HEALING AND MEDICINE: HEALING AND MEDICINE IN INDIGENOUS AUSTRALIA

The indigenous peoples of Australia, the Australian Aborigines, settled the continent more than forty thousand years ago, with some archaeological estimates placing their occupancy at well over fifty thousand years ago. It is most likely that their forebears crossed from Southeast Asia during the Pleistocene period, coming first to the northwest coast and migrating south and east. By the time European explorers and then settlers arrived on Australia's shores in the late eighteenth century, Aboriginal societies, although sharing an economy based on hunting and food gathering, were linguistically and culturally diverse, living across the continent in environments of distinctive ecology and climate. These ranged from inland desert to tropical and temperate coastal zones and alpine regions. Although self-contained for most purposes, neighboring clans gathered for major ceremonies, and localized tribal groupings participated in the trade of goods (such as stone tools, pearl shell, and native tobacco) across hundreds, sometimes thousands, of kilometers.

The health of Aborigines in precolonial times can only be extrapolated from the descriptions of early explorers, settlers, and missionaries, and from knowledge of the traditional diet and lifestyle. It is generally accepted that individuals were in good health, lean and fit, and that the greatest risks lay in periods of famine, accidents, drownings, fighting between clans, childbirth, predation (by, for instance, sharks or crocodiles), bites by poisonous snakes and spiders, and such diseases or conditions as treponematosis, arthritis, congenital malformations, and some cancers (Webb, 1995). In this context, despite a richly differentiated suite of about 250 languages and local cultural and religious traditions, broadly similar systems of indigenous medical practice and belief—again with local elaboration and variation—developed across the continent and Tasmania.

There are few written descriptions of Australian indigenous concepts of health, what it means, or how it can be maintained. Greater emphasis is given to the causes and treatment of illness. The Kukatja of the Western Desert, as described by Anthony Peile (1997, p. 130), hold that health, in the popular sense, consists of the body being "cold" and "dry," and, in the spiritual sense, of having the spirit in the area of the navel and the stomach. Such a feeling of "cold" is different from coldness caused by wind, sickness, or sorcery, which makes a person's spirit shiver. Several authors document ideas of health as encompassing the person and his or her spiritual well-being and home country. Health is also characterized by strength, happiness, and "safety," in the sense of obeying the laws of the community and being cared for (Mobbs, 1991). In an urban setting ideas of fitness, bright eyes, shiny hair, cheerfulness, looking after one self, and not drinking too much alcohol are all expressed as qualities of a healthy person (Nathan, 1980).

The attributed causes of illness and injury had parallel modes of treatment and response, based primarily on symptoms and severity. All maladies except death by old age or in early infancy were interpreted as the consequence of breaches of social or religious proscriptions and commandments. The women of each language group were the primary keepers of extensive traditional pharmacopoeia—or in English, "bush medicines"—employed to treat identifiable symptoms or injuries that responded to herbal treatment. It is likely that in all communities there were spiritual healers. They were generally men, if the written reports are taken as representative. Their skills were engaged where herbal and other "natural" treatments did not work, or when the causes of the condition were thought to be supernatural in origin, be they malign or angry spirits or human sorcerers able to draw upon extra-human powers.

Almost all premature deaths would have been, and still are in many communities, subject to forensic speculation and inquiry about the cause, the responsible persons or agents, the reasons, and in some cases the appropriate retribution. Each of these domains of illness, bodily harm, healing, and explanation, although diverse and complex, have been described in journals and ethnographies from the late eighteenth century onwards.

Sorcery

The figure of the skilled and secretive human sorcerer remains ubiquitous across Aboriginal communities in the Central Desert and tropical north of Australia, where indigenous language, religion, and concepts of being are still strongly held. These are the communities that were least affected by what many now describe as the invasion and appropriation of traditionally owned lands, the forcible resettlement of Aborigines on missions and government reserves, the "stolen generation" (young children taken from their families to group "homes" for reeducation and Anglicization), massacres, and the devastating impact of waves of infectious diseases. For communities that were not as harshly subject to such violence, suffering, upheaval, and repression of language and culture, indigenous frameworks continue to be powerful sources of explanation and interpretation.

Central Australian groups widely invoke the kadaitcha (or kwertatye ), an Arrernte word meaning "evil person walking about." The term can refer both to men who are secret killers and to the feathered slippers they wear to hide their footprints and silence their footfall as they track their victims. Among the Aranda/Anmatjirra Central Desert people, illness caused by kadaitcha and others who have acquired the requisite knowledge or powers is known as arrengkwelthe. Kadaitcha executions by "singing," "boning," or other dangerous modalities are assumed to be carried out for offenses relating to secret ritual and religious knowledge and ceremonies, desecration or trespass in sacred areas (i.e., those associated with "Dreaming" or creation stories), killings and assaults, or other serious breaches of the social or religious order.

A parallel figure is the galka of northeast Arnhem Land in the high northern tropics of Australia (Reid, 1983). Galka are individuals who have acquired the power and training to kill by stealth. One of the most detailed descriptions of the way galka attack, immobilize, and operate on their victims was given to Lloyd Warner (1958) in the 1930s by community members and by a self-confessed sorcerer who claimed to have killed several people using elaborate and magical "surgery." Today most people will claim that galka come from distant and potentially hostile groups, rather than from within.

Galka attacks typically have four phases. First, the perpetrator is believed either to waylay solitary victims in an isolated spot or to draw victims to a secluded location where they will not be disturbed. Second, the galka puts the victim to sleep, cuts the body open, removes or mutilates certain organs, and drains away the victim's blood. The galka may insert stones or objects in place of organs or blood. Third, the galka induces amnesia in victims to ensure that they are either unable to remember or unable to recount anything about the attack. Fourth, the victim dies, usually within hours or days of returning home.

The source of a galka' s power may be tutelage by other sorcerers, or it may come from association with death or the spirits of the dead. The galka' s acquired techniques are several, although in this area there are as many reported variations of these weapons or techniques as there are people willing to talk about them. One frequently mentioned weapon across Australia is a sharpened object, such as a bone taken from a victim's arm, a stingray barb, or a piece of hardwood that has been rubbed with the blood or flesh of a dead body. The weapon is pointed at the victim, with incantations or songs, whereupon the victim slowly sickens and dies. "Image magic" is also designed to "kill a person's spirit." The intended victim's image or name is drawn in a sacred and powerful place, and spells are uttered according to the areas of the body being targeted. Alternately, the galka may follow a person, piercing his footprints with a spear or hot object and willing an illness upon him (such as leprosy), which slowly penetrates and "rots" the body. Individuals are usually careful about disposing of hair and nail clippings, excreta, blood, or personal clothing infused with sweat or bodily fluids, since it is believed that a sorcerer who obtains any of these can heat, burn, or bury them to cause a debilitating or deadly condition. In contemporary society it is sometimes held that galka can extend their arsenal of weapons by using modified bullets, battery acid, flashlights, or other items with similar spells and effects.

The transgressions or enmities said to provoke attacks of these kinds are broadly similar across Australia, although they differ in detail and description from place to place. All transgressions center on conflicts or acute mistrust between individuals and groups, on breaches of social and religious laws that cannot go unpunished, or on deaths, theft, or violence that must be avenged. For instance, if a man reveals secret religious knowledge that is not his to pass on, or if a woman enters a sacred area or views a religious object without permission or the authority of age and standing in the community, the offender may be punished by sorcery. A failure to honor the webs of ritual and social or economic obligations that exist between tribal groups and individuals may be considered sufficient cause for retribution.

The theft of land, ritual objects or ceremonial body painting designs, trespass on others' sacred sites or the unauthorised use of others' creation myths and songs, are all given as a legitimate reason for seeking revenge, as are personal grievances arising out of broken marriages or adultery. Forbidden or inappropriate love affairs cause serious tensions, especially in societies where marriage and relationships are strictly governed by kin relationships, some of which may be prohibited to the point of actual avoidance of each other by individuals who are related in specific ways. Where betrothals are negotiated between families for their children, and girls are "promised" as marriage partners in infancy (or even before birth), particular tensions will arise if either future partner breaks the agreement by marrying or consorting with someone else. In addition to matters of family and the heart, jealousy over achievements, position, or power may be seen as motivation for the contracting of a sorcerer to cause a serious illness or death.

Everyone can trace grievances, conflicts, or offences in his or her own extended family, recent or longstanding, to which serious misfortune, illness, or death could ultimately be attributed. Murder, of course, is reason for revenge, either directly by the responsible kin of the deceased or by contracting the services of a skilled sorcerer.

From the point of view of an outsider, it is impossible to say whether kadaitcha, galka, or other workers of malign magic actually exist or are solely part of an explanatory framework for the misfortunes that strike individuals and constitute an acute threat not only to the sufferer but to family and community. Certainly some individuals have claimed to be sorcerers, have shown sorcery items to inquirers, or have described their feats (e.g., Warner, 1958). A 1993 paper from the Aboriginal Resource and Development Services warned of an increase in sorcery in northern Australia, describing it as a "real" phenomenon, not solely an explanation for misfortune. Whatever the interpretation of sorcery fears and accusations, they do address the why of illness and death, not just the what.

In contemporary society Aboriginal people are usually familiar with Western medical notions of pathology, injury, pathogens, and organ failure (such as heart disease). Indeed Aborigines today, like many fourth-world peoples, suffer very high rates of degenerative illness (such as diabetes, kidney failure, heart disease, and cancer), familial and intercommunity violence, midlife mortality, alcoholism, and substance abuse. There are far too many occasions in which people are impelled to search desperately for meaning and causation in the early death of a relative from illness or injury, sifting through signs, symptoms, and circumstances for an answer. The bereaved may understand and accept a medical explanation of the proximate cause, such as bleeding on the brain from a blow to the head, injury in a car accident, a crocodile attack, a heart attack, pneumonia, or renal failure, but they still invoke an ultimate cause that relies on their own understanding of the dangerous forces at work in human affairs and the sacred domain. For example, they may consider the cause to be that the dead person was "doomed" by sorcery to be bitten by a snake (Roth, 1903, p. 28). Even in communities where the language and traditional culture have been overwhelmed by white colonization, such beliefs continue to be held in attenuated forms (Clarke, 1999).

Human agency is not the only possible cause of affliction. Misfortune may also be visited directly on a victim as a result of breaches of the conventions and laws surrounding the Dreaming, or those governing sacred places and their resident spirits, religious rituals, and sources of supernatural power, such as key locations or ceremonial objects (Biernoff, 1978; Morphy, 1991, p. 261). Evil spirits are recognized in many Aboriginal language groups by various names: for example, ju ju (Warlpiri), arrentye (Aranda), and mamu (Pitjantjatjara). Most groups also recognize spirits of the dead and spirit custodians of sacred places (Nathan and Japanangka, 1983). A trespasser in a dangerous ("poison") or forbidden location, particularly a person who is not the owner of the area or otherwise authorized to be there, may contract boils, leprosy, or weakness, may sustain bone fractures, or may even have his or her spirit stolen by the guardian, creation, or ancestral spirit that dwells there (Berndt, 1982).

Similarly, if an uninitiated person approaches too close to or handles sacred objects, whether intentionally or unintentionally, the power inherent in those objects may be released and cause harm, either directly to the transgressor or to those nearby. Epidemics or illnesses may be linked to such a breach. Illnesses may also be linked to the flouting of food taboos related to menarche, pregnancy, and birth. Such food taboos may also be linked to religious occasions and rites of passage, and include the right to eat or proscriptions against eating animals that are totems for a particular clan or extended family (Spencer and Gillen, 1968). Some bush foods are, in fact, poisonous and cannot be eaten at all or unless properly prepared. Women are expected to be particularly careful with their diet in order not to cause birth complications or deformity in an unborn child; mothers may also observe dietary restrictions in the early months of a child's life.

Healers

Throughout Australia the figure of the tradi-tional healer, called a "clever man," "medicine man," or occasionally "medicine woman" (Bell, 1983; Peile, 1997, pp. 174–175), is a powerful and often reassuring counterbalance or antidote to the threat of inexplicable or life-threatening illness (see Elkin, 1945; Spencer and Gillen, 1968; Warner, 1958). Central Australian healers called ngangkere, while having at their disposal the means to inflict death, primarily practice counter-sorcery. Ngangkere may remove objects inserted into the victim's body by a sorcerer, restore the lost or disturbed spirit of a person who has been "sung" or "boned," diagnose illness, converse with spirits, read minds, dream travel, see into a person's body, endure psychic terrors, exercise telepathic powers (Elkin, 1945), preside over inquests into deaths, and identify a murderer (Nathan and Japanangka, 1983). The mabarn of the Western Desert similarly has the power to cure illness, influence the weather, and chase away evil spirits (Tonkinson, 1982). The source of the mabarn' s power is in magical objects that are usually kept in the stomach or, less often, in the arms, thigh, or head and removed when needed for healing activities.

However they work, these healers all have in common extraordinary powers, wisdom, and skills that enable them to diagnose and cure sickness. In Western Desert communities the healers are often sons or brothers of other healers, and it is generally held that they are born with their powers. Such powers are considered to be djugurdanidjanu (from the Dreamtime). However, in most areas for which there is written information, an aspiring healer must pass through a form of initiation that may involve isolation, encounters with the spirit world, an experience of being ritually "killed" and revived, transportation to secret and powerful places in dreams, encounters with the dead, and other often frightening experiences (Elkin, 1945; Reid, 1983; Roth, 1903). Powers to heal are associated with certain sites of significance, ancestral beings, or totems. These powers are manifested in the treatment of the sufferer through touch, sucking, massage, and pressure on certain parts of the body, during which the mabarn' s own objects of power may be inserted into the patient's body, or objects of sorcery may be removed. The healer's spirit helpers may be summoned to assist in the treatment. An alternate modality is the use of dream travel or dream consultations with spirit beings or helpers.

Treatment sessions are almost always public, with the healer talking to the patient, the family, and onlookers as he works, while explaining, reassuring, and talking through his diagnosis, remedial activity, and insights into the cause and its removal. The mabarn' s challenge is to counter the work of the sorcerer (called djinagarbil in the Western Desert), the same challenge facing such healers as the marrnggitj of northeast Arnhem Land (Reid, 1983), the margidjbu of western Arnhem Land (Berndt, 1982), or the ngangkere (ngangkayi ) of the Central Desert. The djinagarbil are men who travel from distant places, enter a community in darkness, find the victim (who will usually be away from camp when captured), stun the person, and insert a lethal item into his or her body; the djinagarbil then revives the victim, who returns to camp unaware of the attack, then sickens and dies. People in the Western Desert area are also at risk of attacks by malevolent spirits (marlbu ), and the loss of the nunu (soul), both of which may be discerned and treated by a mabarn.

Like the mabarn, the marrnggitj of northeast Arnhem Land has been described as "the reverse of the coin on whose other surface appears the black sorcerer" (Warner, 1958). Marrnggitj are generally ordinary members of the community, differentiated only by their possession of special powers acquired through dramatic rites of passage or the patronage of spirit familiars who assist and empower them.

In a 2003 story, the journalist Nicolas Rothwell described an encounter he had with a maparnjarra (mabarn ) in Central Australia. The maparnjarra described to Rothwell the experience of dying spiritually and being reborn with the ability to see at night, to receive charged dreams, to roam in other realms, to see a person's spirit, to look inside a person's body, and to project his body through space. The work of healers today, in areas where they still practice, is intertwined with that of Western healthcare providers, some of whom work in tandem with healers, recognizing their powerful influence and standing with their communities—and the faith their communities place in them. The ill or seriously troubled are often pragmatic in their choices of treatment, depending on the symptoms, severity, or duration of the illness. They will try various treatments in both medical systems for relief and recovery, in much the same way that people the world over use both conventional and alternative therapies in the pursuit of good health or a cure for intractable illness, chronic pain, and suffering (Mobbs, 1991). Indeed, in Christianized communities in Australia the boundaries between Christian and indigenous beliefs blur, with the power of Jesus, the Holy Spirit, angels, or the apostles conflated with that of the mabarn in the healing quest (McDonald, 2001, pp. 142–146). In fact, the marrnggitj, mabarn, ngangkere, and spiritual healers from other regions "perform several of the functions associated in Western society with the doctor (healing the body), the therapist (healing the mind), the priest (comforting and instilling faith), and the coroner (determining the cause of death)" (Reid, 1983, p. 78).

Other Healing Practices

"Bush medicines," as they are described in English, were, and in some areas still are, used to treat a wide range of injuries and ailments. Most such medicines are derived from the bark, roots, or leaves of plants, but people may also use sea flora or invertebrates, earths and clays, insects, insect nests, charcoal, molds, and fungi. A wide range of remedies exists for the treatment of skin conditions, toothache, bites and stings, wounds, burns, general malaise and pain, and eye, gastrointestinal, and upper respiratory tract infections (Roth, 1903, pp. 38–42; Saggers and Gray, 1991, pp. 43–45). The Warlpiri of central Australia classify remedies as intended for rubbing, drinking, tying, sniffing, chewing, and smoking (blowing the smoke of a burning plant over the patient). One study of Yolngu medicines (northern Australia) documented the indigenous and botanical names, preparation, and application of over one hundred plants (Scarlett et al., 1982).

In general, stewardship of local pharmaceutical knowledge rests with the women of the community, although all community members will be broadly familiar with common medicines and are able to find and use them when needed. Women care for, wash, massage, and minister to the sick. Diane Bell describes how female relatives of a sick Warlpiri person may prepare goanna and witchetty grub fat and red ocher, then massage the patient in much the same way as a ngangkayi (traditional healer) might. They may also sing Dreaming songs. According to Bell, women's health-giving ceremonies, practices, and religious songs give "love, care and power" (1983, p. 161). Women control the collection and preparation of medicines relating to menarche, menopause, pregnancy, childbirth, contraception, abortion, and breastfeeding, all described in English as "women's business." In contemporary communities, however, much of women's knowledge and authority in childbirth and infant care has been usurped by health professionals using Western medicine, and traditional medicines and rituals have become less central.

Not all illnesses are attributed to supernatural causes. It is well understood that some conditions are self-limiting and not serious. Some may be the result of contagion, emotional upset, foods, heredity, old age, predation, pregnancy, neglect (of self or by others), self harm, or even exposure to very hot, wet, cold, or windy weather. Today other risks and threats have emerged in the abuse of alcohol, tobacco, and drugs (including the sniffing of gasoline), as well as in motor vehicle accidents, poor nutrition, poverty, unsanitary living conditions, and family violence. These are all typical of patterns of deprivation and illness suffered by indigenous peoples in many countries, whose land, resources, and identity have been affected by colonization and dispossession.

Aboriginal medical beliefs and practices constitute internally logical and powerful systems of explanation and healing, which both draw upon and reinforce the social and religious orders. Traditional Australian medical practices have been adapted to contemporary realities and have absorbed Western medical ideas and treatments, but in many communities they retain their underlying integrity and force, providing a framework for interpreting and gaining some sense of mastery in an unpredictable and threatening world.

See Also

Australian Indigenous Religions.

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Janice Reid (2005)