Obeah, duppy and your health (part I)

The story is told of a man who fell in love with a young woman in a tenement yard. The woman rejected him and, shortly after, a bump appeared on her foot which matured into a sore. The man was blamed for casting a spell on her.

Many people believe in demons and spirit possession. In fact, the Bible makes numerous mentions to demon possession; evil spirits tormented Saul (1 Samuel 16:14) and Jesus cast out evil spirits (Mark 16:17). It is also widely held in our culture that people can set demons, evil spirits or the spirits of the dead on another individual or that the spirit of the dead can torment or occupy the life of another person. Many people even believe that demon and spirit possessions can cause physical and mental illness.

'Set a hand'

As a young doctor, working at the Bustamante Hospital for Children, I was surprised at the number of parents who believed that their children's illnesses were due to someone casting a spell on the child. A spell is often referred to as a 'blow ' or a 'set hand'. They particularly believed this if the child had a condition that affected the brain. Common explanations were that the babyfather's other girlfriend or wife was the culprit and, sometimes, it was the babyfather's mother who 'set a hand' or cast a spell for the babymother and this spell turned on the baby.

It is widely held in the culture that whenever someone wants to hurt another person, they give them a 'big foot'. In our local dialect, foot refers to the legs and feet. Certain conditions such as heart disease, kidney disease and liver problems may result in swelling of the feet and many people with these conditions sometimes blame a neighbour or a family member for causing the 'big foot'.

The dreaded sore foot

'Sore foot', referred to as ulcers in medicine, is very common. Ulcers can occur in individuals who have circulation problem, diabetes, high blood pressure or sickle-cell disease. To have a 'sore foot' in the culture is a source of shame and scorn.

Many people refuse to come in contact or eat from people who have leg ulcers. Many leg ulcers are difficult to treat because the affected area on the leg has poor circulation. In such situations, people often turn to the local healer or obeahman for help. People will also use their own remedies. People have been known to mix dirt with nutmeg and pack it in an ulcer. Of course, such an action will breed germs and make the ulcer worse.

In the health system, we have to deal with people who will question the doctor's diagnosis by saying, for example, "Doctor, this sickness mix or it bigger than you?" This sometimes appears true if the doctor cannot offer a proper explanation for the illness or if the treatment does not appear to be effective. As a result, either the patient or family members will request early discharge from the hospital so that they can go to get a second opinion from a local healer or the obeahman.

I remember, many years ago, doing my ward round early one morning at the Victoria Jubilee Hospital. A patient was absent and when I enquired, the other ladies laughed. I sensed something was suspicious. Later in the day, a patient told me that the lady left the ward early in the morning to go see an obeahman. She returned later that day.

Rub up with oil

Health workers often get upset and angry at the oils that people use on relatives in hospitals. These may be specially prepared oils that are available at drug stores and are recommended by local healers.

Other patients often object as well to the use of oils commenting that, "the oils stink up the place". As health-care providers, we have to be sensitive to people's belief and cultural practices and we should, therefore, never devalue their beliefs or embarrass and humiliate them. At the same time, we have a responsibility to educate people about their illnesses.

Mental Health is an area that is not well understood and many people attribute mental illness to demon or spirit possessions. It was reported on local television that a young boy was possessed by the spirit of his friend. Next week I will offer some explanations.

Next week: Duppy and mental illness

Dr Wendel Abel is a consultant psychiatrist and head, Section of Psychiatry, Dept.of Community Health and Psychiatry, University of the West Indies; email: yourhealth@gleanerjm.com.