Tag Archives: pujok

Women, culture and healing

Why are most Asian babies born with a birthmark that looks like a bruise at the base of the spine? Doctors and traditional midwives usually have different explanations for this “Mongolian spot.” According to medical experts, abuse has nothing to do with it. The bluish-grey blotch is merely a genetic gift from the parents and it will gradually fade. However, if you ask a Korean rural villager about its origins, you might get a different answer. One old woman once told me that babies need a little kick to help them come into this world because life is so hard that they don’t want to be born. A “three-spirit” deity of heaven, earth and the underworld gives a gentle push, leaving a telltale trace on the baby’s back.

Burmese Traditional Birth Attendants
Burmese traditional birth attendants

In rural Korea in the 1970s, traditional healers such as “three-spirit” grandmothers on Cheju Island took charge of mother and child health care once the baby was born. Until the first 100 days of life had passed, these traditional healers were the family consultants on child nutrition, illness and postpartum recovery. They also performed rituals that included prayers, food offerings and songs so that the ancestors will watch over the infant’s well being.

In many countries a large group of health care providers in rural areas are women known as traditional birth attendants (TBAs) and female traditional healers. Village women often trust them because they have qualities that are sometimes missing among younger doctors, including a “caring feeling,” “strong moral character” and “years of experience.”

For decades, UN agencies such the UN Population Fund (UNFPA) have regarded local village health workers as invaluable human resources for providing services such as immunization, family planning and nutrition education—all part of an effort to improve maternal and child health. Maternal mortality continues to be one of the greatest challenges for health planners. In Afghanistan 1 out of every 11 women dies in childbirth. According to the World Bank, for every woman who dies during childbirth in Sweden, 815 women in Somalia and 495 die in Nigeria.

Training programs in countries like Nepal, Nigeria and Burma have been highly successful in mobilizing village workers to help bridge the gap between modern and traditional health beliefs. As one Burmese traditional birth attendant explained to me, “We have sterilized birthing kits, but we also stick to our traditions like cutting the umbilical cord on a coin so that the child will have good fortune. Doctors have taught us how to sterilize the coin and knife beforehand.”

Although traditional women healers have participated in government-sponsored programs, few health policy makers are aware of the problems that these women face in carrying out their work. Female traditional healers are often heads of household, poor, illiterate and landless. Their fees are typically lower than those of male specialists so that even after years of practice, they still can barely make ends meet. It is common for them to be paid in kind.

Another obstacle facing women healers is prejudice on the part of doctors who think that they discourage patients from using health services. While that happens on occasion, the degree of quackery and competition is probably far less than is assumed. In Thailand, Indonesia and Burkina Faso I found that healers themselves often used modern medicine. Women traditional healers typically deal with chronic ailments or conditions that require prolonged care like tuberculosis or cancer when patients may lose the will to live.

Depression and psychosocial complications that may accompany birthing or illness often interfere with effective medical treatment. When women feel defeated by their ill health, they may even give up trying to recover. There are also conditions that patients believe have spiritual origins for which modern medicine has no cures. For these and other reasons such as proximity and failure of medical treatments, patients may choose alternative medical care. Ultimately, the losers are the poor–many of whom are women–who go back and forth from one system to another. Like many patients in Europe and the US, they are looking for someone who will treat the whole person–heart and soul as well as mind and body.

The soaring use of alternative medicines and healers—even in industrialized countries—should alert modern medical practitioners to the shortcomings of their practice. Yet time is short to learn from the past. The ageing group of traditional birth attendants and healers is fast disappearing in many villages. With an abrupt and unannounced exit, their knowledge and experience will likewise be gone—and that may be a loss for us, all.

If Cowry Shells Could Predict the Future

The weeks surrounding New Year’s Day are prime time for the world’s fortune-tellers. While many people have resolutions, others are looking for help on important decisions ahead about health, marriages and jobs. Fortune-tellers are natural allies. They listen patiently as clients mull over last year’s disappointments and express their fears about what lies ahead. For those afflicted by deep anxiety, the seers suggest a fantasy where there is meaning in every life event and a predictable destiny for all. Whatever the accuracy of any given prediction, the reassurance that everyone has a place in a grand cosmic plan is enough to allow some people to take charge of their own lives.

Turning the empty jug sideways to "keep out the genies"
Turning the empty jug sideways to “keep out the genies” – Mossi  girl

Fortune-tellers throw rice, cowry shells, knives, sticks or look into the glowing crystal ball. These are the tools of the trade. All these magical objects are like physicians’ medical instruments; practitioners use them to read symptoms. But the props are often just used to buttress what the quick study of the clients’ faces has already revealed. Intuition is probably medicine’s best complement to science, and the best seers have more than average practice in its use.

Who is to say if fortune-tellers’ words are true? “Truth” may not even be the best measurement. Can they provide a useful service? The fortune-tellers I have met are like doctors – some are quacks; others are geniuses. The best of them do not work for money but out of sympathy for the suffering of others.

One woman who fit this description was a traditional healer I met in Burkina Faso. She lived through troubled times. Grand forests had disappeared during the repeated droughts, and almost everyone had lost heart. But she offered a strong and steady voice of hope, calling on the ancestors to hold together the thin threads of life. This healer was also in charge of young girls’ rites of passage to adulthood. Throughout their lifetime, she would be part of their household – as a midwife, healer and friend.

When I left, she gave me her own cowry shells that she used to tell people’s fortunes. These three white shells, about the size of quarters, had lost their shine from years of being thrown on her mats. She said that it was important to know how the rough and smooth sides fell. I never learned the code for reading the shells, but I knew that three round sides up several times in a row was not good. She threw the shells. “Ah,” she exclaimed, “Your years will be full of good luck and fortune. Take these shells back to your country so that you will remember us.”

Despite their noble heritage, my cowries aren’t infallible. They are a long way from the plateaus of Burkina Faso and admittedly in untrained hands. But like all good fortune-tellers, my aim is not necessarily to conjure up a pixel-perfect picture of the future – just to offer enough hints to prompt the customers to think for themselves.

My Life with Shamans

Although shamanism shaped Korean culture for centuries, it is rarely mentioned in Korean dynastic records. Extraordinarily resilient, it survived persecution during the l970’s as well as rapid industrialization, partly because it was embedded in family rituals and community life. Unraveling its mysteries was my anthropological passion because I believed it was a key to understanding the modern Korean mindset. A family friend and former general in the army during the Korean War urged me to do research on Cheju Island before its shamanist cults disappeared. “They worship snakes,” he said, tempting my curiosity. He described village rituals devoted to a powerful snake spirit who could cause illness or make people rich. I could not imagine a more compelling academic adventure.

I reached Cheju in the summer of l977 but I was apprehensive about the feasibility of my project. It often takes weeks to infiltrate a community of shamans and gain their trust, but the island’s spirits must have been watching over me. During my first visit to the local folk museum I was invited to a shaman rite. A 40-year old woman was afflicted with an illness that prevented her from speaking. The doctors said there was nothing wrong with her physically so they could not cure her. In desperation, her husband’s family had called upon one of the island’s most famous shamans, Mun OkSun. A small, frail woman in her 60’s, she nevertheless commanded everyone taking part in the 3-day ceremony. She jumped with such force into the air when she danced that her long sequined dress flew above her knees. One family member told me that a messenger spirit had possessed her.

During an interlude, Mun sent me an intense look across the room. Did she disapprove of my presence? I was about to leave when she motioned me to come closer. Then she smiled and reached for my hand. I was reluctant, but my assistant explained that she wanted to read my fortune. “You are part of a family with five children (which is true). You have done many things in music and art (also true), and you will marry before the end of the year (I had 3 months to go and no prospects in sight but my future partner showed up as predicted).” She invited me to share their meals and participate in the ceremonies.

Mun Ok Sun in Buddhist dress
Mun Ok Sun, shaman from Cheju Island,1976

By sheer coincidence, Mun OkSun lived next to the sacred tree in which the famed snake spirit was said to rest. One day at her home she sang for me the epic tale of the Agassi snake spirit. The tale is as follows. “There was once a Chinese couple who was called by the heavenly spirit to govern in Heaven. They were very sad because they would have to leave their 7-year old daughter behind. Misfortune struck when a servant who was entrusted with her care lost her in a forest. A monk rescued the girl, carrying her away in his begging sack. Miraculously, the child became pregnant. When the parents returned, they searched for her and after consulting with the monk were reunited with their daughter. But upon learning of her pregnancy, they were full of shame and banished her. She was locked in a box and sent out to sea where she floated under the protection of the dragon king. Finally, she landed on Cheju Island. On the beach, Cheju women divers discovered the box and opened it to release a beautiful giant snake and seven baby serpents. Soon afterwards, the divers became ill and they realized that the snakes were spirits. After they made offerings, they were healed, became wealthy and had many children. From that time on, the Cheju islanders have worshipped the snake spirit.” Mun explained that the Agassi snake spirit was commemorated in heaven by the Big Dipper, which has seven stars. At ceremonies, we often added a bottle of Chilseung or Seven-Star soda just for Agassi on the offering table.

For a few days afterwards, I visited Mun to conduct interviews. Finally she decided it would be easier if I just moved in so I was given the room near the sacred tree. The propitious location of my bedroom obliged me to point my feet toward Seoul while sleeping. According to some folklorists, that posture brought me even better luck. Mun OkSun soon adopted me as her Korean-American daughter. She introduced me to the inner circles of shamans, and I traveled with her throughout the island as part of her group.

I accompanied her to the cancer clinic where she herself was receiving treatments. I was puzzled by her confidence in the Western-trained doctor, naively believing that shamans competed with modern health practitioners. But Mun never saw any contradiction between her healing methods and those of modern medical practitioners. She had great faith in pharmaceuticals and always told her patients to follow doctors’ orders. She told me that shamans dealt with mental and spiritual problems that were often ignored by doctors. Indeed, most of the cases I witnessed involved patients whose physical ailments were inseparable from their psychological well being. A tuberculosis patient had become an alcoholic and stopped taking his medicine. A partially paralyzed boy was so depressed that he wouldn’t eat. Others suffered from mental disorders or distress from chronic or incurable illnesses. I believe Mun’s greatest contribution to healing was her ability to restore her patients’ will to live, and she had what no doctor could offer: the authority of ancestral spirits to back her up. With extraordinary intuitive skills and a wealth of understanding about her patients’ symbolic universe, Mun accomplished what any effective psychotherapist might achieve. She accepted the subjective world of her patients, and she bestowed high status upon their inner suffering.

Perhaps the key to understanding a shaman’s role is what T. S. Elliot once referred to as the “wounded surgeon.” Many shamans have a history of serious illnesses, and they share their patients’ worldview as members of the community—all useful experiences when working with the rural and urban poor. Like any group of healers, doctors included, there are charlatans among them. But most Cheju shamans I met were people of great faith who strongly believed in their right to freedom of religion. We should be grateful that they defended that right. Shamanism is a religion with no temple, bible or institutionalized priesthood and yet it thrives to this day. It is a cultural legacy worth more than all the jewels of the Yi dynasty.