‘Kulam’ and medicine

I’ve written about kulam in many columns, emphasizing how it relates to mistrust. When a serious adverse event happens, we wonder if it might have been caused by kulam.  The suspects can be anyone, from that neighbor who we’ve always seen as being envious of our own good fortune, to that newcomer in the neighborhood, the one with shifty eyes, who just moved in from the provinces.

From the perspective of the person who does the witchcraft, anthropologists propose that this happens in societies where people feel there is no way to obtain justice through formal systems like the courts. So, if a partner—a spouse, or a business associate—cheats on you and takes off, you know nothing will happen through the legal system so you head off to Quiapo, buy black candles shaped like a human being, insert a photo and the name of the cheat into the candle and light it, upside down. “Pang konsensiya” (to bother the person’s conscience), the vendors explain, and I can almost hear the evil laughter of witches in the background.

I wanted to go on a different track today and share some of the discussions I’ve had with physicians and other health professionals, who often encounter patients and families invoking kulam.

It’s clear that there are certain diseases where kulam is more likely to be invoked as the cause. First, the ailment has to be serious, causing suffering. This can be physical, usually great pain. Abdominal pains are often mentioned, which is linked to the idea that the mangkukulam  (sorcerer) sends foreign objects into the victim’s body. To heal the victim, these objects have to be removed and I’ve actually seen the “kontra-kulam” (who I’m sure are also mangkukulam) using amazing sleight-of-hand procedures to remove all kinds of stuff, from nails to rope.

It’s not always intense pain though that brings about suspicions of kulam. Mild suffering, but which is intense and persistent, will be attributed to kulam. There are all kinds of neuritis, an inflammation of nerves, which apply here.

Patients are usually older people, and those with vitamin B deficiencies.

Then there are diseases which are visibly disfiguring, usually skin ailments. The more diffused, the more likely people will think of kulam. Psoriasis would be an example.

Note that skin ailments and nervous diseases can overlap.  Notice how when you’re anxious or nervous about something, you begin to scratch. In grade school I had an American Jesuit teacher who would ask the most difficult questions and before we could answer he’d scratch his head, which got us scratching our heads too like we had armies of lice, even less likely to give a correct or coherent answer.

So, we’re worrying about bad business and the more we think about it, the more nervous we get and the more we have those strange itches and mild pains, which worsen with time. Then we wonder, maybe it’s our business partner cooking up something, with a mangkukulam.

Chronic ailments

A second feature of medical ailments that attract kulam explanations: They tend to be chronic or prolonged. It’s not surprising kulam suspicions come about when a person has a distended or swollen abdomen. It fits into ideas of kulam being caused by foreign objects sent by some mangkukulam courier.

Now, a swollen abdomen is actually ascites, the accumulation of fluids, often caused by liver problems.  The liver is our body’s Balara, a filtration system, so when you have chronic diseases—anything from alcoholism to cancer and even to prolonged use of certain medicines—your liver weakens, leading to ascites. As the stomach bloats up, your grandmother gets suspicious: “It must be that yaya of yours who we fired.” (Never mind that she was fired 30 years ago and has long gone on to a happier life.)

A last important feature of kulam and medical ailments is the psychiatric component. Here, psychosis is often an underlying cause for kulam complaints.  The lay term for psychosis is paranoia, where you are pathologically suspicious of people around you, the paranoia extending into suspicions of mangkukulam.

Paranoia

To emphasize how this works, let me describe a friend who once told me that she believed she was being “sorcerized.”  Suddenly she paused and pointed to the lizard on the wall: “Look, even that lizard was probably sent by the evil ones, to listen in on us.” I looked at the lizard and thought that it did look like it was watching us. Paranoia can be contagious.

The problem then is not the mangkukulam, but the many cases of psychosis in the country, with causes we are often unaware of.

There’s something called typhoid psychosis, where typhoid, an infectious disease, leads to an added problem of paranoia. Health professionals are often unaware of this link.

Then there are shabu users, who will refuse to leave the house, convinced the  t aho  vendor, the security guard, is out to hex them. They try to find comfort in shabu, unaware that it’s the  shabu  producing the psychosis.

I worry about body-builders using steroids, which they think give them more muscles when it’s actually edema (manas).  Besides that, steroids can cause psychosis and, by extension, suspicions of kulam, probably a fellow body-builder envious of your steroid-induced physique.

All said, we’re talking about kulam being used to explain the unexplainable diseases. Some years back, my housekeeper asked for help for friends of hers who had come from Samar, with an 18-year-old daughter who had been suffering from severe coughing for several months and inflamed lymph nodes. I knew immediately what it was but referred her to the Philippine General Hospital, and they confirmed my suspicions: TB. Several months later, I asked my housekeeper what had happened to the girl. She went into a long story about how the family went from PGH to Jose Reyes Memorial Hospital to the Lung Center, refusing to believe their daughter had TB. They had this perception, shared by many Filipinos, that TB only affects men, older ones at that.  So if their daughter didn’t fit the stereotype, then it had to be kulam, and they suspected it could have been one of her spurned suitors.

The girl died, and I was just so aghast, realizing how widespread, and dangerous, this kulam  belief can be.

I know too of a young man suffering from HIV/AIDS but who has to get treatment secretly because his parents are convinced it was caused by  kulam. There you have denial: no, not our son, not our virginal son. He’s gay, not so incidentally.

Kulam  reveals so much of the Philippines, from the lack of health literacy, to our social relations. Fighting  kulam  is going to involve much more than removing foreign objects from the abdomen, or burning black candles in Quiapo.

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