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Remembering to Live

Illness at the Intersection of Anxiety and Knowledge in Rural Indonesia

M. Cameron Hay

Publication Year: 2001

Sasaks, a people of the Indonesian archipelago, cope with one of the country's worst health records by employing various medical traditions, including their own secret ethnomedical knowledge. But anxiety, in the presence and absence of illness, profoundly shapes the ways Sasaks use healing and knowledge. Hay addresses complex questions regarding cultural models, agency, and other relationships to conclude that the ethnomedical knowledge they use to cope with their illnesses ironically inhibits improvements in their health care. M. Cameron Hay is a NSF Advance Fellow and an Assistant Adjunct Professor at the UCLA Center for Culture and Health.

Published by: University of Michigan Press

Contents

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pp. vii-viii

List of Illustrations

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pp. ix-

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Acknowledgments

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pp. xi-xiii

Sasaks frequently asked me, “Are you alone?” finding it difficult to believe that anyone would actually travel alone to live among strangers. What they could not see was that I was not alone. I carried the encouragement, support, and wisdom of others with me into the field. Nor was I alone during the long months at my computer, for the Sasak strangers had become friends, and their laughter and wisdom kept me company ...

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Introduction

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pp. 1-24

Laughter rings throughout Sasak compounds even though illness and death knock constantly at their door. Sasaks live on Lombok, the island immediately east of Bali in the Indonesian archipelago. Of Indonesia’s thousands of islands, Lombok consistently has one of the country’s worst health records. How do people cope with the fragility of their lives so that they can return to laughter? This ethnography, about Sasak ...

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Part I: Less than Healthy

This ethnography is written in two parts. It begins by guiding the reader into thoughtful acquaintance with rural Sasak people. Chapter 1 explores maps: the map of Lombok within which Sasak people live, the map leading geographically to the field site, and the maps written on people’s bodies pointing to realities defining their lives and health. Chapter 2 abandons maps and surface writings on bodies in order to ...

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1. Written on the Body

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pp. 27-64

It was late afternoon on my third day in the field. I was sitting on a mat just inside the doorway, a glass of too-sweet coffee in my hands. Two men, Amaq Mol and a neighbor, were drilling my limited Sasak vocabulary. Inaq Mol and her daughter were shelling beans and laughing at my errors. A man I did not recognize crept silently into the house and sat leaning ...

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2. Learning Sasak Anatomy

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pp. 65-94

In late February 1995, nearly every household in Pelocok had at least one person ill. In my household three of us were ill; I was one of them. The illness usually lasted more than a week and seemed flulike: fevers, loss of appetite, fatigue, and stomach pains. Everyone, I was told, was sick with the same thing: “Enyakitne pede doang” (The illness is just the same). Everyone said it was a penyakit biese—a usual illness.1 Nonetheless, ...

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Interlude: Learning to Be Vulnerable

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pp. 95-97

After about a month in Pelocok, I was beginning to find my feet. I had a basic grasp of the language. I knew my way around and was beginning to get a sense of people’s lives. I had even collected a couple of illness case studies. Indeed I was beginning to think that living there, inconveniences aside, was quite easy, and the people were not too surprising. One conversation was all it took for me to realize that my feet were not ...

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3. A World Full of Dangers

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pp. 98-140

It was dusk in the compound, the time of gathering at the end of the day. Some were out bathing. Others were sitting and chewing betel or smoking cigarettes. Cooking ‹res were being lit. “Ape kelakde”—which vegetable are you boiling for dinner?—could be heard as women ducked into kitchen huts to ask for coals to start their own ‹res. Voices drifted across the compound in the stillness. “Lekan embe? ”—where are ...

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4. Agents of Coping

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pp. 141-168

How does one cope in a world full of dangers? In a world where everyone is less than healthy, in a world where there is no certainty that one will be alive a few weeks hence, in a world where people are rarely brave and experiences of vulnerability are common, anxiety is part and parcel of everyday life. How then do people manage to get through the daily tasks of living? ...

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Part II: Coping with Illness

We have seen that people are busy coping with illness before anyone is actually sick. In their anxieties about and agencies for coping with vulnerability, Sasaks set the groundwork for staying alive in the presence of illness. We step into the presence of illness by tracing a young boy’s illness day by day, which emphasizes the uncertainty of life lived forward and ...

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Case Study: An Ill Child

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pp. 171-185

I first met Lo Budin when he was about four months old. His father, Papuq Junin, introduced the child thus: “This is Small Uncle [Paman Kodeq].1 He will be the one that will grow big in knowledge. He will be the one who will know all the knowledge of the ancestors.” Papuq Junin was a senior person in Pelocok, yet he had an ageless quality about him. He laughed often, the smile twinkling in his eyes, as he ...

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5. Naming an Illness

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pp. 186-225

Getting the name right for an illness is the essential first step in successfully coping with its presence. The efficacy of treatment depends upon it. As we saw in chapter 2, Sasaks generally are not interested in knowing about the body and its workings for its own sake. Their interests are motivated by particular vulnerabilities and illness episodes. ...

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6. Winged Words: The Politics of Communication about Illness

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pp. 226-261

It was the third morning that I had sat with Inaq Sarin in late June 1995. She was near term on her ninth pregnancy and lately had had some breakthrough bleeding. Inaq Sarin was very nervous—seven of her previous children had died, mostly in childbirth. She and her husband desperately wanted this child to be all right. Although her elian was Papuq Isa, she had consulted with the Bu Bidan at her clinic about ...

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7. Communication Slippages: Interactions with Biomedicine

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pp. 262-285

In egalitarian knowledge systems everyone has access to knowledge, and the social processes legitimating one interpretation over another require that authority must constantly be negotiated in social interactions. In hierarchical knowledge systems, people have differential access to knowledge, and knowledge is legitimated or rejected automatically based on the knowledge and corresponding social position of ...

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Denouement: Epitaph for Lo Budin

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pp. 286-287

Lo Budin remained in the hospital for 10 days. During all the interactions Inaq Budin had with doctors and nurses over the course of those 10 days, no one managed to communicate to her that although the symptoms were disappearing, the killing disease remained. When he was discharged, Inaq Budin brought him home, smiling and happy. She was confident that now all would be well with her son. ...

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8. Time to Remember

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pp. 288-297

The old woman was dying. She lay on a mat on the dirt floor surrounded by the loved ones who had kept vigil with her since her collapse a few days before. Various treatments had been tried, but her primary illness, as everyone said, was old age. Neighbors, friends, and family sat with her, waiting out her illness, fearing she would die. Each time she seemed to be at the point of death, too weary to even breathe, ...

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9. Illness at the Intersection of Anxiety and Knowledge

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pp. 298-310

How do Sasaks cope with the fragility of their lives? They cope by remembering themselves, those around them, and ilmu. In order to find and understand this answer, we have delved into people’s bodies, anxieties, economics, metaphors, agencies, relationships, creativities, interactions, and authorities within a complex setting of pluralistic medicine. The undergirding thread was the understanding of life as ...

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Epilogue: The Irony of Knowledge

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pp. 311-316

The illnesses and deaths of tomorrow are partially anticipated in Pelocok: people are aware that they are less than healthy, that they may die before they meet someone again, that they are vulnerable to a host of potential ills. When vulnerabilities are experienced or illness enters, the rush to prevent and to treat them attests to both anxiety and hope. Nonetheless, the health statistics cited in chapter 1 imply that Sasak ...

Glossary

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pp. 317-320

References

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pp. 321-336

Index

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pp. 337-345


E-ISBN-13: 9780472026319
E-ISBN-10: 0472026313
Print-ISBN-13: 9780472067855
Print-ISBN-10: 0472067850

Page Count: 360
Illustrations: 10 B&W photographs, 2 maps, 6 illustrations int text
Publication Year: 2001