the person undergoes a protection ritual after he or she is cured in order to be able to block future attacks. Rehema Shabani, a female healer in her early forties and the neighbor of Elie Wamba, told me about two ways of protecting oneself against the attacks of a witch (Kigoma, 29/08/2012).

The first protection ritual is a very common one which is explained me by many healers in other interviews too. Two little cuts are made with a little razor on certain locations of the body, especially the folds of the body. The tattoos are made on the forehead, in the neck, on the shoulder, the elbows, the wrists, the breasts, the belly, the back, the knees and the ankles. Madawa ‘medicines’, called

subisubi, are put on these little cuts. Rehema told me bad spirits often graft themselves onto the folds of the human body when attacking a person. “When your knee or foot is damaged, you cannot even run,” she says.

The second protection ritual is only practiced by Muslims and is a public event. First, Rehema reads specific verses from the Quran called yasini ‘judgement’. Afterwards, different seeds are mixed together: maize, beans, ufuta, peanuts, sorgo, nkunde and mbazi. She puts them in a vase together with coals and ubani ‘incense’. While doing this, Rehema talks to the vase and says: “All those who want to harm you or me that they don’t find us…” Then, they sacrifice a sheep by decapitating it. The meat of the animal is distributed among the family and friends who are present, but the patient itself does not eat from it. The head of the sheep gets covered with a white blanket and gets buried at the entrance of the house of the patient. The patient has to bring the vase to a crossroad where he or she has to throw it on the ground so that it breaks. The person can choose to do this at night or during day. Although, most people do this at night, because they are ashamed or they do not want everybody to know they are doing this.

6.2.1.4. Becoming well and emerging as healer: the case of Mskitu Getting sick is not always caused by nature, evil spirits or witchcraft. It can also be a call for further initiation. In that case, illnesses and certain conditions are caused by ancestral spirits, who have been healers during their lives.

A female healer in her early thirties called Mskitu tells her story (Kasaka, 26/09/2012). She is a very proud and self-assured woman, a characteristic many healers have. She lives in Kasaka and has had twelve children, from which only seven are still alive. When she was young, during her first pregnancy, she got obsessed by a spirit. The spirit directed her to the forest, where she wandered around, totally lost and confused. She got an infection on the breast and airways because of the cold nights in the forest. The condition that made her flee to the forest was caused by an ancestral spirit that took possession of her and was a sign and guidance towards further initiation to become a healer. A male healer, who was looking for plants in the forest, found her and took her home. He took care of her and made sure she got well again. He assisted her during her initiation which

58 was mainly guided by the spirit. The spirit revealed itself in dreams, showing her where to find plants to make medicines from for certain conditions and helping her to choose the right treatment for her patients. Also the male healer shared its knowledge with Mskitu.

Not all spirits will lead people to become traditional healers. Some spirits make a descendant sick to punish him for his neglect. These spirits wish to be remembered, they want a celebration. Only the spirits of a former (related) traditional healer choose a descendant to reveal the traditional healing knowledge to. In the case of Mskitu, the ancestral spirit was of the mother’s family. The grass hut right beside Mskitu’s house is the hut for her ancestral spirit. She has to take care for the hut: keeping it clean and buying things for decorating it. When the spirit comes and tells her what she wants, the offer or ceremony is done in or in front of the grass hut. These grass huts resemble the houses in which the ancestors used to live.

For Mskitu, it is important that her patients also learn about the treatment they receive and the medication they take, not in order to become a traditional healer themselves, but rather as a part of the holistic treatment. Mskitu considers her patients as specialists and experts on their own condition and put a lot of importance to the fact that they understand how she addresses their condition in order to cure them completely. For this purpose, some patients stay for several months in the patient’s house that Mskitu set up just near her own house. The house is full of symbolism. It has one very small door, and it quite dark inside. It is like stepping into the save haven of a mother’s womb. This place is ideal for the patients to come to rest which is very important in a healing process.

Mskitu and her collection of medicines in her house in Kasaka (own photo, September 2012).

6.2.1.5. Initiation: the case of Usein Shabani Not every healer got sick before starting to work as a traditional healer. Many of them got initiated by the father, mother, one of the grandparents or another relative or close friend. This happens when the former notices the child or young person is ready for the initiation and is thought of as having what it takes to become a good healer: the skills, the swung, the feeling and the intellect. Is does not happen often that a healer talked openly about this initiation. They mentioned a few words about it, but never went into detail. The initiation and the conclusion of it, often celebrated with a closing ceremony, is a secret ritual matter.

The Parents from Usein Shabani were both from Mshingisha. In that village, they were well known traditional healers. Usein Shabani started his job as healer in Kasaka in 1981. He has inherited the experience and the knowledge on traditional healing from his both parents. He thus inherited the expertise from two families, the one of the mother and the one of the father. His mother was specialized in toxemia. She taught him about the dawa ‘medicine’ en miti ya porini ‘trees of the forest’. Usein Shabani was the only one from his brothers and sisters who got initiated and now works as a traditional healer.

On the question if he was planning to initiate one of his children, he answered that the oldest daughter has the feeling, the touch and the mind for the job. She has the wisdom to understand and to adapt and she is a person that is always willing to help. When a patient comes, she already actively helps her father. An initiation starts at the moment the parents decide that the child or pupil is ready to be initiated. The initiation of the daughter started eight years ago, when she was twenty years old.

During the initiation there are a number of taboos the pupil has to live by. Shabani gives the examples of lying, which is strictly forbidden during the initiation period. The pupil needs to build a grass hut for the guiding spirits. It is important to keep the grass hut clean and pure and to buy things for the spirits. The initiation is done with the help of two ancestral spirits who guide the initiated one. The two guiding spirits who directed Shabani during his initiation are still beside him today, and can give him relevant information in dreams. When a patient has visited him by day and Shabani has some ideas about what this patient could be suffering from and how he will try to help and treat the person, he can sleep over these ideas by night, and the spirits will advise him what is the best thing to do.

Shabani’s initiation was concluded with a ceremony called kubindigwa. It is done publicly so that the community knows he is the next healer of his family. The whole family is invited. A sheep is killed. The initiated is dressed with the skin of the sheep and taken to the bush. There, he is learned how to take plants and dry them, how he has to use them in treatments and how he has to make dawa ‘medicine’ from it. Most plants that are taken the day of the closing ceremony are samples. Although, a healer learns a lot of medicine during his initiation, that is before the final ceremony is held, Shabani still tries to find new efficient dawa via trial and error research. He has knowledge of more than one hundred medicine, and each of them consists of roots of two or three trees. He mixes all these trees together to obtain dawa (Usein Shabani, Kasaka, 23/09/2012).

6.2.2. Popularity and Succes of traditional healing

Traditional African health cultures last in the urban areas alongside scientific biomedical health systems, as is the case in Kigoma too. Cults of affliction survive the attacks from

Christianity and other spiritual churches and people still consider pills to be more efficacious when paired with an extensive client-healer interaction (Van der Geest & Whyte 1988). Why is traditional medicine still popular in Kigoma? Why does it happen more often that people consult a traditional healer first, before going to the hospital for treatment?

One ground for misunderstanding dates back to the 1960s. In this period of rationalistic optimism, the belief was held that the traditional healing practices in Africa would disappear because of the introduction and the accessibility of western-style biomedical practice (Janzen 1978). Nowadays, in the view of the worldwide economic crisis, effective biomedical programs are becoming far too expensive for a growing number of African countries, owing principally to the cost of training, infrastructure and drugs. Because of the many managerial failures the development of health systems is in crisis. The crisis of the health systems also has a sociocultural component, since the root of many health problems and conceptualization and implementation of healing is cultural (Devisch 1993).

The end of the 1970s thus saw a rediscovery and reevaluation of African healing practices within the African scene (WHO 1978b). This recognition is accompanied by a cultural emancipation and redirects attention to the potential role of healers who live and work in the rural or popular urban milieu (Fassin 1992). It is increasingly recognized that African healing practices with its focus on forces and meaning reconstitute the very regenerative heart of a people’s culture. The WHO reports in 1978: “Since traditional Medicine has been shown to have intrinsic utility, it should be promoted and its potential developed for the wider use and benefit of mankind (…) It has certain advantages over imported systems of medicine in any setting, because, as an integral part of the people’s culture, it is particularly effective in solving certain cultural health problems” (1978b: 13). This last sentence is of major importance in respect to my study on pese and kisigo, since these conditions seem to be untreatable by the biomedical doctors of the hospitals and health centers. Many African countries are subscribing this position taken by the WHO (Akerele 1984). However, actual attempts for further research and collaboration are unfortunately often restricted to the study of traditional herbal knowledge. The failures concerning the promotion of traditional healing within public health care are often due to the fact that the decision makers lack sufficient knowledge of the specific nature of these therapeutic forms (Devisch 1993). They ignore the cultural dimension and the therapeutic skills of these traditional practices. This is also the truth when talking about Tanzania, where the government fails to establish traditional healing

62 practices as compatible to the biomedical practices of the health centers. This is discussed later on in more detail when I write about the Research Unit at the University of Dar es Salaam and Muhimbili and the view of the Tanzanian government vis-à-vis traditional healing.

A first reason why traditional medicine is still important and popular in Kigoma is the failure of introducing the traditional healing knowledge into the public health centers in Tanzania. This pushes these traditional practices into the informal or private sector. The failure of establishing good working biomedical health care has developed into a crisis of this biomedical health care (Devisch 1993). A second reason, which can also be deduced from the information above, is that the medical treatments offered in the hospital are often too expensive for the normal African family.

A national survey in the DRC in 1974-1978 which is guided and reported by Bibeau (1979), revealed that in the towns, most of the healer’s clients turn first to the biomedical health care systems, contrary to what has been commonly held. However, this was before the economic crisis hit the world. The crisis has made biomedical care unaffordable for most of the African population (Devisch 1993). Many other reasons can be the basis on which people rather visit a traditional healer than a biomedical doctor in the hospital or health centers. The most frequently reasons for resorting to traditional medicines that came out of the 1974-1978 survey were as follows: the desire to know the underlying cause of the disorder, the presence of certain symptoms that threaten social functioning, referring to traditional health care by a member of the biomedical institutions because the symptom or the patient’s anxiety seems to suggest the need for closer group support and ritual treatment and the inaccessibility in the area of Western type medicine (Bibeau 1979).

This is partly in line with the information I have gathered during my research in Kigoma. A number of people also claimed to first visit the hospital before resorting to traditional practitioners. The reason why people first visit a traditional healer were again manifold, but the most frequently given reasons were that the hospital and biomedical treatments are too expensive (while healers often ask a chicken or goat, or a smaller amount of money when they know the person is not able to pay full price), that the people suffered from a condition that the hospital was not able to cure or to help with (often conditions believed to be caused by witchcraft or spirits) or that family or friends advised them to see a healer. In my opinion, an

63 important part of this popularity is also due to the fact that people trust the traditional medical system which is inherent to their healing culture. The holistic treatments and the intimate relation between healer and patients are important elements in the healing process that are not part of the biomedical treatments offered in the hospitals and health care centers.

However, critical views on traditional healing practices exist even among the people who make use of it. Elie and Aimée for example, talked about the imprecise doses of medicines, the lack of hygiene and the seemingly arbitrary examinations as the three major problems of traditional healing. At the same time, they believe in the complementary of traditional healing with biomedicine. The capacity of the biomedical health care has its limits. When Aimée suffered from a severe skin condition, the hospital was not able to help. Elie concluded that many of the traditional African illnesses and conditions, the ones caused by witches or ancestral spirits, cannot be treated or cured by the hospital staff. These kinds of conditions need an appropriate and adapted treatment which only a traditional healer can offer (Aimée binja, Kigoma, 27/08/2012).

6.2.3. Witchcraft and Morality: social or anti-social acts?

It is not easy to define witchcraft. It is even not easy to name it, since the English term has quite different connotations than the Dutch word hekserij or the Swahili term uchawi. Witchcraft is a complex matter and many things have been written about it. There are numerous definitions available in the literature. Evans-Pritchard (1937) defined witchcraft as a material substance in the bodies of certain persons which is believed to cause injury to health and property, while Kluckhohn reserved the term to cover “all types of malevolent activities which endeavor to control the course of events by supernatural techniques” (1944: 14). The two also offered a different explanation to the phenomenon of witchcraft, as the first one referred to social conflict and the last to a psychological conflict of oppression. Simmons claims that witchcraft does not lend itself to a simple definition: “Witchcraft assigns meaning to the inexplicable by providing a native theory of failure, misfortune and death” (Simmons 1974: 5). Bond and Ciekaway (2001) write in line of this view that to be able to begin to understand the concept of witchcraft; one has to explore the epistemological and philosophical principles of local knowledge. To understand the phenomenon of witchcraft, one thus has to attempt to understand the manner in which individuals and collectivities manage human problems and seek to explain the world in which they live.

“Witchcraft is more than a mere social construction; Witchcraft is about power and inequality, individual and collective interests, the parameters of belief and action, the conditions of knowing and the criteria of knowledge” (Bond & Ciekaway 2001: 25).

The Commaroffs (1993) also emphasize that rather than being anti-rational, witchcraft provides explanatory descriptions for actions that are morally wrong. Witches can in this respect be seen as “modernity’s malcontents” rather than as advocates of traditions. Witchcraft thus forms a framework of explanations for different actions and events. People believe that when one gets sick, this misfortune is caused by malcontent spirits or by means of witchcraft. An ancestral spirit can bring illness to a descendant and make its whishes public during a healer’s divination. The motives for a witch to make a person suffer can be manifold. Witchcraft can be seen as an explanatory model for events out of motives as envy, jealousy, personal gain but also morality. Witchcraft is related to power and its allocation, resources and mechanisms. As already cited when talking about the relation between modernity, globalization and witchcraft, the recent period of rapid globalization and transformation within the African state, has not made witchcraft to stop to form an integral part of the social life. It has not diminished but rather assumed new forms according to the socio-economic changes and the new modernities (Comaroff & Comaroff 1993).

Stroeken (2010) points to a very specific relation between the witch and the victim, one of intrusion, intimacy and debt. He described the witch as an absolute outsider within. The witch is a “kin or allied one, yet an absolute other in her evil motive and in the secrecy of the action” (Stroeken 2010: 120). A complete outsider will not be expected to have a motive for witchcraft practices. As a member of the same social and normative system, the witch is entitled to compare. To be able to kill, the witch must partake of the system. The Sukuma witch operates within the intimacy of the family or homestead. She has to know the victim. This forms the logic of intrusion. Then, the reproach of violation of shared norms such as solidarity and hospitality may provide the entitlement and access a witch needs to kill. The moral dimension of her actions endows the witch’s exteriority. Her absolute inside position furnishes morality. The paradox existing in the Sukuma society is that patients allege they deserve their illness because of this moral dimension. They thus place the witch’s grudge under the same category as the ancestor’s anger. The ancestral spirit can bring illness when provoked by the descendant’s neglect, like mentioned just earlier. The witch also punishes the arrogant who have violated the social law like denying others respect that comes with social

65 exchange or evading the solidarity that forms the basis of society. Stroeken concludes that the witch thus should be at the heart of society because of her moral power (2010: 120-133).

One can thus ask the question if the witch commits social or fundamentally anti-social acts. Social and anti-social acts are connected to the notions of morality and immorality. In my opinion, the acts in se can be called anti-social. Making someone sick, suffer or die is an anti- social and immoral act in every society. However, the reasons and motives upon which the witch acts are harder to classify. The acts of the witch can be legitimized because of the moral motives behind it. It is striking that Sukuma often think they deserve to become sick (Stroeken 2010: 133). Do they see their misfortune as a just and moral punishment, an important warning, maybe even a possible second chance?

The punishment cannot be just. A witch should be seen as evil. She is not social but rather ‘hyper-social’. In the same way, she is also not moral but rather ‘hyper-moral’. Hyper-moral is not the ordinarily morality but defines an extra dimension. The witch is more evil than evil. Her moral motives lose their morality through her acts. What she does can no longer be seen as moral (Stroeken 2010: 137). She kills or inflicts because of morality without negotiation or warning, without eye for context. Moreover, the power of the witch is not moral because it is unrecognized power instead of being a just authority. From the interviews with the healers I have conducted in Kigoma and surroundings, things seem different in that the witch’s motives are not always that moral: jealousy, pure hate or personal gain. Some, reasoning further on jealousy as motive, claim that when a person is jealous of another, that other may not have followed the social notions of solidarity. And that again would legitimize the action of the witch. Legitimizing actions out of hate or personal gain is not that easily done. The nature of the witch is thus quite ambiguous.

A central discussion of the sociocultural configurations described by scholars as witchcraft has been the question of the belief in the reality of occult forces and practices such as witches, sorcerers and the efficacy of spells and fetishes. Like Geschiere (1992), Bond and Ciekawy (2001), I have the opinion that whether witchcraft does or does not exist is rather unimportant and irrelevant. The relevant issue is that people believe it does exist. It is a reality for the people who (make) use of it. And this reality is an interesting topic that can be and should be studied by scholars as alternative ways to handle and explain social acts and worldly events.

6.2.4. Image of the witch

How is the witch then perceived in Kigoma? Who is doing witchcraft? What are her driving forces and motives? These are only some of the questions one might ask. They are not easy to answer, since the witch is a very complex figure. When the Comaroffs (1993) write that modernism is the witch, they mean that the witch can have many faces according to the rapidly changing social, economic and political context in the recent global setting. Worldwide and in many cultures the link between elderly women and witches is found. Different theories attempt to explain this widely found link. Some say, because she can no longer make herself useful in society, the old woman is only a burden to carry. Because of this people want to get rid of the person and see her as a nefarious person in society. Also the Sukuma men point to the strong outside position of older women because of the fact that they are no longer a candidate for marriage, alliance or other forms of social exchange. In the patrilineal system, older women are outsiders to the clan who became insiders because of marriage. They are insiders because of the social tasks they have fulfilled (Stroeken 2010: 134). Geschiere talks about ‘eating one’s kin’ as the most compelling urge of the witch and thus emphasizes the connection between witchcraft and kinship (Geschiere 1997: 61).

Although witchcraft is often linked to older women, not all witches are female. The interviews I had with healers were very helpful in identifying the witch. While the Sukuma often point to the sengi ‘paternal aunt’ because of debt and the secretly demanded ‘cattle of her lap’, the healers in Kigoma pointed to envious people with bad intentions who are not always related to the victim. To be able to go further on the fundamental question concerning the being of the witch, one has to understand the distinction between culprit/client and the witch which is vivid in Kigoma. Many witches are somehow related to the victim as a friend, a colleague, a neighbor or as family. However, witches can also act in the name of a client. In that case, the witch is not related to the victim. He or she handles out of pure economic self- interest. He/she performs an act against an unknown person in trade for the money from a client who wishes to harm that person. The witch is simply the executor of the wish of the client. Austen (1993) mentions the very useful distinction between anti-personal and impersonal witchcraft. The first stands for attributed misfortune towards peers while the latter stand for manipulation of human material for individual purposes only. He adds that impersonal witchcraft equates the pure attainment of power and wealth (Austen 1993: 91). One can label the witch’s actions not as anti-personal witchcraft but rather impersonal

67 witchcraft here. The hyper-moral character of the witch, discussed in the former chapter, is not applicable in this case. It is the client who acts hyper-moral and punishes the victim out of motives like envy, hate, jealousy. Geschiere writes that it is especially this version of witchcraft, one that consists of accumulating wealth, which prevails in modern times (Geschiere 1997: 5).

Usein Shabani is the only traditional healer I have met during my fieldwork who has told me that next to healing people, he could kill and inflict people too. Thus, he told me that he is a healer as well as a witch. He can perform evil actions towards a certain person if a client would ask and pay him to do so. I was very curious how this was expressed towards the villagers and how they reacted on that. Does everybody of the village know he is a witch? Do people avoid him because of that? To they look down upon him because the evil acts he performs? He answered me that there are two groups in the village. One group that believes he is a witch and has the power to inflict, harm and kill people and a second group who thinks he lies and wants to make fast and easy money. Shabani is not an isolated individual, he is known in the village for his healing practice, and by some, for his witchcraft capacities (Usein Shabani, Kasaka, 23/09/2012).

Interview with Usein Shabani in Kasaka (own photo, September 2012).

The witch has different ways by which he or she can attack a person and perform the act of intrusion. Stroeken (2010) mentions five different forms of attack by which the witch accomplishes her intrusion of the victim, unnoticeably bringing in a harmful substance. From my data, I distilled four forms that match the attacks Stroeken sums up. Though they will be discussed in respect to pese later on, I sum them up here to give a small overview. A first act of intrusion can be accomplished by placing the substance on the road, mostly a crossroads, where the victim often passes. The witch can also throw a harmful substance from a distance or blow the substance over her hand in the direction of the victim. A last method of intrusion is the formulation of a spell while secretly pointing at the victim.

I presume that more of the interviewed healers could have been witches, but admitting this to a foreigner is quite taboo. One will not easily publicly admit performing such acts of evil. That is why Bastian, and I follow his view on this, claims that public recognition is the final and best fight against witchcraft. Witches normally operate secretly and in the dark. Making the practice public does not only put an end to it, but is accompanied by the society’s disapproval and thus constitutes to a social punishment (Bastian 1993: 154). Most healers, when I asked for the relationship between healers and witches, answered me they are the biggest enemies possible. The healer heals while the witch inflicts and kills. They work against each other. Stroeken writes that no one can exchange with the witch, unless one gives up his social identity and becomes a witch himself. The only measures one can take against the witch are protective and healing measures for the self. Healers try to keep up by adapting their medicines according to the principle of the witch, which can be revealed to them in their dreams (Stroeken 2010: 123). However, Deo told me that this is not always exactly the case. People, who possess the skills to do magic, can use it for good and bad. That is the own choice. Many people know and do both. Healer and witch can be one and the same person. Often, that is also the case, Deo claims (Deo Baribwegure, Kigoma, 18/09/2012).

6.2.5. The government of Tanzania and its witchcraft policies

As is already clear from this dissertation so far, traditional healing and witchcraft practices are inextricably intertwined. Geschiere (1997) points to the importance of the continuing salience of ideas about witchcraft for understanding contemporary African societies. This is also the case for Kigoma. For almost all people in Kigoma, witchcraft remains an idiom through which life is experienced and acted upon, as manifested in everyday conversation and means of handling day-to-day ambiguities or means of allocating responsibility. It explains

69 accusations of witchcraft practices out of envy, jealousy, greed, hatred, rivalry, vengeance or misunderstanding, political and economic frustrations and so on (Mesaki 2009). However, witchcraft is also still quite a taboo in Kigoma. That is not only because witchcraft actions are evil and anti-social, it is also because of the Tanzanian law. In this respect, it is important and interesting to have a quick look at the history of the Tanzanian government’s position towards witchcraft reflected in the Tanzanian law on witchcraft practices. I first present a small overview of the point of view of the Tanzanian government vis-à-vis traditional healing, before heading to the law concerning witchcraft.

Form the colonial period onwards, traditional medicine and biomedicine has been practiced alongside each other in Tanzania. Today, the practice of traditional medicine is threatened by several factors. There is a lack of written documentation on traditional medical practices. This has not only made its promotion difficult, it also holds the risk that the traditional know-how disappears (WHO 2001). Usein Shabani told me that the real traditional medical know-how decreases. He has now two students who follow an initiation at his home. According to him, many of the other traditional healers in Kasaka are young men without much knowledge who want to make fast money. There is also a decline in biodiversity in the local forests, which are the traditional medicinal resources (WHO 2001).

Many African countries started with the founding of centers for the promotion of traditional healing (Devisch 1993). In 1974 the Traditional Medicine Research Unit was established as part of the University of Dar es Salaam and the Muhimbili Medical Centre by the Government of Tanzania. The goal of this initiative was to promote and standardize traditional medicine. This is not without problems. The Unit indeed researches on traditional medicine, but that is the only thing they research on. The healing effect of the traditional treatments does not exist of medicines alone. These treatments are holistic and do not focus only on the physical or the mental side of an illness or condition, but address the two as one. The social context of the patient is included in traditional treatment but almost always ignored by biomedical medicine based treatments. As Devisch (1993: 27) writes “(O)ne often ignores how the ritualized gestures of daily life (blessings and curses, invocation of peace, visits of uncles, purifications, and so on) continue to have much impact on the health or mental balance of individuals in both town and village.” Patients are also educated during their treatment about the medicines they take. Mskitu told me that her patients sometimes stay at her home for up to six months. That is what is overlooked by this Research Unit. And thus as Kaba has put it, a pattern of

70 neglect for psychological and socio-anthropological dimensions, and for the clinical evaluation of the healer’s total performance, has become apparent (Kaba 1981).

In 1989, the Ministry of Health has established a Traditional Health Services Unit. This Unit is working to unify traditional health practitioners and mobilize them to form their own association, called the National Association for Traditional Medicinemen. Moreover, traditional health services are officially recognized in Tanzania since 1990 (WHO 2001). The Traditional and Alternative Medicine Act from 2002 provides rules for registration of traditional practitioners, the rights and the duties he or she has to fulfill, offences and finances (Parliament of the United Republic of Tanzania 2002).

Tanzania is surely an interesting case for analyzing witchcraft regulation. The country has a strong national culture nurtured through the Kiswahili language. Uchawi ‘witchcraft’ transcends local and national culture and is part of daily life in all social settings and in all locations. The Government of Tanzania is aware of the importance of the witchcraft problem, but has not yet come to formulate an explicit strategy for dealing with the social problem. A big obstacle in dealing with the problem is that Tanzania, as so many other African countries, is still relying on the colonial legal instruments through which it fails to get grip on the phenomenon (Mesaki 2009).

During the colonization, the British anti-witchcraft strategy in the colonies reflected its own legal history towards the problem. The Tanganyika Ordinance of 1922 reflected the English law of 1735 in many ways. In 1928, the 1922 Ordinance was superseded by an enlarged and harsher piece of legislation (Mesaki 2009). An ad hoc committee on witchcraft was formed in 1958 to assess and review the state of witchcraft in the territory. The committee concluded that the fundamental problem of witchcraft was ignorance, on the part of the government and on the part of those who kept it alive. The revised edition of the witchcraft ordinance of 1965 defined witchcraft as to, “include sorcery, enchantment, bewitching, the use of instruments of witchcraft, the purported exercise of any occult power and the purported possession of any occult knowledge” (2009: 135). The penalty continued to be imprisonment for a period not exceeding seven years or a fine not exceeding 4,000 shillings or to both (Mesaki 2009).

The current legislation on witchcraft matters is the revised edition of 2002 of the law which is named the “Witchcraft Act”. The act refers to the various previous editions (1928, 1935, 1956

71 and 1998) denoting the numerous amendments it has undergone so far. However, there is not much divergence of the former ordinances and stipulations. The government of Tanzania prohibits performing witchcraft practices and condemns witchcraft beliefs by means of penalties as described before, although the content of the concept witchcraft is not by everybody filled in in the same way, as illustrated by the many discussions and following amendments. For further information about the content, I wish to refer to the article of Mesaki (2009) and the Witchcraft Act of 2002.

Legislation against the practice of witchcraft raises the problem of evidence, which is crucial in legal parlance. The biggest criticism of Mesaki and others on the Tanzanian approach is that “the current instruments in Tanzania against witchcraft focus solely on the law, rather than on a wider portfolio of responses which could potentially address their negative social impacts” (Mesaki 2009). In fact, Mesaki joins the opinion of Reynolds (1963:165) who has long advised that witchcraft, like belief in religion or racism, “…may not be eradicated by the stroke of the pen or fortuitous prosecutions...the cure, if this is appropriate expression, is the removal of ignorance by introducing a scientific view of the world through educating the masses". Of course, a new discussion opens the doors when one start arguing about what should be educated. Are we so sure about the validity of our worldview and our ways? The witchcraft act is furthermore very ambiguous since it fails to give a clear cut definition of witchcraft. In the 2009 report of the Legal and Human Rights Centre is written that belief in witchcraft in the country is reinforced and legitimized by the existence of the Witchcraft Act which is a reflection of the societal perception that witchcraft is undesirable and it is necessary to punish those who practice witchcraft. This opinion is also reflected in the journal article of 17 November 2012, written by Abela Msikula and issued in the Citizen, which asks for a revision of the Witchcraft Act.

6.3. The importance of skin in sorcery: a conceptualization of a condition called Kisigo

The previous section attempted to overview the various traditional healing practices in Kigoma and the current legal situation on traditional healing and witchcraft in Tanzania. During the interviews I conducted with traditional healers in August and September 2012, I got especially intrigued by one specific condition which affects the skin and is coupled to witchcraft practices, a condition which is called pese. As I worked further on this one condition, I found out that another name is used in a closely situated village called Kasaka. There, the healers name it kisigo. However, it remains a matter of discussion whether these two names refer to the same condition. At the end of my fieldwork period, a female healer in

Kasaka gave me a classification of five different types of kisigo. In this classification, one of the four conditions had a striking resemblance to pese, as it had been described to me by healers from Kigoma, Ujiji and Mwandiga. The classification I received from the female healer has been the starting point for the present attempt to reproduce a wider conceptualization of kisigo. This conceptualization is of course explorative, needs further research and remains open to further discussion.

Pese and kisigo seem to be widely known among the traditional healers of Kigoma, Ujiji, Mwandiga and Kasaka. However, there is no information available on the internet, in books or any research paper so far, there is no knowledge about pese in the hospitals, no governmental action is undertaken to research this condition and there is no straight forward definition available. Apart from what I collected through my interviews with healers and patients, there is no information on which I can rely to describe this condition. This is a rather exceptional situation and it needs a just approach. Therefore, as presented earlier, I worked out a holistic framework that meant to capture the emic significance of this condition.

This explorative and qualitative study is based on 27 interviews with practitioners, patients and medical staff of the local hospital during my two months of fieldwork in the Kigoma region in West Tanzania on traditional healing practices. Focus is put on one specific condition named pese (Bembe language), also named kisigo (the local Kiha language). Attention is paid to the different explanatory models of practitioners on and the experience of patients of this condition. By looking to these from different angles, I want to describe the condition in all its important aspects. But how can one study a condition that “does not allow for generalized or definite statements about prevalence, burden and presentation?” as Karin van Bemmel expresses in her article on the Nodding Syndrome in Uganda (van Bemmel et al. 2013). She concludes that one can learn more about a condition by looking at the various and distinct discourses and their development. The meaning of illness terms is the result of their position in a semantic network negotiated in dialogue (Pool 1989). Therefore, I paid a lot of attention to the narrative dimension of this condition. I did so by interviewing healers and collecting illness narratives from patients, from which it is possible to reconstruct a conceptualization of the condition from different angles. The different discourses on pese and kisigo are synthesized into a handful of categories, as presented below.

6.3.1. Pese: the illness narrative of Aimée Binja

The first time I heard of the condition called pese was when I met my translator Elie for the first time. I decided to do a small interview with Elie in order to get to know each other and to get to know his background and point of view in relation to traditional healing and witchcraft before starting my further research. He started talking about his wife Aimée who had suffered from a severe skin condition, almost not curable. She was scratching herself all the time. He took her to the hospital for several tests but nothing was found and no treatment helped. The hospital staff gave her injections in the morning and evening, she did all the possible tests a person can undergo but in vain. The hospital could not find what his wife was suffering from. Relatives who had more knowledge on condition of this kind, told him that this was an ‘artificial’ disease, caused by someone. They told him that his wife cannot be treated in a hospital and that he must go see a traditional healer. With the situation getting worse, he had no other option than to try every possible solution to stop this disease. During the interview, he repeated several times that his wife had suffered a lot. In total, Elie contacted five different Congolese healers. All five said his wife was suffering from pese. They gave powders of certain trees to drink and to put on her skin. It was the fifth healer who finally was able to cure his wife. It took about six months before she became healthy again.

A week later I visited Elie at his home near Mwanga market and I met his wife Aimée Binja. She talked to me about her experiences with pese. She explained me how the skin condition started in April 2008. She started to have an itchy skin and irritations that resembled scabies on her arms, and later also her belly and breasts. Scabies is defined by the WHO as “a contagious skin infection that spreads rapidly in crowded conditions and is found worldwide. The principal sign of the disease is a pimple-like rash. Scratching of itchy areas results in sores that may become infected by bacteria” (WHO 2013). Thinking she had scabies, she went to the pharmacy and bought a tube for treating scabies. At first, when applying ointment, the rashes disappeared. However, after one month the itching started again. She started cutting her nails preventively to avoid the development of big wounds on her skin as a result of the scratching. Still, she could not help but scratching. After a while, her skin developed rashes and she got the appearance as suffering from the measles. She was having a high fever. The itchy feeling was enormous. She was scratching all the time. When she was sitting on a chair, she was shaking. She was no longer at ease.

In August, the rashes and the itchy feeling worsened and Aimée decided to go to the hospital. In Maweni, they asked her if she already had got the measles as a child or on a younger age. Aimée did not have any idea and she could not ask her parents, since they already had passed away by then. The hospital staff thus prescribed her medicines and gave her several injections of antibiotics and anthelmintic, a drug against parasitic worms. After three days there was no positive evolution, on the contrary even, the skin of Aimée got worse and worse. After a week the hospital decided to start a strong treatment existing of one injection of antibiotics in the morning and one every evening. But even this treatment did not change the condition of Aimée. That was the moment when the hospital said they could not help her. An older lady who was a friend of the family, was shocked by Aimée’s appearance and told her not to go to the hospital again. “This illness”, she said, “cannot be treated in the hospital. You have to visit the fetishists; they will tell you what you have. They will be able to help you.” By then, Aimée was developing black spots on her hands, she was not able to sleep anymore because of the itchy feelings and her skin looked terrible.

Elie had already told me that he and his wife had visited five different healers before Aimée got finally healed. The reason is not that the former four were not able to heal the condition of Aimée. Rather, it is a question of migration politics in Kigoma. All healers Elie and Aimée visited, were Congolese. This is a logic choice since Elie and Aimée are both Congolese themselves. Also, the condition of pese is believed to come from the Bembe people of Eastern Congo. However, many of these Congolese healers had problems with the local migration officers. The first healer for example, was sent back to Congo after the second week of treatment. He was an illegal refugee and was forced to return. The second healer they visited gave her medicinal leaves to put in water to wash her skin with and to take as enemas. Her body inflated but she also started feeling better. However, also this healer got send back to Congo by the migration officers. Aimée was obliged to visit a third healer to help her with her condition. She started developing spots on her eyes too. The sight of Aimée got worse, she was not able to see clear anymore. The third healer gave her medicines for her eyes too. The medicines he gave her for her skin, had to be put on the skin by the healer himself. Her nails started falling out. After a while she started developing even more spots. She could barely sleep, it was hard to wash herself and every position was painful. It was clear that this treatment was not helping Aimée. They decided to visit a fourth healer for a second opinion. He warned them to stop seeing the other healer. He offered Aimée medicines to drink and to

75 applique on the skin. After two months, he had to travel somewhere far for his w ork. This interrupted the treatment for a while.

At this point, we are already four months further. It is December 2008. The old woman, who had advised her earlier, was surprised when she visited Aimée and found her still sick. This time, she herself searched a healer for Aimée. She brought her in contact with Jerome Mwakamo, an expert on pese. Aimée and Elie are laughing when they tell me about Jerome and how he has examined Aimée. He was talking to a little bottle with a black fluid substance in it. He positioned it in all possible ways next to Aimée’s body and asked questions to the bottle. Aimée and Elie heard a little but not understandable voice. Jerome gave her mvuko. These are certain leaves, which he puts in a pot of water above a fire. Aimée had to hang her head, which was covered by a blanket, above the damping pot. There was essence burning at both sides of her. She could not see anything and it was hard to breathe because of the smoke. She told me she felt very anxious. She felt like if she was suffocating because of all the smoke around her head. Fifteen minutes later the towel was removed. Aimée felt relieved. The mvuko defiled her whole body. Jerome gave her this mvuko to wash herself with and as a purging clyster/enema. He also inspected her excreta, because this condition also affects your intestines, like measles do. Change was visible after three days. The scratching diminished and she was able to sleep again in the night. Her nails grew back and the black spots disappeared little by little.

Jerome in his house in Ujiji (own photo, September 2012).

From February onwards, she started feeling much better. However, she kept on using palm oil and fat to spread on her body in order to avoid irritations on the skin. Jerome had warned her that because of the storage of all kinds of medicines in her body, cysts would grow. That is the problem of traditional healing according to Aimée. There is no precision in dose, only estimation. Furthermore, there is a problem of hygiene and conservation. Jerome told her to go to the hospital afterwards for a checkup. They removed seventeen cysts.

According to the healers, Aimée was the victim of Bembe witchcraft. She said: “Selon eux, c’est une poussière qu’on jette et que si tu passes, ça te touche. Ils m’ont dit, c’est peut-être quelqu’un qui a de la jalousie et qui a mis le poudre sur la chaise…” (According to them, it is dust that someone throws and when you pass by, it touches you. They said me that maybe somebody is jealous and has put this powder on the chair…). This powder is a mix from the skin of elephants and other things. Somebody can put it on your chair or they can blow it at you. Jerome had asked a lot of questions, Aimée remembered. He wanted to know if Aimée had any enemies, if she had a problem with somebody, or if this attack could have been intended for a family member. Aimée knows that somebody did this to her, but she does not know who. However, she does have a suspicion. She heard that there was a woman who did not like her. She broke contact with that woman and only greets her from a distance. Aimée underwent a protection ritual after she was cured from pese by Jerome. She got two little cuts, also called tattoos, on her head, breast, both of her arms, belly and legs. In these little cuts, medicines are put. It should protect her to any kind of witchcraft.

6.3.2. Discourses on Pese: trying to define a mysterious condition

My interest in pese grew as the illness kept coming up in the following interviews with traditional healers, often without explicitly asking for it. In this chapter, I present you a synthesis of the different information about pese that I collected from my interviews with traditional healers in Kigoma, Ujiji and Mwandiga during August and September 2012.

Mzee Habibu is a healer living in Mwandiga, but his grandparents come from Uvira, West DRC. This is an interesting fact since pese seems to be a product of Bembe sorcery, as many told me. Mzee Habibu often asks his patient to go to the hospital first, get an examination there and come to him with the results. He will then start the treatment. However, not every condition can be found or treated in the hospital. Fabian Kunga also stated that the sick go to the hospital but cannot always be helped there because of the complexity of the disease they

77 are suffering from. They hear from the doctors that they suffer from an incurable disease. Therefor, many of them start thinking that there are (bad) spirits involved.

Mzee Habibu gives the example of pese. The reason why this condition cannot be detected in the hospital is because it is caused by uchawi ‘witchcraft’. He mimes the way in which witches throw the spirits towards somebody, a movement which concentrates the five fingers and then suddenly opens, throwing the powder mix or spirit from under the nails. Shabani Husseni Saidi, a traditional healer with Congolese roots now living in Ujiji, mentioned pese among the five diseases he has to treat most often as a healer. Pese is a condition by which one experience continuously itches. Buttons and black spots develop on the skin. Patients will even use knifes to scratch themselves. A liquid substance leaves the wounds on the skin. People even have to cut the nails in order not to peel their own skin of. Habibu himself has suffered from this condition. He treated himself with a mix of different medicines and coconut oil. Habibu claims that as a healer and a former patient, he can recognize at a glance if somebody is suffering from pese. The itchy feeling is so strong that people cannot stop scratching. In that, it is different from other kinds of skin infections or rashes. According to Fabian Kunga, the condition develops a similar appearance as leprosy, in an advanced stage. Patients have a hot feeling, like a constant fever, and they sweat a lot. This condition also manifests inside the body. The person develops wounds on the intestines and even in the eyes, comparable to a form of cataract. Because of the wounds on the intestines and the big fatigue from sleep deprivation, one can die from pese. It is thus important that the condition is treated fast, as fast as possible. It also depends on the resistance of the body of the victim and of the strength of the mix, how fast the condition worsens.

Jerome Mwakamo Abedi is the healer that treated Aimée and cured her from pese. He is a proud man and declared himself a specialist on treating pese. He told me pese is a Bembe name, as this condition comes from Bembe sorcery. One can mix death toads, chameleons, leaves of plants and other ingredients together to make a powder. While mixing, the sorcerer is declaring out loud who is the victim and what will happen to him or her. Jerome stresses that the spell is a very important facet of the preparing process of pese. While he was praying for Aimée’s health, he got a revelation in which he saw the hands of two persons. This is a sign that Aimée was bewitched. The one hand was of a man, the other hand of a woman. According to Jerome, the man tried to bewitch Aimée first but failed. The woman tried it a second time. Together they managed to bewitch Aimée. According to Jerome, the motive to

78 do so was jealousy. Aimée has four healthy kids, a lovely husband, a nice house and a good job.

If one wants to bewitch another, he or she will look where the intended victim passes a lot, Habibu declared. The witch will prepare her powder mix, and blow or throw it at the victim when he passes by. The powder is a strong mix of different things like membranes of animals, but also of men, toads, chameleons and plants. While throwing the powder from under the nails, the sorcerer can say who the intended victim is: “I send you to X to bring misery and suffering”. Again, the formula or spell is an important element of the act. Of course, there are more ways to send pese to somebody. Fabian Kunga said a witch can also put the powder on the hand balm and blow it in the direction of the wind, saying a certain formula which directs the powder towards the victim. The wind will make sure that the powder reaches the victim. Also, a witch can put the powder on the hand while shaking hands with the intended victim. A fourth possibility that Fabian Kunga sums up is putting the powder on the chair of the intended victim. Kunga as well as Habibu claimed they do not know how to make this powder or how to send it. After some time, the condition will start to manifest on the skin step by step, and gets worse and worse. Fabian says the condition starts where the powder has touched the skin of the victim. According to him, the condition is not contagious since it is not caused by bacteria but by sorcery.

The remark of Fabian Kunga deserves some extra explanation. One has to be careful and pay attention to the context when using the concept ‘contagious’, since the connotations that accompany the word are culturally loaded. It is important to understand the Western perception in which illnesses and diseases overcome a person. The person himself is not to blame for his condition. The person can be marginalized because of the possible danger people perceive for their own health. This isolation in Western health care has nothing to do with morality and is thus an amoral act. In the Bantu societies in Africa, for many illness cases, this social distance is not perceived in the same way. Witchcraft, as a framework for explaining all sorts of actions and events, offers explanations for someone’s health condition. When a person is affected by pese for example, the question whether or not pese is contagious, stands in strong opposition with the question whether or not the condition is evilly intended. When witchcraft is involved, people will worry less about possible health effects. They will rather

search for possible moral intentions because when a witch attacks a person, morality is always involved. So, the person can be blamed for his condition and can be socially marginalized not because of health matters, but rather on moral grounds. Taussig (2011: 17) comments in this respect that “a person who breaks a taboo, for example, is likely to be an object of dread, full of some evil toxin that can spread to other people.” Taussig mentions Freud (1950) who refers to this dread as "contagion" in his book on taboo. A person, who does not behave according to the central values of the Bantu cosmology, can be punished by the witch through her ‘moral power’ as is discussed in detail above. Pese affects the skin, the public part of the self, and is thus for everybody to be seen. The victim cannot escape the social judgment to be seen by society.

Pese is a not that often occurring condition. It seems that it is only used to make somebody feel uncomfortable and suffering. According to Mzee Habibu, there is also another possibility to send pese, which does not come from the Bembe but is rather typical to the region of Kigoma: by using the force of the jinn. They can make you become mad, epileptic or paralyzed. Jerome stated that Aimée was bewitched with the force of jinn. Jerome adds that the spirits of people who died from pese can also be sent to make somebody sick. He heard that witches knock on the graves of the ones that died from pese. When the spirits emerge the witches dictate them what to do to who. According to Fabian however, pese is always prepared by a strong powder mix and has nothing to see with bad spirits.

Lucy Mtenga, an older woman working in the pediatric section of the Maweni hospital in Kigoma, is quite skeptic about pese. She told me that a correct examination of somebody who claims to have pese, often reveals another skin disease like the measles, chickenpox or a skin infection caused by a lack of hygiene. But again, many told me, that in the case of real pese, the hospital is not able to track the cause of the condition. They seem convinced that the hospital is not able to treat a complex condition like that.

Before we proceed to discussing the treatments for patients suffering from pese, I present a quick summary of what one can understand under the notion pese from the available information listed above. There are a number of elements often mentioned when talking about pese. The itchy feeling, the rashes, the development of buttons on the skin and the scratching of the skin seems to be basic symptoms of the condition. However, I am not sure if pese is

80 recognized that easily, since most healers told me about how the condition is examined. Probably it is visible from the skin that a person is suffering from something, but to be sure it is pese, further examination is needed. Pese has a negative effect on the intestines and the eyes. The condition is caused by somebody with bad intentions, the witch. The witch throws a powder mix or sends a bad spirit to the victim. The spirit that is sent can be a spirit from somebody that has died of pese, a jinn or another evil spirit. The witch calls the spirits and dictates it what to do to who while sending it away. According to Mzee Habibu, sending a spirit to invoke pese is a local Kigoma variant on the Bembe sorcery which exclusively works with powder. The powder is blown from the hand palm towards the victim, or she can make a movement concentrating the five fingers in one point en then abruptly opening the hand, so that the dust underneath the nails gets thrown at the victim. Another option is putting some of the powder in the hand palm and shake hands with the intended victim or putting some of the powder on the chair of the victim. The condition starts developping there where the powder has touched the skin. The interviewed healers named the condition as magic of the Bembe of the DRC.

6.3.3. Treating Pese

In this chapter I discuss the treatment of pese as given to me by Mzee Habibu, Shabani Husseini Saidi, Fabian Kunga and Jerome Mwakamo. This information is not complete since the healers are not keen on giving away their secret information and knowledge on treatments. “That is giving away my income, it is of great value since I live from this” Jerome declared. Even if the information on treating pese is not that elaborated, it is still interesting to list it up to get an idea of how the process of healing is performed.

Fabian Kunga is very short on the treatment of pese. He mixes certain medicines with water. This mix is used in three different ways. Something that is seemingly typical to the treatment of pese. The patient has to wash himself with this water, he has to put it on the skin (mixed with lotion or oil) and he has to take it as an enema, injecting it into the anus with a pump.

Mzee Habibu declares that when there are jinn involved, the first thing to do in the process of healing is chasing the jinn away. This is done by putting a pot with water and strong medicines on the fire, while the patient keeps his head, covered with a blanket, above the damping pot. The jinn will start to shout and scream. If the jinn leaves, the person falls down. When he gets up again, he feels much better. When the jinn has left, Mzee Habibu can start

81 healing the patient. The treatment for pese that he uses exists out of two steps. First, the patient washes himself with dermatologic soap, then an ointment made of mwavi leaves, marandura roots, grains of the mninga tree and coconut oil is applied on the skin. They have to do that during four days, two times a day. After the whole process, the patient undergoes the process of protection which happens according to what is discussed earlier. Two tattoos are made on several points of the body, a medicine mix from the mlanga mia and the mtopetope are put in the little cuts as means for protection.

Shabani Husseni Saidi says that from the moment a patient with pese walks in, he is able to see the bad spirits in the eye of the client. For knowing who this bad spirit is, the client’s head is covered by a small blanket, he sits on hands and knees above an illuminated incense stick and a pot of damping dawa ‘medicines’. The spirits go up to the head of the victim and talk through his mouth. Shabani will invocate his spirits. The spirit in his head will talk to the bad spirit of the client. The bad spirit will tell who has sent ‘it’ to the victim. This can be everybody, every person with a bad intention towards the victim. Most of the time, it is a person from the direct environment of the victim, such as family, neighbors and friends. At the end of the conversation, the spirit will order the bad spirit to leave the body of the victim. However, this is not the end of the treatment. The skin and body still need extra care. The further treatment consists of the use a powder that is made from the roots of different trees and plants and is boiled in water. The victim has to wash himself with this water; he can also drink the water or inject it. I heard in many of my interviews that when a medicine is used to wash, it means it clears the body from spirits. The powder is also mixed with lotion to put on the skin. So, here we see again the three usages of the medicines that were also mentioned by Fabian Kunga. After treatment the victim comes back for a final check-up, if things are fine he can undergo the protection ritual. This control after treatment is something Shabani Husseni Saidi does for every disease that has its origin in witchcraft.

Jerome says his treatment consists of five steps linked to the five dimensions of the condition. The first thing to do is praying for the patient to purify his aura and chase the spirits. Secondly, he will give certain black watered medicines in jerry cans to wash the skin with and apply on the skin in the morning and in the evening. This will make the skin fine and normal again. The third thing to do is injecting the medicines to chase away the spirits and treat the wounds on the intestines. The patient also has to drink the medicines in order to take away all the dirt in the body. When drinking the medicine, it is possible that the patient has to vomit or

82 will have diarrhea. This ensures a fast exit of dirt out of the body. Finally, before the patient goes to sleep, he or she has to apply the medicines on the forehead and on the thighs. As to the time of the treatment, Jerome does not fix a period. It all depends on the level of advancement of the condition.

We see that when a spirit is involved, the first thing to do is chase the spirit away. This is often done in a similar way. The patient has to sit on the hands and the knees, his head covered and above a pot of damping medicines. Afterwards the treatment of the skin starts. We see certain regularities between the different treatments, in that most medicines offered for pese, are used in three different ways within one treatment. They are used to wash the body with, in order to clean the wounds and to make the itchy feeling disappear. The medicines are applied on the skin, mixed with coconut oil, as a kind of lotion. Finally, the medicines are also injected into the anus with a pump to heal the intestinal wounds. The medicines have the primary goal of an intense cleaning of the body, outside and inside. Very often, as discussed earlier, the patient undergoes a protection ritual as conclusion of the treatment. Important to conclude with, all four stated that the hospital cannot help when the condition is caused by witchcraft or spirits.

6.3.4. Pese and Kisigo: “Je, pese ni tofauti na kisigo au la?”

When I started conducting research in Kasaka, I was struck by the fact that the healers there did not know pese. At first sight not, anyway. Because once I started explaining what I meant by pese, healers answered me they called it kisigo. But the similarity of these two conditions is not as clear-cut as some present it. It seemed to me that pese is much more the result of bad- intentioned witchcraft, while kisigo is caused by the angry spirits themselves, called kisigo (ibisigo in plural), which could catch you when walking next to river banks or mountains during some moments of the day.

Visigo is a term which is not unknown for the healers outside Kasaka. It is a widespread Kiha concept, also known in Kirundi speaking and neighboring Burundi. When I asked for kisigo, Mzee Habibu could answer me these were demons, living in dirty places. They are invisible, but when you meet them, you can get sick. Kisigo stands for different conditions. When one develops buttons on the skin, a healer can say: “you have met the visigo”. Also Jerome Mwakamo made the distinction between pese and kisigo. He classified pese as Bembe sorcery, reproduced in Kigoma. Kisigo is a disagreement from ancestral ancestors and bad

83 spirits, he says. In that case, the condition of a person is a message of the ancestors that they want to be heard.

Usein Shabani lives at the right outermost side of Kasaka. When I explained pese, he answered me he knows the condition under another name: kisigo. It is not healed with modern healing. Deo Baribwegure told me kisigo is a concept which includes many often mysterious or hardly explainable conditions. According to Shabani, kisigo it is the local name for all kinds of infections, illnesses and conditions you can get from nature or by natural cause like plants, bacteria and so on. You can get sick when you go to river banks, at the end of a certain rain, early in the morning, in the evening when you go home a bit late. Then, one says you met the visigo. The visigo spirits or mashetani ‘devils or bad spirits’ go along the flow and the rivers. They are no family spirits, but rather water spirits. You start scratching your skin and by doing so you spread the infection over your whole body, and even to others. Your whole skin is burning. Sharifu Idi, a traditional healer who comes from Kihinga but moved to Kasaka in 1975, described kisigo to me as heavy scratching of the belly caused by bad spirits found near the water and rivers. He emphasized to me that this is not uchawi, ‘witchcraft’. There is no human intervening. It is the spirits who attack the person. However, Shabani claims that a strong witch or sorcerer can be able to send a kisigo spirit from to river to a certain person.

Sharifu Idi and me during an interview in the house of Sharifu Idi in Kasaka posing with some of his dawa and Arabic medicinal books (own photo, September 2012).

The mashetani have to be chased out of the body of the patient before one can start treating the physical condition. The patient has to sit on the floor on his hand and knees and hang over a pot of damping medicines, the head covered by a blanket. The mashetani shouts and cries and will finally rise up and leave the body. Now, once the spirits left the ufahamu ‘consciousness’, nimeenda ‘it is over’ and the person is healed. Shabani gives the patients medicines to drink and to use as body lotion to make the rashes disappear and to stop the itchy feeling. He adds that it is a quite frequently occurring condition. But as one can understand from the explanation above, it is also a very wide term with a lot of condition and illnesses classified under it. Some areas are known for the risk of getting kisigo because of geographical features like presence of water and climate. The condition occurs more often in these places because of rivers or the lake, like is the case for the Kigoma region and the other regions surrounding Lake Tanganyika. The condition cannot be treated in the hospital. Only via the creative solutions and the traditional know how from the periods before contact with Europe and biomedicine, a condition like kisigo can be treated.

At the end of my research, more clearance about the link between pese and kisigo came up when Koenraad Stroeken and I interviewed a father and his daughter who are both traditional healers and live in Kasaka (Mskitu, 23/09/2012, Kasaka). They told us that there are five different types of Kisigo and that one of them corresponds to pese. The father told us that the Kisigo spirits can catch people without the intervention of a witch. In that case it is the demon itself which enters you and makes you ill:

“Unaweza ukapita mtooni ukiwa na bahati mbaya, ukakuta kimesitarehe mahali ila wewe hukioni. Yaani ukapita, ukasikia kinalalamika, kwa nini ananikanyaga, kikakukemea. Ndiyo anapatwa na tatizo lile.” (Mskitu, 23/09/2012, Kasaka) You can pass by a swamp, have bad luck and find yourself positioned somewhere where you don’t see them. When you pass by, you hear them lament: “Why does he walk here over us?” and they reprimand. It is at that moment that you are caught by this problem.

About the appearance of the Kisigo spirits, the father told us the following.

“Ni umbile la sisi watu vilevile. Tena kana rangi nyekundu kama yenu hiyo […]Na nywele unakuta ni ndefu zinafika mpaka huku. Katika kiswahili wanasema “shetani” wengine wanasema “jini”. (Mskitu, 23/09/2012, Kasaka) It has the shape as we have, the humans. Moreover, it has the colour red like you have (the Europeans). Even their hair is long. In Swahili we call them “lishetani” or “jini”.

As discussed later on, we were told that there are five different types of kisigo referring to five different conditions. They are however not all caused by the kisigo spirits. In several cases the name kisigo is given to conditions which are not easily explainable, not easily understandable and untouchable. These mysterious conditions often get linked to witchcraft practices in negotiations about the possible cause of someone’s condition. Deo Baribwegure gave me different possible understandings of the term kisigo. The term can refer to illnesses and conditions you get from the bushes, often related to water. You only get these at certain moments, for example early in the morning, but also late in the evening or after heavy rains. In the bushes, it is dark, Deo explained. You have no idea of what is hiding in there, like father Mskitu also declared in the quote given above. That is the moment when you can meet the ibisigo. The person gets sick from the ibisigo or mashetani ‘evil spirits’. The term kisigo can also point to something inside the stomach. However, this should not be taken too literal. Deo told me this can be conditions that in biomedical terms would be named cancer, pneumonia, severe abdominal cramps or heavy diarrhea. In the biomedical world, most of these conditions would probably be fought with heavy antibiotics or other medicines, Deo explains. The holistic treatments offered by the traditional healers are creative solutions from the long period before there were hospitals and local health centers available in these parts of Africa. All these conditions are called ibisigo (plural of kisigo or igisigo) because of the government politics towards witchcraft. The government has forbidden the belief in sorcery and witchcraft, as is discussed earlier in this dissertation. They do this in order to prevent eventual conflicts between different autochthones, according to mister Mskitu. It is for this reason that one speaks of ibisigo, the daughter confirms. But all are evil spirits or witchcraft practices.

Kisigo thus became the name for the illnesses caused by the kisigo spirits, without human interference, but also for witchcraft practices and even for diseases for which there is no real explanation ready. Pese is also a condition that fits in this broad description. How does kisigo

86 manifest itself? Is it always visible from the physical appearance that somebody is suffering from this condition?

“Ninao watoto wadawa wa ujauzito tumbo lilikuwa linanyonga ndivyo tunasema kisigo; au wanatokwa na maupele yanavimba au yanatokea kumwasha eh kwa wengine huwa wanasema fankasi lakini sisi tunasema ni visigo. Huwa yanatokea tena huku sehemu za sili unakuta ana madonda hata akiwa mtoto mdogo.” (Mskitu, 23/09/2012, Kasaka) I have children who have been born thanks to my medication, who would have succumbed to threats of abortion during pregnancy, known as "IGISIGO"; or one can see buttons appearing on the skin that swell or cause itching, some often refer FANKASI but we say IGISIGO. It often attacks the genital part: we see patients, even small children, develop sores.

Mystery has many names, some call it pese, others kisigo, still other fankasi. And this list is endless. One could conclude from this quote that the condition is visible from the patient’s appearance because of the buttons developing on the skin. The outside look of the patient does not always show that the patient is suffering from kisigo, as one can read from the quote of Mskitu below. The itching is central to the description of kisigo, as is the case for pese. The fact that it attacks the genital parts is something I heard for the first time in this interview with father and daughter. But it is not that surprising, since a lot of skin conditions develop easier in the folds of the skin..

“Anaweza kutokuwa na upele wara nini, tumboni unakuta panawaka moto. Na kila kitu, ila akijinyamanzia unaweza kumwambia wewe una kisigo kwa sababu naona tumboni unawaka moto na yeye yule mgonjwa anasema naamu ulivyosema ni sawa.” (Mskitu, 23/09/2012, Kasaka) He (the patient) may not present buttons or anything on the outside, while his womb/intestines are burning with fire. He can say nothing but when you observe him, you can say him, "you have a demon because I see your belly is on fire" and he will say that what you are saying is true.

Talking about who is most vulnerable for these conditions, the daughter said that it can happen to everyone: children, adolescents, babies, grown-ups and aged peoples. And like one

87 can deduce from the two previous quotes, the manifestations of the illness vary. Some present buttons that swell and itch, others do not develop these. Some get diarrhea or worms, however most healers did not mention this.

“Hata mtoto mdogo anaweza kutokewa kuvimba akapasuka, au akawa na mabaka ya vimbalanga au akawa na lidonda likubwa sehemu za sili unakuta anakunya hovyo, au kuwashwa sehemu za sili, au unamkuta ana minyoo, sisi tunasema ni vishetani.” (Mskitu, 23/09/2012, Kasaka) Even a small child can inflate and burst, develop colored spots on the body, have a large wound at the genitals, show diarrhea, or have roundworms (intestinal worms). We're talking of evil spirits.

“…Eeh na wale wanakuwa na mabaka meusi, tunasema kama vile ni kisigo. Yanakuwa na mabaka meusi wanaweka chungwa yanasafika tu; lakini badaaye yanajirudia harafu yanaleta ganzi. Yote tunayaita ni kisigo.” (Mskitu, 23/09/2012, Kasaka) And others may show black spots, we call it "ikisigo." These are black spots, often one tries to heal them with orange juice, but it makes them only disappear for a moment, after a while the problem reappears and then it also causes paralysis. All this, it is called "igisigo."

During the conversation with the father and the daughter, I explicitly asked what the difference between pese and kisigo was, since they did not seem to have exactly the same cause or manifestation. Pese is always caused by witches or people with bad intentions; a powder mix or evil spirit gets thrown at the victim. Kisigo is not an unambiguous concept and can have several causes which are not always linked to human actions. The answer I got explained me that there are several types of kisigo and that pese can be counted to one of the subtypes of conditions classified under the broader term of kisigo.

“PESE ni ibirozi vy’ikibembe lakini hapa tunaviita ni mashetani. Mashetani tuyajumlisha yote yana tabaka nne au tano : kuna kisigo cha MPINIRA, hiyo wanaoita PESE sisi tunasema ni kishetani NYAMABUBA, kinakutoa ngozi, kuna kile cha kuvimba, kuna kile cha mabaka.” (Mskitu, 23/09/2012, Kasaka)

Pese is witchcraft practiced by the Babembe, but here we are talking about evil spirits. We classify all evil spirits into four or five categories: there is gisigo named Impinara, this is the one known as Pese, and we call the bad spirit Nyamabuba: he will tear your skin; it is him who makes the human body swell and causes spots (on the skin).

Mskitu also links pese to the Bembe of Congo. As mentioned above, there are five different types of Kisigo, corresponding to five types of spirits. The five different spirits were summed up by the daughter as presented below.

“Kuna kisigo cha NYABURO, hari igisigo c’IMPINIRA, hari INTIIMBITSI, n’igisigo c’ikawaida rero kirya c’injwiri cirabura. Na kisigo museru yaani INTIMBITSI-MUSERU” (Mskitu, 23/09/2012, Kasaka) There is the spirit called NYABURO, the one called IMPINIRA, one called INTIIMBITSI and the ordinary spirit, the one with black hair and finally the kisigo MUSERU which is also called INTIIMBITSI-MUSERU.

From these five kisigo spirits - Nyaburo, Impinira, Intiimbitsi, Museru and the ordinary kisigo spirit - Impinira is the one that corresponds most to pese. However, there all still differences one can spot, given below. So we can ask ourselves if one of the two, be it pese or kisigo cha mpinira, is a more recent development or represents a local mutation of the other.

After Mskitu presented all the kisigo spirits to us, Koenraad Stroeken and I started asking questions about each single kisigo spirit. We started to ask further information about the spirit Mpinira, the one that was said to be the spirit to cause the kisigo comparable to pese.

“Mpinira huwa inatokea tabaka kama mbili : unaweza kuwa unawashwa unavimba, au kwenye ngozi panatokea kama pale pameunguzwa na moto ipo inatokea hivo, harafu tuna nyingine ambayo panatokea kama vile umeungua na maji baadaye panajichana. Hiyo ni Impinira na huwa tunasema ni impinira yafashwe n’igikoko c’impinira.” (Mskitu, 23/09/2012, Kasaka) “The mpinira manifests itself in two ways: you can feel the itching followed by swelling or the skin may look as if it was burned by fire, so there is the one that appears like this. And then there's another one that makes the skin appear as if it

was burned by hot water, and after it begins to tear. It is also Impinira, and it is often said: "Such a person caught the parasite impinira!”

Here, there are similarities and differences visible with the notion of pese that can be formed from the earlier data. The itching, even swelling, or seemingly burned skin can easily be linked to what is earlier said about pese. Also the tearing of the skin is not surprising. Several healers told me that fluid substances come out of the wounds on the skin cause by the continuous scratching. The element that a spirit causes the illness is also often named when talking about pese. However there were never parasites mentioned. Pese is said to be made and thrown by somebody through a powder mix or an evil spirit. When we look at kisigo cha mpinira, we are facing a condition that is caused by nature, by parasites or by natural spirits living close to the water.

“…Sasa hiyo mnayosema yaani PESE, hiyo ya kuchubua, huwa wanaunganisha mashetani tunasema ni uchawi wa kienyeji.” (Mskitu, 23/09/2012, Kasaka) “…And the one that you just mentioned, PESE, who tears the skin apart, to become it, one has to combine different sorts of sorcerey and we name it local poison.”

Here, the question if pese or kisigo represent a recent and local mutation of the other moves again to the fore. If pese is caused by a mix of different elements and witchcraft called ‘local poision’, the witchcraft origin of the condition is recognized and explicitly stated. This contradicts the Tanzanian law which says that witchcraft beliefs are illegal (Mesaki 2009). Does kisigo then represent a local mutation on this Bembe witchcraft, based on the legal system of Tanzania which copes, according to Mesaki (2009), inadequately with the challenges of witchcraft because it does not accept the reality of it? Or are pese and kisigo just two different conditions with some similarities but different causes? These are difficult questions that need further research in order to be able to answer them with more certainty.

Asking about the other kisigo spirits, we first asked for kisigo cha ntimbitsi.

“Kuna wakati mtu anakuwa kama vile ana utapiamlo. Anavimba lakini anaweza kuwa anapasukapasuka ukamfanyia lishe ikashindikana ndipo tunasema ni NTIMBITSI.” (Mskitu, 23/09/2012, Kasaka)

A given moment somebody appears to be suffering from malnutrition. He inflates although his body also starts to become very skinny. You try to put him on a diet but in vain. It is then that one speaks of INTIMBITSI.

While kisigo cha mpinira grafts itself on the skin, kisigo cha ntimbitsi puts your whole body out of balance. The belly inflates in a way that is also typical for edema caused by malnutrition. Even if you try to put the person on an adapted diet, the situation does not change. Abdominal cramps and heavy diarrhea are secondary symptoms of this condition.

A third kisigo that was mentioned in the interview was kisigo cha nyamabuba. The description of this condition is very similar to kisigo cha mpinira and pese. While the mpinira version makes the body swell up like burned skin, tears the skin apart and makes one develop buttons on the skin, the nyamabuba variant gives you the appearance of somebody suffering from leprosy. The last variant develops black spots on the skin, a symptom I heard often when talking about pese too.

“Kuna mtu anakuwa na madude kama vile ukoma anavimba na kuwa na mabaka meusi harafu baadaye anakuwa na madude ya upeleupele.” (Mskitu, 23/09/2012, Kasaka) And then what about the spirit Nyamabuba? Someone may have stuff like leprosy: it swells, with black spots (on her body), and afterwards it develops something like buttons.

Mskitu was not very clear about kisigo cha nyaburo, although she mentioned an inflamed skin as the main symptom. She also did not give further information about the ordinary kisigo spirit. I can imagine that many and even divergent conditions fall under this variant since kisigo stays a broad term for many untouchable conditions. I am thinking in this respect about a strong fever, severe stomachache and other aches in limbs and body.

The classification of the five forms of kisigo contains more interesting and rich cultural information than I have been able to report here. It is a pity that I met the family Mskitu only towards the end of my fieldwork. If I had met the family earlier, I could have transcribed the interview after a first visit in order to process the information carefully and to be able to ask very specific and focused questions in a next meeting. More time to discuss with father and

91 daughter Mskitu could have enabled me to work more detailed on the classification of kisigo and its relation to pese. Etymological research of the classification could have helped analysing the rich metaphors that lie in the names of the different forms of kisigo and could have shed more light on the relation between pese, kisigo, the Bembe people and Kigoma. Further cultural research could maybe as well have revealed if this classification, applied on kisigo, is a well-known and widely used local classification.

To conclude the interview on Sunday the 23rd of September 2012, I asked father and daughter Mskitu how they can help people suffering from kisigo. Interestingly enough, they did not answer as I expected them to do. Unlike the others, they do not always start by chasing the kisigo spirits away to continue by treating the skin and intestines. Rather, they stated that the need to chase away the spirit is only there when the spirits has acquired control over the victim to the extent that the person gets mentally ill. When this is not the case, a single medicine is enough to cure the patient and make the rashes and intestinal wounds disappear.

“Tunatumia dawa yakufukuza mashetani kwa mtu yule ambaye kinampanda hadi kumkuta amegeuka kama mwehu, maana upepo wake ulisha mganda ; na hapo ndipo tunatumia dawa ya kukifukuza lakini ikiwa ni hii ya kuleta upele au moto tumboni anatumia dawa tu na palepale inapona.” (Mskitu, 23/09/2012, Kasaka) We use a medicine that will chase the spirits away, only in the case that the patient is traumatized by the spirits to the point that he or she became mentally ill. In other words, his spirit already has him under control. It is in this case we will use medication to chase the spirit. But if it is a demon that simply causes pimples or burns in the womb, we only use a single drug and it cures directly.

6.3.4.1. Conclusion What seems to be an important difference between pese and kisigo is the fact that pese is not always caused by evil spirits. With pese there is always a human agent involved. A witch can throw an evil spirit at her victim; in that case the spirit will cause the illness. But she can also opt for a mixture of plants and dead animals to throw in order to evoke pese. Different sorts of sorcery are used in the process of evoking pese. The appearance of a person who suffers from pese can vary. One can develop fear rashes, buttons and even black spots on the skin. The intestines of the patient are also affected, the body can inflate and the eyes can develop a form

92 of cataract causing a diminished sight capacity. Dissimilarities occur when comparing pese and kisigo. This questions the fact if pese really is a subcategory of kisigo. It even questions if pese is the name for one bordered condition or rather a collective name for more different manifestations of a similar condition with different causes, like kisigo seems to be. In my opinion, none of these names have a strict definition or uniformity and consequently, it is not easy to define them. But how I see it now, kisigo cha mpinira and kisigo cha nyamabuba have strong similarities with the condition of pese and can surely be compared. Although the cause is explained in a different way, the physical symptoms are quite similar. And one has to be careful with the argument about different causes, since the Tanzanian government politics towards witchcraft can maybe have influenced this.

Father and daughter Mskitu in the ancestral grass hut built by the father for his guiding ancestral spirit (own photo, September 2012).

6.3.5. A conceptualization of Kisigo

As final facet of attempting to conceptualize the conditions of pese and kisigo, I like to capture these conditions into my central framework based on the three bodies of Scheper- Hughes and the seven facets of emotions according to Shweder and Haidt. Some of these seven facets, like the somatic element, are already discussed in detail above. As I already have

93 discussed the physical development of pese and kisigo, I will thus not elaborate on these topics again. However, it is important to keep in mind that these somatic elements are important factors in shaping the social consequences that a victim of pese and kisigo experiences.

The affective element is not discussed so far. It indicates the subjective experience of the person suffering from the condition. During my fieldwork, I have only once had the chance to speak to a person that suffered from pese. Aimée told me she feared that she would never return to her initial health. The uncertainty of getting well again kept her mind busy the whole time. She felt quite okay one minute, while one minute later she felt incredibly sad and hopeless. She was continuously nervous and could get tantrums when things got too much for her. Aimée had difficulties talking about her condition, but at the same time, she could not hide it from her social environment. She got consolation from her friends and family who supported her with encouragement by saying that the condition will pass again. But then again, Aimée met people who told her that the condition is harsh and would not end that quickly. That could make her courage disappear again.

The personal consequences of having a certain condition, the collective perception and the speculation about possible causalities, are parts of the second body or the social body, in that they all relate to how people in a society perceive, talk about and react on a particular condition of somebody. Since pese severely attacks the skin, which forms the visible and public side of the self, one cannot hide the condition from the social environment. This is not without effects.

Speculation about the causality of an illness or a condition is as old as humankind. As I mentioned earlier, pese and kisigo are no well-defined condition but rather quite wide concepts. Deo told me kisigo is a concept which includes many often mysterious or hardly explainable conditions. You can get sick when walking through the forest or near the water, seemingly without any specific cause. Then, people start to speculate about the possible cause of your condition. In Africa, unexplainable conditions are often interpreted from out the own cosmological framework as caused by ancestral spirits, evil spirits or witchcraft. Like I already wrote earlier, when witchcraft enters the stage, the question whether the condition is contagious or not seems less important than the question whether the condition is evilly intended. People start negotiating on possible witchcraft involvement and search for possible

94 moral intentions to strengthen this hypothesis. Consequently the person can get blamed for and socially stigmatized because of his medical condition. The result is social isolation not because of health matters, but rather on moral grounds. The victim cannot escape this social judgment and that is exactly the intention of the witch.

After seven to eight weeks, Aimée felt like she had turned into a monster. Her skin looked terrible and she got socially isolated. People who did not know her personally would avoid passing her by or getting close to her. Some even ran from her. Her whole body was covered with wounds. Even her friends were asking questions because they had never seen something like this before. Her husband kept supporting her with whole his heart. His commitment towards her helped Aimée to fight against her condition.

In the biomedical world, most of these conditions would probably be explained in terms of bacteria or malfunctioning of body cells and organs. Interestingly enough, not all conditions can be found or treated in the hospital as gets clear from the interviews with the healers and from the illness narrative of Aimée Binja. Then, many of them start thinking that there are (bad) spirits involved. That is the same in the case of pese and kisigo, where both conditions are explained in the frame of the realm of an unseen world of witchcraft and spirits. For pese, where the cause is witchcraft, this speculation leads also to accusations of the offenders of the attack. In the case of Aimée Binja, the question rises if the bewitchment can be linked to the fact that she is a Congolese woman and thus a foreigner immigrated to Kigoma. We already shortly touched the fact that the people of Kigoma and especially the immigration officers are not keen on Congolese immigrants. One can understand that if a person is not fully accepted within a group, this makes him or her a number one victim for witchcraft attacks. Aimée Binja is not sure who bewitched her, but she has a suspicion and keeps those women at a distance. She still greets them, but will never approach them for a conversation.

How can one react on an attack by witches or spirits? In order to know what one is suffering from, people visit traditional healers, who possess the traditional know-how in dealing with these evil forces. The diagnosis reveals ‘what’ has caused the condition but ‘who’ is not mentioned. The replacement of the continuous uncertainty by certainty of the cause, the condition and the treatment, already has a healing effect. Often, when the healing process is concluded and the treatment has succeeded, the patient undergoes a protection ritual. This ritual exist of making two little cuts with a little razor, also called tattoos, on certain places of

95 the body like the forehead, in the neck, on the shoulder, the elbows, the wrists, the breasts, the belly, the back, the knees and the ankles. In these little cuts a medicine is applied. This protects the patient of any further attacks of witchcraft for several years. This is also what Aimée did. When it became clear that the hospital could not help her, she visited traditional healers in order to return to her initial health status. Once she was cured, as a conclusion of the healing process, she underwent a protection ritual. Pese changed Aimée’s life increasingly. Aimée told me that periodically, some buttons develop again on her skin. From the moment she gets rashes, the fear of getting sick again overpowers her immediately.

6.3.6. Skin and sorcery: skin as boundary of the social self

The skin is central to the conditions discussed in this dissertation. In this chapter I like to present some theories about why the role of the skin is also important in relationship to witchcraft and healing in Kigoma. What is the role of skin in human life? Why is the skin often concerned with witchcraft and sorcery? Why is the skin attacked by evil forces?

The surface of the body has been of great interest since the beginning of anthropology. Anthropologists have projected their understandings of society, commonalities and cultures onto the skin (Schildkrout 2004). The skin, the physical boundary and the visible public side of the human body, forms the immediate point of contact with the physical world outside and is thus the niche for expressing social notions. Van Gennep (1909) also describes bodily transformations when discussing the rites of passage which form the transition from one social status to a new social status. Being the outer self of a person, the skin symbolizes the point of contact between the person himself and the social forces that surround him. Feelings can be expressed on the skin too. Strathern (1975) writes about the very complex notion of shame known by the Hagen people of Papua New Guinea which is described as being ‘on the skin’. When persons feel shame, they say in Hagen that their skin breaks out in a sweat. Europeans also say they start to blush when there are embarrassed, or they get red in the face when they get angry. In both cases the internal feeling triggers off an external sign which is on the skin.

The body expresses social notions by means of decorating, covering or uncovering, types of dress and so on. The Yaka for example perceive the body as the pivotal point from which the subject gradually develops a sense of identity. The body is a relational tool which, when in balance, ensures your health (Devisch 1993:139-146). Showing the social status seems to be a

96 concern of every human society. The skin plays an important role in this. As Terence Turner writes “… the surface of the body seems everywhere to be treated, not only as the boundary of the individual as a biological and psychological entity but as the frontier of the social self as well” (T.Turner 2007: 83). In this, the skin becomes the symbolic stage upon which socialization is enacted. Individuals affirm their social status in society by applying tattoos, scarifications and paintings on the skin and piercings into the body (Schildkrout 2004). This is desired and done consciously. Having the feeling of being in harmony with society, expressed through symbols of socialization, gives people a save feeling.

Schildkrout (2004) writes that bodily inscriptions have a lot to do with boundaries; boundaries between self and society, between different groups, and between human and ancestral world. Turner follows him in this view:

“The surface of the body and thus also the skin becomes, in almost any human society, a boundary of a peculiarly complex kind, which simultaneously separates domains laying on either side of it and conflates different levels of social, individual and intra-psychic meaning. The skin is the concrete boundary between the self and the other, the individual and society” (T.Turner 2007: 103).

People form groups through bodily decorations. Such groups consist out of people who are members of the same community, people who have the same social statuses or youth that has been through the same initiation. This can for example be compared to tattoos, colorful hair and piercings found in the punk groups in the Western world. People redefine the social boundaries and redefine the self by decoration of the body. Gell (1993) refers to a "double skin folded over itself" which mediates relations between past, present and future. With tattoo, "the body multiplies and subsidiary selves are created; spirits, ancestors, rulers and victims take up residence in an integument which begins to take on a life of its own" (Gell 1993: 39).

Like tattoos or piercings, dress can be an important factor in socialization, but also a haircut or the painting of the body can express social notions. Turner writes very detailed about dressing codes among the Kayapo. He makes the point of the importance of cleanliness in the Kayapo notions of property in bodily appearance. To be dirty is considered not merely slovenly but actively anti-social and seen as a threat for the health of the unwashed person. An elaboration on this is that health is perceived as a full integration into society, while illness is

97 an encroachment by natural and animal forces upon the social world (T. Turner 2007). This connection of beauty and health to the social dimension offers an explanatory frame for witchcraft practices which attack the appearance of somebody. If the witch wants to make her victim suffer and exclude him from society, making him visibly sick is a good way to do so. Transformation of the skin is visible to everyone and can constitute to the perception of the ill and excluded subject. In this respect it is interesting that many healers from Kigoma told me that when a medicine is used to wash the body with, it means it is used to clear the body from evil spirits.

The article of Todd Sanders (2001) about skin trading and occult forces, again emphasizes that the skin is seen as a very important border of the human self. In the article Sanders discusses six cases of people who were murdered and skinned in the Mbeya region in the south of Tanzania. The skins of these people were allegedly offered for sale in the neighboring countries of Malawi, Zambia and the DRC for the use of witchcraft activities. According to many Tanzanians, the motive for these killings was private economic and political gain. The human skins are wanted by sorcerers in order to compose powerful concoctions that which are potent to make one richer, more successful and more powerful. A Tanzanian workman declared that when a government position becomes vacant, lots of people go to visit diviners in Bagamoyo to get these powerful medicines. This puts attention to a significant link between human skin, occult forces and wealth. The notion of using human skins of body parts for occult medicine is foreign to the Ihanzu of the Mbeya region as Sanders notes in his article. He adds however that ‘few would deny that others across the country, region and the continent routinely use human skins and body parts to generate illicit wealth through occult means” (Sanders 2001: 169). This is also exactly the case in Kigoma. Healers say they don’t have the habit of using skins or body parts from people in the production of medicines, they would not even know how to. However, they admit that some surely do, without pointing at anybody in particular.

Schildkrout (2004) makes a very interesting point in respect to witchcraft when he points to the essential ambivalence of skin as boundary. He ascribes this ambivalence to the possibility of subverting the individual agency by externally imposed inscriptions. Tattoos, scarifications, and brands can be imposed by authoritarian regimes as a punishment or even as a symbolic denial of personhood, like in the Nazi concentration camps (Schildkrout 2004). The skin can get modified and attacked by external individuals or groups. Skin is often involved in sorcery

98 and witchcraft because it constitutes such a strong attack on the outermost physical boundary of the human self. Decorating the body and the skin to express and affirm social notions is done consciously. Pese on the contrary, which also has a visible effect on the skin, happens unconsciously, unwillingly and unintentionally to a person. By attacking the skin, the witch also commits an assault on the socialized status of the victim and his capacity to live his normal live. The repulsive appearance of a person suffering from pese and kisigo forms a mismatch with the accepted social appearance of a person in a certain community and is a public indication of bewitchment. This has a big impact on the victim's life. Bewitchment is believed not to merely hit a person without reason. The negotiations held within the community on the possible cause and moral intentions of the condition, are an enormous burden to carry for the victim. Pese and kisigo can thus be seen as being social conditions. The appearance of the patient makes clear to everyone that the person is bewitched. The victim does not only suffer physically from his condition but can also not escape the social judgment of the community. This isolated suffering is the exact intention of the witch. In the case of pese and kisigo, not only the skin is severely attacked when one suffers from pese or kisigo, but also the intestines are affected. This indicates the very strong intrusive power of the witch.

6.3.7. The Unspoken Third: Bembe People of the Western shore of Lake Tanganyika

As I emphasized earlier on, it is important in every research not to lose eye for the wider context of the subject of study. Also for the study of pese and kisigo, it is thus important to take a look at how these conditions are embedded in its context. This is not an easy task, since the information on these conditions is very limited and not always within my reach. However, in a first attempt to contextualize pese and kisigo, I take a look at what information is available on the Bembe of the DRC.

Several practitioners told me pese is a condition coming from the Bembe magic. In search for the origins and the broader context of the condition of pese, I thus went looking for any information I could find about the Bembe of the Democratic Republic of Congo (DRC). Quite fast it became clear to me that only few research is conducted on the Bembe. Ethnologue estimates the number of Bembe population on 252 000 in the Democratic Republic of the Congo in 1991 (Lewis et al. 2013). They are located on the western shore of Lake Tanganyika, in the Sud-Kivu Province and the Fizi territory. Biebuyck states that the ethnical situation of the western shore of Lake Tanganyika is extremely complicated. The land of the

Bembe is far from homogeneous in language and culture (Biebuyck 1981: 11). There are also Bembe living in the Kigoma region and the Eastern shore of Lake Tanganyika in Tanzania, although Etnhologue does not give any information on their numbers apart from saying that they are only few. Some of them are Tanzanian citizens; others are recent immigrants and citizens coming from the DRC. The Bembe of the DRC must not be confused by the distinct Beembe of Congo Brazzaville and the Bemba in the southeast Katanga Province and Zambia.

As the Bembe are rather undescribed, searching for historical and ethnographical accounts on the Bembe is not an easy task, however it would be very interesting to find information on pese or linked healing practices. I did find some very interesting art-historical works on Bembe statues like the book from Biebuyck (1981) and the article of Simon and MacGaffey (1995). Art-historical works can reveal interesting data on illness, since African artworks and especially masks, were sometimes used to represent afflictions and illnesses during ceremonies as means of moral warnings or to commemorate immoral ancestors (Van Damme 1996). Unfortunately, it does not happen often that illness is represented in statues. And all the Bembe art works that I could find a description of were statues. There is nothing to find that was really relevant for my research on pese. For further information on the Bembe, I strongly recommend the book of Biebuyck.

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7. Discussion

In this work I have presented my research on traditional healing practices in Kigoma, a city in the north-west of Tanzania. My research started from a very broad scope in which I focused on the different stages of the healing process as a holistic and social event. During my fieldwork my subject got more and more narrowed down until I started focusing on the conceptualization of one specific but unknown skin condition.

In the first part of the section ‘Results’ the traditional healing practices in Kigoma are discussed. With the help of a number of case studies, the different steps of a healing process are addressed. Traditional healing has an important role to play in current African societies. I have explained what can be the reasons for the popularity and the success of these holistic treatments. I have also touched on some problematic issues concerning traditional healing. I mentioned that a number of young healers have emerged without really mastering the traditional know-how, and this reportedly for the purpose of fast money-making. Also, critics speak about the sometimes arbitrary examinations and the seemingly random doses of medicines. On the other hand, people also commented that the biomedical hospital had its limits. The many benefits linked to the promotion of traditional healing need to be mentioned. Institutionalized promotion could lead to the disappearance of malpractice and deceit. One can reach wider networks of people while these people can enjoy a careful follow-up during and after treatment. Biomedical health-care could learn a lot from the holistic approach and the personal touch of traditional treatments. If the hospital and the traditional practitioners would work together, the best of both worlds could be combined. It would be very interesting studying the possible cooperation of these two forms of health care in the current - not only local but also urban - societies of Africa. Moreover, traditional healing constitutes an important and wonderful piece of local culture that should not get lost for future generations.

Witchcraft is extremely intertwined with traditional healing and the relationship between the two is a rather complex one. Witch and healer work against each other, however, it occurs that the witch and the healer are one and the same person. Morality is discussed as a key element of witchcraft practices. The witch is neither moral nor immoral but rather a hyper-moral individual. She represents irrevocable, unilateral and cruel acts towards others without any authorization.

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Skin is the public side and the outermost boundary of the self. Because of this, skin is the symbolic stage on which socialization is enacted. People decorate their body and skin to express social notions. An attack on the skin is an attack on the person, influencing his social situation. That is why skin is often involved in witchcraft practices. The victim cannot hide the fact that he or she is bewitched. Consequently the judgment of the witch expressed through the suffering of the victim is seen by the community. The victim gets stigmatized and socially marginalized.

Pese and kisigo are examples of conditions that affect the skin. I have discussed pese and kisigo in further detail in this thesis, but more research needs to be done. Pese and kisigo seem unknown outside the region surrounding Lake Tanganyika, while within this region every healer is familiar with the skin condition. There has been no earlier research on these conditions. I have collected numerous amount of data from my fieldwork, but since my fieldwork was limited in time and no other sources than my own data are available, this is a rather explorative work. Further research needs to be undertaken to find out what these conditions exactly stand for. The relation between pese and kisigo is also not yet completely cleared out.

In this respect, it is interesting to refer to an article of David-Bird (2004) on illness images from the Nyaka, forest-dwelling hunters of South India. In the beginning of this article he writes about a condition called batha.

“ (…) batha does not refer to a particular disease or a class of ailments. This Nayaka category (…) transcends western conceptual divisions and refers both to medical problems and to other misfortunes that Nayaka remedy through trances and divinations.” (Bird-David 2004: 325).

It is very probable that pese and kisigo do not refer to any particular disease or ailment either, but that these conditions form a local category which is broader than the western concept of medical condition. I addressed the probability that pese and kisigo would be named cancer, pneumonia, severe abdominal cramps or heavy diarrhea in biomedical terms, but then again; the striking issue remains that the hospital seems not able to diagnose the patients suffering from pese and kisigo, let alone that the hospital staff can treat the condition. Bird-David

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(2004) claims that it is not unusual in the non-western world to classify medical condition and misfortunes together.

A central concept in sensory (or ‘sensual’) anthropology is intercorporeality. Weiss writes in her famous work on body image: ‘‘to describe embodiment as intercorporeality is to emphasize that the experience of being embodied is never a private affair, but is always already mediated by our continual interactions with other human and nonhuman bodies’’ (Weiss 1999: 5). Intercorporeality is then the embodiment of exterior relations and classes in each individual’s body and body-images. Bird-David, concerned about the western-centrism in Weiss’ work, emphasizes that intercorporeality in respect to the Nyaka people is rather “a relational conception that does not see the individual as plural, but rather as joined inseparably to fellow beings” (2004: 13). The concept of intercorporeality redirects attention to local medical conditions that are unkown or not directly and obviously visible to outsiders of a particular culture. There are (cultural) conditions, ailments and afflictions that outsiders just do not perceive or at least not in the same way. These conditions can be stated to be seated ‘in-between-physicalities’, for example in the way people behave towards each other. People in Africa maintain a different body awareness than is dominant in the Western world. This is noticeable in the way people are staring at or speaking to each another. Certain behaviors and conducts are culturally linked to specific conditions. Outsiders can be blind to these conditions. Applying the concept of intercorporeality can open doors towards a series of conditions so far unknown in biomedicine. A person who is allergic to certain products and often gets plagued by severe skin rashes, has to deal with the physical aspects of the rashes, but also with other physical and the mental aspects of his allergy. The broad insights of the concept of intercorporeality can surely help to acquire a new perspective on unknown conditions like pese and kisigo.

Bird-David (2004) applies the concept of intercorporeality to a condition known by the Nyaka and called batha. Batha, from which the symptoms resemble the ones of tuberculosis, are illnesses and misfortunes for which the dodavaru are responsible, as distinguished from ailments that are classified as related to naturalistic causes. The dodavaru are mythic ancestors and naturalistic spirits with whom the Nyaka believe to share the world. Batha is all about inter-subjective relatedness and social skills of living with one another. In discussing batha, one should not speak about the Cartesian ‘autonomous self’ or Weiss’ ‘plural self’ but rather about ‘joined beings’. Nayaka perspectives focus on ‘persons-in-touch’ rather than on

103 the singularized ‘skin-bounded body’. If in some cultural images the skin binds and isolates ‘the body’ from the ‘outside’; in local Nyaka experience it equally connects bodies. The skin for them constitutes the interface as much as the boundary between social bodies. In this context, batha-illnesses are not thought to ‘invade’ the ‘skin-bounded body’, but rather come ‘between’ body-subjects. Having batha means something is wrong with tactility, and more broadly with one’s ‘touch’ toward others in the community, and especially with the dodavaru

(David-Bird 2004: 331-337).

I discuss batha here rather extensively because it is an excellent example of a non-western medical condition that can be brought into comparison with pese and to a lesser extent also with kisigo. Batha does not only graft on the lungs, it also has a lot to do with behavior and relations within the community. Pese, as originated by witchcraft forces, has moral implications. A person gets inflicted by a witch because of negative feelings like jealousy and hate, next to greed and self-interest. The first two motives can arise because the inflicted person’s behavior was not in line with central Bantu values. Batha is a condition that comes between persons-in-touch. Good communicative skills are central in the Nyaka community. In batha, the afflicted person is the recipient of an anger that is released by joined others who could not repress their feeling. The fault does not lie with the inflicted person here, but rather with the others who could not control their feelings and communicate in an appropriate manner. The first concern of the Nyaka community is to deal with the physical condition and to heal the social wounds within the community. Intercorporeality is a very important concept in healing this condition. The Nyaka people are described by David-Bird (2004) as joined beings and then healing is important for the while community. In the case of pese, one can equally state that the condition comes between body-subjects. The condition constructs a social divide strengthened by negotiations on moral implications, however the cause of the condition is perceived differently. This can be linked to what Pollock (1996) writes on Kulina illnesses:

“Kulina illness beliefs are an "idiom of distress" with social as well as bodily and spirit referents. As in many other cultures, illness among the Kulina is not merely a social commentary on bodily states and processes, it is also a kind of commentary bodies and spirits make on social processes,” (Pollock 1996: 338).

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Within the Kulina community, Illness and infliction thus form a commentary on social processes. This is also sometimes the case for Kigoma where pese is the result of the social verdict of the witch or client.

As Bird-David mentions, the symptoms of batha resemble the ones of tuberculosis. One can as easily discover similarities between the physical symptoms of pese and kisigo and the symptoms of leprosy. Leprosy is an infectious disease caused by a bacillus that mainly affects the skin but also the peripheral nerves, mucosa of the upper respiratory tract and the eyes (WHO 2012). Linking pese and kisigo to leprosy seems obvious to do. However, leprosy is a well-known illness in the Kigoma region with a name of its own. So, there is no reason to assume that people of Kigoma rename this medical condition and create so much mystery around it. Moreover, leprosy can be diagnosed and treated at the hospital, while this does not seem to be the case for pese and kisigo. However, studying the concrete relation between pese and kisigo on the one hand and leprosy on the other could bring forward interesting information and views on these two mysterious conditions.

Because several questions on pese and kisigo still remain unanswered, I would like to end this thesis with a warm recommendation for further research on pese and kisigo, on skin and sorcery, on the Bembe and on the Kigoma region. A historical approach to the conditions could shed more light on the relationship between pese and kisigo and on the evolution and the developments of these conditions in the area. Etymological research can be an important facet of this historical approach. In order to work out an elaborated conceptualization, more people who suffered from these conditions need to be heard. The social effects that suffering from a condition like pese and kisigo can have for the victim are a promising research subject as well. By focusing on this, the phenomenon of social exclusion on the basis of moral intentions rather than health issues can be explored deeper. It would be a very interesting subject to study and compare the different societies around Lake Tanganyika to see if pese is found in all bordering areas. In this thesis I have also tried to contextualize these conditions in a wider perspective by addressing the unspoken third, the Bembe. It is said that pese originates from this group living in the north-east of the DRC. Unfortunately no ethnographic or socio-cultural research has been done on these people before. Finally, working further on pese could also shed more light on the interesting link between skin and sorcery, which has been a major topic of this thesis. As much as a matter of discussion still.

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8. List of Interviews

Elie Wamba, Kigoma, 18/08/2012 Fabian Isaam Kunga, Ujiji, 18/08/2012 Habibu Mzee Ibrahim Kibore, Mwandiga, 20/08/2012 Shabani Husseni Saidi, Ujiji, 21/08/2012 Pastor Victor, Kigoma, 23/08/2012 Aimée binja, Kigoma, 27/08/2012 Rehema Shabani, Kigoma, 29/08/2012 Docteur Chantal, Kigoma, 29/08/2012 Margerit, Kigoma, 31/08/2012 Mzee Mwalekwa Omari Bakari, Ujiji, 03/09/2012 Alan Mwanza Matafwali, Msimba, 04/09/2012 Bunyemu Samwali, Ujiji, 05/09/2012 Fabian Isaam Kunga, Ujiji, 05/09/2012 Doctor Muganga, Kasaka, 06/09/2012 Mzee Mwalekwa Omari Bakari, Ujiji, 07/09/2012 Rehema Shabani, Mwanga, 07/09/2012 Usein Shabani, Kasaka, 12/09/2012 Sharifu Idi, Kasaka, 13/09/2012 Jerome Mwakamo Abedi, Ujiji, 17/09/2012 Deo Baribwegure, Kigoma, 18/09/2012 Lucy Mtenga, Kigoma, 18/09/2012 Mzee Habibu, Mwandiga, 20/09/2012 Usein Shabani, Kasaka, 23/09/2012 Mskitu, Kasaka, 23/09/2012 Mskitu, Kasaka, 26/09/2012

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