Social Discord and Bodily Disorder: Healing among the Yupno of Papua New Guinea (review)

Despite the enormous ecological, cultural, and linguistic heterogeneity that characterizes Papua New Guinea, and the wealth of anthropological work that has occurred there, only a handful of ethnographies have focused solidly on medical issues. Indeed, somewhat surprisingly, the total volume of sociocultural work dealing with sickness and healing in this region of the world is not yet large. Hence, this volume, encompassing seven very readable chapters supplemented by maps, photographs, notes, and so forth, comprises a welcome and important expansion of a slim body of literature.

Beginning relatively uncritically with a summary of major work in medical anthropology dealing with the concept of ethnomedicine, the book quickly moves on to introduce the Yupno and their way of life in a remote highland region of the eastern Finisterre Range of the Huon Peninsula in the northeastern part of Papua New Guinea. Several chapters summarize Yupno ecology, contact history, social organization, and concepts of person, before launching into an account of their medical thoughts and actions. In particular, Keck discusses their clan structure and kinship system, including the complex land rights, economic exchanges, and political obligations surrounding marriage and bride-price practices. These sections assume that the reader has a working knowledge of basic anthropological approaches to kinship structures or is willing to learn them. In order to successfully understand the intricacies and nuances of the powerful data and analysis that follows, this kind of theoretical exposition and knowledge cannot be avoided. The rewards are well worth the intellectual effort of delving deeply into Yupno thought and kinship practices in order to realize their centrality to this people's way of life and cognitive processes around sickness and healing.

Together, these three early chapters provide the necessary theoretical and informational background for the reader to understand the events recounted in the particular case that serves to provide extensive data and an intellectual bridge to the second, more analytical half of the book. This central case involves the prolonged serious illness of the infant Nstasinge, whom Keck encountered first in 1987. Here the author expands through richer detail and contextualization her previously published journal articles about this child and his kin groups' healing attempts, focusing in particular on their diagnostic and therapeutic efforts. In this pivotal chapter (chapter 4), Keck uses a series of commentaries from Mayu, the little boy's mother, along with accounts of several meetings involving more than twenty people, mainly extended family members, to chronicle how this group of Yupno grappled with and conceptualized the historical, kinship, and natural causes of Nstasinge's illness, and the corrective actions necessary to heal him. This triangulation across various data sources allows the author not only to present how the Yupno recognize and respond to bodily disorders as "oppressing problems" but also to examine the ways in which government-provided biomedical services permit the Yupno to select and incorporate some non-Yupno elements into their attempts to alleviate, exacerbate, avoid, or manipulate ill fortunes stemming from mismanaged or improper kinship arrangements.

Keck successfully demonstrates that the idea of "oppressing problems"—caused by ruptures in the myriad threads that comprise the fabric of social and kin relationships essential to proper Yupno existence—is a highly versatile one. This central organizing concept is able to account for many different kinds of problems at multiple sites of social and cultural significance for the Yupno. It is a pity, however, that Keck does not conceptually link the idea to a similarly named concept present in the work of medical anthropologists such as Merrill Singer or Philippe Bourgois. The conceptual similarities could nevertheless be fruitfully explored by readers themselves.

From the single provocative case in chapter 5, the book turns to presenting a systematization of Yupno medical thought. This chapter comprises the very heart of this ethnography in which...