Master Ho Thanh Tam
Faculty of History, USSH, Vietnam National University, Hanoi (VNUH)
(Presented at the Conference of “Population, Health, and Medicine in Developing Countries: The Examples of Vietnam since the 18th Century” on Oct 31th-Nov 1st 2013)
Central Highlands is an age-old residence of minority groups, who were called as “Moi”, “Man” by Vietnamese feudal dynasties. This is a high mountainous area, covered by the South Truong Son Range, extending from the border of Quang Nam-Da Nang to the Southeast Vietnam. With an average altitude of 500-1.000ms, the Highlands is characterized by humid tropical climate: divided into two seasons: rainy season (May to October) and dry season (November to April next year). Humid climatic conditions, long rainy season and the jungle environment make the Highlands to become the “navel” of tropical diseases in Vietnam, especially malaria, leprosy, dengue fever, smallpox… Reports point out, even to the last decade of the 20th century, Vietnam has recorded 2 million malaria cases with 4,646 deaths. Most of deaths (50%) due to malaria occur in the Central Highlands. This contributes to explain why for a long time, the Central Highlands region is still considered as a “sacred forests, water poison” in people’s mind.
Besides the typical disease of the humid tropics, poverty, low hygiene conditions and simple concept of people to ensure daily nutritional requirements, diseases such as leprosy, goiter, malnutrition, and diarrhea… are also popular. One custom of Highlanders is usually built villages near water sources (groundwater, rivers, streams and lakes). Natural water, which often contains impurities and harmful microorganisms, is used directly without filter, causing intestinal diseases arise. Lack of iodine causes goiter, cretinism, miscarriages, premature or stillborn fetus…. Not eating enough essential nutrition makes many children get malnutrition… However, the basic medical knowledge above were too strange to the Highlanders at late 19th century.
We believe that human’s behaviors to the Nature depend on their level of development, cognitive abilities about the Nature. The reactions of Highlanders before natural phenomena such as disease reveal the development of their society.
There seems to be a fault somewhere in the process of historical movement of the Highlands region. The area had witnessed strong growth of the archaeological cultures as Lung Leng Culture (Kon Tum), Bien Ho Culture (Gia Lai), Buon Triet Culture (Dak Lak) from the Paleolithic Age, which clearly linked to the ancient residents of the South East Vietnam, the Champa and Indochina region. However, for unknown reasons, residents here were not able to promote their cultural values to the next higher level. It seems that till the end of Neolithic age, the Central Highlands had lost its momentum and just described, by its coastal neighbor, as secondary characters. Since then until the mid-20th century, Highland’s societies still remained at a very low step on the general evolution of humanity. Influences of French onto Highland started since the second half of the 19th century and gradually made the rich-poor division, but not forming classes. That level of socio-economic situation regulated how people recognize and deal with the Nature as a reversed worldview, in which the Natural /disease are elevated as supernatural forces that have power to dispose human/community’s destiny.
The concept of the Highlanders about disease is closely related to their beliefs. Like any communities that had undergone pre-class society, traditional belief of the Highlanders is Polytheism. Polytheism presences so deeply in the life of the Highlanders up to the level of “whole of their life, both physical and mental, are molded in a custom, which beliefs permeate from head to toe”. They believe the world order is arranged by God (Yang) and human’s task is only complying with that order through generations, the next footprint overlaps the previous one. If there is a disturbance (represented by phenomena such as natural disasters, epidemics…), it means that people have angered Yang, and for them it is a terrible disaster. The only person who can open the door to contact/transmit the Yang’s will is bojau (or njau, pojau, mjao: general terms refer to sorcerers) through his/her mysterious magical practices.
Disease, according to the Highlanders, is not the consequence of non-compliance with the medical rules as our knowledge. That is an expression of the Yang’s will. “The chaos of disease’s situations, according to the Highlanders’ logic, are consequences of disturbances in the common laws that declared by Yang. A disturbance in the nature’s orders will certainly lead to a confusion in people’s lives, especially when human is the cause of that disorder”. Different ethnic groups almost uniformly in explaining the cause of a disease: an unlucky guy has (accidentally) provoked an evil spirit (porang for the Bahnar, mtao for the Ede, Ae Mdao or caak for the Mnong, caa for the Sre…) and this demon makes its revenge. The revenge action is done by shooting an invisible arrow containing pathogens (deng) and its victim cannot be avoided. Anne De Hautecloque-Howe said that some Ede nurses had worked in the French hospitals, equipped with minimal medical knowledge to understand the origin of diseases is caused by bacteria, but for them, bacteria come from the poisoned arrows of the evil one.
Kidnapping human’s soul is also other retaliation of Yang and caused disease to its victim. Human has souls (pohngol) and they exist inside the body. A person has some souls and at night, when the body going to sleep, souls escape out in the form of animals (spider, cricket, grasshopper…). Souls can go anywhere, even to the world of Yang and return to its body at day. If a soul unfortunately is imprisoned by a caak, its master will get sick. This interpretation is also popular in the South Central Highlands ethnic and Laos’s tribes. Belief so has its roots deeply in the worldview of the Highlanders. Small and weak, they find peace of individual/ family/community in the will of Yang. To understand the Yang’s will, they have to ask for help from special person, who called as bojau.
The Highlanders believe that bojau has special power which comes from Yang. This power could be revealed in young age but he/she can act as an official bojau after the recognition of community. Typically, people only ask for help from bojau when they have no cures anymore (diseases, bad death, childbirth, serious illness…). They’re obsessed with diseases that their primitive cognitive does not allow them to understand. So they elevate diseases as gods, such as God of smallpox (Yang Cu), God of measles (Yang pohroi), God of chickenpox (Yang cu hono), and God of buffalo’s disease (Yang kapo romo)… The magical healing of the Highlanders always includes two works: praying (mho’) and sacrifice. In a sacrifice ceremony, the soul of sacrificed animals will go to the world of Yang and bring with it the pleas of people. The more serious diseases are, the more copious sacrifices need. There can be no praying without sacrifice and vice versa. And for the Highlanders, that is enough.
Obviously, this medical method has its effect morally only, but people would rather not take medicine than do not praying Yang. This contributes significantly to explain why the health status of the Highlanders was very low. However, the power of bojau was never suspected. Through generations, people absorb correctly the ancient lifestyle. That mind/faith/magic exists immutable throughout thousand years and the change only comes from the outside that environment: the Westerner and their religion.
By the late 19th century, the Westerners have been in Vietnam for 3 centuries, mainly Christian pioneers. As the representative of a new civilization, the West civilization, they have been contributed to develop the local culture. In 1851, the first French priest came to the Central Highlands, and set an important milestone in the historical process of this area. They found this place as a relatively safe area and a big crowd of potential devotees. However, firstly, the French priests had to win the trust of local people, pull them out of traditional Yang belief and its speakers: the bojau.
The response of bojau before the Catholic missionaries had different types. Some bojau agreed to give up magic and believe in God, but in contrast, some of them tried to harm the French. In this conflict, the French priests, were equipped with modern medical knowledge, had easily broken the tricks of bojau and thereby asserted their credibility before ethnic communities.
1. Because of the tropical climate, the Central Highlands has become the “navel” of tropical diseases in Vietnam. On the other hand, due to the low awareness of native people in defending themselves before the attacks of diseases, their life sank into multi-aspect difficulties. Illness and death are always impending threats over any tribes. Powerless before natural disasters which their primitive socio-economic development does not allow them to understand, the Highlanders rotate to find the cures into Yang.
2. Medical treatment methods of the Highlanders tie closely to their traditional polytheism. Illness strikes any people/community because that they have violated the Yang’s orders. A treatment usually includes a praying and a sacrifice. Those are all the necessary procedures to do. Religion/magic has infiltrated into every corner of the thinking of the Highlanders. The bojau, with his essential role, is respected in communities.
3. Since the mid-19th century, the Western missionaries had penetrated onto the Central Highlands. They came with a new civilization, higher than the level of the Highlanders’. And their religion, the Catholicism, is a monotheistic global religion. In order to spread Catholicism, priests had to defeat bojau’s power and they done it successful. Along with other elements of the Western civilization were introduced to the Highlanders from the late 19th century-early 20th century, the French missionaries also brought new knowledge, new methods of medical treatment for people and contribute to change the local people’s think about diseases. However, due to the difficult conditions at that time, lacking of infrastructure and the Yang belief was deeply rooted in the mind of the Highlanders for thousands years, the new things were far from real effective.
 Nguyen Van Chien (1985), Tay Nguyen dieu kien tu nhien va tai nguyen thien nhien, KHKT Publisher, Hanoi, pp.113-119.
 The causative agent of malaria in Vietnam is mainly Anopheles maculatus, Anopheles aconitus that their larvae often live in swamps, ditch waters. A survey on the health of the Highlanders in the 1960s, which refers to the popular tropical diseases in this area, see American University (1966), Minority Groups in the Republic of Vietnam, Department of the U. S. Army Pamphlet, No.550-105.
 WHO (2005), World Malaria Report 2005, p.205. For more information on malaria at Vietnam see Du thao chien luoc quoc gia phong chong va loai tru benh sot ret giai doan 2011-2020 va dinh huong den nam 2030 at http://www.chinhphu.vn/portal/page/portal/chinhphu/congdan/DuThaoVanBan?_piref135_27935_135_27927_27927.mode=detail&_piref135_27935_135_27927_27927.id=538
 http://www.wpro.who.int/vietnam/topics/malaria/factsheet/vi/index.html First 9 months of 1992, the number of deaths because of malaria in the Central Highlands was 507 cases, accounting for 50.2% cases in Vietnam this year. The number of malaria cases was 92,398 people, accounting for 20% of the total malaria cases in the country. With a population of fewer than 3 million people, the number of malaria cases and deaths due to malaria of the Central Highlands were so high. See Chi thi so 12-TTg ngay 17-10-1992 cua Thu tuong Chinh phu ve cong tac phong chong sot ret o Tay Nguyen at http://thuvienphapluat.vn/archive/Chi-thi/Chi-thi-12-TTg-cong-tac-phong-chong-sot-ret-Tay-Nguyen-vb38378t1.aspx
 Therefore, the Highlanders often use name of rivers, streams or lakes to set their village’s names, such as Dak, Ia, Ea… View a survey of place-names, village-names in Gialai Province in Nguyen Thi Kim Van (2010), Dia danh va di tich Gia Lai tu goc nhin lich su-van hoa, KHXH Publishing House, Hanoi. So, one of the most important festivals of the minorities in the Central Highlands is the “worshiping water post” ceremony, and Water’s Spirit is called Yang Dak (Bahnar, Jorai) or Yang Ea (Ede) …
 Till 2005, 48% Highlanders population have not fresh water for usage. See Chuong trinh muc tieu quoc gia nuoc sach va ve sinh moi truong nong thon: ket qua thuc hien giai doan 2006-2010 va dinh huong 2011-2015 at http://xttm.agroviet.gov.vn/XTTMSites/vi-VN/76/tapchi/141/144/2641/Default.aspx
 http://www.ykhoa.net/duoc/sachdinhduong/chuong08.htm Early 1990s, 29% of the Highlands population are goiter. The authors of Minority Groups in the Republic of Vietnam pointed out, in the 1960s, the Bahnar average life expectancy was only 37 years-old, the Bru’s children mortality up to 7/10; 25% of Koho’s babies death in the first year… Other examples see American University, ibid, pp.12, 62, 397.
 After 4 years of implementation of the National Action Plan on Nutrition (1995-1999), 49.1% of Highland’s children are still malnourished. http://maxreading.com/sach-hay/dinh-duong-cho-moi-nguoi/thuc-trang-tinh-hinh-dinh-duong-4077.html
 Nguyen Khac Su (2007), Khao co hoc tien su Tay Nguyen, Giao duc Publishing House, Hanoi, pp.243-248.
 Jacques Dournes (Dam Bo) calls this is the “transfixed standing situation” in the process of historical-cultural development of the Highland’s societies. See Dam Bo (2003), Mien dat huyen ao, Hoinhavan Pubilishing House, Hanoi, p.4 (PDF version).
 The French priests came to Kon Tum in 1851. Since then, they’ve used Kon Tum as a center to spread Christianity throughout the Central Highlands, even to Laos. See P. Dourisboure (1972), Dan lang ho, Saigon and https://cehitam.wordpress.com/2013/04/15/vai-tro-cua-cac-giao-si-trong-cong-cuoc-phat-kien-mien-kon-tum/
 Vietnam’s Committee of Social Science (1989), Tay Nguyen tren duong phat trien, Khoa hoc xa hoi Publishing House, Hanoi, pp.77-79.
 Dam Bo, Ibid, p.175.
 Dam Bo, Ibid, pp.169, 175, 177.
 American University (1966), Minority Groups in the Republic of Vietnam, p.63.
 Dam Bo, Ibid, p.86.
 See P. Dourisboure, Ibid, p.121; Anne De Hautecloque-Howe (2004), Nguoi Ede – Mot xa hoi mau quyen, Van hoa dan toc Publishing House, Hanoi, p.115; G. Condominas (2003), Chung toi an Rung Da-Than Goo, Thegioi Publishsing House, Vietnam Museum of Ethnology Publisher, Hanoi, p.77.
 Anne De Hautecloque-Howe, Ibid, p.120.
 Therefore, the Bahnar does not kill these insects at night for fear that they can kill their relative’s soul. See Nguyen Kinh Chi, Nguyen Dong Chi (2011), Nguoi Bana o Kon Tum, Tri thuc Publishing House, Hanoi, pp.166-167.
 Le Thi Ngoc Ai, Mot so net ve xa hoi nguoi Bana in Historical Studies, vol. 122, May 1969, p.59.
 Dam Bo, Ibid, p.219; Anne De Hautecloque-Howe, Ibid, p.111. It is divided bojau into some different types, such as the Reungao has 3 types of bojau: Bujau putuh kotap ir (Bojau broken eggs), Bojau Huda (Bojau measure), Bujau chol (Bojau transmits Yang’s will). See Dam Bo, Ibid, p.227. The Bahnar also has 3 bojau-types (Nguyen Kinh Chi, Nguyen Dong Chi, Ibid, pp.180-181).
 Nguyen Kinh Chi, Nguyen Dong Chi, Ibid, p.183.
 Dam Bo, Ibid, p.86.
 P. Dourisboure, Ibid, pp.120-122.