The following expose of the medical problems facing health workers in Asmat does not intend to give a detailed account of statistical frequencies of particular infections or their density in the various areas of Asmat. It does not record the difficulties met by medical personnel in their frustrating attempts to instill in the minds of the Asmat the causes of illness and the subsequent action to be taken to diminish frequencies of them. The presentation only points to a few of the ingrained perceptions of the people of the causes of illness and death supported by a belief system that determines that outlook. Although records exist in the more established health centers of the area of the type and number of diseases treated yearly in those centers, no one has, to date, made a detailed research of the entire area of the health problems of the people.
An initial research into disease prevalence was made during the month of January 1965, in the villages near Agats. The research aimed at statistical data of yaws cases (frambesia) and malaria. It was discovered that 10 percent of the population was infected by yaws and 85 percent by malaria (van Amelsvoort 1964: 76-77, 93). Health officers treated yaws as their initial effort to disease eradication among the Asmat. According to the report, other infections frequently treated were eye and ear infections, boils, sores, skin rashes, bums, diarrhea, pneumonia and thr'6at infections (Van Arsdale, Peter W. p. 268, An Asmat Sketch Book).
The discussion of this paper encompasses the entire Asmat area in general. The examples of beliefs and practices regarding health are similar throughout the area although they may differ in content and practical application. For the purpose of this paper not many of these examples will be illustrated, however, the writer hopes that all will understand that the principle beliefs and their foundation are the same.
In order to understand the beliefs and practices of the Asmat it is necessary to understand Animism which is the basic underpinning that supports them. Basic to the cosmology of Asmat is that all life, whether it be human, animal or plant, is animated by external sources, namely spirits. Life requires continued animation otherwise it ceases to exist. Life, once it begins, does not continue on its own but requires a continued animation. If the sources are removed death occurs. This principle is the reason that throughout life the Asmat will be ceremoniously given additional names, and are called by such names, for the very fact the name of formerly living person is given to an individual he or she takes on the life giving powers and aptitudes of that individual. Spirit power enhances and assures continued existence. Spirit power is also able to immerse into inanimate objects, for instance a shield by using the name of an ancestor, and thus affords protection to those using those objects. If misused, the power at whim is able to leave said objects and return to the realm of spirit world. The fact that spirit power is able to retract itself worries the Asmat.
Three principle spirit forces are necessary for human existence, animating it so that it maintains life. Upon birth an individual is given two animating forces, yuwus and ndamup. Later on, ndet, infuses itself and animates to complete the fullness of powers of animation.
Yuwus animates the human body and is thought to reside in the area beneath the navel. It is the region where emotions are felt and reacted to, such as anger, fear, hate, love and so on. The belief is that a thin thread-like connection attaches it to the navel. If severed, life discontinues.
Ndamup gives the power of bilocation. The Asmat regard it as the power but a "shadow" or "image" of the person. Ndamup usually leaves an individual's body when he or she is sleeping and roams about. People easily mistake it for the real person. It responds normally when addressed since it is the "carbon-copy" of the individual. A person's ndamup possesses the power to metamorphose into other forms of life, such as a crocodile, and is able to harm others if it so desires. Ndamup, however, may not remain separated from the individual for a long period of time for the danger is that the yuwus will also escape, resulting in death. If the ndamup is killed while a person roams death occurs instantaneously.
Another animating spirit source ndet (ndat or mbi, depending on the language area of Asmat) completes the essential elements for complete human existence. Life is sustained through ndet animation. Ndet is the spirit of some ancestor that infuses itself in a human being, giving life strength and personality. Although its infusion takes place at conception, its full power is obtained when the ndet's name is ritually given to the child. Depending upon the area of Asmat more than a year after the birth of a child the ndet name is ritually applied because to do so too soon might endanger the young and fragile life. Until a person receives a ndet name it is called yoser (no name). Ndet completes a healthy functioning human being (Sowada, Asmat Myth and Ritual the Inspiration of Art, p. 67; ed. Gunter and Ursula Konrad).
Similarly, plant life continues to 'grow because of animation. Each plant has its animating source. Asmat perception maintains that the source is sufficient to bring a plant to maturity and produce fruit. If the plant should die, however, that very fact is an indication that its spirit source power was insufficient to keep it alive. The attitude carries over in the Asmat indifference to cultivate, clear the weeds so that seeds, once planted, grow. The spirit powers given to the plant should make it grow without the need for human intervention as plant care. Accordingly, the Asmat are heedless if a garden should be overgrown with weeds eventually absorbing the soil energy for the growing of food plants. The fault is not with the non-care of plants, but only indicates that the plants' spirit source was insufficient to make them grow. Correspondingly, the insistence of a need for a proper diet for babies and small children does not impress the Asmat since not these precautions but the power of the spirit will see that the child will mature to become a healthy human being.
The challenge to the Asmat is to discover means to ensure the continued input of spirit power needed for life. The need to manipulate to obtain the good will of those powers is of utmost importance to prevent weakness, sickness and final demise. The key to the solution for the Asmat is once of balance, keeping relationships with the world of spirits and human beings at an equilibrium that provides harmony. Respectively, the sealing of good relationships between those elements of power is ever foremost in mind. Whenever a relationship is disrupted because of some imaginary or real refraction, the individual focuses on the problem of rectifying the situation. In every possible manner, the person will manipulate until a resealing of a good relationship is thought to have been obtained. The action taken to rectify does not indicate that the motivation to do so is genuinely one of absolute forgiveness and friendship. The motivation is based upon the necessity of obtaining favors, personal gain by trickery or otherwise, whether obtained honestly or dishonestly. It is the position of the opportunist. In daily life, of course, good relations are easily and frequently fractured since people live constantly in close proximity. Daily life, then, consists in a tight-rope walk of maintaining harmonious life interchange with one's neighbor.
Ancestral spirits are ever influencing the lives of their “offspring”, the people struggling on earth in search of a secure existence. The norms for life, prescribed by them, are innumerable and influence the manner in which social, economic, artistic, educational, and religious endeavors need to be performed. They are so enmeshed in Asmat daily life that without them life would cease. The regulation of them consists in a system of taboos touching upon all activities. Norms for social, economic and all human endeavors as the cooking of food, carving items, carrying out a feast, actual or imagined infractions against a person, jealousies, and child rearing regulate how tasks are to be done thereby regulating patterns of behavior. The breaking of these norms brings about the consequence of various types of sickness, weakening societal structure as a whole or individuals because of infractions. Depending upon the taboo not heeded the result may be cases of boils, diarrhea, infections, fevers, headaches, barrenness, and even possibly death. Taboos regulate societal life, keeping the society a cohesive functioning group. Continued help of the ancestral spirits always depends upon the faithful adherence to taboos. Infractions result in sickness or general societal weakness making continued life questionable. Such weakness affects the fertility of the group, diminishing it so that eventually the group's future outlook becomes bleak. (Cf. Tabu di Asmat: Penelitian oleh Mahasiswa/wi STFT Fajar Timur, Abepura-Jayapura: 1986, 77 pages).
When disputes, jealousies, violence causing fractured relationships occur among the living, efforts are made to rectify matters by those involved. However, if the injured party feels that due recompense has not been made, he or she will employ malevolent magic with the hope of obtaining satisfaction by its effect resulting in serious sickness and even death. Throughout Asmat the ways and means to manipulate "black magic" are innumerable. Many times individuals will employ the powers of evil spirits or make a concoction of items based on a formula provided by the spirit that will release negative powers that will overwhelm the intended victim. In the Atsj area the practice is to call upon the aid of douti, an evil spirit power to harm someone. As the identity of the person needs to be specified for the douti to wreak vengeance, various combinations of items used or belonging to the person are collected and combined in order to have the power of douti enter it. The combined items may consist of fingernail parings, food remnants, hair, and pieces of clothing, feces, footprints and so on. These are wrapped in leaf bag to be left near the paths the intended victim normally takes, within the thatch of his or her hut or near any spot that the person might eventually visit. Once in the vicinity of the bag of magical objects the negative powers arau pok of the douti are released to inflict maladies upon the person. The belief in the Sawa area is that when a person is inflicted with very potent arau pok he or she will eventually die.
The process of change taking place throughout the years by education or by instilling a new awareness has not brought about a cessation regarding the practices of malevolent magic. The knowledge gained through the change process has served to make the practice of black magic more sophisticated. Now-a-days, a seeker of revenge might draw a skull on paper, inscribe it with the intended victim's name, or enclose his name written on a scrap of paper and combine it with his finger nail parings, food remnants and place the concoction on pathways, trees in the intended victim's foraging area, or in a graveyard.
As illustrations of the practice and results of malevolent magic I offer the following examples.
Dekes of the village of Erma (Sawa region) became a noted hand sawer of lumber and carpenter. He was paid well for his work, which instilled jealousy among a number of members of the village. One day when Dekes was called upon to help erect a long antenna pole required for radio communication of the pastor, he immediately directed the crew members required for that purpose. As the pole was being elevated with rope, tackle, and stringers of ironwood, one of the village chiefs took a position near the bottom of the heavy ironwood pole and shouted commands as his position as "boss" of the group. Dekes asked the chief to remove himself from the area near the pole in case one of the ironwood stringers should slip, fall or break. The chief did not heed his warning. Unfortunately, one of the stringers broke, fell and hit the chief on the head knocking him unconscious. The immediate reaction of the group of workers was to let the pole fall and throw themselves upon the unconscious chief in the belief that he had been killed. Fortunately, a religious brother was at hand to rescue the chief from being smothered by the frantic response of the workers and brought him into the house. A number of pails of cold water revived him.
A number of days, one morning Dekes did not show up for regular work. Upon questioning the rest of the workers I was told that Dekes had been afflicted by arau pok because he was the cause of the mishap of the chief. I was told that he was very sick and undoubtedly that he would die because of the arau pok. From the far end of the village I faintly heard the wailing of people. I went over and discovered that Dekes appeared to be near death. After quieting down the crowd, I yelled into Dekes's ear but elicited no response. Dekes was in a coma. I began to slap his face without obtaining any results. His body and limbs were not flexible. I had a number of men help me erect Dekes in an upright position against the center fireplace pole of the hut. I held him and bounced his back against the pole repeatedly. Finally, Dekes shook his head and regained consciousness. I immediately gave him a cigarette. While he was smoking it I informed the people that the arau pok ceased to have power over Dekes. I took Dekes to his place of work to have him back on the job. Dekes still lives happily in Erma, but undoubtedly without my interference he would have died. When he was informed that he had been afflicted by black magic because of the horrendous mishap of the chief, he became so frightened psychologically that he was thrown into the process of dying.
Last year a young lady in Atsj gained renown for her artistic weaving of mats and handbags. Along with some noted carvers she was selected to go to Germany in order to demonstrate her art. Some time later I was informed that she would not make the journey to Germany since she fell seriously ill. While on a visit to Atsj later, the young lady, thin and emaciated, arrived at the pastor's residence seeking my help for forestalling the ravages of what she believed to be black magic. Apparently, a number of people of the village were envious of her success. They successfully fostered the rumor that the lady had been inflicted by malevolent magic. She subsequently fell seriously ill with fevers, headaches, dizzy spells and felt that she was about to die. She solicited the help of a village healer who informed her that indeed some person, jealous of her artistic capability, had made black magic against her. The healer attempted to cure her by a sleight of hand removal of bits of glass, nails, razor blades, needles from her body. In the process, the healer indicated that he also discovered who had made black magic against her. As an additional measure the healer rubbed her body with a counter-magical potion. Then, he called the perpetrator of the black magic to wash the lady's body with water, a remedy believed to cure her of illness.
Recently, a young man from the village of Per came to my house in search of protection against black magic that he believed was being directed at him. He explained that a good number of people informed him that someone attempting to entice his spirit away from his body while he slept (undoubtedly, the roaming spirit power, ndamup). Once enticed away from his body, his spirit could be easily killed. The young man was in search of a counter magical force from me that would hinder all attempts to kill him.
As in the Asmat relationship pattern with the spirits of the dead and the relationship with the people of his society, they exercise the same pattern of cooperative interplay with the spirit world of animal. Animals, birds, fish, the fruit of plants may be hunted for food for the livelihood of the group but, here too, norms had to be followed. Food sources originally were not permitted to be exploited beyond limits but based on needs. Over-exploitation and a disregard for these limits, also controlled by taboo systems, would bring about unfavorable reaction of the spirits of the sources of food.
Originally, the norms for hunting and gathering food assured the Asmat of environmental conservation since the exploitation of food provided by nature was limited. Greed brought about recrimination of the spirits of the plants exploited beyond the limits set down by taboos. Many of the norms directed to conserving resources have been shattered through the process of economic change in Asmat. Greed and the amassing of profits to the utmost are the motivating factors behind such enterprises as logging concerns or any other enterprise that attempts to take advantage of the salable products grown naturally in Asmat. These factors have tremendously influenced the Asmat to the extent they now ignore indigenous regulations (taboos). Originally, for instance, the harvesting of ironwood was forbidden for the ironwood tree was connected with sacred beliefs. It was a special tree to be protected. The Asmat would not dare use it for house construction either in the form of pilings or lumber. As time elapsed, however, the Asmat saw that outsiders could use ironwood indiscriminately without suffering any ill effects of the ironwood spirits. Initially, slowly but fearfully, the Asmat begin using the tree for construction purposes, also without suffering any serious ill effect from the angry ironwood spirits. Now, ironwood is being used in construction by the Asmat without any reflection to the original tenet that the ironwood spirits forbid it.
Another illustration of the interplay of the spirits of nature and humans is an incident that took place in Erma a number of years ago. Titokon of Erma proved himself to be a most capable crocodile hunter. He amassed much wealth from the sales of crocodile skins. One day his son of approximately fifteen years of age disappeared in the jungle and was never found. Titokon immediately concluded the irate spirits of the crocodiles killed his son as a sign to Titokon that he had killed too many crocodiles. Sometime later, Titokon's only grandson died because of malaria. He believed that the spirits, still not satisfied, took the small child as an additional retaliation to Titokon's greed. Titokon totally ceased hunting crocodiles.
While the Asmat still attempt to keep a cosmic balance in relationship to spirits and humans many factors supporting their belief system have fallen by the wayside. Nonetheless, the major portion of belief in taboos and what results in the disregard of them still is operable among the Asmat. As late as 1986 many of the taboos regulating daily life the people of the villages of Jamasj, Sawa-Erma and Komor were still faithfully by the people (Cf. Tabu di Asmat, pp. 9-39).
The purpose of the preceding paragraphs indicating the ways in which the Asmat relate to the entire cosmos, composed of spirits of the dead, evil spirits, the spirits of plants and inanimate Objects, is to demonstrate that the Asmat believe the causes of maladies, and death are the infractions committed (breaking of taboos) that disrupt Respectively, the Asmat mental framework does not recognize that sickness are actually resultant of genetic weaknesses, bacteria and virus. Consequently, the Asmat do not see the necessary of hygiene, cleanliness and ways to diminish the ravages of bacterial or viral infections. In the Asmat mind, flies, mosquitoes or any other ways of disease transmittance are not the causes of subsequent maladies and death. The causes of sickness to them are the result of direct intervention of spirit or human agencies retaliating for neglecting to adhere to norms.
Death is looked upon to be natural in the instances of the deaths of the babies and those who have reached old age. All other deaths are cause by the direct interference of the spirits or the malevolent magic practices of the people. The Asmat consider people of old age to have reached their end and are destined to move off to the world of the spirits. Infants who die many times are thought to exercise a choice of life or death. If the spirit of an infant considers that its parents are mistreating or about to mistreat it, it will decide on its own to return to the world of the spirits. There isn't any societal consternation over the deaths of the very old or the very young. It is only when the maturing and the healthy die that immediately cause the people to look for the cause. Normally, it is determined to be black magic or the wrath of the spirits. Often, through the aid of the seers, they attempt to discover who might have caused the death of the person. This is done by the seer calling out the names of people in the village, and when a bush near him shakes rapidly back and forth at the mention of some name of a person the phenomenon pinpoints him or her as the perpetrator. Of course, such deaths need to be retaliated.
Since all illness are caused by the spirits because of infractions, breaking of taboos, or by human manipulation that calls on the aid of evil spirits and the combination of items gaining magical potency to cause illnesses (arau pok), cures must be obtained either through the placation of spirits or by the use of magical means to eliminate them, The elimination is accomplished not through medical means but by diminishing or eliminating spirit discontent or purgation of magical forces that are the cause.
Parts of ritual feasts of Asmat are aimed at placating the wrath of the spirits. Through ritual the society strives to regain and maintain favorable relationship with the spirit world. The Asmat believe that through the process of ritual harmony will be reestablished. Strife between individuals or groups of people within the village are settled in the framework of ritual. Previous to the feast of the return of' the spirits of the dead squabbles erupted among the people frequently. During the time of the feast of the spirits in the village of Erma-Sona animosities ceased to the extent that during the eight months that it took to complete the feast no individual or village fights occurred. Former arguments hindering marriage arrangements were quickly resolved. Ritual battles between the men and women eased tensions. Factually, the women were given a number of days to stab, bum or wound in some manner those men they considered hurt them in the past either physically or psychologically. All altercations were taken care of during the feast process so that when the spirits returned to the village for the climactic celebration with the people they would witness perfect village harmony. During the closing night of the feast the spirits (masked figures) danced with the people. On occasion, one or another of them would pull the nipples of maturing girls and the penises of boys, not in a ribald display of sexual play, but as signs given by them to the people that indeed they would continue to work toward the welfare of the people so that they might be ever fertile and prosperous.
During normal times, a number of ways are employed to dispel illnesses. Individuals, normally fathers of families, attempt to drive away the cause of illness in the instances of children through a magical process. On one of my visits to a home where a child was seriously ill with malaria, the father was in the process of driving away the cause of the illness. He placed an arrow, slanted upward with its tip protruding through the hut's doorway, and with his arms he made upward swings at the same time chanting, "woo, woo, woo," in the hope of driving away the cause of the child's malady. On another occasion, after I had a number of people cutting the grass around the rectory, the next night I heard a man exclaiming "woo, woo, woo!" I looked out of my window to see him swinging a bow back and forth while pronouncing the magic word. Upon questioning him, he informed me that his small son was critically ill. He explained that on the previous day his wife brought the child along when cutting grass. The area of cut grass held for him the source to the child's affliction.
Frequent maladies, such as headaches, toothaches, muscular aches fevers, stomach disorders, are treated based on general practices customary to the society. Although these maladies are caused by evil spirits or agents of black magic, customary practices are believed to expel the undesired elements causing sickness from the body. In instances of headaches and various other types of aches small incisions with a clamshell or sharp reed are made near the area of the ache. This drains off the bad blood believed to be infested with the "spirit of sickness" implanted by evil spirit or human manipulation. Shaving off the head hair, too, will prepare the way for the evil elements to evaporate from the body through the top of the head. Many times too, sympathetic pains are created by burning spots with fine tinder near the area of the pain. The pain of the burn serves to take the individuals attention away from a throbbing toothache to the pain of the burn. In the mind of the sufferer the original pain site feels as if it had diminished. Bodily aches are treated by massaging and stretching the limbs and muscles (Cf. unpublished papers from the Agats, Yamasj, Ayam, Pirimapun, Basiem and Komor areas). Various jungle leaves and fruits are also employed as curative measures to be taken in instances of these types of illnesses (Cf. unpublished papers from the areas of Agats, Yamasj, Aymn, Pirimapun, Bayun and the Komor areas).
Unfortunately, these methods often do not result in cures. The patient becomes progressively more sick and soon death will result if other measure are not taken. On these occasion the expertise of the healer is sought. Dr. Vincent van Amelsvoort who was the Dutch medical officer in Asmat during the years of 1959 to 1962 presented an article in the ethno-medical magazine Curare in which he discusses the Asmat as a unique instance of a society, contrasted to other pre-literate societies, where there is an absence of a traditional healer (p.67). In the article he writes: "I think the explanation is quite simply a medical one. The Asmat people were so healthy, that there was no social need for a community specialist in health matters!" (p.68) However, he does mention that he presents the hypothesis with caution and avers that more research is required (p,69).
Dr. van Amelsvoort was stationed in Agats and of necessity most of his time was dedicated to the health problems of the Bismam groups of people near Agats. Nonetheless, his hypothesis creates wonder because throughout the period of his work in Asmat he did not become aware of the traditional healer in Asmat society, although in another work he writes that Fr. Zegwaard reported 7 healers in the village of Syuru (An Asmat Sketch Book: No 5, part B, Peter van Arsdale pp. 274-275). Dr. van Amelsvoort's hypotheses is all the more surprising since even during his time of service mortality rates must have been relatively high. Even today, before the children reach school age over 50% to 60% of them born within the time of a particular year die. The high mortality rate today, however, has been increased because of epidemics of non-indigenous diseases such as whooping cough, cholera, various types of influenza, measles, gonorrhea, syphilis and other contagious diseases.
The Bismam Asmat, near Agats, call the healer namer-o (eram pok ipitsj); the Simai, ndambaroromtau ipitsj if a man, and if a woman ndambarororamtau cowotsj or iram ipitsj, iram cowotsj; the groups of the Pirimapun and Bayun areas yaram pa ipir; the Sawa-Erma dialect peoples erem pok iwir; and the Yoasakor and the upstream peoples call him eram pak aptam ipit.
These traditional healers are believed to have obtained a direct connection with the world of the spirits and are able to ask them how to treat various illnesses. Their administrations consist primarily the use of sleight of hand tricks, abstracting such items as nails, bits of glass or other sharp objects from the body of the afflicted. They also prepare concoctions of various tree leaves, bits of roots and other items to make magical potions that they use in the treatment of the sick. They, too, resort to the customary treatments of incising parts of the body in order to eliminate bad blood, or burning spots on the body, or employ the common methods used by others (van Arsdale p. 274 and unpublished papers). The most important aspect of the healers' administration is that it cures many of the psychosomatic illnesses affecting the people, especially since the power of suggestion that they have been afflicted or released from an illness are automatically believed.
Although modem medicine is resorted to in instances of sickness, its effect resulting in cures are still interpreted in line with indigenous beliefs. The injection of penicillin, for instance, is viewed as a method, similar to the sleight of hand tricks of the healer, used to expel the evil spirit or elements causing the illness. In the early days, when penicillin was used to cure yaws infections, the people visually saw the immediate and tremendous effects. After a few days the infection disappeared and healing started. This made such an impression on the Asmat of that period that they would always insist on the use of the "miracle method" (the injection) whenever a practitioner of modem medicine would give anti malarial tablets for malarial affliction. Often, the Asmat refuse to take any sort or tablet for sicknesses because the consumption of something foreign to them is viewed with suspicion since the tablets might cause more harm and even death. Most of the time, when a sick person receives a packet of tablets to be taken daily for a period of time, many of the Asmat do not take them but toss them away. This is especially the case if tablets must be mso-bidi-font-size: 13.0pt'>taken over a number of days. If the person considers that no change in his or her condition is taking place within the time of a day or two, he or she will toss the tablets away in the belief that they are ineffective. Based on their perceptions regarding cures, a cure must take place immediately not within the time of days, because the general belief is that the ministrations of the healer usually bring about immediate good effects. Time is not required. Additional to this is the fact that the healers reside in the villages with the people. They are immediately available to the sick, whereas a sick patient must make the journey, much of the time distant, to the nearest health clinic for help. That journey is made, however, many times with a suspicion that the ministrations of the clinic will not actually help. In fact, the Asmat fear that clinics are places where people die. This happens, if only a few times, when patients too near death's door are not able to be helped by any medical aid do die in the clinic. These incidents reaffirm the belief that hospitals are, in fact, sometimes very dangerous places. The belief is reaffirmed during discussions of the people of the village subsequent to any death that takes place in the clinic. Reluctance to visit a clinic is also bolstered by the necessity of paying for the medical help. The perception is that hard earned or rarely available cash sources are reluctantly used for something that does not guarantee a positive outcome.
Reverting to indigenous beliefs regarding the causes of illness is illustrated by the following example. About fifteen years ago, a good number of people of the village of Ewer fell victims to the diseases of syphilis and gonorrhea. As the number of people so afflicted began to increase at an alarming rate, the local pastor began an eradication program with the help of medical personnel. People who showed symptoms of the diseases were immediately treated with penicillin. Through awareness sessions the people were informed of the causes of the affliction the ways to avoid having them reoccur. The hope was that through both awareness of how the diseases were contacted and spread of them and the nature of medical treatment the people would avoid the possibility of re-afflictions. The fact, however, was that those treated and cured kept returning with re-infections of both syphilis and gonorrhea. Evidently the program did not impress the people. Finally, I wrote to Dr. Sander Batuna, who formerly worked as a medical officer in Asmat, asking him to send us a series of slides that would graphically illustrate the terrible results of advanced stages of the diseases. Initially, the slides did impress the people. No one, of course, wished something like that to happen. Nonetheless, the cases of the illness did not decrease but increased. Finally, one day the men of the village started reprimanding the women, blaming them for the continuance of the diseases. They accused the women of not preparing the sago according to norms set down by forbearers. The modern and scientific clarification of how and why the diseases continued to be rampant in the village did not impress the people. Indigenous belief of the causes and eradication of the diseases held sway.
Diarrhea is a constant among the Asmat. As they do not possess background knowledge or a fundamental understanding of microbes causing the affliction, their concept as how to remedy the cause is based on their "time-tried" cultural background. The question of cure to them is simple. If a child is afflicted with a diarrhea, for instance, the procedure is to stop fluid intake. The child will quickly die since there is no replenishment of body fluids.
In my association with the Asmat regarding this illness I encountered extreme difficulty in attempting to explain or get the young mothers to constantly increase fluid intake. Additional fluid intake to them only resulted in the increase of liquid-type defecation.
Many more examples of this nature could be cited, however, the examples serve to warn medical personnel search traditional belief obstacles they might encounter when applying modem medical practices among a people of a society that hold to the "historically tested."
Although Taboos permeate the life style of the Asmat in their cosmic view of the world, I now explain in what matter they work in Asmat respective of conception, birth and rearing of a child.
At the onset of the menstrual cycle a young woman, during those periods, is not allowed to eat various types of food, notably red colored fruit, or wild boar meat (especially the heart or meat near it. She is also not allowed to care for small children, to help others at work or to use public facilities, such as paddles, axes and so on. Children, too, must avoid coming near her. The danger for not observing the food restrictions is that she will face the danger of excessive bleeding. If she should take care of small children or use public facilities, the children who had contact with her or items she used will become sick and perhaps become physically incapacitated in some way (Penelitian STFT p.23).
Once the young lady marries, the Asmat believe that she is open to conception and able to carry new life. Conception, however, does not result from the copulative act of husband and wife.
The jungles of Asmat are filled with the spirits of those who formerly lived on earth that are seeking to be conceived by some married female. One of these spirits enwrapped in some fruit, food, or within other things within the environment manages to take up residence in her womb. A lady will know that she has conceived when she feels some weight in the lower abdominal region, and after some sign from the spirit world indicating that she is pregnant. Although there are a number of signs that she is pregnant, the most usual sign is when a small green frog hops upon her shoulder or somewhere near her. The green frog indicates that the child to be born will be a girl. In addition, if she sees a parrot or a bird of paradise fly nearby at the time or she dreams about them, the supposition is that the girl will also be beautiful. If such birds as the king cockatoo or a year bird appear they indicate that the child will be a boy. Bees are a sign that the child, whether male or female, will be artistic (Unpublished papers). The copulative act is regarded as providing the developing child in the womb as feeding and forming the child. Pregnancy is the result of spirit intrusion.
During pregnancy taboos regulating food restrictions need to be followed by the pregnant woman. These restrictions vary among different groups throughout the Asmat region.
One restriction that is the same is that both husband and wife may not copulate during the time of the advanced pregnancy, after birth, and until the child takes its first steps. Disregarding this taboo would endanger the life of the child. The food restrictions for a pregnant woman of the Sawa-Erma district forbid the consumption of lizard, cuscus, coconuts, the skin of a large sago ball, fish that are caught by nets, mud crabs, red ants, tuberous plants, flesh of sharp clawed animals, sea bass and a few other types of fish, red bananas and nipa fruit.
If she should eat lizard or cuscus the spirits will make the birth difficult. Consumption of coconuts or the skin of large balls of baked sago will make the birth so difficult that she may die since a coconut or large baked sago ball represent the skulls of human beings. The eating of netted fish will result in the child being afflicted by cascado (scabbies). Mud crabs, red ants or tuberous plants, if eaten, will prevent the vagina from opening properly at the time of birth. The consumption of sharp clawed animals, sea bass and some types of fish will make the woman sick at the time of birth. The eating of red bananas or nipa fruit will result in the birth of a weak and unhealthy child (Penelitian STFT p. 23).
The Asmat of the Ayam region must also follow a good number of taboos. They, too, do not permit the copulative during late pregnancy. The people, however, prescribe both husband and wife to the restriction of certain food taboos. They may not consume large sago balls, large bananas, various types of fish, parts of the wild boar, the eggs of birds, fish, crocodiles and turtles. (Unpublished papers).
As the time of parturition nears, the wife must distance herself from the husband; weave a special birth mat that no one may touch before and after the birth of a child. The peoples of some of the region (Yamasj, Ayam and the Asmat of the coast) build a special hut behind the village as a birthing place. Among the Sawa-Erma peoples a woman near parturition is set off in a comer, walled off by mats, of her residence and is not allowed contact with her husband. All people avoid a woman about to give birth because the blood escaping is terribly dangerous, especially to the male population. It always causes sickness and sometimes even death. The only people allowed to assist woman during birthing are grandmothers, or a sister of the husband. After birth the umbilical cord is cut by a sharp piece of bamboo or clamshell. Neither the mother or child are allowed to bathe until the umbilical cord during healing separates itself from the child's abdomen.
As the child matures more taboo restrictions need to be followed until the child is old enough to get along on its own. Throughout life, however, taboos particular to an individual or to the society need to be adhered to. Taboos exist for the making of implements as the paddle, the sago pounder, a dugout or for any other activity of this nature. Certain taboos need to be observed during feasts, etc. The entire life of an Asmat person is regulated by taboos which, if not observed, will cause the displeasure of the spirit world or result in some serious malady.
Innovation among the societies of people of the world always faces a challenge. Changes take place within a society quickly if the demonstration of the worth, of them is immediately evident. Such items as steel axes, iron implements or styles of clothing are quickly integrated into societal cultural patterns because they demonstrate visually their value. Changes, however, that involve deeply engrained beliefs and societal norms much of the time meet up with opposition since their advantages are not immediately demonstrable. Innovations that threaten basic societal tenets since they are thought to be the stabilizing elements for societal security will meet up with spontaneous opposition. This is especially true for new ideas regarding health and the very lives of people. New health concepts are reluctantly accepted, because the ingrained indigenous methods "proven" to assure security in the perception of people have historically always worked. Attempts to change them often results in the frustration of medical officers. The difficulties of transmitting new health measures are not caused because the people lack interest in their health and welfare. All peoples whatever the society seek for good health and continued life.
Another complication, because of indigenous perceptions of the causes, preventions, and the cure of disease, to instilling an awareness of hygienic practices necessary to combat diseases will prove to be a very difficult task. Any program that hits directly at-transferring knowledge that microbes are the source of many diseases and how to prevent them from having negative effects on the populace will not convince. Ingrained beliefs will always be adhered to modem perceptions will appear to have no foundation in reality. This is especially true of the Asmat who believe in magical-religious causes for disease and the cure of them.
The problems lie in the basic conceptualization of the people as to the causes and subsequent measures to be taken for maintaining health that determine the negative reactions of a people. The Asmat believe that the causes of sickness and death are inflictions caused by some agent, either spirit or human. Cures, then, will necessarily be based on the way to either placate those spirits or expel the matter implanted through magical means causing the illness. Within this mental framework a medical officer will meet up with societal disbelief when he or she attempts to transfer the concepts and subsequent belief of the factor of microbes causing many sicknesses and the measures to be taken for cures. The people will always adhere to indigenous beliefs since they are to them “time-proven”. It would be futile for any medical officer to attempt to change the entire cosmology of the Asmat for the purpose of integrating new concepts of health and practices.
Coercion through legislation has never worked at changing the attitudes of people. People will normally avoid imposed rules, especially since their value is questionable, or will abandon following the rules once the pressures to do so are removed. Undoubtedly, too, the indigenous healers will continue to exercise influence respective of additional heath practices.
Complicating the issue are sexual mores of societies. Sexual norms or the disintegration of them fostered through change will promote the spread of venereal diseases. The Asmat practice of wife exchange, formerly strictly regulated, has undergone change to the point that former regulatory norms are disregarded. In addition to this factor, is the reality that within any village there exists a number of unattached females who become careers of venereal disease. These factors bodes ill for the future of the Asmat people since the incidence of AIDS in the South Coast, especially in Merauke, the regional city, where high number of cases have been discovered. The disease will undoubtedly spread since many Asmat males do visit Merauke and do take opportunities for sexual intimacies with the prostitutes of the city.
The implications are that the instilling of new medical knowledge cannot be accomplished in isolation from the ramification of other cultural factors. Those factors need to be recognized and worked with if a medical officer hopes to obtain some success. The process, however, will of necessity be a slow but hopefully a progressive one. Ingrained beliefs based on a magico-religious foundation are extremely difficult to change because they not only deal with the mysterious and great sources of power, but also because they are the very foundation for security within the society.
Any venture to instill awareness will prove to be a difficult challenge for medical officers. The approaches used should not be applied isolated from cooperation of those who presently exercise control over the health management of the society. Continuous contact and cooperation with the recognized healers of any village are required. If their role is not considered, the health office can expect only their subsequent resistance. It will be necessary to include them in a cooperative manner when attempts are made to instill new perceptions of the causes of illnesses and the cures. The health officer in the task of obtaining the cooperation of the healers will be challenged to include them in the realm of modem medical practices. He might venture including them in an advisory capacity for any health program sponsored in the village by the Department of Health. In that position of honor the health officer might also give them responsibility in some tasks aimed at fostering new health methods in the village. Health officers need to be extremely sensitive regarding criticisms of indigenous practices, and may not transfer feelings that those practices hinge on stupidity. If the health officer should criticize in any manner then he will face resistance. Indigenous healers should feel that their cooperation is a matter of prestige.
Presently, in Asmat there are a number of boarding facilities both for Junior high school and the one senior high school in Agats. As most of the students of those schools will eventually return to their respective villages, intense and continuous awareness courses provided by the health department regarding matters of health, hygiene, diet and sexual matters should be given to the students. Later on, these graduates will be in a position of influence among the ordinary village people. Whatever pro gram the Department of Health will use in order to convince the Asmat of the values of modern medicine, the program always will necessitate obtaining the cooperative assistance of village healers, mid-wives or any of those in authority over the daily lives of the people.
This paper has been offered in view of offering a number of insights into Asmat beliefs and medical practices hinging upon those beliefs. My hope is that it will prove to be of some help to the medical officers working among the Asmat people.
May 2, 1997
Alphonse A. Sowada, OSC
Bishop of
Agats-Asmat