How witchcraft impacts health in PNG
GOROKA, 27 March 2014 (IRIN) - When Mary got sick, residents in her remote highland village in Papua New Guinea (PNG) didn’t take her to the doctor, but to a traditional healer with magical powers instead.
“They said a witch had put a curse on me. They had to remove it. Had they not brought me to the nearest health clinic, however, I could have died,” the 45-year old said.
Such stories are not uncommon in PNG, a largely tribal society of over 800 languages where a longstanding traditional belief in witchcraft or “sanguma” as it is known in Tok Pisin, the local language, continues to undermine healthcare in the country.
“People routinely delay seeking proper medical care when they attribute their sickness or illness to witchcraft rather than natural causes,” said Sibauk Bieb, executive manager of public health within the Ministry of Health. “At that point, however, it can be too late.”
“Whether it’s diarrhoea, diabetes or heart attacks, people think witchcraft is involved and are not open to a medical explanation,” Josephine Andreas, a registered nurse of 36 years working in PNG’s Eastern Highlands Province, echoed. “This is the biggest problem and one deeply entrenched in people’s mind.”
A pervasive belief
According to the Melanesian Institute (MI) which has studied witchcraft extensively in the country, upwards of 90 percent of the country’s 7 million inhabitants believes in witchcraft, including many educated urban Papua New Guineans.
“When people get sick they don’t think in terms of the medical cause, but rather who is to blame,” said Jack Urame, the institute’s director in Goroka.
The problem is a complex one, further compounded by the current state of PNG’s deteriorating healthcare system.
According to the PNG Department of Health, less than 50 percent of the population has access to health care; a figure particularly pronounced in rural areas where 87 percent of the population lives, and residents are largely dependent on more than 2,000 community health posts – the mainstay of PNG’s healthcare delivery, comprising more than 70 percent of all health facilities - many of which have fallen into disrepair or closed.
In the Highlands province of Ora alone, nearly 40 percent of all health posts are closed, authorities confirm, due to shortages in funding, staff, or other resources.
Where there are no aid posts, village health volunteers, village birth attendants and marasin meri (medicine women) provide basic first aid and health education in villages and homes.
All this in a country where babies, children and mothers continue to die in large numbers across the half island nation from preventable causes, while poor drug distribution and PNG’s largely rural and remote population find it particularly difficult and expensive to access basic medical services.
Compounding the problem, is the inability of health staff to properly diagnose the cause of a specific illness or ailment, and convey that message effectively to patients and their families, a fact which can further strengthen people’s traditional beliefs as to why a specific illness or situation occurred.
“When delivering health messages, people need to recognize that such beliefs exist and do impact people’s understanding of health,” said Lillian Siwi, head of provincial health authorities in Eastern Highlands Province in Goroka.
Doctors and nurses unable to properly diagnose a specific illness or offer treatment options will routinely suggest to patients and their families that their sickness might be sik bilong ples (sickness from the village); which today serves as a code word for illness of magical origin stemming from social disharmony in the village, suggesting that someone with a grudge had caused the sickness by sorcery or witchcraft.
However, speaking about sik bilong ples by default essentially creates two categories of sickness in the minds of people: sik nating (ordinary sickness), which can be cured by modern medicine, and sik bilong ples, which can only cured by removing or countering a curse, according to MI.
Violence against women
But PNG’s pervasive belief in witchcraft goes far beyond undermining healthcare, resulting in increasing reports of sorcery-related violence against women as well.
“When access to a basic human right – the right to health – is limited, communities will look for alternative ways of addressing their health needs,” explained Signe Poulsen, human rights adviser for the UN Office for the High Commissioner for Human Rights in Port Moresby, which is currently researching sorcery-related violence in the country. “Our office has documented numerous cases in which illness or death in a community has led to accusations of sorcery and witchcraft.”
The situation is particularly bad in the provinces of Chimbu, Giwaka and Eastern Highlands, where many cases go unreported, said activists.
“It’s a big problem. It’s part of our culture and belief and hence difficult to address,” Eriko Fuferefu, director of Kafe Urban Settlers Women’s Association, which is working with victims of sorcery-related violence, noting, however, many cases go unreported making it difficult to give exact figures.