Of witches and shrinks (Ghana)

Tamar Golan, Haaretz, 3 August 2007.

A bold, rare attempt to challenge the scientific assumptions of modern Western psychiatry, and to compare them to the ways traditional African societies treat people.

I once met Ori Schwartzman on a literary talk show hosted on television by Yaron London. Schwartzman had just returned, enchanted, from his first journey to the rain forests of Ghana and published his book “Isha shel or yareach” (“Woman of Moonlight”). London had an amused look on his face as he introduced the young and infatuated doctor to me, a veteran of Africa.

It was immediately obvious that Schwartzman had contracted a particularly virulent strain of what we, the elders of the white tribe of Africa lovers, call “the African virus” – or, as the white doctor himself describes it in the opening of his book: “The longing settled inside me like malaria parasites, which even after the disease has run its course continue to circulate through the blood stream and erupt again with no prior warning. And indeed, even when I was some 5,000 kilometers away from the village … and living in Tel Aviv again, the longing would send sudden tremors through me, like a genuine attack of malaria.”

But this is not only a book about how Schwartzman returned to his beloved Ghana and Africa, although it contains many stories, written in a rich, colorful language, which, when looked at superficially, seem to be “exotic” – the kind of stories that fuel the imaginations of readers who do not know Africa. This fact actually raises the alarming possibility that the reader will have trouble coping with the very core of the book, which is a bold, rare attempt to challenge the scientific assumptions of modern Western psychiatry and its methods for treating the mentally ill, compared to the ways in which traditional African societies treat their own unordinary men and women.

Many pages are devoted to modern psychiatric descriptions and definitions of diseases and disorders such as depression, hallucinations, schizophrenia and more, as well as to the symptoms found in the official diagnostic manuals of the American Psychiatric Association, the World Health Organization or the Chinese psychiatric establishment. Schwartzman brings living examples from his work in the rain forests to prove that African society treats these phenomena better than, or at least just as well as, Western medicine through rituals performed by shamans or “witches.”

Schwartzman explains the essential difference between the two cultures. For us in the West, the individual stands at the center. To be a “mature and normal person” means, among other things, to arrive at a stage of disconnection from the (negative) grasp of one’s parents and family. “Western psychotherapy praises the process of moving away from your family, and it perceives this process as healthy and conducive to growth … until [the individual] can find his true self.” In traditional African society, by contrast, a person is always an inseparable part not only of his family, but of the ever-present spirits of his ancestors. From these he derives strength and peace of mind, and without them he is lost.

It is clear that Schwartzman prefers the ancient ancestors and forest dwarfs of Africa over his own “ancestors,” the white psychologists and psychiatrists, and he writes: “The ancestors teach that commitment, the basis of African society, is eternal.” This insight is of the highest importance, and it may be the most significant factor supporting Schwartzman’s claim that Western psychiatric medicine, which is based on the individual, is not relevant to traditional African society, and therefore should not presume to be suitable for all humans everywhere.

Greatest challenge

The greatest challenge that Schwartzman puts before us is his analysis of attitudes toward death, for here lies the essential source of difference between us Westerners and them, the traditional Africans. And so he writes in his unique descriptive prose in Chapter 8, titled “The soul is longer than the grave,” in the subsection “Death does not mock you or threaten you, it is simply there”: “Death on the African continent is a companion with clear lineaments. In Africa it eats breakfast with you every morning, sweats with you in the cocoa or coffee plantations and groans with you in the midst of lovemaking on the straw mat. It fills you with a sense of peace, because through its constant presence you experience life as a steady journey, with stages marking the beginning, the end of a chapter, and a transition to another existence in death.” These lines make clear for us how deeply the white doctor identifies with his African “patients” and their ways of confronting death.

Later in the same chapter he writes: “In Western culture there is a belief, conscious or not, that medicine can save us from the death that lies in wait for us … In a study conducted in 2006 among Israeli doctors, 68 percent of the participants reported that patients had unrealistic expectations of them. The study reflects unrealistic expectations of medicine in general.”

Schwartzman notes that Africans, too, do not settle for their shamans and will go seek the help of the white doctors, “traveling dozens of kilometers to get to the missionary hospital.” Unlike patients in the West, however, “they have come to terms with the limitations of medicine, out of painful acceptance and without rage, aware that disease and death are present in our existence … Every person knows with certainty that even if he manages to postpone death a few times, once by having lethal demons exorcised, once by taking a potion, and once by injections of chloroquine [against malaria – T.G.], ultimately the system will be vanquished, and death will engulf us all.”

Schwartzman knows that his book is a challenge to the medical world from which he hails, and it seems that his main goal is not to tell the anonymous reader about his African experiences, but rather to convince his colleagues, the psychiatrists. He sees himself as a mediator between the world of African shamans and witches, who use drugs and potions and believe in the constant presence of ancestral spirits and forest dwarfs, and the psychiatrists with their white coats, pure scientific knowledge, seemingly objective outlook and many-colored pills.

The change in Schwartzman’s own attitude toward death is not theoretical, and it is tested in the book at what is perhaps the most difficult moment in any parent’s life: the moment when the life of his beloved two-year-old daughter Amarel was threatened by an acute attack of malaria. Schwartzman describes how he gave his daughter a weekly dose of the common Western anti-malarial drug Lariam, and how his desperate efforts to care for her when the fever was at its peak did not help. At that moment he appealed to his mother, the child’s grandmother, who had died a year earlier and whose grave was extremely far away. He said at that moment to his mother: “She is your granddaughter, and she might die today. It is your duty to make the child you love so much well again.” The little girl survived.

“Death walked beside me down every path in the rain forests. It did not seem as frightening as I had imagined it in my childhood … It seemed more like a faithful companion, walking silently by my side, adjusting its paces to mine,” Schwartzman recounts.

Will his readers be able to match their paces to those of death? I don’t know. But if the white doctor from the rain forests has managed to arouse in Western man some thoughts and questioning about his own life and death – that is enough.

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