Sometimes We Do The Same Things Differently

A series of readings on the cultural implications
of health and medicine

One of the articles in Good Medicine (IC#39)
Originally published in Fall 1994 on page 14
Copyright (c)1994, 1997 by Context Institute


The French align a strong inner constitution – terrain – with good health. French medical thinking reflects the influence of philosopher Descartes and emphasizes logic and theory, while discounting practical data. Other attributes include:

  • Deep concern with the aesthetics of the human body
  • Commitment to the preservation of sexual organs and fertility
  • Strong belief in the importance of the vitality of the inner terrain in resisting illness
  • Lack of concern about dirt, to which exposure is seen as a sort of immunization


The British focus on details rather than abstractions. Health practitioners are taught to use conservative, critical questioning, which is at least in part responsible for their economic use of all medical services, tests and procedures. British doctors do less of nearly everything. They are also known for their:

  • Advances in geriatric medicine
  • Emphasis on relieving and comforting over curing
  • Focus on quality of life over length of life
  • Acceptance of death; it is not considered a failure of the practitioner’s skill


The Americans are known for their "frontier spirit" – an aggressive can-conquer-all attitude that doctors apply in a fix-it approach expecting immediate results. US doctors perform more diagnostic tests, surgeries, and often prescribe drugs at higher doses than doctors in France, Germany, or Britain. Other health values include:

  • Passion for diagnosis; increased demand for tests
  • Strong belief in germs as the main cause of disease resulting in a penchant for cleanliness
  • View of the body as a machine: check-ups thought as important as tune-ups


Germans combine efficiency and romanticism, the two poles of which come through in their use of high-tech medicine in combination with low-tech natural therapies as found in homeopathy. Their quest for balance comes through in these medical beliefs:

  • Nature’s healing power: mud baths, herbal walks in the forest
  • Heart is viewed as more than just a pump, and is related to love and emotions
  • Less attention paid to germs, more paid to patient’s resistance

-Lynn Payer

Balinese Bright Faces

by Unni Wikan

Health, in the Balinese conception, depends on an intricate relationship between body and spirit/life force (bayu), two mutually sustaining parts of an integral whole. Most decisive is the condition of the life force. As the vital energy that keeps all else moving, it offers the best protection against illness of every kind.

The bayu also offers inestimable protection against illness from natural causes. Said a Balinese doctor: "The power in healing is the person himself, his bayu. If the person feels sick, who can make him well? Medicine is only a means to ease the obstruction, it cannot heal by itself." Others may say; "In recovering from sickness, medicine works only 5 percent; 95 percent depends on the person himself, his bayu." Yet others stress the role of the heart as the repository of emotions, and see health as a function of proper feeling-thinking.

The bayu is like a thermometer the Balinese constantly use to check their viability and what manner of danger they may expose themselves to. When the bayu is weak or low (cerik), it is foolhardy to do such things as to drive a motorbike or visit persons one truly fears. But when the bayu feels big and strong (gede), one moves with greater ease, trusts one’s own judgment, and dares what others do not.

Feeling, in Balinese experience, is the surest indicator of health, as of many other vital matters. And the bayu is an aspect of feeling. So intimately connected is it with "heart" that the Balinese often confound the two and speak of one when they actually mean the other. The distinction, though they know it full well, does not seem important to them, for the bayu is felt to be a reflection of the heart. Managing one’s heart is almost the same as strengthening the bayu. The real meaning of the bayu is like energy or power, but the Balinese feel the bayu through the heart.

Feeling and thinking are linked and mutually affect one another. In their native language the Balinese do not distinguish between the two: both are summed up in the concept keneh. Emotional expression shapes and modulates feeling. Hence, by deliberately making oneself appear, or being made to appear, cheerful (girang) or happy (gembira), feelings conducive to health are nurtured. Unless this premise is taken into consideration, we cannot understand what the Balinese mean when they say, as they often do – for example, when they return from a wake – "We laughed to make their hearts happy from sadness (menghibur hati)."

Emotional expression is a collective concern. Conceived as spreading easily from one person to others, the expressed emotions of one may damage the feelings, hence the well-being, of another. The Balinese are thereby under a moral social obligation to manage their hearts, to present the world with a clear, bright face (mue cedang). Cedang has connotations of luster, radiance, smoothness. Yeh mue, the water of the face, is also used to convey an image of how the face should be: smooth and clear as water, transparent throughout, and reflective of light.

Reproduced by permission of the American Anthropological Association from American Ethnologist 16:2, May 1989. Not for sale or further reproduction.

Becoming Whole Again

An interview with Siberian healers, by Sarah van Gelder

Alexandra Tchirkova, Akulina Danilova, Helen Kapulova, and Michael Ilein are indigenous people from Siberia trained in Western and traditional healing. Most of the year they live in the city of Yakutsk, where they work at the Center of Traditional Medicine, but they often return to their villages in the summer to raise food for their families.

The four were in the US this June to attend a Spiritual Unity of Tribes gathering hosted by the Lummi Tribe of Northwest Washington. This is one of a series of such gatherings that have been held in the Pacific Northwest, Alaska, and Siberia this year. According to Roberta Charles, a Tlingit Indian who was among those hosting the Siberian visitors, these gatherings are an outgrowth of Black Elk’s prophecy that the indigenous peoples would lead the way to spiritual unity between all peoples. These gatherings, now called "Spiritual Unity of the World," have been held among North American Indians since 1948 and continue throughout the world. Two gatherings are scheduled in Siberia next year, as well as one in Australia, and two more in the US.

During their visit, the Siberian healers practiced their art without charge during gatherings and at an occasional impromptu meeting. Once they aided a stranger they encountered at a roadside restaurant. At the end of a 20-minute session in the restaurant, the man – who had injured his shoulder in an accident, and had had five surgeries to repair the damage – announced that he planned to follow the healers back to Siberia for continued treatment.

Our encounter in June 1994, began at a salmon bake at the Winslow Cohousing Common House, and ended with songs, circle dances that included all of us, and hugs. In between we had a chance to talk to them about their healing traditions. All four contributed to the discussion.

The Russians first came about 360 years ago. Christianity arrived along with them and so did all the infectious diseases. The big migration came when they were sending prisoners to Siberia who would end up in these little villages. The industrial development of the 1960s just intensified the influx and the illnesses that resulted.

Native people who live where the reindeer are, who live in isolated villages, didn’t get the sicknesses that the city people got – they didn’t have the contact.

Sarah: What happened to the traditional medical practices when the Russians came?

Siberians: When the missionaries and the church workers started to come, the repression of the shamans and natural healers began. There are very very few shamans left. Alexandra [one of the four healers interviewed] is the daughter of the most famous shaman in our country. He’s no longer alive. The shamans were considered charlatans and unbelievers. They had so much insight, such a prophetic vision, that the church and also the Soviet power were very much opposed to them.

Sarah: What methods did the shamans use to heal?

Siberians: They used herbs and natural products and also meditation. Shamans acted as a healing channel. They took power from above and allowed it to flow through them. A shaman’s whole life was dedicated to being of service to people.

Now others are beginning to realize that the shamans know how to heal and they’re desperately trying to get this power back.

Sarah: Where does healing come from? What does healing mean in your culture?

Siberians: Healing comes from the soul. The most important thing is that the doctor has to be a spiritual person. If they’re spiritual, they can give their patients more than pills.

The Soviet doctors have divided up treatment: the ear is treated by one doctor, the eyes are treated by one doctor, the skin by another person, the soul by another. People are tied to nature, and what we’ve done is chop them up.

People are seeking to find the place where their souls belong. If they don’t find such a place, one becomes an alcoholic, another becomes so godless that you’d be shocked in amazement. Or else people don’t believe in anything, they don’t do anything, and in their isolation, they barely exist.

Sarah: How do you bring people back together once they’ve been splintered in such a way?

Siberians: The reason we have been traveling is that we are looking for ways to solve this problem. How can we make people whole again?

We’re searching, and what we’re seeing is the same thing: people are chopped up everywhere. We’re in dissonance. We’re not harmonized inside. We really have to learn how to live as one family on this planet. We’re all in need of healing.

And we are inter-related, we are inter-dependent. Maybe until we all begin this process of gradually moving together we won’t have that healing. That’s up to us now, isn’t it? Maybe our real healing will come when we recognize our oneness as the human family. Then we will also attain that integrity, the unity of hearts and souls.

A Healing Dance

by Richard Katz

The !Kung people of Botswana, Namibia and Southern Angola have a healing tradition that supports the culture’s emphasis on sharing and egalitarianism, its belief in the life of the spirit, and its strong community ties. Healing involves health and growth on physical, psychological, social, and spiritual levels. It affects the individual, the group, the surrounding environment, and the cosmos. Healing is an integrating and enhancing force, far more fundamental than simple curing or the application of medicine.

The central event in the healing tradition is the all-night dance. Sometimes as often as four times in a month, the women sit around the fire, singing and rhythmically clapping as night falls, signaling the start of a healing dance.

The entire camp participates as the men, sometimes joined by women, dance around the singers. As the dance intensifies, n/um ("energy") is activated in those who are healers, most of whom are among the dancing men. As n/um intensifies in the healers, they experience !kia (a form of "enhanced consciousness") during which they heal everyone at the dance. The dance usually ends before the sun rises the next morning.

Those at the dance confront the uncertainties of their experience and reaffirm the spiritual dimension of their daily lives. They find it exciting, joyful, and powerful. "Being at a dance makes our hearts happy," the !Kung say.

While experiencing !kia, one can heal. Those who have learned to heal are said to possess n/um and are called "masters of n/um" or simply "healers." N/um resides in the pit of the stomach and at the base of the spine. As the healer dances, becoming warm and sweating profusely, the n/um heats up, becomes a vapor, and rises up the spine. When it reaches the base of the skull, !kia results.

An experienced healer described the !kia experience:

You dance, dance, dance. Then n/um lifts you up in your belly and lifts you in your back, and you start to shiver. N/um makes you tremble, it’s hot. Your eyes are open, but you don’t look around; you hold your eyes still and look straight ahead. But when you get into !kia, you’re looking around because you see everything, because you see what’s troubling everybody … N/um enters every part of your body, right to the tip of your feet and even your hair.

N/um is held in awe, considered powerful and mysterious. It is this same n/um that the healer puts into people in attempting to cure them. So, once heated up, n/um can both induce !kia and combat illness.

The dance provides healing in the most generic sense. It can cure an ill body or mind, as the healer pulls out sickness with a laying on of hands; mend the community’s social fabric by promoting cohesion and a manageable release of hostility; and protect the camp from misfortune as the healer pleads with the gods for relief from the Kalahari’s harshness.

The all-night dance also provides training for aspiring healers. It gives healers opportunities for fulfillment and growth, in which all can experience a sense of well-being, and some experience spiritual development.

These integrated functions reinforce each other, providing a continuous source of curing, counsel, protection, and enhancement. One could say the dance is the !Kung’s primary expression of religion, medicine, and cosmology – their primary ritual. For the !Kung, it is an event of great importance, a point of marked intensity and significance. The healing dance is woven into their hunting-gathering life without undermining the execution of everyday responsibilities. It is a public, routine cultural event to which all have access. The dance establishes community, and it is the community – in its activation of n/um – that heals and is healed.

This article was excerpted from Toward a Paradigm of Healing: Data from the Hunting-Gathering !Kung, an article which first appeared in the April 1983 Personnel & Guidance Journal.

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