Herbal Medicine, Ritual Curing, and Modern Health Care in a Pastoral Community in Northern Kenya
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CONCEPTS OP HEALTH AND DISEASE AMONG THE ARIAAL REND1LLE- HERBAL MEDICINE, RITUAL CURING, AND MODERN HEALTH CARE IN A PASTORAL COMMUNITY IN NORTHERN KENYA // BY ELLIOT MAYER FRATKIN if\vaAW5C-ri{5r' 0U><^ Cjo |«JOI U J a l* j T ^’7"" \f?A U ^ oBV ° F.u S"l^°lES \WSt- 0f ^1980 ELLIOT MAYER FRATKIN UNIVERSITY OF NAIROBI LIBRARY 0100075 1 I ABSTRACT The Ariaal Rendiile are a nomadic pastoralist population who lorm a cultural bridge between the Samburu cat tie-herders -:nc Her.dille came 1-herders ot northern Kenya, Bast Africa. The Ariaal utilize the intermediate ecologic zone along the highland-lowland interlace ot trie Ndoto Mountains, enabling them to practice a dual cattle-camel economy where the population suosists off the camel and small stock herds and use their cattle tor traditional and modern cash exchange. Despite a nutritious diet ot milk, meat and blood and an en- vironment relatively tree oi water-bourne diseases, the Ariaal lace periodic undernourishment and exposure to a variety ot infectious diseases including malaria, pnuemonia, whooping cough, and measles, mortality is particularly high in children. In addition, the socie ty laces tamiliar but debilitating health problems related to childbirth, accidents, old age, and mental illness. The Ariaal are not helpless in the face of these health problems, but possess a traditional medical system that categorizes, diagnoses, and treats many of the illnesses they experience. An out standing reature of their ethnomedicine is the rich inventory of herbal medicines prepared as ointments, fumigants, purgatives ana emetics. Herbal specialists are widespread and often competent in midwifery, massage techniques, and bone setting. Their skills encompass an exten sive empirical knowledge of health problems experienced by the Ariaal. 3 A distinct but equally important aspect oi Ariaal traditional medicine is the belief in sorcery, where human enemies can manipulate supernatural forces to inflict harm and illness. Problems in sexual re production and mental illness in particular are thought due to sorcery. To this end, the Ariaal believe only a ritual specialist, the Samburu Loibonok, can treat, cure, and prevent sorcery acts. Both the ritual curing of the loibonok and the mechanico-chemical treatments of the heroal specialists coexist as methods of health care, where either or both specialists will be consulted when illness occurs. The advent of western medical treatment represents a new component of Ariaal response to illness. Modern Health care has been among the most important changes in Ariaal society and represents a fundamental development in their integration into the wider Kenya society and economy. Of significance both demographically and socially is the health care delivery of preventative medicines, particularly vaccina tions, to the rural nomadic populations in Kenya. This dissertation, a medical anthropological description, analyses the concepts and practices of Ariaal traditional medicine and its integration with modern health care delivery in northern Kenya. 4 PREFACE This dissertation is the result of many years of endeavor, from its inception as a research idea at the Department of Anthropology, London School of Economic in 1973, to three years research in Kenya, and to two difficult years of writing in the United States. This disserta tion is also tne result of many people helping me along the way, without whom this work wouldn't be possible, and to whom I wish to express my sincere appreciation: To the Department of Anthropology, London School of Economics, who encouraged me to pursue pastoralist research in East Africa, particularly Dr. Jean La Fontaine and Dr. James Woodburn; To the Central Research Fund of the University of London and the Small Grants Award from the Smithsonian Institution who provided the initial funding to undertake the research; to the faculty and staff or the Institute of African Studies, University of Nairobi, who provided a stimulating environment to collect my thoughts and sum-up my field research, particularly Mr. Paul Kavyu, Mr. George Mathu, Mr. James van der Allen, and Miss Rose Macharia. Eighteen months of my research of the Ariaal Rendille was spent living with Lewokoso Lukumai settlement in the western border region of Marsabit District, Kenya. This experience has been among the most rewarding and exciting periods of my life. Members of Lewokoso LuKumai accepted me as a brother, and I in turn was humbled by their dignity, kindness, and resourcefulness with which they adapted to this 5 beautiful but hard desert environment. In particular, I extend my deepest appreciation to Mr. Lugi Lengesen, Mr. Lekati Leaduma, and Mr. Lawrence Kilecho Loimusi. Many researchers and specialists contributed to the findings of this dissertation, either by direct participation or by lengthly dis cussions. Much of the objective medical data presented in Chapters 3 and 6 was gathered while working with my close friends, Dr. David and Joan Wiseman, who initiated the Marsabit District Maternal and Child Health Care Program for the Ministry of Health, Republic of Kenya. Identifications of plants used in Ariaal traditional medicine were made by Mr. J.B. Gillett, Botonist-in-Charge of the East African Herbarium, Nairobi. Additional material was sifted from the large collections of Dr. John Galaty*s research of Masai symbolism, and Dr. Paul Spencer*s collection from Samburu. My appreciation is extended for their coopera tion in utilizing their research material. Much of Chapter 2 on the Pastoral Economy was based on direc tion provided by ecologists studying pastoral societies in East Africa. In particular I am gratful to Dr. Jurgen Schwartz of UNESCO and Mr. Shun Sato of Kyoto University, Japan for their researcn information on Rendille Camel production, and to Mr. Michael Rainy for his extensive ob servations of Samburu cattle and small stock production, and to all three for their generous hospitality both in the field and in Nairobi. Dis cussions with Mr. Neil Sobania of the School of Oriental and African Studies, London, who was researching the Dosenach, and to Dr. John 6 Berntsen of the University of Wisconsin who was researching the history of the Masai loibonok contributed to my own understanding of the Ariaal and their historical origins discussed in Chapter 1. I am grateful to assistance and information provided by Mr. Herbert Anderson of the African Inland Church, Logologo and Father Redento of the Korr Catholic Mission in Marsabit District, both of whom discussed their mission's work described in Chapter 6. I am grateful to Mr. Anders Grum for permission to use his architectural drawings of Rendille houses in Figure 3.1, and for his population pyramid of the Rendille settlement of Rongumo in Figure 3.2, and for his many hospitable and animated meetings in "his" settlement at Wambili Dipsai and Nairobi. To Anne Beaman, of Boston University, my thanks for her permission to use Pnotograph 6.1 of the Catholic Church at Korr. My deepest thanks to Miss Arlene Johnson for typing my largely illegible text half-written in the Samburu language, in record time and with remarkable quality. Finally and most importantly, I would like to thank my parents, Ralph and Mildred Fratkin, who not only provided much of the funds to continue the research and prepare this manuscript, but the con stant support and encouragement to see the job done. Without them, this dissertation would never have been accomplished. Elliot Fratkin Baltimore, Maryland February 1980 7 TABLE_J3^C0NTENITS Page CHAPTER 1. MEDICAL ANTHROPOLOGY AND THE STUDY OF THE ARIAAL RENDILLE 1 * 1 Introduction .......... 12 1.2 The Ariaal Rendille: A Bridge Culture .... 22 1.3 Summary and Scope of Thesis ...... 43 1.4 Notes on Spelling and Pronunciation .... 48 CHAPTER 2. THE PASTORAL ECONOMY OF THE ARIAAL RENDILLE 2.1 Introduction .......... 50 2.2 Environment of the Ariaal Rendille: Climate, Water and Vegetation ...... 52 2.3 Livestock Management: Camels, Cattle, Small Stock and Donkies ...................... .... 64 2.4 The Herding Routine of Lewokoso Lukumai Settlement .......... 84 2.5 Livestock Production and Human Nutrition . 90 2.6 Summary ........... 98 CHAPTER 3. ARIAAL SETTLEMENT ORGANIZATION 3.1 Introduction . 101 3.2 Distribution, Composition and Construction of Ariaal Settlements ........ 103 3.3 Settlement Recruitment: Descent and Non-descent Affiliation . 113 3.4 Work Roles ........... 122 3.5 Decision-Making and Conflict Resolution . 131 3.6 Summary ........... 144 CHAPTER 4. HEALTH, DISEASE AND TRADITIONAL CURING IN ARIAAL 4.1 Introduction .......... 147 4.2 Incidence of Disease m Ariaal ...... 150 4.3 Traditional Concepts of Health and Disease . 157 4.4 Health Specialists and Herbal Curing .... 171 4.5 Herbal Medicines and Their Medicinal Applications ................. ..... 180 4.6 Herbal Medicines and Their Pharmacological Value ............ 204 4.7 Summary ........... 215 8 TABLE OF CONTENTS (CONTINUED) Page CHAPTER 5- BELIEFS IN WITCHCRAFT AND THE ROLE OF THE LOIBONOK RITUAL SPECIALISTS IN HEALTH AND DISEASE 5.1 Ariaai Beliefs in Mystical Powers and their Relation to Health Problems ...... 219 5.2 Beliefs in Witchcraft. The Curse and Sorcery . 226 5.3 The Role of the Loibonok in Combatting Sorcery ........... 233 5.4 The Ambiguous Social Position of the Loibonok . 263 5.5 The Role of the Loibonok in Treating Mental Illness . 269 CHAPTER 6. THE INTEGRATION OF MODERN AND TRADITIONAL HEALTH CARE___________________________________________ 6.1 Introduction.................................. .... 276 6.2 Conflicting Ideologies: the Missions, the Government, the Development Planners and the Ariaai Rendille ........ 279 6.3 Existing Health Care and the Initiation of the Maternal and Child Health Program (MCH) in Marsabit District ........ 293 6.4 Integrating Traditional and Modern Health Care in Ariaai ......... 308 6.5 Recommendations for a Comprehensive Health Care System Among the Ariaai, Rendille and Samburu ........... 312 LIST OF TABLES 1.1 Bilingualism in Ariaai and Rendille .... 29 1.2 Distribution of Ariaai Settlements ................. 36 1.3 Ariaal-Rendille Descent Relationships .... 38 1.4 Samburu, Ariaai, and Rendille Age-set Chronology .