The quest for therapy in Lower Zaire

314 Pages·1978·11.986 MB·English

by  John M. Janzen

The Quest
for Therapy
Medical Pluralism
in Lower Zaire
John M. Janzen
COMPARATIVE STUDIES OF
HEALTH SYSTEMS AND MEDICAL CARE
General Editor
john M. Janzen
Founding Editor
Charles Leslie
Editorial Board
Don Bates, M.D.,
McGill University
Frederick L. Dunn, M.D.,
University of California, San Francisco
Kris Heggenhougen,
Harvard University
Brigitte Jordan,
Michigan State University
Shirley Lindenbaum,
The Graduate School and University Center of the
City University of New York
Patricia L. Rosenfield,
The Carnegie Corporation of New York
Paul U. Unschuld,
University of Munich
Francis Zimmermann,
Centre National de la Recherche Scientifique, Paris
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The Quest for Therapy:
Medical Pluralism
in Lower Zaire

JOHN M. JANZEN
with the collaboration of William Arkinstall, M.D.
Foreword by Charles Leslie
UNIVERSITY OF CALIFORNIA PRESS
Berkeley - Los Angeles - London
University of California Press
Berkeley and Los Angeles, California
University of California Press, Ltd.
London, England
Copyright © 1978 by
The Regents of the University of California
First Paperback Printing 1982
ISBN 0-520-04633-1
Library of Congress Catalog Card Number: 76-19982
Printed in the United States of America
The paper used in this publication meets the minimum
requirements of American National Standard for
Information Sciences—Permanence of Paper for
Printed Library Materials, ANS] Z39.48-1984.
This book is a print-on-demand volume. It is manufactured
using toner in place of ink. Type and images may be less
sharp than the same material seen in traditionally printed
University of California Press editions.
Contents
List of I llustrations Vil
Foreword by Charles Leslie Xl
Preface XVii
PART I: THE AREA OF STUDY
1. The Human Setting of Healing in Lower Zaire
The Management of Illness and Therapy
The Society and Its History
Disease, Modern Medicine, and Health
Methodology of Study
2. A History of Medical Pluralism in Lower Zaire 37
Kisi-Nsi and Kimundele in a Single Society
Colonial Medical Policy and Action
The Evolution of Kisi-Nsi
Definition and Control of the Art of Healing Since the
Second World War
Postcolonial Legitimization of Kisi-Nsi
PART II: STUDIES IN KONGO ILLNESS AND
THERAPY
An Introductory Note
3. Disease of God, Disease of Man 67
vi / Contents
Strife in the Family As Cause of Child’s Illness 75
A
A History of Madness SI

N
NA The Professional as Kinsman
Marriage and the Father’s Blessing 101

n
o The Clan as Patient 114
C
PART III: THE LOGIC OF THERAPEUTIC
SYSTEMS
An Introductory Note
9. The Jural Status of Therapy in Kongo Society 129
The Conveyance of Rights in Litigation, Ceremony, and Therapy
Consensus and Dissension in Therapeutic Decision-Making
Categories of Therapeutic Choice
10. Interpreting Symptoms 1$7
Nzoamambu’s Medical Cosmology
Diagnostic Ideas
Il. Contemporary Systems of Popular Medicine
in Lower Zaire 193
The Art of the Nganga
Kinship Therapy
Purification and Initiation
Western Medicine
The Therapy Course Reconsidered
12. Toward an Integrated Medicine 223
Appendix A. Episodes of Case Studies Reported in
Chapters 3-8. 231
Appendix B. Herbarium of Medicinal Plants
243
Bibliography of Works Cited 251
Glossary-Index 258
Illustrations
FIGURES
1. Inhabitants per medical doctor in several countries. 29
Western medical personnel and facilities per inhabitants in
Luozi Territory and Zaire Nationally. 30
Kinship relations in Luzayadio’s case. 70
Y Structure of confession and accusation in Luzayadio’s
B
case. 7I
Close kin marriage types in matrilineal context. 74

Y Kinship relations in case of Axel and Cécile. 78
A
Kinship relations of Nsundi and Kinkanga-Kituma clans. 94

I. Partial genealogy in cases of Lwezi and Mbumba._ 115
W
C. Formation of therapy managing group in case
Studies. 132-133
Io. Social components constituting therapy managing
group. 140
Il. Correlation of social context of decision and therapy
choice. 149
12. Co-occurrence of therapies and specialist’s (or group
therapist’s) roles in case studies. 152-153
13. Correlation of distance travelled by clients with cost and role
of therapist consulted. 154
14. Diagrams of the body. 159
15. Correlation of therapy actions and problems handled by
banganga 204
vill / Illustrations
16. Correlation of therapy actions and problems handled by
kinship therapy and bangunza_ 210-211
17. The course of therapy summarized 220
PLATES (Between pages 106 and 107)
. Out patients at Kibunzi dispensary, Lower Zaire.
. Patients receiving medicine, Kibunzi dispensary.
ND
. Nurse examining child, Kibunzi hospital.

W. Family therapy managers outside ward, IME-Kimpese.
H
. Orthopedic ward, IME-Kimpese.

NA. Major surgery, IME-Kimpese.
Muscle massage in fracture case, nganga lunga’s treatment.

NO. Asperge of oily herbal ointment on place of fracture.
. Application of bamboo mat “‘cast.”’
oC
. Obtaining medicine from finger cactus tree.
O
. Medicines, big market, Kinshasa.
=
l . Modern herbalist preparing vial for injection.
S N
. Treatment for kink in back, nganga nkisi.

W
. Massage of disturbed patient, nganga mbuki.
= hH
. Cupping horn treatment, nganga nkisi.
= OF AMA. Croix Koma Mass being sung by nganga nkisi.
. Intraclan divining session with prophet.
= = TI~OC. Interclan reunion to resolve differences in illness dispute.
~ OO. Restraining disturbed patient in village center.
NW ©. Kimbanguist rite, laying on of apostle’s hand.
. Weighing the Spirit, Church of the Holy Spirit.
NW |=
. Healing, Church of the Holy Spirit.
NW H. Nzoamambu, nganga nkisi, detaching bark from tree.
YNW
MW h.. FMleyd icwihinsek sipnohoenr itiendh erbyi teNd zobya mNazmobaum afmrboum gfrraonmd mother.
WwWa
grandmother.
wv ON . Crockery mug inherited by Nzoamambu from grandmother.
Illustrations | 1x
MAPS
I. Lower Zaire. 10
2. Territory of Luozi, Manianga. 14
3. Manselele, near Mbanza Mwembe: Nzoamambu’s garden
village. 164-165