It was raining when Rachel set out for the hospital—a cool, comfortable rain, which made her slow her pace and enjoy the rare freshness of the air.  The daylight held an anticipation of exciting possibilities.  An hour later she was not so thrilled with the outcome of her morning.

“We are going back to the village to do custom,” the man said matter-of-factly in heavily-accented English.

Rachel looked at him blankly, not understanding what on earth he was talking about.  She had begun the morning rounds and was in the isolation room assessing his wife’s treatment.  The whole family had come to the hospital two months ago, and the wife had been diagnosed with tuberculosis.  They would need to stay for at least another seven months for the treatment to run its course.  Rachel looked around for a nurse, for anyone who could help her explain to this man that his wife needed to stay in hospital.

“He means that he and his wife want to go back to their village to find out who put the magic on his wife that has made her sick,” the nurse said reluctantly after Rachel asked her to explain the situation.

“But we are giving her the right treatment here and she is getting better.  There is no magic; she has TB,” Rachel responded incredulously.

“He says that the hospital medicine is not working, and they cannot stay here any more.  They want to find out from the witch doctor what is happening.”  The nurse shrugged her shoulders as if that was the end of the story and there was nothing to be done.

Rachel struggled with her response.  The man was clearly convinced that his wife’s sickness was the result of some sort of sorcery.

“Tell them I need to talk with the other doctor,” Rachel said, spouting the first thing that came to her mind.  She waited for the man to nod his comprehension if not agreement to her request and then rushed out of the ward to find Dr. Francie.  Hopefully she would come to the rescue of this strange situation.

Rachel walked briskly towards Dr. Francie’s office.  Do they not know that consulting a shaman is complete nonsense? Rachel muttered to herself.  The only way the woman is going to get better is if she stays in hospital.

She could see people queuing up at the outpatients section on the long wooden bench, all holding small pieces of cardboard with numbers scrawled on them in permanent marker.  There were kids with runny noses and adults with a skin disease which made people’s whole bodies peel as if their skin was too dry to stay on.  Babies were crying, and frustrated mothers were calling out to their kids to sit down.  Rachel wondered if they were even confident that the staff at the hospital could help them in any real way—or was this just one of the options for them: hospital or so called “traditional methods”?

Having reached Dr. Francie’s office, Rachel lost no time in explaining the situation.  “The wife is just coming out of her contagious stage and we were about to move them to the TB ward for less frequent medication; she is responding really well,” she finished.

“We cannot condone them going back to their village for custom but we cannot force them to stay,” Dr. Francie sighed.  “Unfortunately, this happens quite often.  As I am sure you realize by now, our job here at the hospital is not only to treat physical sickness but also people’s spiritual sickness.  So many Papua New Guineans are still afraid of the spirits and continue to think that the spirits are in control.”

Rachel was still amazed at the difference in everyday life in Papua New Guinea.  In Australia she would never ask a patient about their spiritual beliefs.  Here it was almost a matter of everyday conversation; the spiritual world was just such a part of normal life.

“We could give them a month’s worth of medicine,” Dr Francie continued, “but most likely it will not be used.  We will probably see the woman again in another six months, very ill—or we will hear that she has passed away.”

“Is there anything we can say that might convince them to stay?” Rachel asked.

The situation seemed so desperate and helpless.  Rachel knew that many of her patients in Australia sought second or third opinions when they were not happy with a diagnosis or treatment.  Some people did not stop searching until they were given the answers they wanted to hear.  Was this the same thing, just on a different level?

“I will get Pastor James to talk and pray with them,” Dr. Francie replied, “and I will see if I can convince them to stay.”

Rachel nodded her head.  “The man did say that they were Christians, although if they are, I am a bit confused about why they would want to consult a witch doctor.”

“Rachel,” Dr Francie paused before exiting, “if you feel up to it you could say something to the couple as well.  Here in PNG it is very acceptable for us doctors to pray with patients and speak with them about spiritual matters.”

Rachel shuddered at the thought of conversing with the couple on a deeper level; what could she possibly say?  She did not even understand why they wanted to leave, and she quailed at the thought of the language barriers between them.

“Uhh, yeah, maybe,” she stammered, as she hurriedly left the office.

The next morning Rachel walked along the busy corridor toward the TB ward where the family was now staying.  She was dreading seeing an empty bed.  She scanned the long narrow room quickly, looking at each wooden slat bed pushed against the walls.  She was pleasantly surprised to see the small family all gathered around their allocated bed.  The hospital chaplain, Pastor James, was praying with them.  She would have been interested to hear what Pastor James said to the couple.  Since coming to PNG she had heard a lot about sickness and sorcery being linked.  She remembered the young mother who had died in childbirth while she was performing a caesarean some weeks before.  That family too had wanted to find someone to blame for “doing magic” on the woman.

It seemed to Rachel that Pastor James must know the family rather well, as he was speaking very familiarly with them.  She had never really appreciated his presence before, but she was beginning to see what a vital role he played.  Here was this man, himself a Papua New Guinean, who was trying to make his own people understand a completely different mindset to what they had been taught since they were children—in essence, flip their beliefs upside down.  Rachel wondered what his testimony was.

At lunch break Rachel walked quietly down the dark hallway that housed the administration offices.  It was quiet and cool, completely different from the bustling, exposed walkways that she normally traversed.  She passed the chest freezer located in a small nook out of the way of the general public.  It was the hospital’s official morgue.  She had noticed that some of the nurses knocked on the freezer lid before opening it up.  She had asked Lena about this and had gotten a rather odd answer about people telling the spirits what they were doing so they would not be disturbed.

“It is just part of our culture,” Lena had said, as if this explained everything.

Rachel had not understood at all, but she had done what she was getting used to doing in situations where she felt completely at sea—she nodded her head and changed the topic.

Reaching her destination, Rachel knocked tentatively on Pastor James’ office door.  She had never had any reason to speak to the man other than an occasional greeting in the corridor, and she nervously wiped her sweating hands on her skirt before entering.  She shook his hand and apologized if she was disturbing him.  Pastor James welcomed her and invited her to sit.

Rachel sat for a moment trying to figure out exactly what she wanted to ask this man, and how to say it in a way that would not be misunderstood.

“I am sorry—I am new to this country and do not really understand some things, but I am wanting to ask you a question.  Why do some Papua New Guinean Christians think it is okay to “do custom,” or think that they need to talk to spirits?”  Rachel was quite proud of herself with the way she phrased that whole sentence; it sounded very Papua New Guinean—maybe she was learning something after all.  She went on to describe what she had witnessed at the morgue.

Pastor James nodded seriously.  “Many people still cannot let go of the old traditional ways.  They mix Christianity and custom together.”

“Whom do people think God is?” Rachel surprised herself by asking.  She was finding the topic quite fascinating and wanted to know more.

“Many people think God is just another spirit whom they need to please to get what they want,” Pastor James explained patiently to Rachel.

Rachel could certainly relate to that.  How many times had she tried to tell God how good she was, and that He really should answer her prayers the way she wanted?

“People here in PNG need to understand that God is far above the spirits, and that God does not want us to have anything to do with the spirits.”  Pastor James was obviously very passionate about this subject.  It must be something that he dealt with all too often.  He continued, “Many people say they are Christians but still hold on to the old cultural ways.  If God does not give them what they want they go back to the spirits and try them.”

“What does ‘doing custom’ mean?” Rachel asked, her curiosity piqued and interested to hear more on the subject.

“There are many different ways of ‘doing custom,’” Pastor James began after a long moment of what must have been some careful thought.  Rachel breathed a sigh of relief; she had begun to wonder if she should have asked.

He began to describe the different methods.  Rachel tried to picture the different acts of expelling sickness:

*    A family scrambling to move the sleeping mat of the sick person in order to confuse the spirits so that they were unable to continue attacking.

*    A man lying on the ground being beaten by his brother with a large bunch of vines which leaves him coated in yellow paste, symbolically beating the sickness out.

*    A scared, incredibly sick woman leaving her family and friends behind to live in an isolated bush hut in the middle of the jungle in order to confuse the spirits and to allow time for her to heal.

Pastor James’ next scenario was so vivid that Rachel could almost hear the ceremonial drums pulsating, with colors flashing and loud chanting filling her ears.  As one man dances out of control, painted in bright colors with a head-dress made of brilliant bird-of-paradise feathers perched precariously on his head, a crowd gathers around, feasting and laughing in a time of celebration.  This show is put on for the spirits in order to communicate that all is well within the community and that the spirits do not need to be bothering the man with sickness.  Pastor James concluded by saying that there were also other ways Papua New Guineans tried to expel sicknesses.

“Thank you,” Rachel replied.  “What you have told me has been very helpful to my understanding.”  She walked slowly home.  The afternoon was cool and overcast; it had been raining most of the day again.  Her conversation with Pastor James had been fascinating, and she had learned a great deal.  It had also made her reflect on her own culture.  For some reason she had always just equated the “western culture” with being a “Christian culture,” but she was realizing more and more that just labelling something “Christian” did not make it so.  Maybe she needed to take a good hard look at the things she dismissed as “just part of the western culture”—things that went against what she knew was right as a Christian.

A week later Rachel was on the walkway between the maternity ward and special care when the husband of the woman with TB, a small man with a big smile, hurried up to her.  He thanked her profusely for her help and explained that the combination of prayer, worship to God, as well as the medicine, was making his wife better; she no longer coughed continuously and was putting on weight.

“We will stay here,” the man concluded, and he walked away.

Rachel was stunned.  Prayer, worship to God and medicine.  Hmmm, interesting combination, she thought.  A week ago she would have concluded that the TB drugs were finally starting to make a visible difference.  The man obviously believed it was more than just medication.  What did she believe now?

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