Understanding ‘Illness’

A study of illness among clients and leaders of Candomblé in Rio de Janeiro, Brazil

Report from a Minor Field Study by Magdalena Brzezinska

An Exam on D-level in Department of Cultural Anthropology and Ethnology Uppsala University Supervisor: Titti Schmidt April 2004 Understanding ‘Illness’: A study of illness among clients and leaders of Candomblé in Rio de Janeiro, Brazil.

ABSTRACT This study describes and analyses understanding ‘illness’ among clients and leaders of the spiritual tradition Candomblé in Rio de Janeiro. The study focuses on the individuals’ narratives of illness and of healing rituals within the cult. Particular attention is given to the consultation ritual called jogo de búzios, which is one of the main practices of finding the reason for the illness as well as its cure. The emphasis in this study is on the necessity to look at medical pluralism, the socio-individual context of illness and narrativity as an intersubjective practice. The conclusion is reached that illness within Candomblé ideology can be understood as disequilibrium in a person’s lifeworld. The individual is approached from within the plurimedical context of both biomedical and Candomblé healing tradition in Rio. Here it is argued that the person creates meaning of the illness in relation to different aspects of his lifeworld. The individual’s lifeworld includes the urban context of Rio de Janeiro; therefore a brief discussion is developed about how this context influences the individual meaning production of the illness. The Candomblé house is described with its social structure and other elements that are important for understanding how the cult might work for the clients as an alternative and/or complementary medical treatment. The study progressively introduces and analyses the lifestories of the individuals that approach the Candomblé cult in order to seek treatment. It also is concerned with stories of the Candomblé leaders and their view on the phenomenology of the Body, the Self and the social milieu of the person. Finally, the study emphasises the importance of studies that focus on the individual’s interpretation of the relations between the Self and the Body, and the individual’s understanding of medical knowledge and practice.

Keywords: Illness, Candomblé, Rio de Janeiro, medical pluralism, lifeworld, narrative, medical knowledge.

2 ACKNOWLEDGEMENTS I owe thanks to many people who have assisted me in various ways in completing this study. I would like to thank all of the persons that were interviewed. I take the opportunity to especially thank Rosangela, Sajemi and Elisabeth. Their thoughts and experiences made a great contribution to this study as well as their friendliness and hospitality during my stay in the field. I am also greatly in debt to my assistant in the field Mr. Erik Vieira, whose help was extraordinary. De Araujo family and their friends in Rio took their time to help me with information and practical arrangements when they were needed. I am also grateful for the assistance of Mrs. Beatrice Pereira de Andrade. To my supervisor in the field Prof. Rita Laura Segato with family, I am thankful for inspiring conversations, advises and for her hospitality and friendship. In Sweden, I would like to thank my supervisor Titti Schmidt for her endless patience, for guiding me throughout the writing and for all comments and suggestions. I wish also to express my gratitude to my friend Ms. Evangelina Villar Fuentes for fruitful discussions, her help and support to overcome difficulties along the way. At the Department of Cultural Anthropology at Uppsala University I owe thanks to all persons who showed their interest in my study and shared their knowledge with me. My thanks go to SIDA (Swedish International Development Agency) for the generosity in the financial enabling of the field study in Rio de Janeiro. My gratitude is also due to Dr. Tyrone Vieira and his family, who helped me to apprehend the Brazilian-Portuguese language before the field trip. Finally, I would like to thank Mrs. Maria Vult von Steijern and my friends for encouraging me throughout the study.

3 ABSTRACT ...... 2 ACKNOWLEDGEMENTS...... 3 The Sickness ...... 5 INTRODUCTION...... 6 Method...... 10 Outline of the Study ...... 12 I. ANTHROPOLOGICAL PERSPECTIVES ON THE STUDY OF ILLNESS ...... 13 Medical Anthropology ...... 14 II. THEORETICAL FRAMEWORK: MEDICAL PLURALISM ...... 16 Ethnomedicine and the Interpretive Tradition ...... 20 Illness and Body in a Social Context ...... 24 Lifeworld ...... 28 Representation and Narrativity: Illness as Exhibition...... 30 Intersubjectivity ...... 33 III. URBAN CANDOMBLÉ IN BRAZIL: A GENERAL HISTORY...... 35 Ethnographic Background ...... 38 IV. CANDOMBLÉ - THE CULT OF ORIXÁS...... 40 The Research Setting ...... 46 Ernesto’s story of mãe Lídia do Oxúm...... 49 Candomblé in Rio de Janeiro...... 54 Treatment of Illness in a Candomblé Context...... 57 The Ritual of Consultation: Jogo de búzios...... 62 V. TREATING ILLNESS IN CANDOMBLÉ HOUSES ...... 65 Medical Knowledge and the Person ...... 68 The Socio-Individual Context of Illness...... 76 VI. UNDERSTANDING ILLNESS ...... 83 CONCLUSION...... 89 GLOSSARY...... 91 BIBLIOGRAPHY ...... 92

4 The Sickness In my attempts to understand illness among the clients of the Candomblé houses, the western idea of illness was an obstacle. In the field I never met a person that defined him/herself according to the Western definition of being ‘ill’ or ‘sick’. For them there was no such thing as illness. There were ‘problems’ or the will to get answers to existential questions and guidance in their life. Two days after my arrival in Rio de Janeiro, my assistant and I went to São José, a village about an hour of travel from Niterói (a city on the opposite side of Rio de Janeiro, 15 minutes of travel with a ferry). In São José we stayed in a small country house guarded by seven dogs. Most of the houses in the village (and our house as well) were built on a hill slope. Outside our gate there was a sand-road, which every time it rained, changed its shape. So did the other small roads leading to the houses. They literally rained away leaving holes and furrows, letting sand, stones, and rainwater sculpture the roads as they pleased. During my stay in São José I got sick. It felt ironic trying to write about illness when I kept running between the toilet and the bed with fever, wishing I was dead every time my head reached the pillow. I had terrible dreams that night... I dreamt that people rang in small bells and danced in circles screaming... There were drums, and no one wanted to look me in the eyes. The many times I woke up that night, I was offered herbal tea, and a sweet mix of alcohol, honey and herbs. I felt so bad that I could have drunk anything that night just to make the sickness go away. The next day the colour of my face was light green. The only thing I was able to eat was some boiled vegetables and drink some water. The mother of my assistant, who took care of me during this period of illness, said that she knew a mãe de santo (mother of saint; a female Candomblé leader) and that she had invited her to the house. Feverish as I was I had no strength to say no, or to suggest that we invite her some other time. This is how I met Rosangela do Oxúm, a mãe de santo that will play an important role in this study.

5 INTRODUCTION In this study I want to understand ‘illness’ among clients and leaders of the Brazilian spiritual tradition Candomblé in Rio de Janeiro. As I have found that the individual has been insufficiently emphasised in much of the ethnographic literature dealing with Candomblé (which has had a more explicit focus on ‘group’ and ‘collective’), the focus will here be on the individual and how illness is experienced and expressed through narratives of consultations and healing rituals. I argue that such narratives of illness reflect the person’s lifeworld following Michael Jackson’s definition of ‘lifeworld’ as a practical activity, a domain of everyday, lived and experienced social existence (Jackson 1996: 7ff). In this study I approach the individual as a conscious entity with emotions, goals, motivations, and aspirations. In order to understand illness I am thus concerned with the individual’s experience of disorder and how that disorder influences the social (body social) and the individual (body personal) life of the person1. Accordingly, I reflect on the agency of the suffering individual as well as the agency of the illness. The aim of this study is to illuminate the ways Candomblé clients choose their treatments in a pluralistic medical context and how these treatments correspond to the individual’s meaning-production in the context of illness. Another issue that will be discussed in this study is the problem of scientific representations of ill health and human body. Those representations can be seen as undermining our efforts to seriously consider health and illness treatments among people belonging to other healing traditions, even those which, like the Candomblé healing tradition in Brazil, seem capable to offer opportunities for better health. The core of my argument is that for the sufferer the body is not simply a physical object, or a physiological state, but an essential part of the Self.

1‘Body social’ and ‘body personal’ are concepts introduced by Nancy Sheper-Hughes (1994) that will be discussed further in chapter two.

6 According to a Western scientific tradition ‘disease’ is the ill health that occurs from an objectively observed phenomenon – symptom, which can be classified, explained and treated in bio-medical terms. In this study I will use the term ‘illness’ instead of ‘disease’ because I choose to study the individual’s experience of ill health and not exclusively the physical, symptom-based disorder connected to the objectively approached body. Individual experience of discomfort and disorder has to be expressed in a way that can be understood by others. According to Kleinman, illness has meanings on several levels and those meanings vary depending on situation and (1988). In line with him and others (Good 1994; Kleinman 1980, 1988; Augé & Herzlich 1995; Sachs 1987) I suggest that; meaning and knowledge are always in reference to a world constituted in human experience, a world that is formulated and apprehended through symbolic forms and interpretive practices. Interpretations of the nature of illness always bear the history of the discourse that shapes its interpretation (Good 1994: 53). Thus, I see it as both a privilege and an obligation of medical anthropology to bring attention to aspects of the individual such as: meaning, experience and interpretation; as well as to highlight narratives and give importance to social formations in the construction of illness and health in different socio-cultural contexts. In this study I will deal with Candomblé, a Brazilian spiritual tradition with roots in the African, Yoruban cult of Orixás (deified heroes of Candomblé mythology). Candomblé is, after many years of secrecy, now relatively open to the broader society. It is commonly defined as a system of beliefs in supernatural beings called Orixás and associated with possession trance and ritual dances. To illuminate the parts of the cult that have significance for the individual who approaches Candomblé in order to seek treatment for his illness I will leave out the discussion of Candomblé as a religious system. Instead I will focus on the role of the consultation rituals,

7 called jogo de búzios (literally “game of cowrie shells”), one of the main Candomblé practices to find the reason for an illness as well as its cure. Jogo de búzios can be seen as a way to translate the reality of the clients and to “reshape” the world to conform to the life of the individual. Through narratives gathered among the clients of Candomblé houses2 and specialists of Candomblé healing (Candomblé leaders) I will try to illuminate the importance of keeping a balance between physical and psychological aspects of the person, which is, according to my informants, the base of Candomblé healing. In order to understand illness within Candomblé and biomedical contexts I discuss the legitimacy of medical knowledge. Problems that arise from the encounter between Western knowledge and local3 knowledge can, in my opinion, be related to the treatment chosen by the afflicted individual. In line with Mark Hobart (1993), I call it ‘politics of knowledge’ as I see all knowledge and knowing as a dynamic, practical, situated and changing activity. Within ‘politics of knowledge’, medical knowledge, whether that of the clinicians, health workers in an urban community, specialists of Candomblé healing, is a knowledge that often refer to distinct aspects of reality which are mediated by different symbolic forms and interpretive practices. My point is thus that worlds of medical knowledge cannot simply be judged by the measures of rationality when it comes to seeking care. I also try to follow Charles Leslie’s argument against the dualism made between “traditional” and “modern” medicine. He insists that all bodies of

2 The Candomblé house - even called terreiro (yard), roça (plantation) or rocinha (little plantation) - is a limited sacred area with various shrines designed to the worship of different supernatural beings called Orixás, and public spaces such as the barracão (shed) where collective rituals take place. 3 The term ‘local’ can be seen as evolutionist and ethnocentric if used as it was in the colonial period, when ‘local’ or ‘locals’ were used in negative way similar to ‘native’ (Grillo 1997: 26). In this paper, I use the terms ‘local’, ‘non-western’ and ‘alternative’ without the colonial meaning of those terms.

8 medical knowledge are dynamic and change as a result of political and social factors as well as the diffusion of knowledge and technological innovations (Leslie in Nichter & Lock 2002: 2). In fact no medical tradition is inherently conservative and, taking a closer look at Chinese or Ayurvedic medicine, we can discern scientific, dynamic, and rational principles, which are generally seen as cornerstones of biomedical, scientific thought. This is also the case with the practice of healing in the context of Candomblé. This practice can include use of pharmaceuticals if it is found to be necessary. The client can also be recommended to seek a doctor from the biomedical tradition. In the practices of Candomblé healing the individual and his lifeworld are central aspects that make finding of the cure possible. Therefore, I argue that as the result of social and political changes in the Brazilian society, the urban Candomblé healing can be seen as a dynamic practice not entirely alien to transformations if they are required to benefit its clients. I have chosen to base my study mainly on the accounts of three key informants: Rosangela (mãe de santo), Sajemi (pai de santo – father of saint; male Candomblé leader) and Elisabeth (member of Candomblé and ‘client’ in the Candomblé house of Rosangela). I their voices, as I believe they are representative for the issues discussed in this paper. I use the term ‘clients’ by which I generally mean those who seek treatment in Candomblé houses. In this term I include members and non-members of Candomblé-cult. Candomblé leaders are called mães and pais de santo and they are also the ‘healers’ or ‘medics’ within the Candomblé context. To simplify for the reader I consequently refer to the ‘individual’ as a ‘he’ throughout the study, meaning of course both a female and a male individual. For clarity, the origins of Portuguese and Candomblé terms are distinguished by italic type style. The only terms that are not in italic are ‘Candomblé’ and ‘Orixá/s’ because they are frequently discussed throughout the paper. The terms are translated the first time they are used in the text,

9 otherwise I recommend using the glossary. Those terms that need a broader explanation are translated in footnotes, but found in the glossary as well.

Method My journey for the search of how illness is understood within Candomblé took me to the ‘’ of Brazil, Rio de Janeiro, where I did my Minor Field Study, sponsored by SIDA (Swedish International Development Agency), between November 2002 and April 2003. In the field everything takes a great deal of time, and patience is a key in almost every situation. I imagined that living in the state of Rio de Janeiro, in the heart of Niterói, would be a perfect situation for conveying an effective research, but no. As the time went by, I learned that I could as well have been living in the middle of a jungle “hunting my own dinner”. Even after I had got used to the way of life in Rio, every now and then my research felt like a never-ending, fast trip with an old, crowded, hot, and noisy, half-out-of-order city bus as the two Candomblé houses (where I did my research) are situated at a great distance from each other. In order to participate in the daily life of the houses and meeting the clients, long daily bus travels were required. During my stay in the field I also made a trip to Brasília DF (Distrito Federal – Federal District) to discuss my work with my local supervisor Rita Laura Segato and to visit another urban Candomblé house I had been told about. On the way back to Rio I made a stop in Salvador (Bahía) to participate in a ritual of purification in a Candomblé house with connections to the house in Brasília. My interest in Afro-Brazilian cults began five years ago when I met Erik, my field assistant, whose family lives in the city of Rio de Janeiro. Having an assistant accompanying me to the field proved to be paradoxical. On one hand it solved many practical problems like having a place to stay (as I stayed in his mother’s apartment on the ninth floor in a multi-storey building in the central

10 part of Niterói) and making available all the contacts within the social network of his family. On the other hand it was a compromise that put me in a dependent position especially when it came to interview situations. My Portuguese was at the start very “fresh” and it was difficult for me to use it properly. After two months, when I was able to talk to people without the help from Erik, a lot of people already viewed us as one person. As many of the Candomblé houses I visited in the beginning of my fieldwork in order to establish contacts had “opening-hours”, it forced me to do adjustments in the method of participant observation. The interaction was limited to those days when the houses were open and people were present. The urban environment influenced the shaping of the Candomblé houses. Instead of being small, self-supportive communities, the houses now depend to a great extent on the earnings of the members and the payments for the consultations performed for the clients. The rituals of consultation stand for the most of the financial income of the houses. Consequently due to the expensive life in the city, and due to the costs of the cult, many of my informants were working fulltime. This meant that they were unable to participate in the everyday life of the Candomblé houses. Instead they showed up on weekends, in the periods of vacations or when they were free from work. Due to this I could not fully rely on participant observation. Instead my information is to a large extent based on individuals’ narratives about their experiences. In structured interviews I often used a taperecorder. Much of the information was however gained through informal conversations while collecting mango-fruits, cleaning up after a ritual, helping out with minor preparations of food or sitting at the porch at Rosangela’s, or at the veranda of Sajemi’s roça, and chatting.

11 Outline of the Study In chapter one and two I will present the theoretical framework relevant for this study. Of major concern is the relation between culture and illness and between medicine and anthropology. I will also emphasise the necessity to look at medical pluralism, the socio-individual context of illness, and narrativity as an intersubjective practice. Chapter three is an historical and ethnographic background to the Candomblé in urban Brazilian contexts. Here I will also introduce the individuals involved in this study and describe the research setting. In chapter four I will describe the Candomblé structure and other elements that are important for understanding how the cult might work as an alternative and/or complementary medical treatment for the clients. After that I will move on to describe urban Candomblé in Rio de Janeiro. In chapter five, I will retell some lifestories of the individuals introduced earlier. These stories will not only reveal the lifeworlds of the individuals but also give us glimpses of the individuals’ understanding of illness in and outside the context of Candomblé. I use this chapter as a starting point for the analysis in chapter six, which also includes my reflections about the coexistence of different medical traditions within the same society. In the end I make some concluding remarks.

12 I. ANTHROPOLOGICAL PERSPECTIVES ON THE STUDY OF ILLNESS ‘Culture’ is often used to refer to the high art that is enjoyed by a happy few. As expressed by Adam Kuper, “[h]igh culture can be represented as an instrument of domination” (2000: 4), and furthermore “[c]ulture is always defined in opposition to something else” (2000: 14). I agree with Kuper, when he states that, “[m]odern theories about culture recycle earlier ones” (Kuper 2000: 245). Accordingly, I view ‘culture’ as a form of collectively shared and socially acquired consciousnesses that are transferred and preserved through communication. This way to conceptualise culture is often observed in anthropological studies of different medical systems, where relations between medicines and are in focus. I argue that in the same sense we can also view medicine as a ‘culture’, that is, “a system of symbolic meanings anchored in particular arrangements of social institutions and patterns of interpersonal relations” (Kleinman 1980: 24). Following the thought of medicine as a , Arthur Kleinman states that, “[s]ymptom terms may be unique to a specific cultural context” (1980: 143). In his study of Chinese patients, for example, he found that patients talked about experiences of illness by relating these to classical symbolic associations from the . In the classical Chinese medical system the term ‘sourness’, which was used by patients when talking about pain in the body, was also related to one phase of the hepatic functional system of the body. The symbolic meaning of illness was particularly in focus among the medical anthropologists of the 1970s who participated in the creation of what has been referred to as interpretive anthropology (Leslie 2001: 430). This perspective (which I will discuss in the next chapter) places the relation of culture and illness at the centre of analytic interest and understands cultures as

13 systems of meanings. But first, let me make a brief presentation of medical anthropology.

Medical Anthropology Medical anthropology is unavoidably concerned with, or perhaps even trapped within, the paradigm of modern Western medicine whether explicitly or implicitly. However, it is not derived from medicine, as one might assume, but from social anthropology in USA and Great Britain where it emerged as a special field of research and training following the World War II. Its roots are to be found in the long-standing interest in shamanism and other forms of ritual acting as well as in the psychological anthropology of the 1940s and 1950s with its interest in culture-bound syndromes, personality variation, and mental illness (Leslie 2001: 430). Another stimulus for the development of medical anthropology came from applied anthropology and health projects among indigenous people in Latin America, Asia, Africa, and the United States (ibid.: 430). Medical anthropologists are especially interested in the relations between illness, medicine and human culture. Many of these anthropologists have shown that illness theories cannot be understood without an understanding of particular cultures and social structures. Lisbeth Sachs, writing about medical anthropology, points to an interconnection between the person and the society (1987). She suggests that illnesses can be seen as signals of conflicts in the individual’s interpersonal relations, or as signals of contradictions in the society (Sachs 1987: 9-15; see also Augé & Herzlich 1995: 12ff). I find Sachs argument interesting as it makes an important point of focusing on the individual in the context of illness. Because even though relations are an integral part of the person, the relations always start off with the individual. Today the field of medical anthropology continues to grow rapidly; however, there is still no widely shared definition of the field or an agreement

14 about its boundaries. For example, in a review of the field, Norman Scotch defines medical anthropologists as those ”[w]orking in medical settings or on problems of health and illness” (quoted in Colson and Selby 1974: 245). Some members of the field implicitly maintain that medical anthropology is a subfield of anthropology with an overriding paradigm no more or less well articulated that in any other field (for further discussions on the subject see Sachs 1987: 9-15). Others maintain that it is a distinct area of its own lying somewhere between the disciplines of medicine and anthropology. There have been multiple ways to approach the concept of illness, as for example through medical ecology or social epidemiology4, but for my purpose the ethnomedical model is the most useful as it is based on individuals’ own ideas about illness and treatment. In what follows, I will introduce the term ‘medical pluralism’ and show how it has been used in ethnomedical contexts. I will also reflect over the problems of incorporating alternative medicine into a dominant medical system. I am aware of the problematic notion of ‘medical system’ especially when it is understood as a product of categorisation and ordering integral to modernisation and globalisation (this has also been pointed out by Charles Leslie in Nichter & Lock 2002: 3). Using the term in this sense runs the risk of assuming that all other medicines in their original form will shortly die out. The goal in many countries is hence to incorporate some aspects of local medicines and create a standardised medical system that can relieve all human suffering and distress. However, as Leslie argues, nowhere has such a vision been realised and in reality pluralism and complementarity are the norm (ibid.: 3).

4 For further discussions on social epidemiology see for example Colson and Selby 1974.

15 II. THEORETICAL FRAMEWORK: MEDICAL PLURALISM One factor that influenced medical anthropology in the 1970s was the growing disillusionment with the Western medical model. It was evident that major shifts in emphasis were needed if there were to be large-scale improvements in health care in developing countries (Pelto & Pelto 1997: 152). This shift was manifested in “Alma-Ata Declaration” of 1978 (WHO/UNICEF 1978), which called for greater recognition of the importance of community participation and the role of indigenous healers in the organisation of health care programs (ibid.: 152). The declaration could be seen as a signal for the need of a ‘pluralistic health care model’. The growing recognition of ‘health care pluralism’ has directed researchers to develop ways to examine how people choose or make decisions among a range of therapeutic options in given cases of illness (Pelto & Pelto 1997: 152). Peter Worsley defines medical pluralism as the process when “the patient moves back and forth in a series of ‘episodes’ not only between agents, but also between systems” (1982: 325). Such processes also occur in the West. A patient starts to self-medicate, followed up by a visit to a physician, then a specialist, and ultimately perhaps the patient resorts to alternative medicine or sometimes even to religion when orthodox medicine fails. This model is dialectical, and not mechanical, because the sick individual is here not seen as a passive, suffering object of the active therapist (with the body conceived of as a mechanical system). He is instead seen as an agent, a subject engaged in the process of seeking health through manipulating the resources available in his social environment (Worsley 1982: 325). Medical pluralism therefore focuses attention on the co-existence of different healing traditions within the same society (Whyte et al. 2002: 11). This co-existence does however not mean that the relationship between different medical systems is equal or free from conflict. One example of this is provided by Susan Whyte (2002). She notes that the traditional systems of

16 healing can gain ideological weight in opposition to synthesized pharmaceuticals (ibid.: 12). In low-income countries, such as Brazil, the choice of natural remedies can be seen as a critique of expensive manufactured products and as a rejection of their symptom-focused, damaging effects on the client’s natural body, which I will exemplify in chapter five with a narrative from my field. Hence as ideologies of alternative medicines and the paradigm of biomedical systems are different in comparison, incorporating them can be problematic on various levels. With the above in mind I want to accentuate a critique towards the incorporation of alternative medicine into the organisational system of the dominant medical system. The process of incorporation may result in a rationalisation of the alternative medicine and thus to a loss of specific, unique features of this particular medicine (Lock 1990: 42). As I understand Margaret Lock’s argument in her article about rationalisation of herbal medicine in Japan, there is an unequal relation between various so-called traditional medicines and biomedical systems. The inequality is already obvious in the expression, “incorporation of alternative medicine into (…) the dominant medical system”, which suggests the passivity of the first in the active action of the second. This relation also involves such assumptions as the romanticised view about traditional medicines and the view of biomedicine as a vehicle for the spread of a mechanical worldview. One consequence of incorporating alternative medicine into the dominant medical system is that the first might change its purpose from being concerned with the cosmological worldview of the patient, to serve existing social and political relations in the society (Lock 1990: 41). As stated by Lock,

Medicine of all kinds, therefore, once it is incorporated within the institutionalized framework of the dominant medical system in any society, tends to act as a force for a preservation of social order. Any existing unequal distribution of power and access to the necessities of life

17 remain unquestioned, as do the social and political origins of distress and illness (1990: 42).

Another perspective concerned with medical pluralism is the one presented by Shane Greene (1998: 636), who in an article discusses the integration of, and collaboration between ethnomedicine and biomedicine. Concepts of collaboration and integration are criticised by Lock who claims that this process secularises and, as I pointed out before, rationalises the local medicine (Lock 1990). Greene’s discussion, however, points to certain problems that arise when ethnomedicine collaborate with biomedicine. As this kind of collaboration often is asymmetric it can have great consequences for indigenous people. Their medical knowledge and practice in comparison with the biomedical is often seen as non-scientifical and therefore non-effective. Greene suggests that we instead should talk in terms of intermedicality, “a contextualised space of hybrid medicines and sociomedically conscious agents” (Greene 1990: 641). Greene also points out the danger of integrating biomedicine with ethnomedicine as it might lead us to overlook those sociocultural institutions that practice ethnomedicine. Later in this study I will use narratives from my informants in order to show how problematic simultaneous use of different medical practices can be on an individual level. Many perspectives from medical anthropology remain focused on physical, experiential and suffering ‘bodies’. But even those perspectives can, if combined with other perspectives, be useful in studies concerned with medical pluralism. From the perspective of critical medical anthropology, for example, Nancy Scheper-Hughes (1994) studies embodied knowledge (that is, how people embody and value what they know in different cultural settings according to David Napier [2002: 290]). Scheper-Hughes introduces the idea of a trinity of ‘bodies’ shaped by the medical anthropological ‘gaze’5. These ‘bodies’ are the representational body social; the controlling, bio-power forces

5 This term was introduced by Foucault in his Birth of the Clinic 1973, the clinical gaze.

18 of the body politic; and the related and self-conscious attribution of meanings to the individual and existential body personal (Scheper-Hughes 1994: 231). In my study, the concepts body social and the body personal will be central as my intention is to investigate the ways Brazilian Candomblé clients choose their treatments in a pluralistic medical context, and how these treatments correspond to the individual’s meaning-production in the context of illness. Anthropologists have traditionally focused on the collective in ritual contexts rather than the individual and as a result of this the individual has been subsumed. Mamphela Ramphele, in an article about widowhood and mourning process in South Africa, highlights a problem, which I also have found to be central in the literature dealing with Candomblé. Mourning rituals that Ramphele focuses on are by their nature collective processes and the widow has a rather small space to come to terms with her personal loss, which results in a delayed individual healing process (1997: 105). Even if rituals are collective processes it is also important for anthropologists to extend their interest to the individual’s experience of rituals. That is important for a broader understanding of the process by which individual suffering becomes a social process. Ramphele argues in the same direction, that by investing the illness experience with meaning it is transformed into suffering, which then becomes a social process (ibid.: 105). The view of suffering as a social process thus demands an acknowledgement of the individual experience. From the view of the suffering individual the acknowledgement of his experience makes it easier to be healed. Margaret Thompson Drewal, writing on Yoruban ritual and agency, emphasises that, “[m]any types of rituals focus on the individual as their central concern” (1992: 63). However, even though the ritual’s focus is on the individual, anthropological representations of individual narratives of ritual experiences seem to be overshadowed by the ‘collective’ and the use of anonymous categories such as the ‘client’, the ‘novice’, the ‘group’, etc. An example of this is the Candomblé consultation

19 ritual. This ritual concerns the individual and his lifeworld. Despite this, an individual is often described as an anonymous ‘client’. For example, Robert Voeks describing the healer’s interpretation of the jogo de búzios writes, “[t]he client should persevere with his current difficulties, knowing that improvement is in his future” (Voeks 1997: 91). To overcome the anonymity of the subjects in studies concerned with ‘understanding illness’, I suggest that we focus more explicitly on the lifeworlds of our informants and their narratives. From the above examples, it becomes evident that medical anthropology can provide us with a rich field of divergent perspectives on illness. Further it might also provide us with tools to develop anthropology in general. For example, by linking cultural constructivism – the ways that meanings shape our understanding and experience of the world – to a social structural perspective – the ways that social realities shape health and illness (Guarnaccia 2001: 423). Understanding illness, as I chose to see it, is concerned with the individual’s experience of disorder and how disorder influences the social and the individual life of a person. With that in mind I think it will be helpful to use an ethnomedical perspective. In the next section I will thus discuss more thoroughly some ethnomedical views on the individual.

Ethnomedicine and the Interpretive Tradition Medical anthropological work focusing on ethnomedicine treats illness and illness behaviour as a cultural category. A usual concern is with understanding the content of the domain of illness behaviour and how it relates to other domains in the context of a particular culture or cultures (Colson and Selby 1974: 246). In ethnomedical studies many definitions are derived from the individual’s own ideas about illness and about different treatments to heal illness (Sachs 1987: 56).

20 I also believe that anthropological works dealing with the cultural dimensions of personhood can provide us with a satisfactory framework for understanding illness. Donald Pollock considers ‘persons’ to be agents of meaningful action or beings who are assumed to possess the capacity to be agents of meaningful action (1996: 320). A drawback with ethnomedical literature, as showed by Pollock, is that it tends to become overwhelmed by perspectives of ‘the Body’ or ‘the Self’. According to Pollock, the notion of the Self is in this literature presented in accordance with the Western notion of the Self as a unitary, bounded thing. Pollock criticises this and argues that anthropologists tend to discuss the Self outside the context of specific cultural conceptions and specific forms of practice (ibid.: 320). In his ethnomedical study of the Kulina6 Pollock discovered that illness could be understood as a particular condition of ‘persons’ (ibid.: 321). That is, Kulina understood illness to be a condition that affected those aspects of their culturally constituted essential being that comprised the culturally constituted ground for their qualification as ‘persons’ (ibid.: 321). From the above example we might conclude that the most appropriate way to do ethnomedical research is to be critical to how the research has been done and to describe the whole social context for the illness and its’ treatment (see also Sachs 1987: 57). This will be the objective of this study. In line with Kleinman I will also argue that the interpretation of illness’ meanings can as well contribute to the provision of a more effective care within biomedical tradition (1988: 9). Following Kleinman’s suggestion, this study will take as its point of departure the view of the individual as an active subject in the therapeutic process. Ethnomedical research must, in my opinion, provide phenomenological accounts of experiences of illness that involve the individual’s emotions and his lifeworld. In the pages that follow I will show

6 Kulina is a group of Western Amazonian indigenous people in Brazil.

21 how a combination of phenomenological and interpretive practices can be helpful for ‘understanding illness’. In the past years, interpretive studies have focused increasingly on embodied experience as grounds and problematics of illness representation (Good 1994: 55). Sickness is present in the human body, and sufferers can face difficulties similar to the ethnographer in representing its experience, as the suffering has to be described and interpreted in a way that can be understood by others. Following from this anthropologists in the interpretive tradition have been especially concerned with producing ‘experience-near’ accounts, which render the body present, while criticising purely cognitive renderings of illness (ibid.: 55). The concept of representation is something that will be developed later. Returning to the interpretive traditions, recent anthropological thinking about health care behaviours, which emphasises the importance of decision making, is often in contrasts with earlier thinking about ‘cultural belief systems’ (Pelto & Pelto 1997: 153). The differences between the two approaches are striking. In the earlier formulations about ‘cultural belief systems’, actors were seen as passive embodiments of “traditional cultural wisdom” (ibid.: 153). In newer perspectives they are seen as active decision makers, selecting and deciding from a series of health care alternatives (ibid.: 153). This newer perspective is especially important for this study as my focus is on persons as agents of meaningful action and active decision-makers. This is something that I will return to in chapter five where I will more thoroughly discuss the issue of individuals choosing between biomedical treatment and treatment within Candomblé. Interpretive studies in medical anthropology have been criticised for being irrelevant to most applied work, for attending too little to human biology and for lacking in scientific rigor of epidemiology or cognitive studies (Good 1994: 55). However, as interpretive anthropologists place the relation of culture and illness at the centre of analytic interest (Good 1994: 52), I argue

22 that this paradigm, despite its critics, continues to maintain a distinctive perspective on the representation of illness (see also Kleinman 1988, 1980; Pollock 1996; Rebhun 1993; Good 1994). One major challenge we face in cross- is to investigate how diverse actors, each with their own interpretive practice and form of knowledge, contribute to the constitution of illness in subjective experiences, as well as how illness is constituted as an object of medical and social attention. Byron Good insists that a primary task for comparative analysis is the identification of interpretive practices, which is, to analyse how these mediate experiences of illness, and make systematic cross-cultural investigation of effects on phenomenology and the course of illness (1994: 174). But do different medical systems have to be compared? Kleinman argues that, “we do not now possess valid conceptual frameworks for comparing indigenous and Western forms of clinical praxis, or for testing hypotheses about healing mechanisms, or for precisely determining therapeutic outcome” (1980: 375-6). According to both Kleinman and Good, we should instead focus on the formative practices through which illness and other dimensions of medical reality are formulated (Kleinman 1980: 375-6; Good 1994: 69).

Rather than belief and behavio[u]r, the focus is thus on interpretive activities through which fundamental dimensions of reality are confronted, experienced, and elaborated. Healing activities shape the objects of therapy – whether some aspects of the medicalised body, hungry spirits, or bad fate – and seek to transform those objects through therapeutic activities (Good 1994: 69).

Comparative research can thus help us to investigate these practices across cultures, the realities these practices formulate, how they apprehend and act on reality, and their efficacy in transforming the apprehended reality.

23 In the next section I will discuss the view of the body as a subject of action. I will also reflect over and in what ways the understanding of the relationship between Body and Self can mediate the meaning of illness.

Illness and Body in a Social Context As I argued earlier, illness cannot be studied or understood without understanding the cultural context. In every sociocultural context there are specific frameworks for understanding the relationship between illness and body, and how this relationship has meaning for the individual. These frameworks can in turn mirror culture-bound norms for how to draw the line between ill and healthy. Illness in modern Europe brings the sick person to the recognition of the divided nature of the human condition; which is “that each of us is his or her body and has (experiences) a body” (Kleinman 1988: 26). In this formulation the sick person is the sick body, which is believed to be distinct from the Self. Illness takes on meaning as, for instance, suffering because of the way this relationship between Body and Self is mediated by Western cultural symbols of a religious, moral, and spiritual kind. Kleinman, using anthropological analysis to show how meanings on several levels are created in illness, has shown that meanings of symptoms are standardised “truths” in a local cultural system (1988: 10). He goes on to state that cultural values and social relations shape the experience of the body and illness and situate suffering in ‘local moral worlds’ (Kleinman 1980; 1988). In each culture and historical period there are different ways to talk about illnesses that are understood by people belonging to the same socio-cultural context. One example is headaches. In Sweden we might say “I have a migraine” or “It is only a tension headache” and such expressions have a meaning for the listener. Implicit in such statements are accepted forms of

24 knowledge about the Body, the Self, and their relationship to each other and to the more intimate aspects of our lifeworlds. How is then Body approached in anthropology? In social and cultural anthropology the Body is largely absent, and in physical anthropology and the biomedical sciences the Body is present but silent (Scheper-Hughes 1994: 230). Donna Haraway sees the Body “as a strategic system highly militarized in key arenas of imaginary and practice” (Haraway 1993: 378). In her article she discusses some of the popular and technical languages constructing biomedical, biotechnical Bodies and Selves in the postmodern scientific culture in the United States in the 1980´s. Haraway presents an interesting view of individuality that is strategic in every level of meaning, but she also sees the Body as the embodied, lived locus of signifying power, a body-in-the- world. It is noteworthy to mention that ‘embodiment’ is seen in medical anthropology as a very unstable, but central paradigm, which is situated between biological, biomedical, sociocultural and symbolic meanings (Scheper-Hughes 1994: 230). But the aspect of power can also, as I will show in this study, be used in a different way if illness is viewed as a stimulant or a “signal” (a form of power) for the person to act. The intentionality of actors as conscious agents will also be the issue in this context, as the ill individual takes action in order to create equilibrium in his lifeworld. However, interpretations of illness and treatment are not only culturally bound variations, but they also vary and change through time. Many anthropologists have stressed the importance of considering the temporal factor in the study of illness (Romanucci-Ross et al. 1983: viii; Kleinman 1980, 1988; Pfifferling 1976: 426). In colonial societies, like Brazil for example, biomedicine was seen as a gift to rescue “natives” from infectious diseases. “Creation of amenable bodies” or, in other words, the control of the Body through schooling, discipline to shape the body and mind of the population, were colonial projects created to serve economical or military

25 interests (Mitchell 1988: 98ff, Foucault in Rabinow 1984: 17). Michel Foucault sees agency as produced through discourse which acts on the Body through various disciplinary systems and techniques which emphasise the positioning of Bodies within spatial relations such as the panopticon-oriented prison (Rabinow 1984: 18ff). The emphasis Foucault places on the Body leads him to treat it as a transhistorical and cross-cultural unified phenomenon always ready to be constructed by discourse. That I would say is an objectivist view on the Body. But what about the experience of the living subject? The colonial view of the Body (particularly the objective and mechanic view of the Body) has in some parts remained in the epistemology of biomedicine, where disease has been located in the Body as a physical symptom of a physiological state. So whatever the subjective state of individual minds, biomedical knowledge consists of an objective representation of the sick Body. An anthropological alternative to such a view has to be based on how medical practices shape the individual experiences of their health conditions. I thus argue for a subjective account in the study of illness experience. Also concerned with the discussion of the Body, Anthony Giddens notes that the Body is an object that all of us refer to, a source of joy but also a nest of illness and physical distress (1991: 122). Maurice Merleau-Ponty (1997), on the other hand, sees the Body as merely an element of the system that constitutes the person and his lifeworld. His view of the Body and the society is, as I see it, highly accurate in the context of Candomblé. He sees society as intersubjective practices based on action and interaction, placed neither inside the subjects nor outside them (ibid.). Because illness is “created” and embodied through storytelling and ritual it can be seen as existing in an intersubjective practice. The field of intersubjectivity can include relations between people as well as relations between people and things (Jackson 1996: 28). In many

26 cultures there is also an intersubjective relationship between people and the earth, people and masks, people and supernatural beings. In Brazil the relationship between an Orixá and a member of the Candomblé cult is an example of that. Within the Candomblé the Body is seen as a mediator of life, a media through which Orixás are given opportunity to express themselves. The body of a novice is “marked” in the ritual of initiation, for example through shaving of his head, in order to create a channel of never ending communication between the Orixá and the initiated human. For many people the suffering Body is not simply a physical object, but an essential part of the Self. The Body is also a subject, the very ground of subjectivity and experience in the lifeworld. Thus the Body as a “physical object” cannot be neatly distinguished from consciousness. Consciousness itself then has to be seen as inseparable from the conscious Body. It is therefore possible to suggest that the sick Body is an agent of experience. The Body is a subject of our action, through which we experience, comprehend and act upon the world. I will later in the study discuss this matter, in the context of Candomblé, through narratives from clients and leaders of Candomblé. Through the help of these narratives it is possible to view an illness as a “signal” for the individual to join the cult. On the other hand it is also possible that in the experience of illness the Body is seen as a passive object for the agency of illness. This latter concept will be dealt with in the next section. To sum up, I suggest that if we can describe health and illness behaviour from the individual’s perspective, we can begin to formulate health therapies that do not conflict with the individual’s lifeworld. Issues as Kleinman’s ‘local moral worlds’, which I chose to refer to as ‘lifeworlds’ and different kinds of views on the Body will in the following subsection illuminate some of the problems of illness narratives.

27 Lifeworld As shown above, in discussions about the Body there are perspectives that emphasise the importance of the lifeworld in the study of human experience. In line with the above, Michael Jackson suggests that when we make cross-cultural comparisons between various ‘systems of thought’, we ought to construe these not as worldviews – worlds of theoretical thought and explanatory ideas – but as lifeworlds (1996: 6). Lifeworld is thus considered as a domain for social and practical action that is produced between the subject and “me”. It is the domain of everyday, immediate social existence and practical activity. This world is often contrasted with the objective world of science and many assume that the latter represents reality in the strict sense of the word. Edmund Husserl has argued that science is grounded in and dependent of the lifeworld (cited in Bengtsson 1988: 38). Science is however not identical with the lifeworld, but seeks through theories to conceptualise the reality. One could perhaps say that science is a way to idealise and conceptualise the concrete reality. Jackson argues that trying to assimilate for example African thought, or in my case Brazilian thought, to the categories of Western scientific and philosophical discourse is presumptuous (Jackson 1996: 6). Instead of exploring the epistemological “status” of beliefs, it is important to study their existential uses and consequences, as for instance, what illness means for the individual, which was the question I frequently asked my informants. Merleau-Ponty (1964) explains in the same direction as Jackson, that to want to understand myth (or a story of illness) as a proposition, in terms of what it says, is to apply our grammar and vocabulary to a foreign language. In this case the phenomenological perspective can provide us with a solution. Merleau-Ponty elaborates an analysis of the Body as the ultimate medium of experience and thus of our understanding of the phenomenal world (1997). Following the phenomenological tradition, he examines the movement

28 of perception from the Body (the grounds of experience and intentionality) to the objects as constituted in perception. His analysis has served as the basis for recent discussions about embodiment in both philosophy and medical anthropology. This phenomenological tradition suggests that in attempting to understand and study illness experience in different societies, we must explore the organisation of embodied emotion, the organisation of experience, as well as the experiencing individual. Phenomenologists have often been criticised for their failure to comprehend that lifeworlds are always constituted historically and socially (Good 1994: 61). The critique has, however, led both critical and interpretive anthropologists to develop important questions for the study of illness such as, how can we recognise the presence of the historical and the social within the human consciousness, without devaluing local claims to knowledge? How can we narrate about illness in a manner that shows our understanding of emotion and lived experience and still illuminate the presence of the historical and social processes of which the actors are only vaguely aware of? What I mean is, if we also consider these questions in a phenomenological study of lifeworlds of illness, the study will be more complete, and illuminate illness in its social and cultural context. Following Merleau-Ponty, illness has to be seen as a personal ‘experience’ of a specific disorder in a particular lifeworld. But I believe that it can also be seen as a ‘strategy’ to bring order into the individual or collective lifeworld. As I said before, illness has meanings on many different levels. However, my concern in this study is to investigate illness experience, expression, and treatment on the individual and social level. That is to analyse illness as a network of perspectives through which the individual narrates his illness into understanding. To sum up, studies of ‘embodiment’ and ‘phenomenology’ of illness experience (see case studies in Kleinman 1988) have become important ways

29 of investigating the relation of meaning and experience as intersubjective phenomena. The difficulties of adequately representing experience and illness in ethnographic accounts, the problematic relation of experience to narratives, and efforts to understand the experience in lifeworlds are problems of current concern in interpretive studies (Good 1994: 55). Those problems I have also came across during my field study and I will discuss them in the next section. But first I will introduce and explain the term ‘representation’.

Representation and Narrativity: Illness as Exhibition It is common in the West to refer to states of human health as something that is physically visible, which is, as I stated before, closely linked to the recognition of the division between the Self and the Body. The problem with studying illness is that it is a condition that not always shows as a physical state. In this section I reflect over how illness is made “visible” through representation in narratives distancing the person from the illness. Mitchell believes that through a representation one creates a truth that is built into the objective representation, for example: the painter has a distance to his object (the motif) and the painting is a representation. Representation is thus also a form of objectification, which is supposed to create a distance between the sufferer and the illness. In order to distance oneself from illness the sufferer, or the healer, or the researcher symbolises the illness through giving ‘it’ a name and making ‘it’ manageable, a sort of Foucauldian “creating manageable bodies” (Foucault 1973: 22-37). In the case of representation, Mitchell raises critique against modern research, which creates categories, and through that creates representations. In my opinion there are some similarities between Jackson and Mitchell. Seeing storytelling as a form of representation, Jackson says, “[t]o tell a story is to immediately put a distance between oneself and the events with which the story is concerned” (Jackson 2002:186).

30 In the following pages I investigate the representation of experience through narrativity and how narratives can illuminate the lifeworld of the individual.

Like any expressive form, narrative says things about behaviour indirectly – by metaphor, allusion and symbol. The investigator must somehow dissect the subjective experience derived from participation in the narrative performance, then trace the effect of this experience on participants’ behaviour in nonperformative contexts (Colby & Peacock 1973: 628).

Narrative studies problematise the relation between culture, symbolic forms, and the experience (Jackson 2002). It is a form of communication in which experience is represented and recounted, but anyone can always describe an event from a slightly different perspective, recasting the story to reveal new dimensions of the experience. In what follows, I reflect over how narratives can be seen as embodied experiences helping the individual to relate to his lifeworld. Experience, as suggested by Mary Steedly, can be understood as an internal shaping of data into an emotional and interpretive landscape, or a process by which subjectivity is constructed, something that “happens to” a person in a socio-individual context (1993: 26). Consequently, subjectivity can be seen as derived from one’s personal engagement in the practices of social signification. The narrative can, according to this kind of thought, be seen as one of the reciprocal processes of both personal and social efforts to constitute the world. We of course do not have direct access to the experience of others. It is the narrative that gives shape to the experience. However, as I mentioned before, there is a tension between the experience and the representation of it, seen here as a practice of narrativity, as it could imply an aspect of control or of objectifying the experience in the representation. Prioritising lived experience over scientific, theoretical knowledge is already presaged by phenomenological studies of illness because it is “lived through” by the patient rather than conceptualised and defined by medical

31 science. What I mean is that, in the phenomenological study of illness, scientifical biomedical definitions do not provide us with the access to the particular lifeworld of the suffering individual. Narrativity is a process of locating suffering in history, of placing events in a meaningful order in time. Storytelling is nothing that occurs outside time, lifeworld and the individual. Narratives of for instance pain experiences describe events along with their meaning for the persons who live in and through them. The narratives are aimed not only at describing the origins of suffering, but also at imaging its location and source, and imaging a solution to the predicament. Persons suffering from illness often describe their feeling that their world has changed. The Self is then constituted in relation to the world. It is thus not only through direct description of embodied experience, but through the description of that lifeworld that we have access to the Selves of others. From the above follows that private events are translated into public stories through narrativity. Consequently, as stated by Jackson (1996: 8), ethnography is a dialog with others. Since research is a social activity, practising research means practising a social role. So, the storyteller and the listener have to be included in the recognition of the character of all experiences, even those that seems physically self-evident and “natural” (Steedly 1993; Bourdieu 1999). A story on its way to the reader, filters through the ethnographer’s own lifeworld, which includes her or his . Listening and telling are integrally linked in the art of storytelling. Consequently, the listener is a partner in the story’s creation and a future teller of the story as well (Steedly 1993: 204ff). This is also the case with me. In the next chapter I will be the re-teller of the narratives from my field. In order to reach an understanding of the process of re-telling the stories a brief discussion of intersubjectivity is in place.

32 Intersubjectivity As I argued before, illness is “created” and embodied through narrative and ritual, and can therefore be seen as existing as an intersubjective practice. I also discussed Merleau-Ponty’s view of society, which he understands as intersubjective practices based on action and interaction between subjects. The consultation ritual within Candomblé is an example of this kind of relationship. The client’s story of illness is narrated to the healer through participant and productive interaction. The intersubjectivist position is concerned, as I understand it, with the participant and communicative actions of the subject, and examines the way in which the social world is produced through interactions. Intersubjectivity implies that there is an activity between a subject and other subjects that might contain both empathy and conflict. The dialectics between opposite spheres of life, emotions and ideas have meaning only in relation to the dynamic interplay of Self and “not-self” which defines intersubjectivity (Jackson 2002: 29f). The source of energy that both motivates and structures storytelling is the existential tension that informs every intersubjective encounter. Following this kind of thought, narration and social rituals are intersubjective processes. According to Merleau-Ponty, the world is constituted prior to our entry into it, it is not a result of our thinking – we are thrown into it. It is an intersubjective world, a social and cultural world, a world that resists shaping it to our own whims, a world of social and empirical facts and realities that cannot be wished away (Merleau-Ponty interpreted by Bengtsson 1988: 38ff). The intersubjective dimension of the social body is missing for instance in Foucault’s theories. Here the Foucauldian ‘discourse’ can be seen as operating directly upon individual Bodies, that is, individuals are not taken to have a social or cultural existence with attendant meanings through which the influence of the ‘discourse’ might be mediated.

33 “No human being comes to a knowledge of himself or herself except through others. From the outset of our lives we are in intersubjectivity” (Jackson 1995: 118). In other words Jackson argues that our existence and our knowledge of others are grounded in sociality, for sociality is intersubjectivity. Developing it further, it is then possible to say that learning and reflecting about others is a main definition of anthropology. Before I proceed, let me sum up the discussion so far. Several theories proved particularly relevant to this study. Regarding the definition of illness I use Sach’s view of illness as signals of conflicts in the individual’s interpersonal relations. I also follow the phenomenological view of Merleau- Ponty in his definition of illness as an individual experience of a specific disorder, and a strategy to bring order into one’s particular lifeworld. As presented already in the introduction, I use Jackson’s definition of lifeworld as a domain for social, immediate interaction between the subject and “me”. Worsley’s, Leslie’s, and Whyte’s (et al.) view on medical pluralism as the process when the patient is an active agent moving back and forth between other agents and the different co-existing medical knowledges and practices, will serve as the repeating component in the narratives presented in the next chapters. On narrativity, which gives shape to the experiences, the perspectives of Steedly and Jackson are relevant in this study. In investigating how the illness influences the social and the individual life of the person, I use Scheper-Hughes concepts the body social and the body personal. Kleinman’s discussion on the individual’s meaning-production in illness is useful in the reflections about the relationship between Body and Self. Throughout the following pages, I will also try to give prominence to the intentionality of actors as conscious agents in the process of seeking treatment for an illness. In the next chapter I begin with highlighting the historical background of the urban Candomblé in Brazil, continuing with a short presentation of the written material on Candomblé that will be used in this study.

34 III. URBAN CANDOMBLÉ IN BRAZIL: A GENERAL HISTORY Modern Brazil is the world’s fifth largest country. The coastline of Brazil, which is 4 600 miles long, has been of tremendous importance for the development of Brazil. As stated by Bradford Burns “the Atlantic serves as the highway to the world carrying immigrants, merchants and bearing the products of the land away” (1970: 7). After the discovery of Brazil by the Portuguese Pedro Alvares Cabral on the 22nd of April 1500, Portugal realised the commercial possibilities of the new land and colonised it (ibid.: 20). By mid-century, fifty mills were producing enough sugar to annually load forty to fifty ships for Europe (ibid.: 25). To resolve the labour problem of the rapidly growing sugar industry the planters directed their interest to Africa (ibid.: 37). In the years to come, the Atlantic functioned as a ‘highway’ between Brazil and Africa carrying inhabitants from various African countries to Brazil to work as slaves on Portuguese sugar plantations and in gold mines. The abolition of slavery on the 13th of May 1888, and the replacing of the monarchy with a republican system in 1889, initiated a period of profound economic, social, and political change in Brazil (ibid.: 197f). By decree on the 16th of November 1889, a federal republic was created and simultaneously the Roman Catholic Church was separated from the State. The new republic became even more identified with the military, than the monarchy ever was (Burns 1970: 206). The change of political system involved also the expansion of agricultural activities drawing inhabitants into hitherto unexploited regions of the country. An example of this is the coffee culture that moved into new areas, to Minas Gerais and western São Paulo (ibid.: 216). The influence of coffee extended beyond the realm of economics into both national and international politics. The coffee producers found their best market in the United States (ibid.: 218). The dominance of coffee concentrated the economic power to the regions best suited for coffee production: the state of São Paulo, Minas Gerais, and Rio de Janeiro. After

35 The First World War processes of urbanisation, industrialisation and modernisation went hand in hand. The building of new roads and railroad networks put an end to rural isolation in these areas. As stated by Burns, “[t]he rails and the roads led directly to the cities and ports, where an incipient industrialisation in need of workers offered the ambitious peasants a means of escape to a promised better life elsewhere” (ibid.: 259). After 1930 industrialisation accelerated and the following urban expansion altered many national customs (Burns 1970: 299). Rural immigrants to the rapidly growing cities had to adapt to new urban demands. Patriarchal families abandoned their homes for apartments in the cities. Legions of poor people settled in favelas (slums) close to the luxurious apartment complexes. Nowadays, these favelas can be viewed as a symbol of the social and economic inequality that characterise the Brazilian society. The African origins of the Brazilian population are extremely varied. Slaves were brought from countries such as Guinea, Dahomey, Nigeria, the Gold Coast, Cape Verde, São Tomé, Angola, Congo, and Mozambique (Burns 1970: 38). It is, however, possible to identify three major African contributors to the Brazilian society. The first are the Sudanese groups, which are dominated by the Yoruba and Dahoman people from Nigeria, Liberia, the Gold Coast, and Dahomey. The second are the Mohammedanised Guinea- Sudanese groups, like the Hausa. The third are the Bantu groups from Angola, Congo, and Mozambique (ibid.: 39). The slaves were put to work in coffee and sugar plantations, and in gold mines without considering their cultural and religious background. A consequence of this “mixing” is the Brazilian cult of Orixás. In Africa, every Orixá (Xangô, Obaluaê, Ogum, etc.) was linked to a city or a whole country where one specific Orixá was devoted collectively (Verger 2002: 32). The transportation of slaves to Brazil transformed this, and consequently the devotion of Orixás turned into an individual matter (ibid.: 33). In Brazil, even

36 on the coastline, the individual groups were too weak in numbers to worship one particular Orixá (Bastide 1978: 62). As a result, one Candomblé house now involves, in general, sixteen Orixás from the Yoruban mythology in contrast to the African Candomblé cults of only one. Nowadays, every member of the Candomblé is considered to “have” an Orixá, meaning a reciprocal relationship including responsibilities towards the deity who in return provides the person with protection against difficulties. I will further discuss this matter in the next chapter. The Brazilian Candomblé of today could perhaps best be described as a translocal religious system, a fruit of Brazilian history and the many African religious systems imported along with their practitioners. Due to its African roots, this system of beliefs is not entirely local as many of the Candomblé leaders continue to travel to those parts in Africa where their Candomblé house once originated. They do that in order to get a ritual name and learn more about the mythology and rituals practiced by their African ancestors. Because of the fact that the African Candomblé cults still are of importance for the Brazilian Candomblé I have chosen to view the Brazilian Candomblé as a translocal religious practice and, consequently, the Candomblé healing as a translocal medical practice. Despite the many studies of Candomblé, the urban context of the cult has not been studied that frequently as in another Afro-Brazilian cult called Umbanda. The Umbanda cult, which is another spiritual practice in Brazil, has both African influences, influences from Brazilian Amerindians, as well as influences from Catholicism and Brazilian spiritism. It is a cult of possession, which to a large degree is derived from the Candomblé tradition. Its pantheon includes Candomblé entities (such as the Orixás), but also Catholic saints, and spirits of Negroes, cowboys, Bahianos (people originally from the state of Bahía), etc. The influence from the Brazilian Amerindian tradition is

37 represented by stereotypes of Amerindians spirits, the caboclos (Brumana 1989: 37). As shown above, Candomblé influenced other Brazilian spiritual traditions like the Umbanda. The first houses of Candomblé were established in early nineteenth-century in Bahía (Bastide 1978: 48). These were founded by three liberated African women, Iyá Dêtá, Iyá Kalá, and Iyá Nassô and all three gained the name Engenho Velho. Power struggles over the leadership of the houses broke out which resulted in the establishment of three Candomblé houses: Engenho Velho, Gantoís, and Axé Opó Afonjá (Bastide 1978: 48). All three houses maintained the Yoruban ritual tradition, serving as models as well as progenitors for many of the Candomblé houses presently encountered in Brazil. The origin of the Candomblé houses in the state of Rio de Janeiro can be traced back to these three Candomblé houses (Verger 2002: 31).

Ethnographic Background A pioneer of anthropological studies of the African immigrants in Brazil was the physician Dr. Raimundo Nina Rodrigues. His work “Os Africanos no Brasil” (1976) is a critique of the long-accepted idea that the Bantu tradition predominated among Brazilian Africans. Instead he demonstrates the strong cultural presence of the Sudanese groups (particularly the Yoruba) in Bahía. He was also the first to study Afro-Brazilian religions (Burns 1970: 268). Many Afro-Brazilian studies conducted before the 1950s were concerned with race and ethnicity (as for example Rodrigues 1976 and Bastide 1978). This can be seen as a result of the political and race conflicts occurring during that time (Cuesta 1997: 28). After the 1950s, the studies of Candomblé shifted to cultural issues. Roger Bastide, for example, did a historical, comparative study describing various religious systems in Brazil (1978). Bastide’s work later influenced urban sociologists like Patricia Birman (1980) and Reginaldo Prandi (1991), both from the University of São Paulo (Cuesta 1997: 30). Their

38 concern was to understand Afro-Brazilian religions as cultural components of the Brazilian post-industrial modernisation process. Prandi was also the first to conduct an extended study of urban Candomblé in São Paulo (1991). Under Prandi’s supervision, a vitally important work of Professor Agenor Miranda da Rocha7 (written already in 1928, by hand and read by several Candomblé leaders) was published in 1999 “Caminhos de Odu”. This study highlights the central, mythological aspects of divination rituals called jogo de búzios. Because of the oral character of transmitting the sacred knowledge of Candomblé such a study can improve our understanding of the divination rituals within Candomblé. Another, more recent study, carried out in the urban São Paulo is the work of Fernando Giobellina Brumana and Elda Gonzales Martinez (1989). It focuses on the problem of affliction, and how it is dealt with in the context of the Umbanda cult. The main focus here is, however, on the mediumnic possession and interactions between different cult centres. Some of these authors’ discussions, for example the agency of the suffering individual, and the authority of medical practice, will be used to support my own reflections on similar issues. A view on Afro-Brazilian religions (especially the Xangô cult in the town of Recife), concerned with symbolism and social organisation in terms of family, personality, sexual relations, and gender categories, is presented by Rita Laura Segato (1997). The work of Marta Cuesta (1997) follows a similar line and discusses the social life in various Candomblé houses, focusing on identity, worldview, ethnicity and gender. Voeks (1997) makes a contribution to the understanding of Yoruba healing system from the perspective of ethnobotany. However, another book of Segato, “Santos e Daimones” (1995), illuminates another process of the Orixá cult, the identification of qualities of Orixás with personality types of individuals. Here, Segato discusses the issue

7 Agenor Miranda da Rocha is commonly referred to as ‘Professor Agenor’ (professor Agenor).

39 through a combination of anthropological approaches and Carl G. Jung’s psychoanalytical theories of human archetypes. Her work is an important contribution to the understanding of the relationships within the mythology of the Xangô cult, combining it with values of citizenship and democracy. As the aspect of the individual’s identification with a quality of an Orixá can have a therapeutic purpose, her ideas will be valuable for my study, which I will demonstrate in the following chapters. The work of Rita Amaral (2002), a student of Prandi, illuminates essential dimensions of the religious life of the Candomblé members. She discusses the complexity of a Candomblé festa (literally: party; Candomblé ritual) and argues that the festa is not exclusively a ‘public’ act in contrast to a ‘secret’ act, but also that a festa is a part of an interaction between the religious and the profane.

IV. CANDOMBLÉ - THE CULT OF ORIXÁS In this chapter I will illuminate the parts of the cult that have significance for the individual who approaches the cult in order to seek treatment for his illness. Following Sachs’ statement about ethnomedical research (1987), I will describe the social context of illness and its treatment. In addition to Steedly’s reflections about experience (1993), subjectivity of the individual can be seen as derived from his engagement with the practice of social signification. When he enters the Candomblé cult in order to seek treatment for an illness, he becomes a ‘client’ in relation to this specific social context of Candomblé spirituality and healing. It is therefore important to accentuate that even if the client is not initiated in Candomblé, his reality is (the moment he enters a Candomblé house) being interpreted through codes belonging to that context. The client has, for instance, to observe some of the most important relationships within the cult. Those are: the relationship with Orixás (because it is through an interaction with Orixás that the problem is solved), and the

40 relationship with the leader of the house – mãe de santo or pai de santo, who is supposed to find the right treatment for the client’s problem. Members of Candomblé recognise the existence of a supreme supernatural being, Olórum, the unknowable creator of all things, an Orixá that is perceived as unapproachable by humans. Olórum does not manifest during possession trance. He has no shrines or terreiros dedicated to him (Voeks 1997: 54). His presence is instead manifested in an intrinsic Candomblé numerology where he is the base of every number. Rosangela explained this to me as:

1 = the “first”, Olórum 2 = the female quality (1+1) 3 = the filho, the result of Olórum together with the female quality (1+2) 4 = axé, power source, vital energy (1+3) 5 = Olórum together with axé (1+4) 6 = 3+3 (according to Rosangela this number is not used, as it personifies something bad, perhaps an incestuous relationship) 7 = spirituality (5+1+1) 14 = 1+4 = 5 = Olórum together with axé 16 = 7 = spirituality (sixteen are the búzios used in the consultation) 21 = 2+1 = 3 = the filho

The above numbers are presented in a specific order and have a ritual significance. In the context of this paper they play a vital part of the divination ritual called jogo de búzios. The ritual is normally performed by a leader of a house and is used to “diagnose” the problem of a client, something that I will discuss further in the next section. To become a member of a Candomblé terreiro one has to go through a ritual of initiation, which varies in length depending on the Orixá assigned to be the “dono da cabeça” (“owner of the head”) of the person (Segato 1995: 106). Each Orixá was originally a local spirit, which in the course of time merged with others of its ilk and eventually became more widely worshiped (Gleason 1992: 4). Yoruba sages tell that when a person is born he or she “chooses a head” thereby becoming endowed with a portion of cosmic essence

41 (ibid.: 4). Primal substances of which our various heads are made can be experienced in their natural manifestations as water, wind, fire, tree, and so on. These environmental forces are not worshiped as such but rather as the loci of beings the Yoruba call òrìsà8. The word ‘Orixá’ literally means head- calabash. Calabashes grow on trees in tropical climates and are used as containers of water, food, or anything that can be put into them, magical substances as well as non-important items. They contain a modicum of sacred substance, which we share with an Orixá. The only way to determine with certainty of what stuff one’s soul is made is through a consultation of the oracle in the form of cowrie shells. Each formation of the oracle contains sacred oral texts, memorised by the diviner-healer-priest (Prandi 2001: 17; Gleason 1992: 4). Certain configurations of the oracle speak of certain Orixás, or it might be said in reverse that the Orixás speak through certain channels of the oracle (Gleason 1992: 4). The social organisation of a Candomblé terreiro is strictly hierarchical and rigidly defined and maintained. The mãe or pai de santo is the absolute leader of the house and represents the principal line of communication between the material world of mortals and the spiritual world of the Orixás. He or she also has great responsibility for all the important, administrative and spiritual functions. Voeks argues that, “[h]e or she is the living repository of the fundamento[s (grounds)] of the terreiro, the guardian of sacred knowledge and the principal educator of novices” (1997: 65). However, as I argue later, urban Candomblé leaders are also responsible for the dynamic of their houses. This can for instance involve using healing elements belonging to other medical contexts, or adjusting the periods of obligations to a time when the members are able to participate. Therefore it is important to argue that I do not consider Candomblé knowledge as a static and passive phenomenon in contrast to Western knowledge, which is seen as having the ability to

8 In this paper I chose to use the Brazilian pronunciation – Orixá.

42 “develop” and “change”. The leader is also considered as a ‘healer’, a concept that has often been mythologised by researchers. As noted by Greene, the shaman or the healer is often seen as a “[n]ecessarily culturally conservative figure of indigenous societies” (1998: 642). As shown above, Voeks’ description of Candomblé leaders has a tendency to fall under this category as he describes them with terms like “the living repository” and “guardian of sacred knowledge”. Beside the mãe or pai de santo other characters, which have an established role in Candomblé houses, are the filho/s- and filha/s de santo (sons and daughters of saint; members who have done the obligation of seven years of membership) and the iaôs (members who do not yet have done the obligation of seven years). The female members (filha/s de santo) are in majority in most houses. All filho/s and filha/s de santo incarnate different Orixás during possession trance rituals. Those acts provide the house and themselves with axé9, the vital force of the Orixás. The symbol of axé of the house is often placed in the middle of the barracão (the public sphere of a Candomblé house, a hall assigned for collective rituals). The day the axé of the house is established, the house becomes officially “casa do Orixá” (the house of Orixá; terreiro). Mãe pequena – little mother, or pai pequeno – little father, is second in command among the members of a terreiro. His/her role is to supervise the day-to-day functions of a house. He/she is also seen as “in command” when the leader is not in the house. Those who are not possessed during rituals are ogãs, and ekedis – women who are assistants and “chambermaids” of Orixás. Ogãs can occupy various functions in the house (as for example atabaqueiro/s – player/s of ritual drums, or responsible for animal sacrifices) and, as noted

9 In the house of Rosangela the axé was visualised by a square, white spot in the middle of the floor in the barracão. In the house of Sajemi the axé was symbolised by a sculpture situated in the middle of the floor in the barracão.

43 by both Voeks (1997: 65) and Amaral (2002: 35), they often contribute financially to the house or act as representatives of the house. Looking closer on the members of the cult in Rio, the members have to structure their lives outside the cult to have free time for their responsibilities in the terreiro. They are obligated to participate in the daily life and duties of their terreiro and, because of that, many of them work overtime for a period, or reschedule their working hours in the city. The members do that in order to, above all, gain more free time to spend in the terreiro working for the Orixás. According to Sajemi, filhos10 working in hospitals use to double their duties in order to gain one day or night off to dedicate to their duties in the roça. In the case of iaôs it is common to approve the periods of vacation (from work or school) to serve as periods of initiation rituals (Amaral 2002:36). Very few people are initiated in the cult before they reach adolescence. In the cases when a child is initiated it is often because of an otherwise unexplainable illness that occurred in the life of the child (Segato 1995: 48). Nevertheless, there are cases where the initiation of a child in the cult results in that the cult members become an extension of the child’s biological family. I witnessed that once in the house of Sajemi when I participated in a rather unusual initiation of a ten year old boy in the function of an ogã (in this case an atabaque-player). The boy was always present in the roça, accompanying his mother, playing, running around, but also doing his duties and playing atabaques during rituals, as for example purification rituals or obligations. It is unusual for such a young person to become an ogã for many reasons. For example, it is common that an ogã helps out economically with festas and also has many practical responsibilities. A ten year old has very little to contribute economically but, according to Sajemi, the boy in question had shown a great

10 Filho/s and filha/s-de-santo – From now on, I use the term filho as a general term for a person initiated in the cult.

44 talent for playing the atabaques. But more importantly “the Orixás have called for him” which was revealed in the jogo de búzios. Besides the boy and some few other younger individuals, most members and clients of Sajemi’s roça are in the ages from twenty to eighty, and from various societal classes. Sajemi described his clients, and the purpose with his roça like this:

I have filhos and clients that are from various societal classes, as for example doctors, nurses, teachers, as well as housewives, taxi drivers, students, cashiers that work in grocery stores and those who are unemployed, “between jobs”. The goal with my roça is to create a community within the society, to be able to give basic education and also to teach people how to care for themselves, to live healthy both in the body and in the spirit.

According to my informants every person “has” an Orixá. This is independent of the person being initiated in the cult or not. In exchange for obligations the Orixá provides the person with protection and guidance. Filho de santo has the responsibility to observe and follow food prohibitions linked to his Orixá. He is also obligated to follow orders expressed through the oracle and messages revealed during the possession ritual or manifested in dreams. If the person does not follow these, it can result in “punishments”. Many accidents, illnesses and in some cases deaths are explained in this manner. To understand the relationships between the Orixá and an individual it is important to highlight some characteristics of the Orixá Exu. At the beginning of every festa the first to be summoned is Exu (o Orixá mensageiro – the Orixá messenger). He is the one who has all the knowledge about the supernatural world of Orixás, the world of mortal humans, the nature, the paths that every man, woman and child go in their daily struggle against misfortunes, poverty, illness and death (Prandi 2002:17). He is a messenger between the Orixás and the humans and is therefore also responsible for the communication between the pai or mãe de santo and the Orixás in jogo de

45 búzios. He is considered to be the one who “opens the paths” when someone has a problem to solve. Exu is thus the Orixá most closely linked to the individual and his destiny. Jim Wafer’s work is particularly concerned with spirit possession and the role of Exu in the Candomblé context (1994). Accordingly, the author notes, “if one experiences obstacles in one’s life, one may make an offering [to Exu] to ‘open the roads’” (1994: 15).

The Research Setting After this general picture of the Candomblé houses and their social order, let me in this section introduce more closely the Candomblé of my field. During my field study I visited various Candomblé houses, which gave me the opportunity to reflect over which house could provide me with valid material for the aim of the study. The issue of ‘understanding illness’, with focus on individual experiences and narratives allowed me to choose those houses where both I and the members felt comfortable with my role as “a person who asks a lot of questions” (as humorously expressed by some of my informants). Rosangela, a woman in her forties (the leader of Rocinha do Oxúm – little house of Oxúm) is the first mãe de santo I came in contact with. Her clients describe her as a charismatic leader, with great self-confidence, sacred knowledge, and a gifted búzios player. She also works part-time (two-three days a week) as a supervisor of students in an elementary school in the city of Rio. Rosangela’s terreiro is situated in São José RJ (the state of Rio de Janeiro) where I spent much time getting to know the people of the village. Through the participation in the life of Rosangela’s terreiro, I became aware of the opportunity I was given to study a Candomblé house “in the making” as this was a recently established house. Due to this, it seemed natural for Rosangela to issue her filhos and me with precise explanations of the events that took place, of her opinion in the matters of Candomblé healing, as well as

46 the mythological background of issues concerning the Orixás. In a way I became a pupil among her pupils. In the house of Rosangela I met Elisabeth, a 52 year old woman who lives nearby Rocinha do Oxúm together with her 11 year old son and her fiancé. Elisabeth is initiated in Candomblé as an ekedi, but before she met Rosangela she had for a long time been looking for a Candomblé house where she could “identify” herself with the leadership and the characteristics of the house (an issue I discuss further in chapter five). When I first heard about a pai de santo who also works as a nurse I got excited. From conversations with my informants I understood that it is an unusual situation within Candomblé. Considering the aim of my study, medical pluralism in practice, I decided that I had to meet Sajemi, a 52 year old Candomblé house leader. His roça is situated in a minor city – Campo Grande RJ (approximately two hours travel with the buss from Rio depending on the mood of the buss-driver). As he works part-time in the Ambulatório (Outpatient Department) in Rio, the roça has certain opening hours and some days are assigned only to consultations. My role in Sajemi’s roça was a bit different from that in Rosinha do Oxúm. In the roça of Sajemi I was more of an observer, left alone with my questions unanswered until I was given an appropriate opportunity to ask them. In his house I also met many clients such as Nicacio in his fifties, who wants to buy a taxi and start his own business selling “Brazilian fast-food” and Aparecida in her late thirties, a sister of a member of the house, who seeks Candomblé guidance three to four times a year. Rosangela’s house and the house of Sajemi can be said to be representative of the many houses in the proximity to Rio de Janeiro, where the activity is closely linked to and dependent on the social lives of their members. As many of them work and have families in Rio, they travel to the terreiros on weekends or when they have the time. Nevertheless, when there is

47 a period of important rituals linked to a specific time of the year and Candomblé mythology, the presence of every member of the house is required. As Rocinha do Oxúm is quite recently established (the 2nd of February 1992), it does not yet have that many members (approximately twenty filhos), in contrast to the house of Sajemi that has 126 filhos. Rosangela is, however, often consulted by people who have their weekend cottages in São José or in Maricá11 and who do not necessarily belong to a Candomblé or Umbanda house. As the official religion in Brazil is Catholicism, many clients and members of Candomblé are often also Catholics. One informant expressed it in the following way: “The Catholics do not openly say that they frequently visit Candomblé houses, but they come and often become members.” An important person in the Candomblé context is Professor Agenor a 97 year old pai de santo (Agenor Miranda da Rocha) whom I visited in Rio. Many times during our conversations he was interrupted by phone calls from Candomblé leaders who wanted to consult him in matters that concerned the future of their houses. “He is well known and respected by many”, as one of my informants emphasised. Agenor himself recalled an event, “When mãe Aninha of Axé do Opô Afonjá died I was asked to do jogo de búzios in order to decide who will be the next leader of the Axé do Opô Afonjá.” Agenor is well aware of the fact that he is a Candomblé celebrity, but he likes to live an “ordinary” life and keep the relations to the clients on a familiar basis. Otherwise, it is usual within Candomblé to refer to a leader as ‘pai’ (father) or according to Agenor’s age it would be proper to refer to him as ‘senhor’ (sir), but I was asked to call him by his name and not by his title. He was initiated into the Candomblé by the famous mãe Aninha Obá Bií in Salvador in 1912. Mãe Aninha was also responsible for the establishment of Axé Opô Afonjá

11 A larger village fifteen minutes travel with a car from São José, there many of the citizens of Rio have their summer cottages.

48 terreiros in Rio de Janeiro (Prandi 2001: 28). Agenor’s qualities as jogador de búzios (player of cowrie shells) were first confirmed in 1941 when the female leader of the Axé Opô Afonjá died and Agenor was consulted to decide who would be assigned for the post. In 1945 Agenor was assigned to assume a position in the Casa Branca do Engenho Velho in Salvador. His skills as jogador de búzios are however not only appreciated by leaders and members of the houses in Salvador. In 1966, for example, Agenor performed a jogo to confirm the leadership of one of the Candomblé houses in Brasília. To be a Candomblé leader is, as I argued earlier, a great responsibility. Because of that it is also a question of individual suitability for the post, which is decided through an observation of several behavioural aspects of the person, for example, the ability to incorporate Orixás, the ability to mediate sacred knowledge, his skills as a healer, his charisma, etc. Sometimes appearance also can be a determining factor in order to be accepted in a Candomblé house as I will show in the next subsection through a narrative from my field. There I will also describe my experiences in other urban Candomblé houses, which I do in order to illuminate the complexity of urban Candomblé. The lifestory of mãe Lídia do Oxum that will be presented below is also representative for many other illness-stories as it includes aspects like the social context of the suffering individual and the agency of illness through the Orixás’ “calling for” the person to join the cult. Those are also the reasons why I chose to visit the house of mãe Lídia in Brasília DF, and follow her to Salvador (Bahía).

Ernesto’s story of mãe Lídia do Oxúm After two months in the field, my supervisor and I agreed that we should meet to discuss my further work. We decided that I would travel to Brasília together with my assistant and visit a Candomblé house that I had been told about.

49 Sitting on the buss I “experienced” Brazil through the windows with all its contrasts in the nature: the red earth and the juicy-green forests. The city of Brasília is like a different country. The architecture and the life in the city are so well organised and planned that it feels unreal in comparison with the rest of Brazil. The capital is built in the shape of an aeroplane. The city’s two main roads cross each other in angles of 90 degrees. In order to make the air in Brasília more humid an artificial lake has been placed in the city’s central part. It functions as an extra water resource in the dry period. Brasília is an artificial city but, in spite of its artificiality, there are Candomblé houses located in the suburban area, outside the “aeroplane”. An early morning the phone woke us up. It was a filha do Yemanjá of the Ilé Axé Idá Wurá (literally: The House of the Forces of the Golden Sword). She was on her way to her Candomblé house and she asked if we wanted to accompany her, to talk to the pai pequeno of the house (mãe de santo of the house was away in Salvador to do her obligation in her house of origin). She picked us up with her car and we drove for quite a while to the suburban area of Brasília. At the gate of the terreiro we were welcomed by Ernesto – the pai pequeno. He said that he would love to show us around if we wanted him to (which excluded opening doors to the shrines of specific Orixá because, as explained by Ernesto, “that decision must be made by the mãe de santo”). The area of the terreiro was wide and open, with some plots of vegetation where herbs used in the rituals of the terreiro grow. On our way to the barracão we passed several shrines assigned to specific Orixás. Ernesto pointed to the living-houses on the back of the barracão and said that he lives there with his family, “We have recently finished building my house, and some houses are still under construction”. As we entered the barracão I was overwhelmed by a strange sound. The ceiling of the barracão was covered with white stripes that rustled every time the wind swept through the many open windows.

50 A woman came in and asked if we would like some coffee. While drinking the strong and sweet Brazilian coffee, Ernesto told me the story of their mãe - Lídia do Oxúm:

Her story is complicated. She is from a Catholic family with very rigid rules. Her family was of the opinion that Candomblé was a religion of “Negroes” and nothing else. People then did not want to mix with the lower class of “Negroes”… In the age of sixteen Lídia began to faint without any visible reason. During a long period of time, her family took her to various doctors, but they found nothing wrong with her. One of the friends of the family was a Gypsy and she told them that the problem with Lídia might be something else, that it may be on the spiritual level. Even the family doctor said that the problem was of a spiritual kind. Lídia herself did not accept it because of her Catholic upbringing. But because nothing else seemed to work, they decided to go to a house of Umbanda… And she started there. She was initiated and started to develop her ability to incorporate the Orixás, to do jogo de búzios, to understand the problems people had, and to find proper solutions. Then her Orixá expressed the wish to have more space, to have her own house. Lídia went to a house of Candomblé, called Pilão de Prata in Salvador, to procure a pai de santo because that was also the wish of her Orixá. At first she did not want to have her own Candomblé house, but as time went by and people started to seek help from her for their problems, she decided that she will open her own house. It was a very controversial step for her. Being almost forty years old, she established a Candomblé house in São Paulo, which led to mistrust and discrimination, both from the society of middle class people with a strict Catholic background, and from her own Candomblé sisters and brothers. Because of her appearance, as she is a white, a blond woman with blue eyes, she had to struggle to prove that she was no different from, or inferior to, other Candomblé leaders. After a long time she won the struggle, and people finally understood… Lídia’s grandparents moved to Brasília and she decided to do the same and opened this house here. However, because the strength of a Candomblé leader is charisma, ability to incorporate Orixás in the possession ritual, ability to heal, and the sacred oral wisdom, mãe Lídia is a great Candomblé leader.

Ernesto’s story about his mãe de santo points to the fact that appearance can be of importance if the person decides to establish a Candomblé house. A problematic situation seems to occur when a conservative Catholic person from the middle class “mixes with the lower class of Negroes” (as expressed

51 by Ernesto) and also becomes a leader of a Candomblé house. This is perhaps more difficult to accept for the average middle class persons than if the person only lives a “double” spiritual life without manifesting it in public. For mãe Lídia the meaning-production process of her previous illness became a political matter. As she evolved in her role as a filha and mãe de santo within Candomblé, her individual past, her illness being the reason why she turned to a Candomblé cult in the first place, was not given sufficient attention. Instead her behaviour was measured by differences between the philosophies of Candomblé and Catholicism, and the low class of “Negroes” and the white middle class. The middle-class-group is by definition forced to maintain the rules for membership (behavioural, financial, etc.) in order to preserve its group-identity. Consequently, individual actions can be seen as “over- crossing” and a form of rebellion if they do not follow the existing behavioural norms linked to the membership of that particular group. The story of mãe Lídia is also similar to other stories of people that seek spiritual guidance for their illness and first turn to other spiritual traditions and later become clients or members of the Candomblé cult, which will be shown in other narratives in this study. Ernesto’s story also points to an aspect that I will discuss further in chapter five: the agency of an Orixá, that is, the Orixá’s ability to physically “call for” a person to join the cult. Inspired by Ernesto’s story, I decided that we should go to Salvador and meet with mãe Lídia. Knowing that she was staying in the Candomblé house Pilão de Prata (the House of a Silver Crusher), and as we had been invited to participate in the ritual for Obaluaê in that house, I again found myself sitting on the bus on the way to Salvador (Bahía) “experiencing” Brazil through the windows. Candomblé rituals are called festa and, as noted by Amaral, are the most expressive institutions of the cult (2002: 30). During the festa the members visualise their ritual roles in the house, the hierarchical division of power, the

52 individual identities of the Orixás and the relationship between the Orixás and the humans. Before any festa begins, all present filhos have to take a ritual bath with herbs adequate to a particular festa. Rocha notes, “[t]he bath prepares the body. Without taking the bath the person is not allowed to participate in any ritual” (Rocha 2001: 27, my translation). According to Rocha, this is one of the many examples of the importance of another Orixá called Ossaim (ibid.: 27), whose area of responsibility is generally associated with all vegetation (Segato 1995: 76). As I mentioned earlier, every Orixá is associated to specific plants and has special areas of responsibility in the lives of human beings. Obaluaê is generally considered to be the Orixá of medicine and health. In the Orixá mythology it is said that he was a very disobedient child. One day, he and his mother went to a very beautiful garden full of small white flowers. Obaluaê’s mother told him not to pick the flowers, but he did. His mother did not say anything, but when Obaluaê turned to her his body was covered with small white flowers. The flowers turned into horrible blisters. He started to cry and was really scared. His mother said that this was a punishment for his disobedience. But she said that she would help him. She picked a handful of popcorn and threw it on the boy. All blisters started to disappear and he was as before (Prandi 2002: 204). The festa for Obaluaê that I participated in was a purification ritual. The music was played for Obaluaê and the filhos danced around a big basket full of fresh popcorn. Some of the filhos became possessed with Obaluaê and while dancing they took some popcorn in their hands, approached the non- possessed (dancing in the circle around them) and poured out popcorn over their heads. Then they ritually hugged the ones purified by the popcorn-bath, and continued to dance. The filhos possessed by Obaluaê were dressed in straw crowns to symbolise the incorporation of the Orixá, with long straw braids covering their faces to hide the frightening appearance of Obaluaê

53 whose face is covered with blisters. I was told that this ritual was a representation of the events described in the mythology of Orixás. In the next section I will pose the question: What does it mean for an individual and for the Candomblé cult to be a part of an urban context? An answer will be elaborated through some reflections about how the urban milieu inspires the individual to transform his personality, to create new roles and identities, and also to create new health problems.

Candomblé in Rio de Janeiro The entry of an individual into a Candomblé group is a complex phenomenon that involves reinterpretation of social values, transformation of the appearance, of the aesthetical customs and of the diet. Those transformations in turn promote production of new meanings (as long they do not reject the Candomblé model) influenced by certain aspects of the urban environment. Those aspects can, for instance, be stimulation of different personality characteristics as: individualism, a will to gain power or sexual liberation (Amaral 2002: 26). The urban field can be described as a field indicating social groups with a division of labour based on class structures dominated of less intense contact in the interpersonal relations, power relations controlled by different political parties, and the presence of the government. The ‘city’ can also be seen as a field of large complexity between the act and its representation, cultural plurality, and valorisation of secular attitude rather than sacred values (da Silva 1995: 21ff). Nevertheless, this model of the urban field can be criticised for its assumption that it is static and never changing. Amaral argues that there are those who view the urban field as a factor of disintegration of traditional values (as for instance ‘family’ and ‘religion’), and there are others who see this field as a new cultural milieu that arises from the diversity where traditional values change to fit this modern formation (2002: 15). In Brazil

54 those changes resulted in religious transformation, but not in secularisation (Amaral 2002: 16). The rise and development of spiritual traditions as Candomblé, Umbanda and others in industrialised cities as São Paulo and Rio de Janeiro are proofs of the complexity of this phenomenon. As argued by Segato, the urbanisation process in Brazil did not exclusively affect the higher classes of the Brazilian society (1995: 69). The transformation of religious, ethnic, individual and social identity occurred on all societal levels and, as I see it, this transformation is still going on. An urban citizen, argues Amaral, defines himself through experiences from his acts in various spheres of his social life: at work, in the family, in school, in the neighbourhood, in religious associations, etc (2002: 17). He is ‘multidimensional’, acting in various roles. His existence is however not limited to his body or to the space of daily activities. The pluriculturalism of urban fields also creates a pursuit for new forms of identity. Through participation and membership in different social groups, like Candomblé, the individual forms his personality and different identities depending on the context; father of a family, worker, passenger, customer, filho de santo, etc. Urban Candomblé reflects itself in the urban field and its mechanisms. It shares the social legitimacy of the dialogue, which is established by religious groups with other groups, institutions and dimensions, in the (da Silva 1995: 17). Candomblé can be seen as a cult that is not entirely of an ethnic or marginal character (as it nowadays includes members of various economic and ethnic groups), but also as an institution that emphasises new concerns and terms to share transformations (ibid.: 17). Today, in the urban environment, the central aspects of peoples’ lives appear to be regulated by institutions like for example the Tribunal, schools, hospitals, business firms, the police, the Church, etc. In contrast to the cult of Orixás in Africa, Rodrigues notes, “the Yoruban priesthood lost all intervention on the acts of the civil life in Brazil” (Rodrigues 1976: 237, my translation). Consequently,

55 weddings and births are regulated by the organisational systems of official religion – Catholicism, and the government, which do not tolerate Afro- Brazilian intervention. It is however important to point out that no matter how much space the institutions of the system occupy there is always a margin for independence and individual choice-making. With my earlier discussion about relations between culture and medicine in mind, I would say that in this urban milieu the individual creates meanings of the illness he experiences, in relation to the local, pluricultural and plurimedical context. The individual meaning-production occurs also in a presence of various frameworks. Accordingly, Worsley stresses that, ”[m]edical conceptions of illness and its cure are always embedded within wider ideological frameworks (as Hinduism or Western science) which provide answers to questions as: Why did it happen to me?” (1982: 327). More importantly, Worsley argues further, “there are undoubtedly new physical illnesses of industrialisation, of bad housing and evil sanitation (…) and consequent new stresses and strains in the urban milieu” (ibid.: 335). This also supports the thesis of Guarnaccia discussed earlier, that social realities shape health and illness in the society (2001). A similar problem is described by Lock, through examples of a trauma called “nevra” in the city of Montréal in Canada (2002). “Nevra” is seen as a manifestation of the particular problems raised by a migration of Greek population to that city. It is a new physical urban location, in which social organisation and working conditions are transformed, creating uncertainty, possible unemployment and exploitation (ibid.: 200). New illnesses in turn require formulation of health therapies that do not conflict with the patients’ lifeworlds. The rise of the Brazilian Umbanda cult in the cities is, according to Worsley (1982: 335), one of the responses to these new kinds of problems; thousands of those seeking employment and appreciation of their personal worth might find the acknowledgment they seek in this cult. This “community of the afflicted” is,

56 like other urban forms, individualistic and associational (ibid.: 335). Candomblé healing can thus be seen also as an alternative therapy fulfilling the individual quests for recognition and suitable treatment for problems or conflicts in the individual’s lifeworld. In my opinion, the urban Candomblé mirrors the of the Brazilian society. Approaching the issue from a different perspective, the Catholic Church generally denies the legitimacy of the Candomblé cult. The cult is also stigmatised by the historical background of slavery and race conflicts. Those facts might make it difficult for the clients to approach Candomblé if they see it primarily as an effective form of therapy and not as a religious association. The general recognition of the therapeutic efficacy of the cult and, on the other hand, the maintenance of the cult in the diffuse area of neither acceptance nor denial mirrors the social reality in which the cult exists.

Treatment of Illness in a Candomblé Context It is possible to say that, generally, the average Candomblé client is a person who experiences disequilibrium in his life and who seeks treatment to restore that equilibrium. The unemployed perhaps seeks guidance for how to make better odds to find work. A wife might want to have a better marriage, while another person might seek an explanation or a cure for a health problem. Yet others might have problems related to their financial situation or personal life. Re-establishing the harmony in the client’s lifeworld may be a simple process or may require all the spiritual medicine available to the mãe or pai de santo. For a client, the healing process begins with identifying the client’s two Orixás responsible for different parts of the person’s life. This is done by the healer’s consultation of the oracle in the form of jogo de búzios, which will be described in more detail in the next subsection. Those who seek treatment for an illness in the cult are often those who experience some disorder in their

57 lives. It can be a health problem in the family, financial or existential problems. In the words of Agenor, “They seek. They procure a truth they do not know yet”. According to my informants an illness is a signal of an imbalance in the individual’s lifeworld that consists of three parts: the psychic of the person (body personal), the body social (the representational aspects) of the person, and the physical body (an integral part of the conscious Self; also a part of body personal-aspect) of the person. The life of the members in a Candomblé terreiro mirrors the terreiro’s hierarchical organisation and religious values. The milieu of a Candomblé house also creates new relationships and responsibilities. The specific organisation, the values, the relationships and responsibilities are also the existential base of the equilibrium in the lives of clients and filhos of the terreiro. The notion of equilibrium in the spirit, the body and the social life is interconnected with the axé of the house and of the person (Amaral 2002: 68). In order to treat an individual the axé of the person has to be restored. The lack of axé, according to my informants, implies an illness, unemployment, or lack of love. Those in turn are interpreted as a disorder, disequilibrium in a biological sense, or disequilibrium in any domain of the social life of the person (ibid.: 69). Candomblé definition of illness is thus similar to Sachs’ definition of illness as something that signifies conflicts in the individual’s interpersonal relations but also Merleau-Ponty’s definition of illness as the individual experience of a specific disorder. A common treatment of illnesses within Candomblé is a ‘leaf bath’, which is considered as the principal purification ritual prescribed during jogo de búzios. It is prescribed for health problems as well as for economic and personal difficulties. It is said to serve to eliminate the negative energies that may be constraining the client, to restore his equilibrium, or to attract good fortune. Leaves used in this purification ritual are usually consecrated to the

58 Orixá of the client and it is very important that they are prepared and gathered during proper time and place (Voeks 1997: 94). Through the interpretation of the jogo the mãe or pai de santo seek a proper treatment for the client’s illness (purification rituals, offerings, etc.), which sometimes includes the use of pharmaceuticals. The use of pharmaceuticals has to be supervised by Orixás, and is therefore always foregone by their consultation through the jogo. For a suffering individual, determining whether his problem is of a physical or spiritual origin may not be that easy. If the health problem is deemed to be of organic origin, the client is often advised to seek a physician. Otherwise, the main treatment for a physical problem is provided through plant therapy. Voeks notes that, “a few Western doctors maintain reciprocal relationships with mães or pais de santo, in which one sends clients to the other if the problem appears to be within the other’s purview” (1997: 96f, italics added). In my experience, the cooperation of the two medical practices is more complicated than that of Voeks’, but I will discuss it further in the next chapter. However, in both contexts, the medical specialist decides what causes the illness. Depending on the cause he gives the illness a name, and this consequently makes the finding of a cure possible, because the illness is then “categorised” in accordance with the medical knowledge and practice within the particular context. According to my informants an active and intentional engagement of the client is crucial in this process. A Candomblé healer needs to apprehend the whole social and individual circumstances of the clients’ illness in order to provide the right treatment. In the consultation, through jogo de búzios, the client reveals his lifeworld to the healer. This process is based on the intersubjective, narrative practice between the client and the healer. In other words, the client’s story of illness is narrated to the healer through participative interaction. Because of the various treatment options in the

59 pluralistic medical context of Brazil, an interesting question develops: how are these options used by the clients of Candomblé? One answer to that question was provided to me by Sajemi. He practices both medical traditions in his role as a nurse and as a Candomblé healer, and sometimes he chooses to send a person with an illness from the roça to the Ambulatório. One of the narratives I heard during my stay in his roça was about a woman he played búzios for. In the jogo, he saw that she needed to make a ritual for one Orixá, because of her menstruation problems. She performed the ritual, but as Sajemi continued talking with her, he decided that she should go to a gynaecologist as well. The woman did what she was told (the treatment also involved surgery) and recovered. Sajemi being a leader of a roça and a nurse was thus able to use both his medical knowledge as a nurse and his medical knowledge as a Candomblé healer, when an ill person came to see him.

I work in two Abulatórios as a nurse and I think that helps me to have a broader judgment. When the illness is totally spiritual, or connected to Orixás, and when the illness is extremely physical, with some pathology, I try to look for it in the jogo and my both professions make it easier for me to orientate in some direction.

When I asked him if the staff of the Ambulatório knew about his other profession, he answered that, “70% does not know, because I do not want them to come and ask me all the time if I can play the búzios for them”. He said that he is trying to keep the two professions separate, but that it sometimes is better for the client if he can “treat the whole person”, which means both the spiritual and the physical part of the person. In the majority of the cases, as also argued by Brumana and Martinez (1989: 29), the client turns to the biomedical profession and if it fails, the client seeks the non-official religious agency of cure like Candomblé, or Umbanda (see for example the case with mãe Lídia described earlier). Despite

60 this, Candomblé is not seen as a practice secondary to biomedical practice. Instead it is seen as a proof of the power of the cult (Cuesta 1997: 111ff). For many urban Brazilians, the failure of the biomedical profession is, according to Brumana and Martinez, a sufficient proof that the cause of the illness is not ‘material’ and that the consultation of other therapies is necessary (1989: 29). According to Voeks, the spiritual disequilibrium is, however, not always the source of every predicament (1997: 95). Something similar was expressed by client Nicacio:

I think that an individual is in charge of his life, not saints or supernatural beings. If something happens, it happens because I did something, which had that outcome, not because Orixá punish me for something. Some things just happen.

There are problems that “just happen”, a broken arm can be a result of simple carelessness, a person dies because it is his or her time etc. I will go back to the aspect of “punishment” in the next chapter. The ritual of jogo de búzios has various functions. In Brazil the ritual year vary from one Candomblé house to another, but in every house obligations begin with Águas do Oxalá (Waters of Oxalá). Before the ritual it is of importance that the house has consulted the oracle through jogo de búzios to determine which odum (type of destiny) will govern the year to come, and which ebóis (sacrificial offerings) are necessary to perform in order to make the year successful (Rocha 2001: 26f). As I pointed out earlier, every individual is regarded as having Orixás, which is determined through jogo de búzios. The problem of the client and the solution for it are also shown in the jogo. The length of the period of initiation is also revealed in the jogo, as well as which obligations the particular house has to perform during the year to come. From the above examples it is obvious that jogo de búzios play a determining and vital role in the lives of the members and clients of the cult.

61 One could also say that consultations or divination sessions are used as a complementary and/or alternative therapy.

The Ritual of Consultation: Jogo de búzios One of the functions of the jogo de búzios is to be an analytic instrument to supply the client with an expansion of his understanding of his own personality and an introduction of the vocabulary of the cult (Segato 1995: 57). This is accomplished during a process of communication between the client and the Orixás. The healer then functions as a medium and as an interpreter of messages of the Orixás to the client. This also works the other way around as the healer, using his symbolic repertoire, interprets the narratives of the client to the Orixás. In the jogo de búzios Orixás communicate with humans through various combinations and positions of the shells. The interpretation of jogo de búzios is a very complex process, demanding great sacred knowledge of the healer. It also demands an understanding of the human nature and the flexibility to adjust the sacred messages of Orixás to fit into the lifeworld of the particular individual. The hour was late when we arrived at the Rocinha do Oxúm. Rosangela was already waiting with the table prepared in the barracão. She said that she would first play the búzios for my field assistant Erik, so that I could “observe and learn”. In the middle of the table was a peneira (a wooden board assigned for the jogo) containing a magnet, various coins, special stones, an obí (kola nut; associated with all the Orixás; “good for the nervous system and the energy” according to Rosangela), an orobô (bitter kola; associated with all the Orixás), feathers (“because the jogo also ‘eats’ to get energy”), “olho de boi” (an amulet that takes away the “olho grande” - the envy), all of that surrounded by a ring of sacred necklaces. On the side of the board stood a lighted candle, a signal for Orixás and symbol for the vital energy, and an adjá (a ritual bell used for salutations). Rosangela invited Erik to sit on the opposite

62 side of the table. When he did, she closed her eyes, took the sixteen cowrie shells and started to shake them in her closed hands, in silence. Before the jogo, I had asked her what would happen, and therefore I knew that she was saying a prayer to summon the appropriate Orixás. Still shaking the búzios she said: “Your full name and the date of your birthday…” Erik answered and Rosangela simultaneously threw the búzios on the board. She picked up some of them, shook them and threw them again. Rosangela repeated this seven times. After the eighth time, she rang in the adjá and said, “An Orixá responded. Your dono da cabeça is Ogum”. She described to Erik the qualities of Ogum and how they corresponded with his personality. Then she took all the búzios, shook them and threw them again on the board. Rosangela repeated this four times and, after the fifth she rang the adjá and said: “Your second Orixá is Oxúm”. The same procedure followed. She explained to Erik Oxúm’s part in his life and which qualities of his personality were linked to Oxúm. And again she took all the búzios, shook them and repeatedly threw them on the board. Then, she said: “You are an alabê12, you are an ogâ. An ogâ who seeks.” She threw búzios several times, while talking, to confirm some of the guidelines shown in the jogo. After a while she asked Erik: “Do you want to ask something special?” Erik thought for a second: “Should I be careful with something in my life?” Rosangela threw the búzios again and said: “All the time be alert, use your heart, and pay attention.” She continued talking and throwing the búzios, sometimes Erik interrupted her with a question he wanted an answer to and then she threw the búzios to seek the answer. The next day, while hanging up the laundry, Rosangela and I talked about the jogo.

12 Alabê: an ogâ who’s responsibility is to play atabaques.

63 When I throw the búzios, an Orixá answers. Then I start to suspect that he is the dono da cabeça and I ask: Is he your son? If no, I have to try again, and ask again. When the Orixá answers yes, then I ask what the Orixá wants to say to the person.

I asked about how it feels and what happens in her mind while she is performing the jogo and she said:

It is like a mishmash of talking in my head and to make questions and answers out of it demands a great deal of concentration. Sometimes it happens that all the búzios are ‘closed’ that means the person either is not ready to hear anything or something is wrong with me as mãe de santo. Then I cannot play the búzios that day. But it yet never happened to me and I have played eleven years.

The divination is played out according to a hierarchical order. O dono da cabeça is believed to represent the basic structure of the personality of the person because, according to Rosangela, “he is situated in the persons head”; therefore he is the first to be found. The second Orixá is an ajuntó (assistant) whose function is to protect and guide the person (Segato 1995: 48). The last thing that is asked is what “function” or odum the person has in a Candomblé house and in life. Aparecida, a client of Sajemi is a sister to an ogã in the house. She told me that she have frequented Candomblé houses as long as she can remember, but she has never felt that she would like to be initiated. While talking about her experiences and emotions during the jogo, she said:

Sometimes when I do the jogo, I feel that Orixás respond, sometimes they say things I already know or have thought about. In a way I feel protected; I feel an energy mediated by Orixás through the jogo.

A similar answer was given by Sajemi’s client Nicacio:

Six months ago I came to Sajemi for the first time. I felt that I had to get a second opinion about what to do. Then Sajemi did the jogo for me. At

64 first I did not say anything about my plans to start my own fast-food restaurant, or about the fact that I thought about buying a taxi. During the jogo I got surprised and also confident, because Sajemi saw all those things I have thought about, in the jogo.

In the jogo each búzio is associated with an odum. Consequently, the sixteen búzios mean sixteen different odums. Every individual have an odum. This is discovered either the day the individual is born or during the process of initiation (Segato 1995: 80). It is up to a mãe or pai de santo to determine which of these sacred oral messages is relevant to the problem under consideration (Voeks 1997: 90). As noted by Prandi, according to the Yoruba mythology it is believed that an odum reveals a story capable of identifying the client’s problem as well as a solution (2002: 18). Consequently, to determine the odum of the individual and find the solution for his problem, the mãe or pai de santo consults the búzios. When Sajemi performed the jogo for Nicacio, he interpreted the positions of the búzios as an odum indicating that Nicacio was about to “invest in a business involving food, and that he may also invest in, and benefit from some means of transportation”. In the same way every búzio is associated with an odum, every message revealed through a specific position of búzios on the peneira is associated with an Orixá (Segato 1995: 80). In the jogo every Orixá expresses himself through one, two or three odums. Segato points to an important aspect of the interaction between the supernatural and the human in the jogo. That is the notion of an Orixá as a personality of an individual that is not necessarily interdependent of the odum, the “path” of the person (ibid.: 81).

V. TREATING ILLNESS IN CANDOMBLÉ HOUSES In the roça of Sajemi Thursdays are the usual days dedicated to consultations. Sajemi arrives already on Wednesday night to be able to begin early on

65 Thursday morning. The clients of the roça begin to arrive at seven. There is a constant coming and going of people until five in the afternoon, with a brief interval for lunch. Those who wait for their turn to perform jogo de búzios sit on the benches on the veranda outside the barracão chatting, exchanging news about the neighbours, families and commenting the “new elements” in the milieu of the roça – the Swedish anthropology student with her Brazilian assistant. My curiosity about the lives of the waiting clients is treated with patience, because the clients are aware of the fact that they may spend several hours waiting for their turn to consult the búzios. As expressed by Nicacio, “it is better to spend the time chatting, than sitting and do nothing”. Today, the roça is full of activity. In the cuzinha do santo (kitchen of the saint); in the back of the barracão, various kinds of food for offerings are prepared. Outside the cuzinha, three large tables are already filled with plates containing different meals for different Orixás. Sajemi calls for me to come and join him with a group of filhos who are about to perform a ritual of purification for a filha of the roça. Hoping to get a chance to talk to her after the ritual, I place myself on the side from the filhos making sure I do not stand in the way for their movements. The woman stands in the front of the shrine of the Orixá Ossaim situated in the middle of the open area behind the barracão. Sajemi and the filhos start to sing, while he lightly brushes a bundle of twigs with leaves on, over the head, back of the head and shoulders of the woman. She sits down on a stool with her eyes closed and after a while she becomes possessed by Ossaim. She waddles slowly, now standing up. The ten-year-old ogã plays an atabaque to the rhythm of the song. Sajemi brushes the bundle on the sides of the woman’s body. An ekedi approaches and dips her fingers in a bowl of water standing in the shrine after which she touches the possessed woman’s head, shoulders, back of the head and palms of her hands. Finally, she puts a white cloth over the possessed filha’s head, and when she takes it off, the filha

66 comes out of the trance. After the ritual I desperately try to find the woman, but she is already gone, so I ask Sajemi about the reasons for the ritual.

The ritual was for Ossaim. I prescribed it after the jogo, because I saw that she had difficulties related to her personal relationship, that she experienced disequilibrium. We talked about her life, about what kind of disequilibrium she experienced. While mediating between her and Orixás, I found out that the proper treatment would be to address Ossaim.

The ritual was thus performed to restore the equilibrium in the woman’s life both through an action of an Orixá upon the woman – during the possession, but also through an active interaction with Sajemi – during the jogo. The Body of the woman became an object for the agency of illness personified in the ritual of possession as a passive entity controlled by an Orixá. However, during the jogo, as well when the person intentionally chooses identification with an Orixá as a treatment, the situation is reversed. As I was told by Sajemi, a cure for an illness can also be provided by the individual himself. Depending on the problem the individual has, he can choose to concentrate on the characteristics of an Orixá. For instance, to be successful in love a person concentrates on, and embodies a personality of an Orixá that has qualities like charm and kindness (for example Oxúm). Those acts show that the problems the individual face are not exclusively solved through faith in the help from supernatural forces. As argued by Segato, the vital part is in those situations played by the intentional identification with the supernatural, seen as an inspiration for the person’s behaviour (1995: 232). The identification with an Orixá can however, not simply be seen as an act of possession. Segato insists further, “[i]n every case, the possession is understood as originating from the will of the Orixá, and not of the filho” (ibid.: 232, my translation, italics added). Segato makes an important point. There is a difference between the ritual of possession where Orixá mediates guidance and messages to the filho, and the person’s intentional identification with a chosen Orixá in order

67 to solve a problem. It is possible to metaphorise this situation and see the possessing Orixá as an active agent, where the filho is passive, and in the second case the person as an active agent while the Orixá is passive. Rosangela described the agency of the individual and the illness in a similar way:

The person can ‘create’ her illness with the intention to form the personality. As a person can create the illness, she can in the same way create the cure. The complaint is as a symptom, a signal for the Orixá to guide you, to show you your choices.

In her view, the individual is an active agent that freely can elaborate with his well-being. It is the individual’s choice to be, or not to be ill, in the same way that it is the individual’s choice to be, or not to be healthy. Rosangela’s comment pinpoints a vital aspect of individuality. In line with Haraway’s view of individuality I discussed earlier, it is possible to see the identification with an Orixá as an intentional strategy of the suffering person to bring order into her lifeworld. If we acknowledge the individual as a strategic entity, another aspect of treatment of illness has to be considered. That is the plurimedical context in which the individual operates. That context consists of different medical knowledges, different medicines and different medics that provide the treatment13.

Medical Knowledge and the Person One problematic aspect of the biomedical knowledge is that it may involve an overreliance on science and technology, which in turn can result in the seeking of a “quick fix” to the problems the individual faces in his life. Science is not that value-neutral as many assume. Western cultures have a deep belief in

13 By the terms ’medicines’ and ‘medics’ I refer to Candomblé healing, herbal medicines as well as pharmaceuticals, and other treatments provided by doctors from the biomedical tradition.

68 science as the ultimate authority on questions of knowledge and truth. This belief is so deep and unexamined that it can be seen as a “cultural myth”. According to this “myth” of scientific objectivity, our beliefs are mere “opinion”- personal, subjective, and biased – unless they are validated by science. Although it is important not to overstate this point – scientific knowledge has a great potential to help us to understand and solve the problems of illness – science is not the purely objective and value-neutral resource that so many assume it to be. In some ways, science is nothing more that a detailed, precise, and documented approach to knowledge existing in a social context. ‘Health’ and ‘illness’ are themselves social categories that have been constructed by medical knowledge and practice (Augé & Herzlich 1995: 12). Understanding medical knowledge is then not only a given and objective set of facts but also a belief system shaped through social and political relations (see also Lupton 1997: 99). The scientific biomedical knowledge may however have hidden, general assumptions that influence the biomedical practice. An example of that is the process of socialisation of doctors from the biomedical tradition. Doctors are socialised into an alienating, Cartesian dualism which separates Body and Mind, and which treats the patient as a ‘case’. The doctors “incapacity” of combining Body and Mind is taught, and in a way expected and desired. According to Worsley (1982: 321), the patient’s social relations, even if perceived, are quite beyond the competence of physicians (apart from psychiatrists). Those aspects of the individual’s life can be seen, according to the scientific approach, as “insufficient” and time-consuming ways to treat the patient. The biomedical practitioner is trained to bypass illness systematically as part of his exclusive interest in the recognition and treatment of disease. This is also emphasised by Kleinman, “[h]e is taught to cure, not to care” (1980: 363). Further, and in the light of the discussion in chapter two, one can perhaps say that for members of Western societies the Body is a machinelike

69 object separated from thought and emotion (as also expressed by Kleinman 1988: 11). For members of many non-Western societies on the other hand, the body is an open system linking social relations to the Self, a vital balance between interrelated elements in a holistic cosmos (Evans-Pritchard 1976; Witherspoon 1977). Although, in generalised terms it is possible to view the two medical knowledges as separated by their ideological differences, on the individual level, when the biomedically trained doctors express their view on illness, the difference is not that clear. In Rio, a doctor from the biomedical tradition expressed his perspective like this:

If the person is gravely ill but has a united family that can support him, the illness becomes easier to manage. When the person is depressed, the immunological system is weakened. In this case the person’s faith plays an important part. Our inner strength is even stronger than pharmaceuticals, because the spirituality creates a shield against bad things that can happen to the person.

My point is that the biomedical practitioners as individuals are not always sceptical of other medical knowledges and practices. In conversations with doctors and other medical practitioners working in an Ambulatório in Rio many expressed the importance of the spiritual care, as well as the social and individual situation of the suffering person. When asked if, and what parts of the personality are affected when the person is ill, Ana Rita working in the social service-section in the Ambulatório said, “The person gets another attitude to others, to the life; he revalues his world, starts to reflect over things.” Her answer mirrors my argument that when experiencing an illness, the individual’s world changes, as it is reshaped by the individual. The social context of the individual is also reshaped, reinterpreted and revalued. As argued by Good, disease as represented in biomedicine is localized in the body; the narratives of those who are subjects of suffering represent illness, by contrast, as present in the life (1994: 157). Sajemi expressed his thoughts

70 about the different medical knowledges, and the differences between the treatments like this:

In reality it is important to see if the illness is physical or spiritual. If the illness is physical you have to observe and look for physical causes in the person and as well in the jogo. Because there are situations, which are connected with Orixás, and others are not... Biomedicine is directed to the organs and the biomedical treatment is directed to the organs as well. The treatment inside the casa do Orixá, the spiritual treatment, is an energetic treatment of transferring energies. Every Orixá is associated with a part of human body, so if you have a problem with your eyes, you do a trabalho [ritual] for Oxúm, if you have some problem with your head it can be appropriate to do a trabalho for Yemanjá, because she is the Orixá of the head, or for the Oxalá who is the Orixá of the cranium. So, you have different ebóis and different Orixás receive them and respond to the rituals connected to the health, the aura, the body. The illness affects those around the person as well; it affects the person’s behaviour against those around the ill person. When you are not well spiritually, then the body gets ill... It is easier to treat the body from an illness, but the spirit is not always that easy to cure...

There are similarities in those two treatments. The practitioner is looking for the cause in both cases and chooses to treat the part of the body where the problem is situated. The difference lies in the practice, the Candomblé-healer works upon the illness indirectly treating the problem without dealing with organs per se; he instead treats the Orixá, connected to the affected body part or to the situation in the person’s life, through a ritual. Agenor, when I asked him about the part Orixás have in healing the illness, he answered:

They are not always doing good things, no... Sometimes you have to go to a doctor... In the case of herbs, if the Orixá indicate a plant that is for curing, then they are always good advisers.

In my opinion it is difficult to deny the possibilities of biomedical technology, as well as the efficacy of the local forms of healing, when both of them contain similar components concerning the client like, for example, specific treatments for specific health problems, treatments directed to the affected

71 body parts and so forth. And both can offer a possibility for better health. In a comparative study of the western medical knowledge and the local it is possible, according to Augé and Herzlich (1995), to find a level where both are meaning-seeking, and as stated by Whyte the meaning of medicines must be understood in terms of the experience and conception of illness (2002: 42). Applying this to my field, the meaning of an illness for a person might be instrumental. That is, the “function” of an illness can be to indicate the existence of disequilibrium in the individual’s lifeworld and through some therapy reshape and revalue the lifeworld of the ill individual. The meaning of medicines, as understood by my informants, is to restore the equilibrium in the Self to that before the illness. However, when discussing the issue of meaning of medicines with Rosangela and Sajemi the consensus of opinion was that the Self is a part of the individual that undergoes continuous changes influenced by stimuli from the person’s lifeworld. Accordingly, the individual changes while experiencing an illness, so when he finally is well again, “he is no longer the same” (as expressed by Rosangela and Sajemi). Depending on the experiences in the illness, the relationship between the Body and the Self of the individual is reinterpreted due to that new situation of the person. The meaning of medicines might then be seen as a way to a deeper understanding of ones personality, an issue I mentioned earlier in the context of jogo de búzios. Returning to the discussion about the dualism of Mind and Body, Nancy Scheper-Hughes offers an interpretation of the embodied lives and somatic culture of the Brazilian Nordestino sugarcane cutters (1992; 1994). Scheper- Hughes criticises the view to standardise our own “medically constructed and socially prescribed mind-body division” (1992: 31). She sees the cutters’ behaviour as both normative and as a socially and politically shaped strategy to cope with problems as hunger/famine, unemployment, urban migration, illiteracy and malnutrition (ibid.: 31). Her concern is to show how such

72 problems are defined as medical problems, and treated with drugs. According to her, this is a form of “medicalisation” of problems, which distracts people from recognising and dealing with the source of their problems. In the exchange of meanings between the body personal and the body social, the nervous-hungry, nervous-angry Body of the cane cutter can thus be seen as a metaphor for the unstable, nervous socio-political system; as well as a metaphor for the rural workers’ disabled position in the present political and economic disorder (1994: 237). In addition to Sheper-Hughes’ notion of “medicalisation” of problems, and with my earlier discussion about the new physical illnesses resulting from industrialisation in mind, a new question can develop. How do clients of Candomblé see pharmaceuticals’ effect on the person? As already stressed by Whyte, the local systems of healing can gain ideological weight in opposition to synthesized pharmaceuticals (2002: 12). In a similar way, Elisabeth explained to me her anxiety of being dependent of pharmaceuticals when I asked, “What does it mean for you to be healthy?”

For example: I am 52, when you are 52 you can get problems with high pressure, your heart do not work so good anymore, if you do not take care of your part spiritual, coexist in the symbiosis with the nature... you will live dependent of the pharmaceuticals for the rest of your life...

Elisabeth’s husband died some years earlier of cancer, which left her and their son grieving and reflecting over the importance of spiritual health. In some measure, I think, that her expressed sceptical view on pharmaceuticals, is based on the “failure” of biomedicine in the case of her husband. On the other hand, I believe that her experiences of death and sickness expanded her view on illness and developed some parts of her personality. Her comment about “coexistence in the symbiosis with the nature” can perhaps be compared with the endeavour to reach equilibrium within Candomblé healing ideology.

73 Another important aspect of medical treatment is that of what kind of a person prescribes the medicine. The complexity of the issue was revealed to me in Elisabeth’s narrative about how to find a “good terreiro”.

It is difficult to find a terreiro there you can adapt yourself. You have to adapt to a person as well, the leader of the house. You have to feel that this particular place is good for you. A good medic. You have to find a right person, a right medic. There are places [terreiros] that do things that you do not approve, you begin to think that they can do the same to you and you build up mistrust against the place. I think you have to seek places capable to help you find a good luck, an open path, a future. Because there is a path for everyone, you do not have to take it from someone else. You have your own path, I have mine. You do not have to destroy for someone to construct for yourself. On Rosangela’s I did not see those destructive qualities. Everyone there has their own individuality, and the most important, Rosangela is concerned with her Orixá, not with mine, with her path, not with mine. Since I met Rosangela na rua [on the street] my path has been open. She is a good medic.

Elisabeth’s description of a “good medic”, who does not interfere with the client’s choices to live his life, is common among the clients of Candomblé houses involved in my study. The healer’s role is instead to guide the person and mediate alternatives shown in the jogo de búzios. Within Candomblé the healer is also important for his ability to appropriate effective power from places distant from the social world: principally the natural world and the spiritual world. Healers can thus be understood not as fixedly beneficial agents of society, but rather as socio-political agents. Their successes in times of crisis increase social faith in their personal healing powers and thus add to their credibility. The failure of Candomblé healing is generally not seen as a proof for the healer’s incompetence. It is rather seen as an action of an Orixá indicating that other spiritual treatment should be prescribed, or that the treatment should be repeated several times. As explained by Rosangela and Sajemi, the failure of the treatment is often a result of a client’s imprecise following of the prescribed procedure. The client may for instance not have

74 gathered the sacred plants on the right time of the day, or the chicken for the offering may have had some defect like, for example, a broken wing. Considering Sajemi’s role as a practitioner of two medical traditions, he is seen as a “good medic” also for his ability to determine if the client should turn to a biomedical treatment instead of Candomblé healing. I also mentioned earlier that the use of pharmaceuticals could be prescribed after the jogo de búzios. But, is it common for a biomedically-trained practitioner to send his spiritually ill patient to a terreiro for treatment? Voeks argues that there are “few Western doctors” who maintain a reciprocal relationship with some terreiros (1997). Through conversations with practitioners from the biomedical tradition in Rio I found out that it is highly unusual. The reason for it can be the fact that Candomblé healing is seen as “non-scientifical” and that it is too closely linked to the generally sceptical view of the elements of the cult, such as possession trance and offerings. Those “mystic” aspects of the cult contribute to the general scepticism against the medical practice in its context. I also think that this is the reason why Sajemi feels that his profession as pai de santo is not (according to him) appropriate in the biomedical context. He does however sometimes make the suggestions for his patients to seek “spiritual treatment”, or if the patient asks for alternatives, it may happen that he introduces him to his roça. The problematic relationship between the two medical practices can also be viewed from the patient’s perspective. It is not the patient’s scientific knowledge that makes him attend the biomedical agencies of cure, but a principle of authority (Brumana and Martinez 1989: 50). The patient has a confidence in a “magic result” of the treatment. In the context of Candomblé the client is attracted to a similar principle of authority and approaches the cult with the same confidence in the treatment’s “magic result”. Consequently, if the patient of the biomedical agency of cure is sceptical towards the authority of a Candomblé healer and knows of the other profession of the medic (in this

75 case Sajemi), it can reduce the confidence in a “magic result” of the biomedical treatment provided by this medic (Sajemi). In addition to the notion of authority, Brumana and Martinez make an important difference. The authority of Hospital, as well as University, and Industry, has risen in the society in the institutional sense. It is explicitly alien to the symbolic codes of its subjects, viewing them as passive objects, and imposes the acceptance on the individual (ibid.: 50). The authority of a Candomblé healer is, on the other hand, achieved through the elaboration of a symbolic repertoire which depends on the individual’s choice to either accept it or not. In the latter case the individual is an active subject, intentionally choosing a treatment for his illness in accordance with his own understanding and interpretation of the symbols in his lifeworld. Let us say that the individual turns to a Candomblé authority to receive treatment. He has perhaps already visited a biomedical practitioner and has been provided with a treatment according to the biomedical tradition, but he still feels a presence of discomfort, he experiences disequilibrium. Perhaps he is not pleased with the treatment of his illness, or with the objective, symptom-based, biomedical explanation of his condition. How is then his illness explained in the context of Candomblé?

The Socio-Individual Context of Illness In the former chapters I already reflected on some aspects of Candomblé, like interactions with Orixás that are important for the client to consider when he enters the cult to seek treatment for his illness. As I stressed in chapter four, such an aspect also can be a relation to the pai or mãe de santo, who beside the role within the cult, is a person with her own desires, experiences and lifestories. Those in turn, when told, contribute to a feeling of mutual confidence and trust between the client and the healer, and they illuminate as well the socio-individual context in which the healer practices his medicine.

76 The lifestory of Sajemi describes his socio-individual context of practicing both medicines:

The roça was established in 9th of May 1970. I was initiated 40 years ago in the house of Tumba Junsara. My pai de santo was Tatá Gorense, a first filho of Tumba Junsara, initiated in 1922. My zelador [the caretaker, a popular name for a mãe or pai de santo] told me, during my obligation of seven years, that my Orixá would in the future express the desire to have an own house. And in the age of 20 years, after a time of building and preparations of the house, I was able to open a house for my Orixá. The choice was not mine, as I said. It was my Orixá who wanted that… I have never been married, and I do not have children. I do not think that I am obstructed to have a private life, more likely I am too absorbed by my practice to have one. I do not have children, and I have 126 filhos initiated in the house. And in reality, I have to say, that I have the affection, love, peace… Filhos that you yourself have initiated into the house, this conjugate and shape your family and you feel as a “big” father. Another thing is that, some time ago, I worked night shifts in the Ambulatório, and when you do that, you do not have time for other things. So, when I am on duty, my family is here, in the house. My family is very important to me. I am only human, and as such in the cult of Candomblé, I live out my function as a human being… My greatest dream is to travel. To go to Nigeria, and also to see those countries where my parents were born. My grandmother was born in Rumania and in the First World War she migrated to Portugal where my mother was born. Then they came to Brazil. And my father was born in Syria and he migrated to Brazil as well. So, my parents met here in Rio.

When I asked how he came in contact with Candomblé, Agenor gave me the following answer:

I was 5 years old... got a fever and no one knew what was wrong with me... and... my parents went to the best doctors... And a neighbour of ours went to ‘casa do Aninha’ [house of Aninha]. And she played the búzios for me, and said: The only way is to get in contact with Oxalá. That was the Orixá that responded in the jogo. So, it was natural for you to initiate in Candomblé? No, they said that I should seek, and my family and the doctors said that I could die so they let me go there. When I have got there, when I begun to shake the sacred leaves to make the preparations for the Orixá, I returned into normal condition... and I have been until now while they are already dead.

77

In the case of Agenor (like in other cases I came in contact with), an illness appears as a signal for the individual to act, to consider if initiation in the Candomblé can solve the individual’s problem. Rosangela telling the story of one of the filhas in her house provided another illustration of this issue.

When Gisele, a filha do Obaluaê [daughter of Obaluaê], was seven years old she started to faint and the doctors found nothing wrong with her. Her parents are Buddhists and they thought that the problem might be on the spiritual level. They took her to a Candomblé house to do an oferenda [offering] for Obaluaê because in the jogo they were told that Obaluaê is her dono da cabeça. Obaluaê told them that Gisele should wait till she is twenty-one to decide if she wanted to be initiated. She should be, but she was not to decide that before she reached that age. And when she was twenty-one she accepted that and joined the Candomblé.

Rosangela’s lifestory provides yet another example of the illness seen as a signal for the individual to take action, like initiation in the cult. In those cases the illness can also be seen as an instrument stimulating the individual to seek the “right” treatment.

Sometimes when I went to Church, when I was little, I used to see a woman dressed in white Candomblé clothes standing still, looking at me and smiling, and every time when I tried to show her to my mother, she was gone. When I was a little girl I often had visions and saw things that were not there. I used to tell my mother about it and consequently she told me that it would be wise to go to some spiritual centre. First, we went to a Centro da Mesa Branca [a Kardecist spiritual movement]. After some time we went to a Candomblé house and I felt like coming home. I started to learn, and everything I learned came so easy to me. I still learn from others. You know, you never stop learning.

Returning to the individual and my previous question of how illness is explained within Candomblé it is said that the Orixá can “call for a person” or “point to the person”. In that case the Orixá is an active agent who acts directly on the person’s lifeworld. The individual is then an object of Orixá’s action. Sajemi explained it like this:

78 Orixá has various ways to “call for” a person. One way is through pseudodoenças [pseudo-illnesses] that disappear after the person comes to a Candomblé house. If the person is initiated in the cult, the person experiences disorder in his lifeworld, like a feeling of discomfort, or through others in the family: someone in the family gets physically ill or experiences disorder. In those cases the Orixá “points to” the individual that he has not done something he should have done. In the case when the individual is not initiated, the Orixá “elbows”, or pushes him to take care of himself and his family.

In Sajemi’s explanation of illness an important aspect of the client’s lifeworld is noted. The social context of the individual outside the Candomblé terreiro is involved in the treatment of the client’s illness. In other narratives described earlier the individual’s family is involved mainly because of the client’s young age. An illness appears in the life of a child and, naturally, the parents, or other family members, are responsible for finding a cure for the illness of the child. Obviously, the family is both engaged and in a way affected by the illness. In Rio it is common that the institution of ‘family’, to some extent, also involves the neighbours. That was the case in Ernesto’s narrative about mãe Lídia where a friend of the family suggested a spiritual treatment for her condition. Social relations are then, in Sajemi’s explanation of illness, linked to the Self. Consequently, and simplifying the issue, the odds of finding a “good medic” and the following treatment that heals the illness are higher in the pluralistic medical context when the individual’s social network is providing him with various alternatives. In addition to Ramphele’s previously discussed argument about the acknowledgement of the individual experience to make possibilities to be healed available, the social relations are of vital importance. Elisabeth explained to me in what terms the sickness of her husband affected the whole family, thus creating a collective illness:

The sick person loses her life, the life that is impossible to go back to, if the person believes that it is impossible to be cured, and then the whole family gets ill, sharing the sick persons suffering. The soul of every

79 member of the family gets ill... The soul of the sick person and the souls of them left behind get ill. Then it is important to treat them spiritually.

In Elisabeth’s lifestory it is possible to recognise the whole social context of illness. She believes that it is important to treat both the sick person and those close to that person in order to produce meaning and not delay the individual healing process. Following the line of Kleinman and Kleinman (1997: 2) it is therefore possible to speak of suffering as a social experience because of the collective modes of experience that shape individual perceptions and expressions, and because of how social interactions enter into an illness experience (as in the example above, the family dealing with the loss of a husband and father). Aparecida is, as I mentioned earlier, a client of Sajemi. In the beginning she used to follow her mother and her brother to Candomblé houses. Nowadays, she seeks Sajemi’s guidance for problems like depression.

I use to come here three or four times a year. I believe that I am in charge of my life, but some times I need guidance, as for example when I get depressed I go to Sajemi. Because depression is like you destroy yourself, you destroy the inner you and the outside of you… you destroy you and your world taking everybody close to you down with you.

She represents her illness as an active, destructive power acting upon both her personal and social Body. To treat the illness Aparecida takes action, intentionally choosing treatment in which she is guided by Sajemi, to be helped to restore the equilibrium in her lifeworld. In conversations with clients of Candomblé houses the emphasis was often on individuals’ freedom to interpret the choices given by Orixá in the consultation. I therefore wanted to investigate how powerful the agency of the Orixá was in the context of individual choice making. Was it possible for an Orixá to punish a person for making the “wrong” decision? The answer was partly revealed to me through a story told by Rosangela while sitting and chatting at the porch of her house.

80 The first filho of Rosangela came to the house with a physical illness. It was a condition that demanded continuous medication. He expressed a desire to join her house of the Orixá. To make a decision, Rosangela consulted the oracle through jogo de búzios. In the jogo she saw that if he, after the initiation, had the faith and trust for the Orixá, he would be cured from his condition. As she explained to me, her Orixá tested both her and him, and she was not permitted to tell the man that after the period of initiation he would be well. The man began the initiation period, but as the time past, he became even sicker. He became uncertain, and asked Rosangela to be permitted to go and see a doctor, even through that would interrupt the initiation process. Rosangela had faith in him, and hoped that she somehow could give him some of that by revealing some of the information gained in the jogo. She told him that the cure existed in the initiation process, and asked if he, despite that, still wanted to interrupt the initiation. He said yes. She felt that it was wrong, but she did not say anything, she let him go. After some time she found out that he had died a month after he left the house. “That felt like loosing a biological son” she said to me, “I did revolt against my Orixá. I prayed and prayed… The time went and Oxùm gave me Sergio14”. As shown in Rosangela’s story, the interaction of biomedicine and local medicine can be complicated in some cases. In the case of the initiation process, the individual is directed by various taboos (especially taboos that are linked to what is consumed by the novice). Gisele, a filha do Obaluaê in the Rocinha do Oxúm, said when we talked about taboos linked to Orixás that, “Because my Orixá is Obaluaê I can not eat certain food as it always leaves marks on my skin. If I, for instance, eat chocolate I get blisters.” Continuing on the obligations of a novice, he is also required to remain in the terreiro, in a house that is ritually assigned for this purpose. On a daily basis the novice can go to work and do other for him necessary things, as long as he keeps his head

14 Sergio is a filho in his forties in Rocinha do Oxúm.

81 covered and wears white clothes. Those are believed to provide the novice with protection. In this liminal state of the person he is, according to Rosangela, vulnerable to the influence of all the supernatural forces – Orixás as well as eguns, which are confused and powerful spirits of the dead ancestors. He needs therefore protection supervised by the sacred places (like the house of the Orixá), foods, objects and persons. In the case of a filho, he has a responsibility to observe food prohibitions linked to his Orixá, but also to consider orders expressed through the oracle and messages revealed during the possession ritual or manifested in dreams. If the member does not follow those, it can result in “punishments”. Segato notes that many accidents, sicknesses and in some cases deaths are explained like this (1995: 225). Rosangela’s comment to her story was that Orixás do not “punish” people. Nevertheless, they consequently expose persons to various tests in order to give them confidence in their role as members of the artificial family of Orixás. Segato argues in the same direction, that the “punishments” are not experienced (by the members) as reasons to leave the cult; on the contrary, they are experienced as powerful feelings of “auto-affirmation”, of having a powerful personal Orixá (1995: 225). This gives the filho security and self-esteem. The ideal relationship between the Orixá and the individual is a relationship of reciprocal and balanced character. If that is the case, and when Orixá is properly cared for he becomes strong and powerful and uses his power to benefit the person. Once the Orixá is established through initiation he constantly works to make the filho mentally balanced in all situations in both the environment and in life (Segato 1995: 230). The Orixá is therefore a constant reference for the well-being of the filho and is also represented as such in the relation to the client. When the equilibrium of the individual is disturbed it can be explained within Candomblé as an action of an egun. This was emphasised by Sajemi:

82 If the individual has someone close, who have died, and this someone becomes an egun the person can also experience a discomfort, things can go wrong, and there is no explanation why. This is very common. The egun “fica muito em cima da pessoa” [literally: gets over the person, hangs on to the person] in an irritating way.

Brumana and Martinez explain the notion of “punishment” in terms of a relation with inferior spiritual entities, which must be interrupted, for example as the action of an egun – a spirit of a dead ancestor – (1989: 39). Those circumstances do not demand the individual’s entrance into the cult. The individual becomes in the context an object of the cure. The Self is then also an object for the agency of illness.

VI. UNDERSTANDING ILLNESS The issue of ’understanding illness’ involves various aspects. To start with, there is an aspect of individual understanding, or interpretation of the relation between the Self and the Body. In the context of Candomblé an illness is understood to be a signal of an unbalance in the individual’s lifeworld consistent of three parts: the psychic of the person (body personal), the body social (the representational aspects) of the person, and the physical body (an integral part of the conscious Self; also a part of the body personal-aspect) of the person. The Body is then seen as merely one of the elements that constitute the person and the person’s lifeworld. Those elements are seen to constitute the individual and in the case of illness the treatment is directed to restore the balance between them. Restoration of the equilibrium is accomplished by either the action of an Orixá upon the passive individual or through an intersubjective communication with the Orixá during the jogo de búzios. In the case when the suffering individual chooses to be an active agent, acting upon the objectified illness, he intentionally identifies himself with a

83 specific Orixá. In my opinion, this process can also be seen as a kind of ‘self- medication’. As I tried to show in this study, the individual agency in the context of possession trance and in the context of seeking treatment is very different. In the ritual of possession the Orixá mediates guidance and messages to the filho, by the will of the Orixá, and in the context of seeking treatment the individual is an active decision-maker. It is possible to metaphorise this situation and see the possessing Orixá as an active agent, where the filho is passive, and in the second case the filho as an active agent while the Orixá is passive. However, I want to accentuate that I have tried to dissolve the dichotomy subject / object, not by creating a new grouping in- between, but rather by demonstrating that, in the illness, the individual can be both. Through that I have tried to illuminate contextuality of agency. Brumana and Martinez state that, “[a]ll mystic systems move to a greater or lesser extent in the competence, in the alternative protagonism, of two kinds of actors, human and divine” (1989: 300). However, the writers on Candomblé cult have not given sufficient demonstrations of this duality. In this study I have tried to reflect over, not the duality itself, but the processes in which the human and the divine contextually and intentionally transform their character in the interaction between them to be either subject or object. I also suggest that illness may be seen as a social signifier, and that a production of meaning can be seen as a modulation of the lifeworld. Augé and Herzlich argue that, “[t]he social dimension of illness (...) lies in fact that it functions as a signifier, the basis of the meaning of our relationship with society” (Augé and Herzlich 1995: 12). So, the interpretation of an illness can be seen as collective, shared by members of the same social group, and also as an interpretation of our relationship with society (also articulated by Sheper- Hughes 1992; 1994). As I insist in my study, it is crucial to not disregard the importance of the individual both as an agent in the social context, and as an agent in the process of his own understanding of and living in that context.

84 Thomas J. Csordas points to the importance of intentionality and meaning- production of subjects in the process of healing like this, “[m]any earlier accounts are descriptions of healing rituals – there is attention to what is done to participants without much attention to what the event means for them” (1996: 94). In my opinion the meaning-production process is also important for the understanding of therapeutic efficacy. This process occurs in the interaction between different agents in different socio-individual contexts. Understanding illness involves the suffering individual as much as the social context in which the individual exists. Accordingly, this context involves the individual’s experience of medical practice and his understanding of ‘politics of knowledge’. The notion of ‘knowledge’ implies existence of something that is not ‘knowledge’. Generally that something is ignorance. Hobart argues that ignorance should be seen “[n]ot as an antithesis of knowledge but as a state which people attribute to others that is laden with moral judgement” (1993: 1). The part of decision-making that involves asymmetrical power relationships and valuation of knowledges are some of the issues that, I see as crucial for anthropologists to investigate. In my opinion, as I agree with Hobart, medical knowledges should be treated not as some abstract conceptual systems, but as situated practices that can illuminate their potential contribution to people’s material, intellectual and general welfare. The Western biomedical paradigm has proven ill suited to explain, and deal with processes that are “non-natural”, and involve reflexivity on the part of human beings concerned (Grillo 1997: 13). Scientific knowledge can be described as having a view on local people, or local medical knowledge, as objects, and the biomedical doctor as being a superior knowing expert that “cures” the “ignorant”, passive recipient. The local knowledge, on the other hand, sees people as subjectified potential agents (Grillo 1997: 14). However, there can be a noteworthy danger within an anthropological approach, which

85 may be the view on local knowledge as complete, accomplished, and hence static and unchanging. It is important to observe that neither side has a monopoly of knowledge or ignorance, and that neither party is impervious to argument. The similar danger lies also in the view of the scientific, biomedical knowledge as something static and alien to influences from other medical knowledges. In this study I tried to demonstrate that this does not have to be the case. The biomedical knowledge and practice as well as the Candomblé healing knowledge and practice can be seen as influencing each other in order to benefit their clients. Sarah Franklin illuminates the importance of more nuanced view on ‘science’. She insists of an examination of science as a cultural system and not as a cross-cultural or transnational practice (2002: 351). It has long been argued that Western scientific biomedical knowledge holds a privileged form of authority in industrialised societies. Its grounds are in line with the project of modernity that consists of rationality, progress, the need of proofs, and innovations epitomised by technological, scientifical and medical advances. Western science is a relatively new knowledge, but already considered as superior to other knowledges. Franklin argues that knowledge means different things to different people (2002: 352). Science is a form of , a culturally based social activity and a source for cultural meaning (ibid: 354). It is in some way predestined in the West that other knowledge systems should remain in subordinate position to the scientific authority. According to Peter Fettner, scientific knowledge is not culture-bound, nor one culture among many (2002). He argues instead that science “has a strongly cross-cultural, international aspect” (Fettner 2002: 198). I agree to some point, as I believe that science consists cross-culturally of objectivity and progress, but other elements, like how scientific knowledge gains cultural meaning, are in my opinion, depending on the socio-cultural context in which the knowledge exists. I think that it is also important to treat ‘knowing’ as a dynamic,

86 practical, situated and changing activity. The metaphors of scientific knowledge as a mirror that reflects the reality are strongly criticised by Hobart in the extent that they exclude the idea of knowing being a dialectical and critical process (1993: 9). Consequently, understanding illness as well as understanding medical knowledge should be seen as not only a given and objective set of facts, but a belief system shaped through social and political relations (Lupton 1997: 99). In that case it is possible to view meaning and knowledge in reference to a world constituted and transformed in human experience, apprehended through symbolic forms and interpretive practices. The context of medical pluralism is a complex phenomenon. While some anthropologists argue that the simultaneous coexistence of different medical practices has a beneficial character for the health system in the society, others maintain sceptical arguing for the scientific approach in providing care for the population. The latter is the notion of incorporation of medical practices into each other. I still believe that the incorporation of the local, alternative medical practice into the dominant, in most cases biomedical, medical practice is trapped within the unequal Cartesian Mind/Body dualism that mirrors the colonial view of the Other. Despite the many texts written on the subject, the biomedical practice remains generally viewed as scientifically superior to the local, alternative medical practices, which is also implicitly shown in our need to discuss those issues. Perhaps our approach should be to discuss the human desire to experience contrasts in various contexts? Perhaps those contrasts do not have to be viewed as “right” and “wrong”? The differences are perhaps necessary. Acknowledgment of contrasts is perhaps the first step to begin discern similarities. The important thing is thus to take the next step from contrasts to a view of the world and its subjects as nuanced and productive. Exemplifying my point, we do not value contrasting colours as blue and yellow in terms of “right” and “wrong”, except in the case of their symbolical and contextual meanings. Perhaps our view of medical practices should be that

87 their use is of a complementary character? In a way, they benefit from each other because of the fact that they can be seen as “different”. They are concerned with different elements of the individual’s Self. Continuing on my metaphor with colours, mixing blue with yellow results in a totally different, and new colour – green, that is neither blue nor yellow. Incorporation of two different medical practices (together with their particular ideologies) results thus in a totally different, new medical practice, which is neither biomedical, nor alternative. It may then be consistent with Greene’s notion of “a contextualised space of hybrid medicines” (1990: 641). As anthropological investigations inspire health professions and society at large to consider fundamental changes in health care systems (Kleinman 1988; Good 1994), Whyte notes further that the current ‘renaissance’ of herbal medicine and other natural products is a worldwide phenomenon (2002: 74). Perhaps the co- existence of different medical traditions within the same society also contributes to the creation of “hybrid medicines”? I think (which I tried to illuminate in chapters four and five) that the greatest obstacle within the biomedical care can be its approach to the patient as the objectified and passive Other. My point in this study was also to demonstrate that all medical knowledges, to some extent, could be seen as inspiring each other to changes that can benefit their clients. This also works the other way around. As I see it, the healing process requires a level of engagement from the client. That is both in the context of biomedicine and other forms of medical practice. In the case of illness, it is of vital importance that there is a space for interaction and narrative practice between the medic and the client. Within that space there should be a room for recognition of both client’s, and the medic’s understanding of aspects involved in an illness.

88 CONCLUSION What conclusions can be drawn from my glimpses of understanding illness in the Candomblé context? Much has already been said. But, let me sum up the principal points of my investigation. Understanding illness involves reflections over the Body, the Self and the social milieu of the individual. As the urban, pluricultural and plurimedical milieu of Rio contains alternatives for treating the individual’s illness, he is able to act and create a meaning of the illness in relation to different aspects of his lifeworld. Through narratives from my field I have illuminated a view of illness as disequilibrium in a biological meaning or in the social life of the person. I have also reached the conclusion that illness is interpreted as a signal for the individual to take action. Another interpretation of illness presented here was that it could be seen as an active, destructive power that affects the person and the person’s lifeworld. Yet another explanation was that illness is an action of a supernatural force (an egun) upon a passive individual. In Rio’s plurimedical context a treatment for an illness is chosen through a consideration of the authority of the medic. It can also be provided through a combination of pharmaceuticals and Candomblé healing. I have demonstrated that a failure of biomedicine indicates that the illness is non-material and that other therapies should be consulted. I have also argued that the ritual of consultation – jogo de búzios – translates reality of the clients and reshapes their world, as it is an analytic instrument that supplies the client with an expansion of his own personality. I have argued that the treatment process of individual’s illness involves a restoration of the equilibrium in the individual’s lifeworld. Through an interpretation of messages revealed in the ritual of consultation individual’s illness is given a meaning. This meaning, as I have demonstrated, is of socio-

89 individual dynamics in which the individual is placed, as it is defined from the perspective of the cult. In order to describe illness, I represented or exhibited “it” in this study, implicitly making “it” an object. Simultaneously, I tried also to exhibit illness by demonstrating its agency upon the passive individual. I have concluded that depending on the context, the individual’s intentions, desires and goals, the agency as well as the individual’s position as subject or object move between the individual and the illness. What does it mean in a wider perspective? What does my work add to the knowledge of individual processes in the Candomblé context and Brazilian society and culture? As I see it, anthropology’s concerns are what and how people think, act, and express their thoughts about the world they live in. Accordingly, I think that each level of a culture reflects and reproduces its characteristics. I concluded earlier that urban Candomblé mirrors the pluricultural and the plurimedical aspects of Brazilian society. I reflected also over this cult as a “community of the afflicted”. In the context when institutions, industries and, on the individual level, desires and goals are created, the individual is the one that is expected to adapt, change and act. Those new societal creations, on the other hand, create new illnesses and situations for the individual to handle. In this milieu the suffering individual is an active decision-maker choosing, among a variety of alternatives, a meaningful treatment that is in accordance with his lifeworld.

90 GLOSSARY adjá – A ritual bell used for salutations during rituals. ajuntó –Assistant; the second Orixá of the person. alabê – An ogâ who’s responsibility is to play atabaques. Ambulatório – Outpatient Department. atabaqueiro/s – Player/s of ritual drums. axé – The vital force or energy. barracão – Shed; large central room in the terreiro used for major ceremonies, including public functions. There, one usually can find the three ritual drums called atabaques. búzios player – Player of cowrie shells; a common reference to a Candomblé leader who performs jogo de búzios. caboclos – Amerindian spirits. Candomblé – A Brazilian spiritual tradition with roots in the African, Yoruban cult of Orixás. Candomblé is commonly associated with possession trance and ritual dances. casa do Orixá, casa de santo – The house of Orixá; terreiro. Centro da Mesa Branca – A Kardecist spiritual movement. dono da cabeça – “Owner of the head”; the principal Orixá of a person. ebó/is – Sacrificial offering/s to Orixás. egun – Spirit of a dead ancestor. ekedi – Women who are assistants and “chambermaids” of Orixás. favela/s – Slum/s. festa – Party; general name for a Candomblé ritual. filha/filho de santo – Daughter/son of saint; female/male Candomblé member who has passed through lengthy initiation process and who have done the obligation of seven years. filha do Obaluaê – Daughter of Obaluaê. filha do Yemanjà – Daughter of Yemanjà. fundamento/s – Grounds; the religious values and responsibilities in a Candomblé house. iaô/s – Members who do not yet have done the obligation of seven years. They are commonly included in the term filhos. jogador de búzios – see: búzios player. jogo – see: jogo de búzios. jogo de búzios – The game of cowrie shells; a divination ritual normally performed by a leader of a house and used to “diagnose” the problem of a client, one of the main practices of finding the reason for the illness as well as its cure, which is accomplished through the interpretation of the positions of the sixteen cowrie shells on the peneira. mãe de santo – Mother of saint; female Candomblé leader. mãe pequena – Little mother, the second in command when mãe or pai de santo is not available. obí – Kola nut. odum – Type of destiny primarily revealed through the consultation of the oracle.

91 oferenda – Offering. ogâ – Male member of the terreiro who normally does not pass through initiation or manifest deities. He often contributes politically and financially to maintenance of the terreiro. An ogâ can also be an atabaque-player. “olho de boi” – An amulet that takes away the “olho grande” - the envy. Orixá/s – Deified heroes of Candomblé mythology. orobô – Bitter kola. pai de santo – Father of saint; male Candomblé leader. pai pequeno – Little father; the second in command when a mãe or pai de santo is not available. peneira – A wooden board assigned for the jogo. play the búzios – see: jogo de búzios. pseudodoença/s – Pseudo-illness/es that can disappear after the person comes to a Candomblé house. roça, rocinha – Plantation, little plantation; see terreiro. Rocinha do Oxúm – little house of Oxúm. Senhor – Sir. terreiro – Yard; the Candomblé house - even called roça (plantation) or rocinha (little plantation) - is a limited sacred area with various shrines designed to the worship of different supernatural beings called Orixás and public spaces such as the barracão (shed) where collective rituals take place. trabalho – A general word for a ritual. zelador – Caretaker, a popular name for a mãe or pai de santo.

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