1. Portions of this chapter appear in a discussion of therapeutic efficacy in another article (see Sharp, in press): these include the overview of fifohazana healing, the case studies of Elisabeth and Vivienne, and figure 10.1.

2. There is an extensive literature in anthropology which addresses the efficacy of indigenous healers in treating mental illness, as well as other forms of affliction (see Fabrega 1970; Janzen 1978; Kiev, ed. 1964; Kiev 1972; Lebra 1982; Lévi-Strauss 1963a, 1963b; Prince 1964; Sow 1980; Taussig 1987, 1989; Torrey 1986; V. Turner 1964).

3. Bloch (1971: 59–60) for example, gives a brief description of a visit to an asylum in the high plateaux. He reports that patients lived in great fear of witchcraft from “heart thieves” (mpaka-fo) because they were surrounded by strangers. In essence, the asylum is oftentimes little more than a prison (see also Sharp, in press).

4. A discussion of the applicability of psychiatric diagnoses cross-culturally is beyond the scope of this chapter. Several authors identify psychiatry as being most effective when applied to Western, middle-class whites (see, for example, Marsella and White, eds. 1982; Meltzer 1978; Pande 1968; Pederson 1982). Kleinman (1978, 1980) suggests that psychiatry can be applied effectively cross-culturally if the psychiatrist comprehends the patient’s “explanatory model” of illness. Kleinman’s stance has its limitations, however, since it overlooks the depth of the patient’s subjective experience. He assumes that mainstream psychiatric practices can be effective as long as the psychiatrist has a grasp of the patient’s cultural background. Also, as Pappas (1990) argues, Kleinman’s model does not include an assessment of power within the therapeutic context. Thus I prefer to speak of competing epistemologies (Sharp, in press) since this emphasizes the complexity of the cross-cultural therapeutic encounter.

5. Spirit possession has long been a focus of interest for theologians; for other perspectives see, for example, Eikelman, Pazder, Peaston, and Salman in Prince, ed. (1968).

6. My informants did not describe spirits as occupying a second world apart from that of the living, as explained elsewhere in the literature (see Boddy 1989: 3ff, 269ff; Lambek 1981: 26; P. Stoller 1989, especially 48–49).

7. For an account of similar practitioners elsewhere in Madagascar see Mack (1986: 65) on the katibo, specialists who use sacred books called sorabe.

8. Until recently the Anglican church had no exorcists. This changed in 1987 when the Anglican bishop, who was a missionary from the United Kingdom, was trained as an exorcist by the Lutherans. He chose to do so not so much because he felt the need to drive out demons, but so that he could learn how to converse with and thus more effectively assist parishioners who believed that they were possessed.

9. These passages are central to defining the work of Pentecostal groups worldwide. For additional references see Goodman (1988); Jules-Rosette (1975); La Barre (1992 [1962]); and Sundkler (1961).

10. English text is taken from The New English Bible (Oxford and Cambridge University Presses, 1970); the Malagasy is taken from the Protestant Bible produced by Fikambanana Mampiely Baiboly Malagasy (1986).

11. For an analysis of the use of the active voice with animals see Bloch (1972).

12. Trexler (1989: 12) reports that a decade ago Lutheran exorcists would hit their patients with such force that in three cases they died; recently they have become more restrained in their actions. I never saw an exorcist strike anyone.

13. As was explained earlier, Malalgasy kin terms and terms of address are determined by the sex of the speaker and the person to whom they are referring. Since the majority of exorcists come from the high plateaux and the south, they tend to use Merina and related terms, thus: pirahadahy “brothers,” pirahavavy “sisters”; rahavavy “sister” for male speaker, anabavy “sister” for female speaker, and so forth. As with Sakalava, alternative terms of address are determined by relative age: zoky for “older sibling” and zandry for “younger sibling.”

14. Elisabeth was reluctant to give the names of her exorcised spirits.