Nevertheless, the overall effectiveness of traditional medical knowledge, interesting as it is, tends to be limited. Malaria is still one of the commonest causes of illness and death in New Guinea’s lowlands and hills. It was only when scientists established that malaria is caused by a protozoan of genus
Views of disease causes, and resulting attempted preventive measures and cures, differ among traditional peoples. Some but not all peoples have specialized healers, termed “shamans” by Westerners, and given specific epithets by the people involved. The !Kung and the Ache often view illness fatalistically, as something that is due to chance and can’t be helped. In other cases the Ache offer biological explanations: e.g., that fatal intestinal illnesses of children are due to weaning and eating solid food, and that fevers are caused by eating bad meat, too much honey, honey unmixed with water, too many insect larvae, or other dangerous foods, or by exposure to human blood. Each of these explanations may sometimes be correct, but they don’t serve to protect the Ache from a high death rate from disease. The Daribi, Fayu, Kaulong, Yanomamo, and many other peoples blame some illnesses on a curse, magic, or a sorcerer, to be countered by raiding, killing, or paying the responsible sorcerer. The Dani, Daribi, and !Kung attribute other illnesses to ghosts or spirits, with whom !Kung healers attempt to mediate by going into a trance. The Kaulong, Siriono, and many other peoples seek moral and religious explanations for illnesses: i.e., the victim brought the illness on himself by an oversight, committing an offense against nature, or violating a taboo. For instance, the Kaulong attribute respiratory illnesses of men to pollution by women, when a man has made the dangerous mistake of coming into contact with an object polluted by a woman menstruating or giving birth, or when a man has walked under any fallen tree or bridge or has drunk from a river (because a woman might have walked on the tree, over the bridge, or through the river). Before we Westerners look down on those Kaulong theories of male respiratory disease, we should reflect on the frequency with which our own cancer victims seek to identify their moral responsibility or the cause for their cancer, whose specific cause is as obscure to us as is the cause of male respiratory illness to the Kaulong.
Starvation
In February 1913, as the British explorer A. F. R. Wollaston was descending in good spirits through New Guinea montane forests after having succeeded in reaching the snow line on New Guinea’s highest mountain, he was horrified to find two recently dead bodies in his path. Over the next two days, which he described as among the most awful of his life, he encountered over 30 more bodies of New Guinea mountain people, mostly women and children, singly or in groups of up to five, lying in rough shelters along the track. One group consisting of a dead woman and two dead children included a still-living small girl about three years old, whom he carried to his camp and fed with milk but who died within a few hours. Into camp came another group of a man, a woman, and two children, of whom all except one of the children expired. The whole group, already chronically malnourished, had exhausted their supplies of sweet potatoes and pigs and found no wild food to eat in the forest except the hearts of some palm trees, and the weaker ones apparently died of starvation.
Compared to accidents, violence, and disease, which are frequently recognized and mentioned as causes of death in traditional societies, death due to starvation as witnessed by Wollaston receives much less mention. When it does occur, it is likely to involve mass deaths, because people in small-scale societies share food, so that either no one starves or else many people do simultaneously. But starvation is greatly underappreciated as a contributing cause of death. Under most circumstances, when people become seriously malnourished, something else occurs to kill them before they die purely of starvation and nothing else. Their body resistance fails, they become susceptible to illness, and they are recorded as dying of a disease from which a healthy person would have recovered. As they become physically weak, they become more prone to accidents such as falling from a tree or drowning, or to being killed by healthy enemies. The pre-occupation of small-scale societies with food, and the diverse and elaborate measures to which they resort to ensure their food supply and which I shall explain in the following pages, testify to their omnipresent concern with starvation as a major risk of traditional life.
Furthermore, food shortage takes the form not only of starvation in the sense of insufficient calories, but also shortages of specific vitamins (causing diseases such as beriberi, pellagra, pernicious anemia, rickets, and scurvy), specific minerals (causing endemic goiter and iron-deficiency anemia), and protein (causing kwashiorkor). Those specific deficiency diseases are more frequent among farmers than among hunter-gatherers, whose diets tend to be more varied than those of farmers. Like calorie starvation, specific deficiency diseases are likely to contribute to someone being recorded as dying of an accident, violence, or infectious disease before the person dies of the deficiency disease alone.
Starvation is a risk that affluent First World citizens don’t even think about, because our access to food remains the same, day after day, from season to season, and year after year. Of course, we have some particular foods that are seasonal and available for just a few weeks a year, such as freshly harvested local cherries, but the total available amount of food is essentially constant. For small-scale societies, however, there are unpredictably good or bad days, some season each year when food is predictably short and to which people look forward with foreboding, and unpredictably good or bad years. As a result, food is a major and almost constant subject of conversation. I was initially surprised that my Fore friends spent so much time talking about sweet potatoes, even after they had just eaten to satiation. For the Siriono Indians of Bolivia, the overwhelming preoccupation is with food, such that two of the commonest Siriono expressions are “My stomach is empty” and “Give me some food.” The significance of sex and food is reversed between the Siriono and us Westerners: the Sirionos’ strongest anxieties are about food, they have sex virtually whenever they want, and sex compensates for food hunger, while our strongest anxieties are about sex, we have food virtually whenever we want, and eating compensates for sexual frustration.
Unlike us, many traditional societies, especially ones in arid or Arctic environments, face frequent predictable and unpredictable food shortages, and their risk of famine is far higher than ours. The reasons for this difference are clear. Many traditional societies have few or no stored food surpluses on which to fall back, either because they can’t produce surpluses to store, or because a hot wet climate would cause food to spoil quickly, or because their lifestyle is nomadic. Those groups that actually could store surplus food risk losing it to raiders. Traditional societies are threatened by local food failures because they can integrate food resources only over a small area, whereas we First World citizens ship food over our whole country and import it from the most distant countries. Without our motorized vehicles, roads, railroads, and ships, traditional societies can’t transport food long distances and can acquire it only from near neighbors. Traditional societies lack our state governments that organize food storage, transport, and exchange over large areas. Nevertheless, we shall see that traditional societies have many other ways of coping with the risk of famine.
Unpredictable food shortages
The shortest time scale and smallest spatial scale of variation in tribal food supply involve day-to-day variation in individual hunting success. Plants don’t move around and can be gathered more or less predictably from one day to the next, but animals do move, so that any individual hunter risks bagging no animal on any given day. The solution to that uncertainty adopted almost universally by hunter-gatherers is to live in bands including several hunters who pool their catch to average out the large day-to-day fluctuations in catch for each individual hunter. Richard Lee described that solution from his own experience with the !Kung of Africa’s Kalahari Desert, but he was also generalizing for hunter-gatherers of all continents and all environments when he wrote: “Food is never consumed alone by a family; it is always (actually or potentially) shared out with members of a living group or band of up to 30 (or more) members. Even though only a fraction of the able-bodied foragers go out each day, the day’s returns of meat and gathered foods are divided in such a way that every member of the camp receives an equitable share. The hunting band or camp is a unit of sharing.” His principle of pooling and averaging among hunter- gatherers also applies to many small-scale herding and farming societies, such as the Sudan’s Nuer people studied
