The ecology of health

As is now reasonably well known, primitive hunters, before killing an animal, first prayed to its spirit and to the nature god, whose function it was to protect wild animals from depredations, in order to ask for forgiveness for what they were about to do. The totemic system, whereby a particular clan identified itself with a particular animal, also assured that at least in this clan’s territory it was regarded as holy and thereby remained unmolested.

Now to sanctify something is the only cultural device that has ever succeeded in preserving it, a fact that is only too easy to verity empirically in the light of the pathetic failure of just about all the efforts of conservationists to preserve our now desanctified society and its desanctified environment from our increasingly destructive activities.

A society, however, is not alone in its non-human environment. It is surrounded by other, often hostile, social groups. In addition a society does not always display the ideal degree of order, for not all behaviour within it is under control. In other words, it displays some measure of randomness, and thereby contains some anti-social elements. Such elements, together with neighbouring hostile tribes are represented by the third category, namely the evil spirits and witches.

It is to be noted that the world is not seen as composed of spirits in the way in which scientists see the world as being composed of molecules and atoms.

Primitive people do not have a reductionist view of the world. The spirits rather than being components of the biosphere are seen, on the contrary, as being organised in such a way as to reflect its truly hierarchical nature. They represent it at every level of organisation not just the lowest one as the scientific model does.

A further feature of the primitive world-view is that the interrelationships that are seen to exist between the different spirits which control society, its enemies and its natural environment, are closely established by tradition and carefully explained in terms of its mythology. What is more, such interrelationships are constantly brought home to people in songs and other ritual activities. Thus, among the Canelos Quichua Indians of Ecuador, as Whitten tells us:

“Playing flutes, singing songs and telling myths, punctuates discussion of Amasanga (who controls the weather, the thunder and lightning), Nungui (who controls the soil-base for the roots of garden-life and pottery clay) and Sanghui (who controls water) These activities are, among other things, mechanisms for associational, or analogic linking of cosmological and ecosystem knowledge to social rules and breaches, and social dynamics to cosmological premises.” [16]

In this respect, the primitive model is also in stark contrast with the scientific model. Rather than being divided up into watertight disciplines between which interrelationships are almost impossible to establish, it is, on the contrary, totally non-disciplinary which, in terms of general systems theory, is required if the model is to permit the mediation of an integrated behaviour pattern as opposed to that mere patchwork of expedients that is the policy of a modern nation state.

It is to be noted that the primitive model is formulated in a language which all can understand. This too is in stark contrast with the scientific world-view, which we so highly prize and which is formulated in an esoteric tongue which only a handful of specialistscan really understand.

This is of particular importance if we consider that stability implies self-regulation. It is cybernetically impossible for a natural system to be governed from the outside, for its goal would thereby be random to it and, hence, to the biosphere of which it is an integral part, and would simply reflect that of the external agencies that were doing the ‘controlling’, as it does in our industrial society today.

For a system to be self-regulating means, above all, that the behaviour of each sub-system must be subjected to the control of the system as a whole, and this is only possible if all its members both use and understandthe same language, i.e. if the language in terms of which their world-viewis formulated be demotic rather than hieratic. [17]

It is in terms of this world-view that a discontinuity such as a disease is interpreted. Sometimes, it is seen as being caused by the evil spirits that reside in witches or other anti-social elements, or else it is seen as a punishment meted out by the ancestral spirits or the spirits of nature for failure to observe the traditional law and in particular for violating a taboo which, in some cases, is also seen as increasing vulnerability to witches.

A typical example is that of the view of disease entertained by the Luo of East Africa. Among them, as Whisson tells us,

“Sickness is believed to be caused by spirits failing into different categories, the most current being the spirits of the parents or grandparents (vadzimu), spirit elders or ancestral spirits and the witches (muroi). While the intervention of the ancestors might be capricious, the diseases ascribed to them or to God were usually felt to he punishments for the sins of the patients or their families. A man who broke a tribal rule might expect to he punished for it by the ancestors or by God in the form of disease. Any man attacked by disease would therefore feel obliged to examine himself and his relationships with the ancestors. A very minor organic disorder – like several days of constipation – might create a considerable overlay of fear or guilt and reduce the patient to helplessness until the rituals were performed and the ancestors propitiated according to the traditions of the society and the directions of the diviner.” [18]

In the Old Testament, as we must recall, a natural disaster whether a famine, an earthquake, an epidemic or an invasion by the Philistines was also invariably attributed to failure on the part of the Jews to worship Jahveh in the correct manner, worse still to worship a rival Baal.

The tendency is for people brought up on the modern scientific values to scoff at such a diagnosis. It is ‘unscientific’ and hence, in terms of our world-view ‘irrational’ but let us look at it a little more closely. The rules that govern the behaviour of a primitive society that are justified in terms of its mythology and imposed by public opinion, the Counsel of Elders and the ancestral spirits, are not of a purely random nature. They can in fact be shown to be highly adaptive.

In the light of the empirical evidence this thesis is unassailable since tribal societies, in particular hunter-gatherer groups, have been able to achieve an unparalleled degree of stability within their natural environment in which they could have survived and indeed thrived almost indefinitely if their lifestyles had not been interfered with and their environment annihilated by western man. Such stability is maintained by strict adherence to a set of laws that assures above all the preservation of the social and physical environment that most closely resembles that to which the society has been adapted by its social evolution.

This being so, failure to observe such laws, the breaking of a taboo, for instance, and indeed sinning in general, can only be construed as a violation of precisely that set of laws that assures a society’s success, indeed its survival.

To sin is thereby to behave in that way which, in such conditions, must lead to the destabilisation of the individual’s relationship with their society and the society’s relationship with its environment, and such destabilisation can only be reflected in all sorts of discontinuities of which diseases are but one, this being so, the primitive diagnosis, however quaint the language in which it is formulated, is in fact correct. Indeed, if the behaviour pattern that the gods of a tribal society have sanctified is adaptive, in that it has led to the lowest possible incidence of disease and other discontinuities, then the occurrence of a disease must indeed signify that the society has sinned.

What is more, if the disease, like any other discontinuity, is due to a biological, social or ecological diversion from the optimum, then its cure can only consist in restoring the optimum. This means that if it has been caused by a witch then the activities of the witch must be neutralised, so as to reduce tensions and, at the same time, to reduce those anti-social activities in which a witch may possibly indulge.

If the disease is seen as being caused by violating a taboo then the violators must make amends. In particular, they must make the appropriate sacrifices to their ancestral spirits, fulfil their various ritual obligations to kin, cease killing wild animals over and above those that they are ritually entitled to kill and otherwise refrain from doing things which can impair the proper functioning of the society’s cultural pattern within its specific environment.

Of course, such individuals are also treated medicinally. For instance herbs and other traditional medicines may be administered as part of a ceremony and these may often prove effective. But to cure the individual is not the prime object of the treatment. It can even be regarded as mere ‘spin-off’, the real role of the treatment being to restore the biological or psychological stability of the person affected, by restoring the proper functioning of the biological, social and ecological systems whose disruption is the real cause of the problem.

This is the conclusion of Professor Victor Turner with regard to the Ndembu:

“It seems that the Ndembu ‘doctor’ sees his task less as curing an individual patient than as remedying the ills of a corporate group. The sickness of a patient is mainly a sign that ‘something is rotten’ in the corporate body. The patient will notget better until all the tensions and aggressions in the group’s interrelations have been brought to light and exposed to ritual treatment. The doctor’s task is to tap the various streams of affect associated with these conflicts and with the social and interpersonal disputes in which they are manifested-and to channel them in asocially positive direction. The raw energies of conflict are thus domesticated in the service of the traditional social order.” [19]

It is also the conclusion of Professor Reichel Dolmatoff’s study of the way the Tukano Indians of Colombia adapt to their environment. A Tukano shaman, as he shows, does not see a disease as the result of a simple biological insult as would a reductionist scientist, but as a socio-ecological imbalance:

“His main concern is about the relationship between society and the supernatural Master of game, fish and wild fruits, on whom depends success in harvesting and who commands many pathogenic agents. To the shaman it is therefore of the essence to diagnose correctly the causes of the illness, to identify the exact quality of the inadequate relationship (be it adultery, overhunting, or any other over-indulgence or waste) and then to redress the balance by communicating with the spirits and by establishing reconciliatory contacts with the game animals. In this way the shaman as a healer of illness does not so much interfere on the individual level, but operates on the level of those supra-individual structures that have been disturbed by the person. To be effective, he has to apply his treatment to the disturbed part of the ecosystem. It might be said then that a Tukano shaman does not have individual patients: his task is to cure a social malfunctioning. The diseased organism of the patient is secondary in importance and will be treated eventually, both empirically and ritually, but what really counts is the re-establishment of the rules that will avoid over-hunting, the depletion of certain plant resources and unchecked population increase. The shaman becomes thus a truly powerful force in the control and management of resources.” [20]

In this way, primitive people, by correctly diagnosing diseases as the symptoms of social and ecological maladjustment, whether at the level of the individual, the family, the community or the ecosystem, bring about those changes that will put their society back on its correct course; that which will assure a reduction of the incidence of disease to the unavoidable minimum; i.e. to that level at which disease kills but the old and the sick thereby applying quantitative and qualitative controls on a human population so as to help maintain its long-term viability.

It is essential to realise that it is not just diseases but all discontinuities that are interpreted in this way. Droughts and floods and military reversals, as already intimated, are also seen as signs of socio-ecological instability a thesis that has so far been most forcefully put by Roy Rappaport in his study of the Tsembaga of New Guinea:

“The operation of rituals among the Tsembaga and other Maring helps to maintain an undegraded environment, limits fighting to frequencies which do not endanger the existence of the regional populations, adjusts man-land ratios, facilitates trade, distributes local surpluses of pig throughout the regional population in the form of pork and assures people of high quality protein when they are most in need of it.” [21]

As I have already pointed out this self-regulation requires the concentrated action of the whole society. All its parts must contribute actively. Each individual must be actively involved in the rituals that will assure his or her society’s stability.

Our modern industrial society cannot function in this way because it has disintegrated into a mass of unrelated and alienated individuals who do not have the capacity to take a real hand in the running of their affairs. In this way we have become totally dependent on external agents of control.

At the same time, our society is so structured that it is impossible to treat a disease at any level higher than that of the individual. Experts in different fields, reared on the specialist knowledge contained within the watertight disciplines into which modem knowledge has been divided, are employed to fulfil carefully defined tasks. Each specialist has a limited brief; he or she cannot venture outside what is considered the legitimate field of activity without venturing on to territory over which some other specialist hold sway.

Not only is this true of the medical profession but even of the Minister of Health. The Minister’s territory is well defined. He or she can order the building of more hospitals, subsidise the production of more pharmaceutical preparations and encourage the recruiting of more doctors and nurses. The Minister can also bring about certain changes to the Organisation of his or her departments, but that is about all. Against the real causes of disease the Minister can do nothing.

What is more it is difficult to see how, within our modern society the present state of affairs can possibly be remedied. Our society is committed to a course – that of further development and industrialisation – that can only exacerbate all the basic problems that confront it, including the growing ill-health of its members.

In the long run of course, the problem will be solved, for conditions are becoming ever less propitious to the industrial process, so much so that we are faced in the not too distant future with inevitable socio-economic collapse. It is only then that our health could take a turn for the better, for out of the ruins of our industrial society, we can hope to see emerge smaller, more decentralised societies that might eventually develop the capacity for cultural self-regulation and thereby create conditions that are more favourable to the maintenance of human health as well as that of whatever forms of life may have survived the industrial holocaust.

References

1.	John Powles, “The Medicine of Industrial Man”. The Ecologist Vol. 2 No. 10, October 1972.
2.	R. Logan. Quoted in A. Malleson, Need your Doctor be so useless?. Allen & Unwin, London, 1973.
3.	A. Malleson, ibid
4.	Ross Hume Hall, personal communication.
5.	Walter G. Cannon, The Wisdom of the Body. W. W. Norton, New York, 1939.
6.	J. Ralph Audy, “Measurement and Diagnosis of Health”. In P. Shepherd and D. McKinley eds., Environ/Mental. Houghton Mifflin, Boston, 1971.
7.	Samuel Epstein, The Politics of Cancer. Sierra Club, San Francisco, 1979.
8.	Bryn Bridges, personal communication.
9.	Stephen Boyden, “Evolution and Health”. The Ecologist Vol. 3 No. 8, August 1973.
10.	Sherwood L. Washburn and C. S. Lancaster, “The Evolution of Hunting”. In: Lee and Devore, Man the Hunter. Aldine, Chicago, 1968.
11.	C. C. Hughes and J. M. Hunter, “Development and Disease in Africa”. The Ecologist Vol. 2 Nos. 9 & 10, September-October 1972.
12.	WHO Chronicle, 1973.
13.	M. Fielding and R. F. Packham, “Organic compounds in drinking water and public health”. The Ecologist Quarterly, Summer 1978.
14.	Stephen Boyden, op.cit.
15.	W. W. Yellowlees. Journal of the Royal College of GPs Vol. 29 No. 27, 1979.
16.	N. E. Whitten, Jr., “Ecological Imagery and Cultural Adaptability”. American Anthropologist Vol. 80 No. 4, December 1978.
17.	Ken Penney of Exeter University has suggested the use of these terms in this context.
18.	Michael Whisson, “Some Aspects of Functional Disorders among the Kenyan Luo”. In: Ari Kiev (ed) Magic, Faith and Healing. New York, The Free Press, 1967.
19.	Victor Turner, “A Ndembu Doctor in Practice”. In Ari Kiev ed., Magic, Faith and Healing. The Free Press, New York, 1967
20.	C. Reichel Dolmatoff, “Cosmology as Ecological Analysis – A View from the Rain Forest. The Ecologist Vol. 7 No. 1, January-February 1977.
21.	Roy A. Rappaport, Ecology, Meaning and Religion. North Atlantic Books, Richmond, California, 1979.

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