Hãwäg and b’atìb: The Balance between Health and Disease among the Hupd’äh in the Upper Rio Negro Region, Brazil

This paper addresses recent debates about body (tsaa) formation and the process of health and illness among the Hupd'ah, also known as Maku of the Uaupés, Papuri and Tiquié rivers. The ethnographic data presented here evinces the relationship between the main substances existing in the body (hãwäg and b’atìb) and manifest in the Hup physiology as well as the potential ways of understanding the processes of health and illness for this people of the Northwest Amazon. Providing an overview of social logistics, this paper intends to provide health care professionals with appropriate curative and preventive actions in this region, especially during flu and tuberculosis outbreaks, the latter being considered the main illness affecting the Hupd’äh. This paper suggests that balance in Hupd’äh life is achieved when the balance between two opposite corporal substances, which are in dispute within the body, is negotiated through quotidian practices. This study is exploratory in character. The questions raised here arose from field work carried out amongst the Hupd’äh-Maku (hup ‘people’, d’äh ‘suffix of plural’) who live in the region between the rivers Tiquié and Papuri, tributaries of the left bank of the Uaupés in the Upper Rio Negro, in the State of Amazonas. When carrying out this study we learnt that some Hupd’äh had been removed from their territories to be treated for Tubercle Bacillus (TB). Most of them, were already being treated for TB, but had abandoned the six months treatment half way. In the attempt to understand the reason for this phenomenon, I was led to research how the Hupd’äh perceive and represent the diseases introduced through contact with Brazilian society, better known locally as the sickness of the Teng’hõid’äh1 pée (diseases of the noise-of-burning-wood-that-crackles). This paper therefore represents the beginning of a systematic ordering of representations of the body, through an analysis of health and disease amongst the Hupd’äh population. It is important to stress that in the region known as the Upper Rio Negro a process known as ‘interaction’ among all peoples (Athias, 1995) has been taking place. The indigenous peoples involved in this process belong to the linguistic groups Maku, Tukano and Arawak. This process enables the indigenous populations of this region to interact and attempt to discover, through their mythology, oral tradition and memory, elements which justify their presence in this territory as distinct groups, each with its identity and, at the same time, integrated into the ecological context of the region (Athias, 1995). These Indians have been in contact with the colonizing pioneers since the XVII century and there are stories to the effect that countless epidemics of measles, smallpox, influenza and colds occurred that decimated part of the population (Buchillet, 1995). Although there are significant differences between the various traditional medical systems of the Tukano, Arawak and Maku, there are nonetheless elements in common among them and especially within the therapeutic processes of shamans. Shamans operate between different clans and are seen and perceived by the various indigenous groups to be intermediate agents able of “seeing” bodies, making a diagnosis and later the cure, in dialogue with the “spirits”. Another common element – among the Hupd’äh, Tukano and Arawak – is the use of the word as an important element or agent in therapeutic healing. In this process of cultural assimilation, and the encountering of new illnesses, the indigenous peoples created specific 61 Published by Digital Commons @ Trinity, 2015 and new knowledge about these diseases, placing them within their portfolio of traditional healing and its associated language. In reality, all are unanimous in stating that, although they do not know the cause of these diseases, they have a mythical explanation for their appearance. The vast experience that indigenous peoples have of infectious diseases, introduced through contact, leads them to identify the river (the means of interethnic communication) as the vehicle of transmission of these infections: The “disease comes via the river” or “influenza comes together with the white-man’s products”, say the Hupd’äh. The arrival of the Salesian missionaries in the region, around 1914, brought enormous changes in the social and political system of these indigenous groups. The way in which these changes took place broke the balance, with regard to concepts of health and disease and reconfigured how the body was represented. It is not my intention to state here that the new concepts or conceptions of health and disease introduced, based on a mainly discriminatory and hygienist approach, were pacifically accepted by the Indians. Never the less their approach and these ideas, instigated though missionary contact, did put an end to a significant number of shamanistic practices, considered to be “devilish”. Many shamans had to go into hiding and accept the prohibition of their practices. Despite many years of a strong missionary presence, indigenous traditional medicine was not destroyed. It lives alongside official biomedicine, to a certain extent pacifically, and perhaps we could say that the two medical systems are complementary. During my health surveys, in 1996 and 2006, three workshops were held with indigenous health workers or the Agente Indígena de Saúde (AIS) and community leaders about their understanding of the prevalent notions of health and disease in the region. During these workshops, the AISs themselves emphasised the importance of the indigenous medical system and the necessity of health workers to learn more and to respect shamanic treatment. As stressed in previous works (Athias, 1995, 1998, 2004), changes in the indigenous economic and social organization have lead to the deterioration of sanitary conditions in almost all villages. The new model of nuclear family housing introduced by the Salesians, which involves small tin houses, for instance, had a negative effect. Furthermore, alternatives put in place in the region, such as the mission hospitals, medical posts, as well as indigenous health agents themselves, all reinforce the western medical system, but they do not provide a sustainable solution to the health problems of these populations. There is an urgent demand on the part of the Tukano and Arawak indigenous health workers (AIS) for improvements in the health situation of the region, as well as for the recognition of indigenous medicine. There is also a demand for “white” medicines amongst the Indians. Between November and December 1996, three important meetings involving both health agents and other indigenous leaders were held to discuss the notion that they held of disease and health in order to set up a new health project.2 From 32 AISs present in these meetings, 20 replied that the main medication that they required were the analgesics dipyrone and aspirin, and anti-parasitics. Many say that they prefer to take the Whites’ medicines to get rid of pain than to do what they would otherwise normally do, which is to use a plant known as pinu-pinu (a species of Urticaceae) a kind of nettle that, when rubbed on the body, alleviates pain. On the other hand, an Indian bitten by a snake is unlikely to seek treatment in a health post or hospital, as he/she believes in the efficiency of his/her own traditional remedy. In other words, there is a selective demand depending on the specific type of affliction. Within the health services in operation on the Colombian side with the same ethnic groups, according to the Indians themselves, this dichotomy was partly solved: in the health posts there are shamans paid (by the government) to attend first to the patients who ask for them, and then refer them to the AIS if need be. This work is in a context where indigenous traditional medicine suffers significant changes on the basis of contact, and therefore the knowledge is transformed, and reformulated as new elements are introduced into a social sphere where relations are more intense. The questions and the elements presented here reinforce the fact that all knowledge relating to the body, health and disease is built up culturally, negotiated and renegotiated in a dynamic process which relates to time (in mythology) and place (territory and ecological context) in social terms. The intention here is to argue that the usual classification of ‘white men’s diseases’, and ‘doenças-de-índios’ (Indians’ diseases) is not a straightforward grouping for indigenous populations and is not really important in the way that the Hupd’äh see their therapeutic practices. The views of these populations form part of a broader collection of in62 Tipití: Journal of the Society for the Anthropology of Lowland South America http://digitalcommons.trinity.edu/tipiti/vol13/iss2/5 terpretations and representations in the context of their cosmogony. What one hopes for is that the institutions that are responsible for health in indigenous areas may offer a health service that incorporates this knowledge and thus is accessible to the indigenous population.