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'''Dr. Jagannath Majhi Dr. P. John Samuel''' '''

A B S T R A C T'''

Every human society, on this earth has developed a wide array of therapeutic knowledge and techniques within their ethno-science and socio-cultural domain to prevent themselves from various diseases. Similarly, the Kandhas have evolved their ethnomedical knowledge and skills to cop-up with the health problems in their socio-cultural milieu. There are health providers known as guruka, gunia, and pejinia, who to cater the health need of the Kandhas as primary health functionaries. These health providers have obtained their knowledge and skills through various means from the experts. The Kandhas have been depending on ethnomedicine from time immemorial.

For this paper, research was conducted in Kashipur block of Rayagada district in Odisha during 2005-2006. Fourty two (42) health providers and 83 patients who were treated by these health providers, contacted for information and discussion on disease etiology, indigenous healing and knowledge exclusion. Information on etiology of disease and healing procedure was collected from the same respondents.

Keywords: Etiology of Disease, Indigenous Healing, Health Providers, Ethnomedicine, Butuka, Bonesetters, poison bites, contagious and non-contagious diseases, Healing, black magic.

1. Introduction

Ever since the emergence of man on the earth, illness and disease have become perennial problems for him. Each society in this respect is found to develop some kind of therapeutic value system within its own ethno-science for the ‘concept and treatment’ of diseases (Dash J, 1986). There are some universal perceptions of health and disease, where all the human societies possess some common considerations and at the same time, there are also some social perceptions unique to a particular society. Biological disorders in the body may be described as disease in case of a human being, but the biological explanation cannot delineate about illness in human societies. Although biological factors tell the basic factors responsible for the disorders in the body, they are found psychological and spiritual explanations for various applications in the body and mind, especially in the pre-literate or primitive societies. The concept of health and disease, thus in cross-cultural perspective requires not only biological explanations for the illness, but also social, psychological and religious explanations.

Indigenous people often do not make a sharp distinction between disease per se and other kinds of misfortune. All undesirable events may be lumped together, both in a theory about why they occur and in-practices directed at alleviating or preventing them. Indigenous people rely heavily, but not exclusively, upon supernaturalistic explanations of disease (Alans, A. Baer et. al., 2003). This prompted Ackerknecht (1971) to view “primitive medicine” as “magic medicine”. Nevertheless, indigenous medical systems contain a strong dose of naturalism in terms of both disease etiology and treatment. The Azande do not resort oracles as a means of detecting the sources of witchcraft, except when naturalistic explanations have failed to explain why people experience a misfortune.

Indigenous societies generally do not compartmentalize their cognitive systems in the manner that Western societies do. Ultimately indigenous disease theories generally have major relevance to the moral order of a society. Disease compels people to reflect on certain aspects of the social order.

Forrest, E. Clements (1932) proposed the first cross-cultural classification of emic theories of disease etiology. These are sorcery, breach of taboo, the intrusion of a foreign object, intrusion of spirit, and soul loss. Many societies emphasize one or a combination of these causes.

Similarly, Foster and Anderson (1978) make a distinction between “personalistic” and “naturalistic”  theories of disease. In a personalistic system, disease emanates from some sort of sensate agent, such as a deity, a malevolent spirit, an offended ancestral spirit, or a sorcerer. Naturalistic theories posit disease in terms of an imbalance among various impersonal systemic forces, such as body humors in ancient Greek medicine or the principles of Yin and Yang in traditional Chinese medicine.

In Greek medicine as delineated by Aristotle, the universe consists of four elements: fire, air, water, and earth. People represent a microcosm of the universe and are composed of four humors with four corresponding personality types: blood is associated with high-spiritedness, yellow bile with bad temper, black bile with melancholia, and phlegm with sluggishness. Disease results from an imbalance of the humors. The physician attempts to restore health by correcting this imbalance.

Keeping in view the most important issues in the study of indigenous health and disease, this paper has been intended to delineate the concept of health and illness as explained by the Kandhas, the classification of diseases, treatment and healing, role of the health specialists, etiology of the diseases and knowledge exclusion among the Kandhas of Rayagada district, Odisha.

2. Local Settings and Indigenous People

The research was conducted among the Kandhas of Odisha, who live in the interior part of the southern region of the State in Rayagada district. The district is full of natural beauty with charming valleys, hills, evergreen forests, perennial streams,  gigantic rocks of different shapes  and deep trenches in the rocks. According to local people, the name Rayagada is derived from ‘raya’ meaning rock, and ‘gada’ meaning deep trenches; signifying deep holes in the rocks for which the district is famous. This district was carved out during 1992 from Koraput district. The history of the district has its foundation with the history of the erstwhile Koraput district, which is reflected in the special Rock Edicts of Ashoka (Census, 2001).

The district is one of the Southern districts of Odisha State located between 19°0 and 19°58 North latitude and 82°5 and 84°2 East longitudes. It is surrounded by Gajapati district in the East, Koraput and Kalahandi district in the West, Kalahndi and Phulbani districts and Koraput as well as Srikakulam (Andhra Pradesh) in the South. As per Census, 2001 the geographical area of the district occupies 8th rank in the State.

The Rayagada district is spread over in an area of 7,073 sq. kms and the administrative headquarters is located at the Rayagada town (Census, 2011). Four Tahsils namely Kashipur, Rayagada, Gunupur and Bissamcuttack including eleven community development blocks were separated from its parent district (Koraput) to form this new district. The district has 2,667 villages constituting of 9, 67, 911 population, out of which the males form 4, 71, 960 and females comprise 4, 95, 951 (Census, 2011).

The district has been the homeland of various tribal communities with their sub-tribes, who are found in different level of development depending upon their assimilation with the so-called mainstream or modern communities. The Kandhas and its sub-section constitute the major proportion of tribal population in the district and the Souras stand second.

The total tribal population of the district is 5, 41, 905, out of which the Kandha population is 3, 85, 437. In other words, the district is predominantly a tribal populated district with 55.76 percent of tribal population. The sex ratio of the district is 1, 048 (females per 1,000 males). Similarly, the literacy rate is 50.88 percent. Out of which, the male literacy rate is 62.61 percent, while the female literacy rate is only 39.87 percent (Census, 2011). The prominent languages of the district are Oriya, Paraja, Kui, Kandha, Savara and Telugu, while, the speakers of tribal languages and Telugu is much higher and the Oriya speakers is comparatively less. The Kandha tribe occupies about 18 per cent of the total population of Odisha. The name “Kandha” has its origin in the root “Ko” or “Ku” which signifies only mountain. The Telugu “Kodu” corresponds to the Sanskrit “Konda” though Konda in Telugu signifies only mountain and not mountaineer.

The Kandhas speak Kuvi, and Kuii, dialect; also most of them understand Oriya. Kandha settlements are in forest and hilly terrains in Western & in Southern part of Odisha covering four major tribal Districts: Phulabani, Rayagada, Kalahandi and Koraput.

The Kandha social organization is based on patrilineal lineages, which are further grouped into exogamous clans with totemic worship. Besides totemic worship, the Kandhas also strongly believe in supernatural beings of lea-pur ti mahapurukas, (gods and goddesses) of heaven, talepuru ti mahapurukas (gods and goddesses) of below the earth. Gods and Goddesses of all kinds are well-wishers of the Kandhas. They have a strong belief in magic, sorcery and witchcraft. They also worship Hindu Gods and Goddesses (Boal, M, 1997). The traditional as well as the present day occupation of the Kandhas is both terrace and shifting cultivation. Women play a major role in agriculture, animal husbandry and other economic activities and reasonably contribute to the family income.

3. Research Methodology

Data for this study data was collected from 18 villages of Podapadi Panchayat in Kashipur Block inhabited by the Kandhas during 2005-2006. Due to time constrain ethnographic details was only obtained from Bandhapadar village. To gather ethnographic details, jani (village headman), disari (priest and astrologer), samata (village secretary) pata pejini (shaman) and other pejinia and also elderly members of the village were contacted. Forty-two (42) healers and 83 patients were enumerated through snowball sampling technique for information and discussion on health care practices and choice of their healthcare. Both participant and non-participant observation methods, and interview techniques using a detailed checklist were adopted to understand the Kandhas perceptions and opinions regarding the concept of health, disease and indigenous healing. Due attention was also paid to confer the diagnosis of the diseases, which includes the techniques for the diagnosis of the disease/illness by the healers and their indigenous knowledge exclusion. RESULTS AND DISCUSSION

4. Kondhas’ Concept of Health

The concept of health and disease among the Kandhas of Odisha, from the insider’s viewpoint revealed some interesting facts that they understand as long as one is able to work appropriate to his/her age, is considered as a “healthy” person. However, they also believe that a person may be physically well, but mentally not sound. The mental well-being is understood in terms of features like following the socially expected behavior and exhibition of the norms of modesty. For example, a man or a woman who prefers to sleep during daytime and work during late evening is not considered as mentally sound. Similarly, one who speaks “continuously”, most irrelevant to the situation is also believed to be mentally unwell. However, the general concept of the Kandhas about “being healthy” is associated with the idea of free from any kind of illness or disease(s). The concept of illness and its causes are elaborately dealt in this context.

5. Indigenous theory of Diseases Etiology and Nosology

The Kandhas are very much particular about their religion. Belief in supernatural being occupies an essential part of their culture. They are in no way exception to it and have installed/established a number of deities like, sunuli penu, jakir penui, lisinimunda, illu penu, nela penu, ladan penka and so on in different part of the village to obtain security from the danger of natural calamities, disease, epidemics, drought and famine. They believe that human life is governed by the natural agencies like, weda (sun), piyu (rain), sagu (sky), gali (wind), bhumi (earth) and numerous supernatural powers living in the nature. Moreover, they take it for granted that human life is insecure and the invisible forces guide the human beings in every walk of their life. It is needless to mention that the discontent of the deities may cause illness/disease among the human beings and domestic animals. Kandhas attribute different causes for illness. They conceive illness as a consequence of misfortune. The main causes of are: 1) due to wrath of benevolent Gods and Goddesses, 2) acts of malevolent Gods and Goddesses, 3) sorcery and witchcraft, 4) ancestral spirits, 5) ghosts, and 6) natural causes of diseases. The process in which a disease is caused, and the nature of the diseases caused due to different agencies, is described below.

i) Diseases Caused due to wrath of Benevolent Gods and Goddesses: The Kandhas classify the Gods and Goddesses into two types: 1) benevolent, and 2) malevolent. The benevolent ones are believed to be the protectors of the Kandhas, wishing their welfare. These supernatural powers may cause illness, when they are disturbed by the deviant behaviour of the members of village community. Such deviant acts may be: incest, torturing domestic animals, not caring the parents at their old age, disrespecting the village priest, or any other form of deviation from the more of the society.

These Gods and Goddesses may cause an illness when the members show disregard them. The disrespect is conceived of such act as not conducting rituals or offering sacrifices in time, stepping deliberately on the stones representing as deities in the village by visiting the premises of the shrines without company of the priest.

An illness is also caused to any member of the village as a punishment for committing a ‘sin’ by way of his/her deviant behaviour such as disrespecting to the supernatural beings and village priest. The punishment is sanctioned to that member for making him/her realize about the mistake, and to assure that in future the will repeat such mistakes again.

The Kandhas have revelead about their several benevolent Gods and Goddesses. The most important among them are: 1) jakiri penu (mother earth), 2) sunuli penu (secretary god), 3) illu peneka (household deities), 4) lisinimunda (village deity), 5) horu penu (forest god), 6) ladan peneka (protector of wild animals), 7) nela penu (god of the agricultural land), and 8) hua penu (water goddess).

It is believed that these supernatural beings are responsible for causing different minor and major illnesses, depending on the nature of sin committed by members of the Kandha community. For minor sin like a petty theft, a minor illness like bandi visa (belly pain) may be caused. For a major sin like incest or disrespecting village priest, a major illness like meha rago (sexual transmitted disease) or krehda rap-kudi (tuberculosis) or kaja rago (leprosy) may be caused. When a person repeatedly commits minor sins, the punishment becomes cumulative; therefore, a major disease is sanctioned to him/ her as a punishment by the supernatural beings. Different types of illnesses caused by various Gods and Goddesses for different types of sins committed is listed in the table no. 1. Table: 1 Diseases given by Gods and Goddesses due to nature of sins committed by the Kandhas

Sl. No Table 1: Illnesses caused by benevolent and malevolent Gods and Goddesses due to different sins committed by the Kandhas 1Name of God and Goddess	Nature of sins for which Illness is Given	Illness Caused (Local Term)	English Equivalent 2	Jakiri penu (earth Goddess)	•	Disrespecting the religious functionaries of the village.

•	Violation of sexual tabooes. •	Not respecting one’s own  Parents’. kaja roga, hirkuli, biyada, buku visa	leprosy, paralysis, belly pain, chest pain 3	Sunuli penu (secretary God)	Not conducting rituals in time (disrespecting the God). nambiri, hupa-kaka	fever, vomiting 4	Nela penu (agricultural diety)	•	Not conducting agriculture rituals. •	Not offering puja during harvesting new grains. bandi visa, anga visa, buku visa	belly pain, body pain, chest pain 5	Haru penu (forest God)	Hunting in the forest without offering a puja to the forest gods/ goddesses. nambiri, tarka visa	fever, head ache

6	Hichu penu (fire God)	Not respecting the fire. For instance, urinating on fire. gari mudka, tati, pada	red urine, jaundice 7	Aa-yabudi (Goddess Takurani)	Forgetting to conduct a ritual in the honour of Goddess thakurani. aa-yabudi	chicken pox 8

Gangi penu (malevolent Goddess)	Gangi penu harms the people who come across this malevolent Goddess during night. Hupa-kaka, bandi visa	vomiting, belly pain 9	Pa-laa penu (malevolent Goddess)	Pa-laa penu harms the people who come across this malevolent Goddess during night. hupa-kaka, bandi visa, bandi	vomiting, belly pain, loose motion 10	Mahani (ancestral spirit)	Forgetting to conduct ritual on time. nambiri	fever 11	Butka (ghosts)	No reason (if anyone comes across the butka) they may cause fever to the people. nambiri	fever

It is also believed that there are separate categories among the Gods and Goddesses living in the heaven. They are referred to as le-a puruthi mahapuruka. The younger ones among the le-a puruthi mahapuruka also cause illness. It is believed among the Kandhas that the younger Gods of the heaven get attracted towards the good-looking girls of the earth and the younger Goddesses get attracted towards the handsome boys of the same. In such situation, these adolescent boys and girlsdevelop some acute illnesses like; severe fever, vomiting, and diarrhea that results in sudden death of such person. In some other instances, death may occur due to falling from a tree, getting drowned in the river or pond, snake bite, becoming prey to wild animals more particularly tiger and bear.

ii) Acts of malevolent Goddesses: People (the respondents) of the study villages listed out two malevolent goddesses. They are gangi penu, and palla-aa penu. These goddesses live on the earth in an invisible manner. They reside in an unhygenic location, where people go for defecation and in the cattle-shed as well as in hollow of trees. They move around the village during nights. Gangi penu moves around the village carrying fire on her head. Both gangi penu and palla-aa penu cause diseases by sucking blood. However, they specially target the children for their tasty blood. During midnight, these supernatural beings hover around the houses. If any member comes across them, then he/she becomes victim of these beings.

It is believed that these spirits bring illness for no reason. They roam around the village, when they are hungry and suck the blood from the people who comes across by them. A member who becomes their prey falls ill due to sucking of blood by these spirits. Palla-aa penu can suck blood from the cattle and cause some illness. There is no definite term for the illness caused by these malevolent beings. A person attacked by gangi- penu suffer from acute chest pain and stomach ache with high fever because she injects fire in the body of the victim. It is believed that if a gunia (magico-religious healer) doesn not tak immediate remedial measure, then the person may bound die soon. The evil design of palla-aa penu on children results in gradual loss of their physical strength, making them weak and pale, and accumulation of water in certain body parts. In such cases too, the service of a gunia is very much required.

iii) Witchcraft and Black Magic: According to Kandhs, illness is attributed to human agents through black magic and witchcraft. Some members of the community learn this knowledge from specialists by paying fees in kind. Generally, men and women, who are isolated from the society for their repeated misbehaviour, learn this knowledge to take revenge on certain members who are held responsible for their seclusion. It is also believed that the children of the pangnia (black magician) or witches acquire this knowledge from them. Later other members of the same village or neighbouring village may also approach them to harm their “enemies”.

There are many beliefs related to the learning of pangnia and witchcraft. It is said that these individuals are trained only at specific places like burial ground and lonely places in the forest at mid night. The learners are supposed to put ashes of the cemetery and remain nude during training.

Pangnia and witches perform the acts of black magic/ witchcraft by various means following the principles of magic as explained by the Frazer. They are: a) once in contact always in contact, b) law of similarity. Thus, the act may be performed collecting some materials like a person’s nail, hair, chips of the twigs used for brushing teeth, faecal matters, soil from the foot prints, pieces of used clothes etc.

Pangnia and witches are believed to cause major diseases that result in death. They cause illness by installing a small mud pot with materials collected for black magic inside the belly of a person, injecting disease causing objects into any part of the body, sucking blood through a thread, while a person is sleeping, effecting kadayan—pangu (drain of blood from the feet) or by injecting bahana (acute fire) in any part of the body. The act of black magic and witchcraft causes bandi visa and buku visa (chest pain). While many of the diseases caused by pangnia and witches are curable, some of them are incurable. The expert sorcerer or witches can inflict kati pangana (incurable diseases) with increasing intensity of pain and sufferings. Also in such cases, the illness brings an early death. iv) Ancestral Spirits: The Kandhs believe that those who have a natural death (death due to some illness) turn into ancestral spirits, after their death ceremony is completed after the 10th day of death. The spirits of these ancestors are believed to visit their respective families during night to take food kept for them. If these spirits are disturbed during their visit, they get annoyed and cause some diseases. Similarly, they may cause an illness if the members of the family forget to keep food and water for them, or when they do not perform the rituals signifying ancestral worship during festivals.

The ancestral spirits cause minor diseases like, headache, fever, diarrhea, vomiting, body pain, belly pain etc. They affect both adults and children. Sudden vomiting by any member along with some “bad smell” from his/her body is considered as a disease caused by the ancestral spirit.

v) Ghosts: From the Kandhs’ point of view, unnatural death of a person caused by an accident like fall from a tree, suicide, murder, attack by wild animals etc turns him/her into a ghost. Similarly, woman who dies during the time of delivery also becomes a female ghost. General reason of this, as explained by the Kandhs, is that any person who dies without fulfillment of his/her wishes becomes a ghost.  According to Kandhs butuka (ghosts) are fond of residing in specific places like burial ground, hollow of the tree, in junction of a road, abandoned house, lonely places in the forest, or places close to ponds etc. The ghosts haunt the place where they had lived and cling to a person who passes by the place quite alone or in night hours.  The dahania (female ghosts) live closer to ponds where the women go to fetch water for drinking or domestic use. They always wander here and there with the intent to cause harm to others for their sadistic pleasure. The chances of attack by dahania are more for the women as they go to ponds for fetching water. Among the ghosts butukas are ‘superior’ and commands the birkas to attack people on behalf of them. As soon as a ghost possesses a man/woman, his/her face undergoes a change and he/she begins to mumbles meaninglessly. His/her eyes widen and he/she develops a large appetite so that he/she alone eats up all the food in the house prepared for all the members. If a person falls unconscious immediately after returns home from outside during night hours, it is deemed that a butuka has possessed him. It is believed that generally butuka bring minor diseases like nambiri, bandi-visa, hupa-kaka, bandi etc. vi) Diseases due to Natural Causes

The following natural causes are attributed for some illnesses by the Kandhas: 1) change of season/weather 2) eating of unsuitable food 3) eating of hard and indigestive food 4) eating of rotten food 5) wounds caused by falls and burns. Generally, the diseases caused due to natural reasons are considered to be of minor ones, often not requiring any specialist for the treatment. Members resort to self-medication using herbal medicines, or by following food restrictions, or by resorting to rest.  On some occasions, they approach herbalist for advice and medicine.

The Kandhas also believe that diseases are caused due to an imbalance of certain elements like, gali, a-yu, sagu, hichhu, and bhumi in the human body. The food and water consumed should help to maintain the balance of these five elements. Similarly, exposure to heat and cold upsets the balance. As the food consumed is an important aspect in the explanation of illness due to natural cause, the classification of food is also regarded another important aspect in this respect.

The Kandhas attribute some diseases due to over-consumption of cold food or working in a cold environment. The cold related diseases occur during rainy and winter seasons, the illness like, diulika (over cold), rapkudi (throat irritation and cough), nambiri and anga visa (body pain) etc. Certain illnesses are caused due to consumption of hot foods like, tati, garimudka (yellow urine), tati nambiri (yellow fever), kuruka (boils) etc. Laymen and Kandhs health specialists have opined that the consumption of hot food also can cause diseases like jaundice and giddiness.

6. Kandh’s beliefs pertaining to the Nature of Diseases

The Kandh laymen and the healers share certain beliefs relating to contagious and non-contagious nature of disease, and also appropriateness and inappropriateness of illness to members of certain age group and sex. Similarly, the perceived severity of illness for members of different age groups also varies. The perceptions relating to the contagious and non-contagious nature of certain major diseases are as follow:

Table: 2 Distribution by Contagious and Non-contagious Diseases

Category	                                   Diseases

Contagious	tati, netru bandi (dysentery), gundi (small pox) krehda rap-kudi, karda (scabies), hadakutni (measles), aayabudi, meha rago, kaja rago, kuli-puyu (patches) Non-contagious	malaria nambiri (malaria), mada gahan, hirkuli, pagala (mental disorder)

The Kandhas believe that certain diseases are contagious and spread from one person to another. Though the exact nature of such diseases is not always known, it is however thought to be due to the close physical contact, use of utensils, or use of clothes used by a sick person suffering from such diseases. Sometimes, even these reasons are held irresponsible for the contagious diseases. For example, one will get krehda rap-kudi or tati, if he or she passes urine at the place where a person suffering from such disease had passed urine earlier. Netru bandi is believed to occur when a person goes to defecation at a place where someone suffering from such illness had defecated earlier. Meha rago is believed to spread through sexual intercourse with a person suffering from such disease. Of all the contagious diseases, tati, gundi, hadakutni, and aayabudi are considered to be highly contagious. While some diseases such as kati (fits), aayabudi are believed to be appropriate for children and others, such as tati, krehda rap-kudi, netru bandi are appropriate for adults and elders. A situation opposed to this is considered inappropriate. Generally, it is believed that there is no disease, which is incurable. But a disease, which is inappropriate for somebody’s age affects a person, then the treatment process become complex and prolong.

8. Indigenous Healers and their methods of Diagnosis of Disease

i) Pata Pejini: Members of Kandh community first approach a pata pejini, a (shaman), available in each village to ascertain the cause of illness. Pata pejini is an old woman of the community and a religious specialist who conducts rituals at the time of festivals. She is gifted with the skill of establishing contact with the supernatural beings and seeks answers to the questions of the members in the community.

When a patient or her family members approach her, the pata pejini establishes contact with supernatural beings, the ancestral spirits, and butu to ascertain directly who among these beings is the cause of illness. She takes a few rice grains in a hechi (winning-fan), offers one grain to each of the beings, ancestral spirits and butu, then puts the same grain into a small earthen pot filled with water. If the grain floats on the water, the illness is attributed to that particular god/goddess, ancestral spirit and butu in whose name that grain is put into the pot. If the disease is attributed to any malevolent goddesses or butu, the pata pejini orders the beings to leave the persons body immediately.

ii) Gunia: The Gunia diagnoses the cause of the illness through different means. First, he applies a simple means such as smelling the body of the patient.  If he feels some specific smell uncommon to the human, then the illness is attributed to a malevolent goddess and butu.  Similarly, he looks at the colour of the palm, the eyes, and the tongue and also examines the patient’s behaviour, if butu or the malevolent goddess is found to be the cause of the illness. If he finds that these tests have not given the required result or when the illness is thought to be due to supernatural beings he will proceed to conduct other tests like, rice test, had-bayin (bone test) and chicken test to detect the cause of the illness.   iii) Herbalists: The herbalists diagnose the exact cause of the disease in terms of some natural agents by physical examination of eyes, skin colour, colour of the tongue and also by examination of urine and sputum. Reading of pulse is also very important. He would also examine the patient’s behaviour; whether he/she is irritable or calm and composed etc. All the herbalists also make a detailed note of the symptoms being experienced by the patients. On the basis of all these examination, the herbalists identify exactly which part of the body is effected and from what reason. However, the intensity of the disease is established by resorting to somewhat magical approach. They would root-out a plant whose material would be used for preparation of medicine for the supposed illness. If it is observed that the root of that plant is healthy and strong, then the intensity of the disease is considered as minimal. Otherwise, the illness is believed to be acute. Based on this test, the herbalists decide doses of medicine as well as the period of the treatment of the patient.

9. Diagnosis of ractures by Bonesetters: The bonesetters resort only to physical examination to know, whether there are multiple fractures or a single fracture or it is just dislocation of the bone.

10. Diagnosis of Poisonous Bites: The specialists of poisonous bites examine the pulse, eyes, and also change of the skin colour in order to determine the severity of the bite. On the basis of the severity, they determine the doses of medicine.

11. Healing Practices and the Role of Healers

In facing any kind of crisis, human characteristically feel compelled to take some kind of action, if for no other reason than to alleviate their anxiety and sense of powerlessness. Healing is the response that humans characteristically adopt in coping with disease. Hahn (1995) states that healing as “not only the remedy or cure of sickness-that is the restoration of a prior healthy state-but also rehabilitation-the compensation for loss of health-the palliation-the mitigation of suffering in the sick”. Even Ackerknecht (1971), who we noted earlier viewed indigenous medicine as “ magical medicine”, recognized the existence of a wide array of “primitive surgical procedures”, including wound treatment, the setting of fractures, bleeding, incision, amputation, cesarean section, and trephination.

Similarly, Reid (1983) explains that all human societies have a pharmacopoeia consisting of a wide variety of materials, including plants, animals (including fish, insects, and reptiles), rocks, and minerals, waters (salt and fresh, surface subterranean), earths and sands, and fossils, as well as manufactured items.

The Kandha community, like other tribal communities have their own therapeutic system to co-up with disease. They have wide range of health providers who cater to the need of health of the community. These providers are known as guruka (healers). They are primarily of two types: 1) Gunia (healers) and 2) Assa Guruka (herbalists). While herbalists provide services for promotion of health, prevention of disease and also for cure of diseases, the Gunia, on the other hand, render services only for prevention and curing of diseases. These Guruka handle simple ailments like cold, the accidents requiring minor and major treatments for snakebites, multiple fractures etc, and for many individual organ-related conditions and specific diseases. They claim to have a holistic understanding of disease, wide variety of diagnostic techniques and disease management etc.

The Gunia claim that they are generalists in the sense that they have ability to diagnose and treat all types of illnesses, but among the herbalists, however, there is a claim of specialization by some to diagnose and treat some specific illness only. The various types of specialists identified among the herbalists in the field area are as follows:

i) Bonesetters: These are the ones who treat both simple and multiple bone fractures. They treat the bone fractures of both domestic animals as well as the humans.

ii) Specialists of poisonous bites (Visa assa guruka): These members treat bites of snakes, insects, and animals like dog, rat, rabbit etc. iii) Specialists of specific diseases: A number of healers claim specialist status, as they are expert to diagnose and treat only some specific disease or organ related illness. Thus, in the study area, specialists for kati, kanu puyu (cataract), palka visa (dental problems), kaja rago, hirkuli, gati biyada (joint pains), krehda rap-kudi, tati, pagala and mada gahan are listed.

iv) Specialists of child diseases: The diseases specifically identified with children like pulini pangu (swelling of navel), bandi (diarrhea), hadakutni, anasi (rashes on the body), altigahan (skin disease) are treated by some, and they too claim specialist status for their specialization in this regard.

v) Specialists for infertility, abortions, sterilization and increasing sex drive: Some herbalists claim special knowledge of fertility related health issues commonly noticed in both men and women. They also deal with complicated deliveries and claim knowledge of identification of sex of the fetus in the womb.

12. Approach to Indigenous Healing

i) Pata Pejini: After ascertaining the cause for which supernatural being is angry with the patient, the pata pejini suggests an appropriate ritual and sacrifice to be made to gratify the annoyed being. The intensity of the disease is believed to be related to the intensity of anger of the being, according to which she suggests to conduct different kinds of sacrifices and thereby cures the disease. In case of high intensity of anger that causes severe and chronic diseases, she recommends a sacrifice of big animals like, a goat, a sheep, or a pig. Similarly, in case of the low intensity anger that causes normal diseases, the pejini suggests normal sacrifices such as a black hen, a mouse, or a fish along with seven different coloured flowers. The patient’s family members assure sacrifices within a given time. Then she gives some medicine prepared from plants representing mahani (ancestral spirit) and peneka (supernatural spirits) for external application. This medicine is expected to relief aggravation of the disease before the prescribed sacrifice is made.

When illness is identified due to butu, the pejini orders that butu to leave immediately from the patient’s body. If the butu is reluctant and does not obey her order, then she drives away the butu by some means like beating the patient with broomstick, throwing mustard seeds over the body, or making smoke by burning rubber. If the pejini fails to identify any supernatural reasons for the illness, but presumes that it could be due to some ancestral spirits, then she will refer the patient to a gunia. If the pejini is sure that no supernatural agent or ancestral spirit is angry or that the illness is not because of butu, or malevolent gods, she will refer the patient to an herbalist for better treatment.

ii) Gunia: After identifying the cause through one or all means the gunia prescribes the rituals and offerings to be made. If the illness is attributed to benevolent gods and goddesses, no animal sacrifices are prescribed, however if illness is caused by  ancestral spirits, malevolent gods and goddesses, human agents then a sacrifice of black chicken or pigeon is offered along with ritual consisting of seven different coloured flowers and other usual ritual materials. If the cause of illness is believed due to the butu, he drives away by adopting similar means, which the peiini does. If such means do not show any expected result to drive away, then he makes an image of the butu with mud and shoot an arrow on the chest of the image and cause a serious injury, so that it goes away from the patient’s body. If the illness is attributed to palla-a penu and gangi penu (malevolent goddesses) a more elaborate ritual is prescribed. In such case, the healer takes patient to a bank of a stream and he catches the malevolent goddess with his magical power. The healer seals her in a small earthen pot and then buries in the ground or immerses it in the stream. If magic/sorcery or a supernatural being is not held responsible for the illness, he will refer the patient to the herbalists.

iii) Treatment by herbalists: The herbalists prepare a variety of medicines using plants, animal products, insects, reptiles and birds. These products are distributed in different forms like syrups, tablets, and pastes for internal consumption and also in other forms such as oil, ointments, saps, ashes and powders for external application. Massage as well as minor surgery is also important methods of their treatment. Medicines prepared from different parts of plants like roots, bark, leaves, flowers, seeds, fruits, and latex have predominant role in their treatment. The plants and animal products used for the treatment of some common and important illness are presented below. Table: 3 The use of plant and animal products for the treatment

Diseases in local term	 English Equivalent	Use of medicinal plants	Treatment procedure Bandi	Diarrhea	Jambu (guava)	Seven guava leaves with honey and ginger Hupa- kaka	Vomiting	Tadi kuna (root of plantain)	Mixture of banana root with honey Tati 	Jaundice Manjuati Mixture of Manjuati root and rice water

Bandi- visa	Belly Pain	Patal garuda	Root of Patal garuda and Mahua liquor Karada	Scabies	Arakha	Milk of Arakha leaves/ sap of neem leaves Kuliipuyu	Skin rash	Mahani punga, garlic The mixture of Mahani punga leaves, garlic and Mahua liquor Tarka visa Headache	Gali marmu Tender leaves of (gali marmu) eucalyptus

Nambiri Fever Tulsi The mixture of Tulsi leaves and honey

Pita Bile Hemakara Ten leaves of Hemakakara and 30 black peppers

Palka- visa Toothache Haru-penjan(mountain brinjal)	Seeds of mountain brinjal

Barsiak Pimples Chandana/Talamuli Paste of sandal wood and root of Talamuli

Rati kanaka Night blindness Banana A glow warm with a banana

Rachu-pednu --	Taya (fig) Milk of fig leaves

Mut-esika Wart Taya (fig)	Milk of fig leaves Padan-tali	Easy delivery	Dindini mada	Dindini creeps with hot water

The use of non-plant materials for the preparation of medicines is as follow: Burns: The oil extracted from the fat of a hen or a cock. Falling of hair/baldness: Oil extracted from the fat of a pig. Paralysis: Oil extracted from the fat of a snake; oil extracted from fat of a tiger. Night blindness: julu jula pid – lue (glow worm) with a banana.

Products of animals, insects, and birds used in different medicinal preparations include: eye of an owl, nail of a jackal/fox, teeth, flesh, milk, and mustache and bones of a tiger, and canines of a wild boar. Even human blood and urine are also used for the preparation of different medicines. In the case of fits, the blood (2-3 drops) of the patient is mixed with medicine prepared from plant a material is given. In the case of snakebite, urine of the child below 12 years is given along with the latex of the arakha plant. Ash prepared from the burning of cloth is used to stop bleeding at the time of injuries. Ash prepared from burning of the dry leaves of plantain along with the juice of plantain leaves are applied to kill the peneka (louse) in hair. The surgery includes the puncturing of the wounds to drain the pus, remove portions of flesh and skin due to wounds, corns etc. Simple instruments like hin-pa (knife) and suja (needle) are used. The hair of the animals or the humans is also used for cutting of warts. Massage is an important aspect of treatment in the case of many illnesses. There are some healers who claim special skill and knowledge with regard to massage. Various types of oil are used for different types of massage and for different complaints. Bone setting is carried out by skilful resetting and by massaging the area with marrow extracted from beef bones. The fractured portion is bandaged placing heated tobacco leaves on it and then using bamboo slants and thread to restrict the movement of the affected part. To quicken the healing, the bonesetters also apply drops of sap, a specific medicinal plant. These drops are put in the ear opposite to the fractured side of the patient’s body. Bandaging for cuts, boils and wounds to stop bleeding is practiced using the gum prepared from the roots of talmuli and a piece of clean cloth.

13. Period of Treatment

The period of treatment in case of the Gunia is only one day. They, after detecting the cause of illness, prescribe a ritual and a sacrifice, which are generally conducted in consultation with the Disari. In case of the herbalists, the treatment may last only for one day as in the case of fits or poisonous bites. In case of other illnesses, the herbalists normally give medicine for three days. If there is no relief from pains and sufferings inflicted by the disease or illness, medicine for another three days is given. There may be an extension for another three days, if sufferings still persist. In any case, the health provider does not give treatment beyond nine days.

When the herbalist fails to diagnose the disease, he refers the patient to the Gunia or Pegini, who is more experienced than him, to detect the cause of illness once again. The Gunia or the Pegini, here, confirms once again that the disease is not caused by butu or confirms that the supernatural beings are satisfied with the sacrifice and conduct of ritual as assured by the patient. Therefore, according to the advice of the Pegini or the Gunia, the members approach another/same herbalist for continuation of the treatment.

14. Preventive care by the Indigenous healers

As mentioned earlier, the Kandha health care providers also provide preventive services of health care. The preventive care is sought from both Gunia as well as Guruka. The illness for which the services are sought is described below. i) Gunia: The Gunia claim the knowledge of prevention of illness caused by all three agents, namely, supernatural, human, and natural agents. They conduct rituals and offer sacrifices on behalf of their clients, and either they give a medicine for consumption, or tie a sacred thread along with some medicine. Generally, for the protection against the illness caused by sorcery/witches, the clients are given medicine for consumption. For other diseases, amulets are prescribed. Amulet is an object worn or carried on the person, or preserved in some other way, for magico-religious reasons, that is, to cure disease, provide luck, or protect the possessor from specified danger or misfortune.

i) Herbalists: Herbalists also provide preventive care for specific disease or diseases caused due to general reasons like weakness. The herbal medicines prescribed in this regard are described below.

Table: 4 The use of plant materials for some diseases

Disease in Local term	English Equivalent	Plant materials used for the diseases Durbala	Weakness	Kuguri kuna with milk (medicinal tuber) Raska visa	Snakebite	Root of patal garuda Aya- budi	Chicken pox	Kajakambli ganchan (medicinal leaves) Bandi- visa	Belly pain	Dindini mada (one types of medicinal creep) Karda/kulipuyu/ tadu	Scabies/white -patches/eczema 	Kopa hiru (root of the cotton)

Kanaka visa	Eyes disease	Human urine with medicine Palaka visa	Toothache 	Horu penjan –mountain brinjal

'''15. Indigenous Knowledge Exclusion ''' The indigenous knowledge of the tribal communities in general and more particularly of the Kandhas is excluded by the larger community, i.e by the modern world as their knowledge is treated as superstitions and blind belief. However, the simpler communities have been depending on their old age practice through generation. Besides their indigenous medicine, they are also well adopted to the so-called Western medicine for their day to day health needs. The Kandhas also have in-depth knowledge on various aspects of the health and health seeking behavior and treatment practices. They treat many specific disease and injuries like, cataract, bone fracture, poison bites, snake and insect bites, fits, paralysis, leprosy and mother and child health. However, such knowledge of them is not widely accepted and it is not brought to the main of the stream society. Their old age practices, which is culturally patterned and proved through the history is directly or indirectly ignored by the modern world.

16. Conclusion

From the forgoing discussion it can be assumed that Kandhas have knowledge about the therapeutic properties of plants. It is also evident that over the generations the herbal medicinal plants that are available in their own surroundings have been integrated with the Kandhas culture and their belief systems. The Kandha have evolved some kind of therapeutic value system within their socio-cultural milieu to co-up with the diseases. Most of the diseases are believed to be caused by the supernatural agents. The acts of sorcerer and witches, ghosts, ancestral spirits, malevolent gods and goddesses are always held responsible for different type’s diseases/illness. The healing occupies a significant role in their indigenous methods of treatment. On a whole, this method of healing/treatment helps the people to get relieved of their physical and mental disorders, to maintain their interaction with the supernatural beings, which on the other hand also help the social system to maintain the mechanism of social control. Acknowledgement: I sincerely thank Dr. B.V Sharma and Dr. K. Laxmi Narayan for their valuable suggestions and guidance to shape this article. I also thank Panigrahi madam for her inestimable help in this regard.

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