To Amber Johnston '99, whose senior thesis examined the impact of western medical methods on Fijian society, the following story is not unusual:
A Fiji woman suffering from schizophrenia goes to a psychiatric ward and receives sedatives, which do little to improve her condition. Worse, because she is using western medical treatments, she is an outcast in her community.
Finally she goes to a local healer, who “discovers” that the woman has been living on another person's land, and that the land's owners have placed a curse on her. She apologizes to the family that owns the land, moves to another house, and is cured.
Johnston, an interdepartmental anthropology and psychology major, studied in Fiji on a term abroad created by Steve Leavitt and Karen Brison, both associate professors of anthropology. Last summer Johnston returned to Fiji to conduct research for her thesis as one of nine students supported by a grant from the Jerome A. Schiff Charitable Trust (she also received an Internal Education Fund grant from the College).
During her term abroad, Johnston and two other students — Sarah Ahart '99 and Debbie Cederbaum '99 — lived in small villages and conducted anthropological field research on village life. Johnston became fascinated by the underlying emphasis on indigenous ancestral spirits in all of Fijian life.
“Fiji was missionized 200 years ago and outwardly appears to be a Christian society,” she explains. “But Fijians really do believe in their indigenous spirits. A lot of their indigenous culture is filtered through Christianity. Since the indigenous spirits play a direct role in almost every aspect of Fijian life, they are an integral component of traditional beliefs about mental illness.”
According to traditional Fijian culture, mental illness is caused by a curse put on an individual, either by another person or by a spirit. Fijian healers help find the curse that has caused the misery, and when the sufferers rectify the situation, the curse is lifted and the illness is cured. (Johnston says the system helps maintain the Fijian social order. “People behave in a certain way because they are afraid of having a curse put on them. This provides a socially-appropriate way to deal with problems in Fiji — all through the guise of mental and physical illness.”)
The people who do not get better are thought to have curses placed on them by the most powerful spirits. Although they don't improve, they are supported by their communities and families as they seek the curse that is causing their problems.
Not so for those who go to St. Giles, the westernized psychiatric hospital in Fiji. These people are treated differently from those pursuing traditional treatments, even though they may have the same symptoms. “Some of the patients at St. Giles are ostracized by their communities because they are labeled as mentally ill, something that is only associated with St. Giles,” she explains.
A good deal of the treatment at St. Giles involves trying to educate the local residents about their illnesses. But indigenous views die hard, and many patients don't regularly take their medication — a staple for western treatments.
Johnston concluded that the introduction of westernized treatment methods has done more harm than good in Fiji.
“These people have the choice of being admitted to St. Giles, taking medication for an indefinite amount of time, and being isolated from their villages — the most important part of their lives — or remaining in their villages, cared for and accepted by the community, and going to an indigenous healer who offers them a hope for 100 percent wellness. It is no surprise that many choose to go to a local healer.”
Johnston thinks we could learn from traditional Fijian treatments. “We take the mentally ill out of their communities, and the hospital becomes their families. In Fiji, they stay in their homes, within their support systems.” In addition, she stresses that there are few differences in the success rates for treatments. “We haven't found anything that amazingly cures people,” she says.
“Mental illness does have a social factor that you can't ignore,” she continues. “At Ellis Hospital, I work in the adolescent psychiatric unit, where ninety percent or more of the children have social problems — they were abused, they have no family, or suffer from other problems. I have to believe that their illnesses are not simply chemical. There is something else affecting these kids.”
Johnston traces her interest in mental illness to a volunteer program she completed at a local hospital near her hometown of Bradford, Vt., when she was in high school. She has worked in the recreational therapy department of the psychiatric ward at Ellis Hospital in Schenectady since her sophomore year at Union.