The Diagnosis Of Misfortune

The student of Central and Southern African collective therapies of the ngoma type is presented in many localities, including the urban centers under particular scrutiny in the present work, with a broad array of afflictions deemed appropriate for treatment. The array is in fact so broad that one can question whether the distinct diagnosis of signs, symptoms, or syndromes is at all a characterizing feature of the ngoma therapeutic mode. And yet, it is analytically important to differentiate problems brought into ngoma-type cults of affliction from other types of problems taken elsewhere.

One way to look for the distinctive arena of problems taken into ngoma healing is to note that, with some exceptions, many of the ngoma orders exist, as it were, beyond kinship. Even those such as Nkita in western Zaire and Angola, although about the reproduction of the matrilineage, are construed as being about how the lineage might transcend the internal dilemmas of factionalism, leadership problems, and ill will that are thought to occasion the sickness and death of infants and the sterility of the mothers. The proto-Bantu cognate verb dòg connotes all the sources of affliction—sorcery, witchcraft, backbiting—that result from relations within the closely knit human community. Ngoma interventions and appeals are made to get beyond the entrapment of dòg (see appendix B, section B.3). Frequently the ancestral shades and

the spirits beyond are believed to call individuals out of their self-consuming destructive tendencies. Ngoma afflictions are thus not noticeably different from non-ngoma afflictions on the surface level of signs and symptoms. The diagnostic interpretation becomes important as a way of reaching beyond the mundane for a way out of an impasse.

An important dimension of all cults of affliction is the analytical and diagnostic function of evaluating sickness and misfortune. A distinction is often drawn, in this connection, between divination, the analysis of a situation, and healing, the attempt to intervene in the situation to change it. This distinction was the basis for Turner's book title Revelation and Divination , that is, the relationship between the cult of affliction and the diagnosis of the problems it addresses. The distinction accounts for some of the diversity of affliction cult types, for where social change is intense, the need increases for cognitive clarity. Thus, in eighteenth-century coastal Kongo, during the decline of the kingdoms with the increase of the trade, including the slave trade, divination cults were in great profusion, particularly those relating to adjudication and conflict resolution. In Southern Africa today, the term ngoma is associated mainly with divination. Closer examination, however, shows that the functions of divination and network-building are complementary.

Divination, or diagnosis, thus always accompanies cults of affliction, either independently of the healing role, or as a part of the specialized techniques and paraphernalia of a particular cult. Divination must be thought of as a continuing query into the "whys," "whos," and "where-fores" begun in the family-therapy management setting but carried through by specialists with expert judgment and training, who may have had their own profound individual dilemmas, who have been recruited to a particular mode of ritual life, and who have been initiated to the spirit world. As a technique, divination may be based on a mechanistic system of signs and interpretations, such as the Southern Savanna Ngombo basket filled with symbolic objects signifying human life, the pengula bone-throwing technique of Southern African Nguni society, or recitation from the Bible or the Koran. Alternatively, and according to some observers increasingly, divination is done by direct recourse to trance, in which the diviner, as medium, speaks the words of the ancestral shade or spirit in answer to a query. Some diviners use a combination of both techniques, or a selection of hierarchically arranged types. In Swaziland, master diviners today train novices in the arts of mechanistic bone-throwing divination as well as the mastery

of trance-divination. In any case, these divined diagnoses, representing a type of analysis or interpretation of daily life, offer the basis for the more synthetic, ritualized follow-through of the cults of affliction. However, there is a contradiction or tension between the specificity and concreteness of the problems channeled into divination and treatment, and the overall hypothesis of spirit causation that brings an individual into a cult of affliction.

The work of Zairian researchers Mabiala (1982) and Byamungu (1982) illustrates this issue. Signs and symptoms (illnesses) accompanying recruitment to Mpombo and Badju are said to include dizziness with hallucinations; throbbing headaches; lack of mental presence (asthenie); skin rashes (algie); lack of appetite; difficulty in breathing; heartburn with anxiety; rapid or arrhythmic heartbeat; fever with chills; sexual impotence; dreams of struggles or of being followed by threatening animals; weight loss or excessive weight, especially if accompanied by spirit visitations; and a variety of gynecological and obstetrical difficulties. These "modes of affliction" are characteristic of most of the other collective therapeutic rites—les grands rites —in Kinshasa.

Byamungu, working in Bukavu, in the mountainous Kivu region of eastern Zaire, is more explicit about the generalized or random character of signs, symptoms, and syndromes in the mode of affliction associated with the five therapeutic rites of this trading and administrative city of about seventy-five thousand people. In the Kakozi rite, of Bashi and Balega ethnic origin, early stages of sickness are manifested by all types of behavioral and physiological problems, reflecting something of the diversity of Kakozi spirits behind these problems. In the Enaama or Mana rites of Bashi origin (a Nilotic, Rwandais group), the characteristic afflictions include behavioral troubles, alienation, and physical sickness such as weight loss. Here again the distinguishing feature of recruitment is not a particular symptom or sign, but affliction by the Enaama nature spirits of Bashi or Rwandais origin. In the Mitumba rite, of Bembe and Balega origin, behavioral and physical troubles of whatever sort may indicate this mode of affliction. The distinguishing feature is, however, evidence in dreams or hallucinations of the presence of "white" or "European" spirits. The same type of symptom-sign randomness exists in the Mulangoyi rite of Lega, Zimba, and Songe origin, in which the major spirits are nature- or river-related, and in the Nyamulemule rite, in which the spirits are of Luba origin, appearing among the Batembo and Bashi peoples. Byamungu emphasizes that al

though signs and symptoms accompanying those afflicted may be identified and even treated with biomedical methods and medicines, the salient point that brings these sufferers to diagnostic entry into the ritual therapies is not so much the sickness but the identification of the spirit force behind the sickness.

Our analytical approach would seem, however, to call for close study of symptoms and signs of affliction or behavioral change in relation to the circumstances of the personal life of the afflicted, on the one hand, and the cultural logic that steers the course of therapy in the direction of identifying the spirits, on the other. It may, of course, be very difficult to correlate the explicit and implicit conditions of distress with the diagnoses and therapies in the Central African setting, where the initial diagnostic work is done apart from therapeutic initiation to a group setting. In Central African cities such as Kinshasa and Bukavu the collective rites are varied by regional and ethnic origin more than by a specialized division of labor. The diagnostic work is often done by kin groups and diviners working separately from the healers. Thus the novices are already identified as being in touch with the appropriate spirits by the time they make their appearance in the ritual communities.

In the Southern African context, that is, in Nguni-speaking societies, the relationship between diagnosis and therapy and the course from diagnosis to therapy may be easier to follow. This is so because here there appears to be a greater concentration of ngoma therapies within a single institutional context, and thus a fusion of divination-diagnosis and therapeutics. In the Nguni context it is easier to see the type of affliction or problem singled out for divination from among the wide array of common afflictions in a populace, as well as those cases further singled out for therapeutic initiation into the ngoma order. Illustrations from Swaziland and the Western Cape, given in chapter 1, demonstrate this process in an ethnically diverse and urban clientele.

The cases seen by Ida Mabuza of Swaziland are said to be both "African" and "non-African"; she has both African and non-African clients, the latter mostly Afrikaaners from South Africa. For Africans, she says, the most common problem presents in vague pains and anxieties and is explained by harm or sorcery (umbelelo to meqo ) resulting from interpersonal tension. This affects both men and women. Next most prevalent is amakubalo , affecting mostly men, in the form of harm or illness resulting from violated social or moral precepts resulting from illicit sex with a protected married woman. Many young people come wishing to divine their fates, desirous of good fortune in job seeking,

examinations, or love. She diagnoses their problems and offers advice accordingly.

Whites also come for these types of problems. Their main concern, however, is fear of poverty. They also come for help in seeking promotions and other job-related matters. Finally, they come with illnesses improperly diagnosed in the hospital or not effectively treated. Stress is a common complaint whose root cause can often be traced, she noted, to tensions or conflicts with domestic workers or subordinates who have retaliated.

The cases that are divined with the more powerful—and expensive—femba (possession) mediumistic method do not vary from those already presented, except perhaps that they are more chronic and less specific, and Western medicine has been unable to produce a perceptible improvement in health.

The foregoing problems typify those brought to ngoma diviners and therapists. Perhaps the most striking feature in this material is the random, vague, and ambiguous character of the connection of sign/ symptom/syndrome to the therapy, both in terms of physiopathologies and psychopathologies. This seems to be the case especially in contemporary urban settings. Nevertheless, in these urban settings there occur quite precise diagnostic readings of life situations that lead to therapy or entry into one or another ngoma therapeutic group. It is not the particular sign, symptom, or syndrome that predicts the therapeutic course. Rather, it is the diagnostic and divinatory judgment that sends the case beyond the confines of a strictly relational interpretation—as found in the concept dòg —to the interpretation that the subject is called by spirits aligned with the ngoma orders.