Title Page
 Luvale natality in earlier...
 Natality in Chavuma, 1971-72
 Postulated causes of low natal...
 Luvale theraputic style and medical...
 The ritual content of curing
 The life cycle of women: Reproduction...
 Conception through partuition
 Contraception and abortion
 Venereal disease
 Child mortality and its ritual...

Title: Indigenous therapeutic style and its consequences for natality
Full Citation
Permanent Link: http://ufdc.ufl.edu/UF00087464/00001
 Material Information
Title: Indigenous therapeutic style and its consequences for natality
Physical Description: Book
Language: English
Creator: Spring, Anita
Publisher: Spring, Anita
Publication Date: 1975
Subject: Africa   ( lcsh )
Spatial Coverage: Africa -- Zambia
 Record Information
Bibliographic ID: UF00087464
Volume ID: VID00001
Source Institution: University of Florida
Holding Location: African Studies Collections in the Department of Special and Area Studies Collections, George A. Smathers Libraries
Rights Management: All rights reserved by the source institution and holding location.

Table of Contents
    Title Page
        Title Page
        Page 1
        Page 2
    Luvale natality in earlier studies
        Page 3
        Page 4
        Page 5
    Natality in Chavuma, 1971-72
        Page 6
        Page 7
        Page 8
        Page 9
        Page 10
        Page 11
    Postulated causes of low natality
        Page 12
    Luvale theraputic style and medical concequences
        Page 13
        Page 14
        Page 15
        Page 16
        Page 17
    The ritual content of curing
        Page 18
        Page 19
        Page 20
        Page 21
        Page 22
        Page 23
    The life cycle of women: Reproduction and ritual
        Page 24
        Page 25
        Page 26
    Conception through partuition
        Page 27
        Page 28
        Page 29
        Page 30
        Page 31
    Contraception and abortion
        Page 32
        Page 33
    Venereal disease
        Page 34
    Child mortality and its rituals
        Page 35
        Page 36
        Page 37
        Page 38
        Page 39
        Page 40
        Page 41
        Page 42
        Page 43
Full Text
'` Jk




Prepared for: Culture, Natality, and F?-.i1v
Plannnina, John Marshall and Steven poiqar eds.

''r f


Prevailing views of indigenous medicinal therapies stress that,

whatever the techniques, curing is generally beneficial to the

individual and group by providing catharsis,scrutinizing social

tensions,and manifesting social solidarity. The beneficent

magical techniques do not harm the individual,although his condi-

tion may deteriorate naturally.

I suggest that therapies (medicines,midwifery,rituals) are not only

socially supportive but also may be physically detrimental to the

individual and contribute to low natality. Among the Luvale there

are definite positive social benefits (e.g.,social supportiveness,

lineal continuity,tension-reduction) which undoubtedly keep the

system going. In terms of reproduction,however,the indigenous

medicinal therapies may inadvertantly (1) cause sepsis resulting

in infertility and (2) increase stillbirths and neo-natal deaths

because of faulty midwifery, thereby lowering natality.

The Luvale are a low natality population in Zambia. Before com-

mencing field research I was cognizant of the low natality from

reports on the region, and I questioned whether social practices

influenced natality. Could anthropological research provide infor-

mation on this problem? Existing literature (White 1949,1953,1959,

1961,1962; White,Chinjavata and Mukwato 1958; and Turner 1967,1968,

1969) and my recent field work (1971-72) show numerous rituals con-

cerned with reproduction and child rearing as well as a developed

"ethno-gynaecology". This report,therefore,focuses on the inter-


relationships between medicinal/ritual 'participation and natality

(i.e.,achieved and volitional control of reproduction).

According to Romani:t the normal fertility standard for Africa

is a birth rate of 50-60 per 1,000 and a "natural sterility"

of -- about 5 per cent among women of

completed natality. The Luvale population shows a birth rate of

38 and childlessness of about 30 per cent in the present study.

Ohadike (1969:41), who analyzed the 1963 Zambian Census, states

that the national fertility ratio of 7ambia is 759. .This is

closer to the fertility of developing nations (e.g., Puerto Rico -

725 in 1940; India 775 in 1930) than to the fertility of

developed nations (e.g., France 319 in 1936; U.S.A. 417

in 1950). The lowest fertility area in Zambia was Northwestern

Province 'with 563 in 1963. TheChavuma Luvale figure is.536

for 1972, and earlier writers (Tables 1 and 2) show figures

.or the Luvale that are comparable to developed countries

(e.g., Kabompo and Balovale 217 and 304 in 1954; Kabompo -

269 in 1958).

The Luvale are a matrilineal people practicing virilocal residence

at marriage. They are hoe cultivators (settled in the location

studied here) with a predominately manioc diet. They have a rela-

tively low male out-migration' for ZamAbia.with an adult sex ratio
presented here
of 70 males per 100 females. The research was conducted

in Chavuma, Zambezi District, Northwest Province. Kabompo,

another Luvale area referred to in the text, is adjacent to

Zambezi in the same province.


Low fertility among the Luvale and neighboring peoples (the Luchazi

and Chokwe) has been noted since the beginning of this century.

A 1904 census and an explorer (Springer 1909) both noted the

small number of children in the villages. Hudson, a district

officer, postulated promiscuity and extensive use of abortifacients

as the causal factors. He believed that "children are not wanted

because men have no further use for a pregnant woman" (1935:243).

The first reliable comparative survey was carried out in the early

1950s by Hitchell (1965) on an urban sample which contained people
from all the major/Rhodesian (Zambian) groups. He was struck by.

the significantly differential fertility of tribal groups.

Checking into regional variation in disease and diet, he'found

that venereal disease, malaria, and cassava could not account for

the variations observed, since these factors were .apparent both

in areas of high and low fertility. The three most significant

variables were, respectively: tribal membership, religion

(Christianity), and the degree of commitment to urban life.

The most significant by far was tribal membership. In his rankings,

the Lwena group (Luvale, Luchazi, and Chokwe) ranked the lowest

with "Very low fertility". Below in Table 1 are some of his

figures, including all those f.or Northwestern Province. He also
showed that the Luvale group A the fewest births per year per

adult woman and the highest rate of childlessness 47.8 per cent

of women over 30 were childless. Mitchell concluded that the

differences were neither modern phenomena nor easy to explain.

(From Mlitchell 1965; 9-11)
Province Placee jor Tribe C/W Ratio Catecrorv

N. Province Luwingu Mambwe 1043 High
N. Province Chinsali Bemba 962 High
N. Province Kasam;a Bemba 887 High
N.W, Province Solwezi Lamba 683 Moderate
Central Lusaka Nyanja 639 Moderate
Barotse Barotse Lozi 545 Moderate
N. W. Province Mwinilunaa Ndembu 478 Low
N.W. Province Balovale Luvale 304 Very Low
N.W. Province Kabomoo Luvale 217 Very Low

In reference to the Luvale, Mitchell cited communications from

Graves and Gilges, two medical officers who had worked in the

rural tribal area (Balovale District). Graves said that most of

the barren women he examined had various forms of pelvic sepsis

and salpingitis, resulting in infertility. In his opinion

these infections were caused by a number of practices such as

childhood intercourse, early marriage resulting in difficult

.labor and consequent vaginal manipulation by village midwives,

frequent abortions, herbal remedies, and gonorrhea (personal

communication quoted in Mitchell, 1965:23).

Gilges- said he could not clinically or serologically diagnose

gonorrhea or syphilis in many cases. Although he listed irritating

and toxic herbs that were used intravaginally, he could not detect

the after-effects with the inadequate laboratory facilities at


his disposal in the district. Gilges became convinced that a

genetic factor was responsible (personal communication quoted

in Mitchell, 1965:23).

A demographic study in a predominantly Luvale area (Kabompo) was

carried out by '. white later in the 1950s (see Table 2); this was

the area of lowest fertility in Mitchell's study. White argued

that "the basic structure of the low birth rate appears to be low

fertility with a high proportion of women who are infertile,

*and a declining fertility among those who are fertile" (White,

1959:55). (Using his figures I calculated the rate of childlessness
tended -to
to be 33.8 per cent.) He suggested that womenwait until they

are in stable unions before producing, and he posited extensive

use of contraceptives and abortifacients.

The general fertility statistics for Zambia in the 1960s provide

a mnoe current perspective for the1971-72 Chavuma data (see Table

2). The two Zambian national censuses of 1963 (Ohadike 1969)

and 1969 (unofficial census figures) show Northwestern Province

having the lowest natality of any province, and Zambezi District

being lower than the provincial mean. Two trends are clear

from these censuses and the earlier studies: (1)-the fertility

of Zambia and its Northwestern Province is increasing, and

(2) even though there is a'general increase, the fertility in

Northwestern Province started out lower and has remained lower

than the national mean.


The conclusions reached in this paper are mainly based on some

measures of natality in Chavuma area of Zambezi District (formerly

Balovale District). Statistics are based on a-sample census (N=1860) of

approximately 15 per cent of the total Chavuma population of

12,325 (1969 national census). A section of this sample, the
805 people grouped under one .political headman",

was more intensively

surveyed. Eost of my interviewing was conducted within this

section, and the section was resurveyed after one year to estimate

annual rates. The child/woman fertility ratios, crude birth

rate, percentage of village versus hospital deliveries, and

monogamy/polygyny ratio were all computed from this section.

Fertility and ritual profile histories were collected for two

samples of women: (1) Village Women, i.e., those women who had

delivered their last (and generally all) babies in the villages,

assisted by indigenous midwives; and.(2) Hospital Women, i.e.,

those women who delivered babies at the nearby mission hospital

during the research period, although any of their previous

babies may have been born in the villages or hospital. Investi-

gations of indigenous medicinal practices and rituals were made

by participant observation and in-depth interviewing over an eighteen
month period.

The Chavuma child/woman fertility ratio was higher than that

of the district and provincial mean (Table 2). This is undoubtedly

a reflection of the easy access to medical facilities enjoyed by

Chavuma w.omon since 50.5 per cent of the babies born in 1971

in Chavumia were delivered in the mission hospital. The child/woman

fertility ratio calculated for only Village Women was below the

district ratio and may, with reservations, be used to estimate

current fertility ratios obtaining in other Luvale areas where

hospital facilities are not readily available.



Women 15-


White (1959 : 54)


no figure

1963 Na-ional Census
(Chadi-ke 196 9:39)

Total Za-mbia

Northwest Province

1969 National Census
(unofficial figures)

Total Zarmbia

Northwest Province

Zambezi District

Sorin.g 1972

Chavuma village and
hospital sample

Chavuma village sample








no' figure

no figure







During 1971 30 live births were born to the women in the sample,

giving a crude birth rate of 38. By comparison, Ohadike (1969:37)

gives the 1963 Zambian crude birth rate as 52. The wide discre-
S- I of 52 and the local rate of 3
pancy in these two figures (the national rate, may be more of a

reflection of the age-sex distribution of the Chavuma sample than

of the Chavuma natalitv. Critics of the crude birth rate

point to how easily this measure, designed to show the gross rate

at which the population is reproducing itself, is influenced by

age-sex distributions. whereas only 9 per cent of the total

Zambian population (1969 unofficial figures) is over 50 years old,

28 per cent of the Chavuma sample is over 50.

69.6 per cent of the Chavuma female population is married. Of

the remaining women, most are unmarriageable, being generally too
61d or (22.7 per cent of total), and the remainder are

between marriages (7.8 per cent of total). Of the married women,

74 per cent are in monogamous unions, and only 26 per cent are

in polygynous unions.

Table 3 shows that the women with completed natality (45 years

old and older) have the lowest rate of live births, and the younger

women' have higher rates. This probably reflects low fertility

conditions in the past and an increasing present fertility.

The e::ected. relationship, in a period when the fertility conditions

are not changing as drastically, is one in which the older women

Shave higher rates. This relationship appears in ,White's data,

the higher rate for older women reflecting the longer period of

time that they have been exposed to conception.


25-29 30-44 45+ vears

Village* (=?=127) 2.47 2.58 1.95

Hospital (1i=88) 2.17 4.74 -

White** (N=216) .945 1.56 2.74

* Includes neo-natal deaths.
f* Calculated from White's data (1959:55).

Comparing Village Women with Hospital W';omen in the same age

category, 30-44 years, it is evident that, even with a general

increase in fertility, the rate of increase may be substantially

greater among those who avail themselves of the hospital facilities

that are available. The apparent inconsistency in the table,

Village Women in the 15-29 year category having a higher rate

than their hospital contemporaries, is explained by -a closer

examination of the Hospital Women in this category. Most of them

are young girls in their teens having their first baby, unlike

the village sample who were generally in their 20s.

The rate of childlessness for Village women of completed natality

(45 years and over) is 23.7 per cent (M=59). Another four women

in this age category only had one pregnancy each, and that

pregnancy resulted in a child who only lived a few hours. This

early death. (within 28 days) of a live birth is herein called

a neo-natal death. After that first pregnancy none of these

four women had another pregnancy. If these women were included


within the childless category the rate rises to 30.5 per cent

childlessness. Either of these two rates is a definite decrease

from the rates recorded by M4itchell and White. The change

probably reflects both increasing fertility, a nationwide trend,

and my careful checking of all women who claimed they were

childless. This check often revealed that the woman had had

a child who died immediately after birth or within the .first two


Number of Births 0 1 2 3 4 5 6 7 8 10 Deaths

Village '4omen 23 35 22 19 11 10 4 1 1 2 32
(N--12 7)
Hospital Women 0 21 21 13 7 12 8 6 4 0 6

Total Chavuma
Women 23 56 43 32 18 22 12 7 5 2 38

Not corrected for age distribution of the two populations.

Some other characteristics of hospital deliveries are interesting.

Using hospital records for the five-year period, 1967-1971,

I found that, of the 1059 total deliveries, 2.77 per cent were

stillborn, and another 4.7 per cent died within the first week,

*while the mother and child were still at the hospital in post-

partum confinement. 12.6 per cent of all live births were

considered premature, i.e., weighing under five pounds. Table 5

records the-percentage of miscarriages, stillbirths, and neo-natal

deaths for the total pregnancies experienced bv the women in these

two samples. This table is, therefore, a record of reproductive


(N is total pregnancies.)
Miscar"riaqces Stillbirths -Deaths Total

Pregnancies of
Village Uomen 12.8 7.5 8.9 29.2

Pregnancies of
hospital l ':omen 3.5 7.3* 1.9** 12.7

This high percentage is misleading as applied to the hospital
environment because 46 per cent of these stillbirths were the first
pregnancy and were delivered in the village.
** The same qualification extends here; even though this is a
very low percentage, 50 per cent of these neo-natal deaths were
for first pregnancies delivered in the village.

Significantly, about half of the stillbirth and neo-natal death

wastage noted.in previous deliveries experienced by the. hospital

sample is traceable to deliveries in the villages. Below I shall

argue that traditional :idwifery techniques may account for much

of the high rate of stillbirth and neo-natal reproductive wastage.

Table 6.presents some preliminary and partial figures on infant

mortality during the first year of life; these absolute numbers

are taken from the fertility histories I collected. I-ore complete

figures and percentages will be available after more extensive

analysis of thedata. Mortality estimates from the hospital sample

are misleading unless it is taken into account that the most

recent birth for each woman in this sample was less than two

'weeks old at the time of interview.



Total Pregnancies
Failed Preunancies*
Live Births
iJeo-ilatal Deaths
Deaths 1 month to 1 yr.
Remainder alive of
total pregnancies

Failed Pregnancies
Failed Live Births
Failed Prcgnancies and
Live Births

Pregnancies of
Village e W.lo:be n

(-) 73
(-) 32
(-) 45


21. 5%


Pregnancies of
Hospital :'.lomrlen

(-) 34
(-) 6
(-) 20*"




* Failed pregnancies are miscarriages and stillbirths.
l" Mortality estimates from Hospital 'omen are incomplete as
the most recent birth for each woman was less than two weeks
old at the time of interview.


Several possible causes for low natality among the Luvale have

been suggested by previous studies: (1) venereal disease,

(2) ethnic or tribal group membership, (3) genetic factors,

(4) indigenous medical practices, (5) malaria, (6) diet (manioc),

(7) contraception and abortion, and (8) marriage patterns and

promiscuity.. Ascertaining the influence of any of these factors

for any specific population is.difficul.t without an e::tensive

medical survey that includes physical and laboratory examinations.

Another method of estimating the general importance of these

factors is correlating their presence and intensity and the

existence of regional pockets of low natality in tropical Africa.

These correlations have established the lack of a significant

and stable relationship between natality and any of the last

four factors mentioned.

The first two factors, venereal disease and tribal membership,

have shown consistently high correlations 'with differential

natality, and ERomaniuk (1968), a demographer who has studied

infertility in Zaire, argues that sterility is "physiological

and not voluntary" and is caused by venereal disease. The third-

and fourth factors, genetic factors and indigenous medical

practices, have received less attention and proven more difficult

to specify and measure. Regarding indigenous medical practices,

although induced abortions with their resulting complications

. and post-coital prophylactic infusions affect fertility,

," Romaniuk qualified their i-.portance by noting that they must be

in general and systematic use before their existence would have

a significant effect.


Whereas I cannot, as a social anthropologist, judge the influence

of venereal disease and genetic factors on Luvale natality,

my field research did establish that low natality among the Luvale

is partially a result of their therapeutic style. This style

lowers natality by adversely affecting fecundity and fetal-

mortality. Medicinal treatments cause sepsis, salpingitis,

and consequent infertility, and midwifery techniques increase

reproductive wastage during gestation and parturition. The most

significant aspect of Luvale medicinal treatments for women is

the frequency of intravaginal application. Intravaginal

therapies, interwoven with public performance of rituals,

are the. most popular mode of treatment for a great variety of

female conditions and ailments.

During the puberty ceremony the labiaminora are elongated and

cosmetically blackened. Pre-coital infusions are applied to

enhance the erotic for normal intercourse. Medicines are given

intravaginally for both gynecological diseases and conditions

(venereal disease, "vaginal frigidity", menstruation, gestation,

and parturition) and non-gynecological diseases (heart palpitations,

backache, hysteria, loss of weight, and worms). In contrast,

Turner's discussion of Lunda medicinal techniques mentions

drinking potions and ooultices as the treatments for the same

illnesses that Luvale women treat intravaginally (Turner, 1964).

A more somber e::pression of the Luvale emphasis on this style

of medicinal application is that the most common mode of female

suicide is 'b intravaginal insertion of the crushed cambium of

a certain root.

This therapeutic style of treatments and techniques may adversely

affect fecundity and fetal mortality in three ways. First,

intravaginal applications of medicines and hands may cause non-

specific infections, perhaps resulting in tubal scarring,
a physician,
permanent sepsis and sterility. Felicia King,. informs me

that pelvic infections may be caused by venereal disease or may

be non-specific and caused by any of a variety of bacteria.

The former is linked to a nale se:: partner and the latter to

intavaginal application. Non-soecific pelvic infections can

cause menstrual disturbances, severe abdominal pains, and also

pains during intercourse--all of which correspond to a variety

of illnesses that the Luvale treat as part of the ritual sequence

for women. E after recovery from this febrile illness'the woman

is infertile and has vague symptoms; more rituals will be

carried out. Zn sum, the fever, abdominal pains, and tenderness

that many of these Luvale women report correspond to pelvic

sepsis and infertility (?.S. King, personal communication).

Timing of intravaginal applications is important since infections
are more likely to develop and be more damaging at specific

vulnerable periods in.the woman's life cycle when the uterus is

healing, for example during menstruation, abortion (spontaneous

or induced), parturition and the post-partum period. During

gestation and parturition, several herbal medicines are frequently

applied intrvaginally to "open the way", ensure an easy delivery,

and quic-ken the labor. Difficult labor or delivery or a retained

placenta call for continual intravaginal therapies, and post-

partum pains require yet other medicines. Finally, the vagina

must be contracted by pouring in hot acidic douches so it will be

"tight" for future intercourse. As one English-speaking infor-

mant put it, "we must slink the vagina".

Frequency of application is important because the possibility

that a woman will become infected is greater the more she is

treated. Many illnesses and difficulties in conceiving and

bearing live offspring require that mny medicines and a greater

number of practitioners be called in for the case. Few or no

difficulties require less use of medicines, fewer rituals and

practitioners--and the medicines are applied to a healthy


Second, specific medicines may affect the woman because of their

chemical components and pharmaceutical properties. Pre-coital

infusions may prevent conception by changing the pR of the vagina.

Some abortifacients are real poisons, and sometimes the pregnant

woman dies with the fetus. Autopsies of women who committed

suicide have shown vaginal deterioration as one of the results

of the intravaginal medicine (.;att and 3reyer-3randwijk 1962:856-7).

Third, midw.ifery techniques consisting of intravaginal examinations

and medicinal application during parturition contribute to compli-

cations, especially in cases of difficult labor and placental

expulsion, and may increase stillbirths and neo-natal deaths--

as well as causing pelvic infections. The midwife performs

numerous vaginal examinations and digital manipulations and

applies a series of herbals to "open the way". She and the other

older women present require early and arduous "pushing" by the

pregnant woman that is not necessarily restricted to when the

woman has contractions. Often the woman becomes exhausted and is

unable to "bear down" during contractions when she is finally

dilated. Due to the frequent examinations and applications the

vagina often becomes swollen and the progress of labor is

further imneded. Sometimes the infant is born with extensive

head moulding and may be stillborn or die shortly thereafter.

As examples of this sequence, I refer to two cases I attended

in the villages when the pregnant woman was required to commence'

pushing when her contractions were very weak and about 30 hours

before she .was fully dilated. There were numerous vaginal

examinations. Finally in each case, after arguments between the

husband and the natrilineal kin of the woman who thought

hospital deliveries more prestigious each woman was taken

to the nearby mission hospital where a live baby was delivered

with the aid of the vacuum extractor. in each case the vagina

had swollen, and the mother had become too tired to push. Both

babies had extensive moulding of the head and required intensive

care during the immediate post-natal period. In both cases, the

nurses remarked that the babies were "distressed" and would

probably have been stillborn or have died within hours after

delivery if the birth had continued in the village. The nurses

supported their remarks by mentioning other similar cases.

Data presented earlier (Tables 5 and 6) -how. that Village W.omen

had significantly higher incidences of stillbirths and neo-.natal

deaths than Hospital .'omen, and that much of the reproductive

wastage recorded for the Hosoital '.Iomen had actually occurred

in previous village deliveries.


Stages in the reproductive process (menstruation, conception,

pregnancy, labor and delivery) and reproductive disorders are all

considered musonco sicknessss. Recourse to traditional curing

practices, therefore, is required and essential to carry the

woman from conception to motherhood. Certain erotic and cosmetic

practices (such as contracting the vagina) are also viewed as

curative. Ill health and.disease are believed to be caused by

the sufferer's transgression or forgetfulness of the ancestors.

Even menstruation and delivery are not considered completely natural,

'since the ancestors control reproduction throughout all its stages.

A married woman normally lives virilocally, there is a

/ danger that she will forget her obligations to her matrilineage.
, fLuvale ancestral ...'Usually afflict their uterine descendants,

the woman who forgets her matrilineal ancestors is "in peril of

having her procreative powers 'tied-up' by the offended shade"

(Turner 1969:12).

At the same timethe sufferer gains ritual power and personal

prestige once she goes through the necessary rituals of propitia-

tion. She is now in direct communication with her matrilineal

ancestors in terms of their spirit manifestations. She can learn

the medicines, song.s'and proper ritual, and, as she begins to

cure others, her power and prestige increase, both among women and

men. It may be a unique situation that, in a matrilineal society,

women may'gain access to ritual power through their.own ancestors,

who were themselves women. Both male and female ancestors afflict

both men and women, but there is a tendency for men to afflict men

and women to afflict women. Certain matrilineages are noteorthy

for their ritual e::perts and the fact that most of their female

members are initiated.

If a woman has trouble in conceiving, if she miscarries, has a

stillbirth, or if her children sicken or die, it is possible to

seek an explanation in terms of general illnesses. But women's

reproductive and child-rearing problems have a oriori the

ancestral shades as their probable cause. Although a minor

illness may be self-diagnosed and treated, any acute or long-

lasting illness needs proper diagnosis obtained through consulting

a diviner.

A woman never attends personally such a divination; her relatives

are responsible for consulting the diviner and carrying out the

prescribed treatments. Sometimes relatives go to several diviners

to obtain a consensus and verify the diagnosis. The diviner
would by
acts as, an ethnographer, obtaining a ritual and health (fertility)

"profile" of the sufferer. Then the diviner identifies the

afflicting ancestral shades and the modes by which they are

manifesting themselves and directs the patient's relatives to

the kind of specialists) needed. Diviners are most likely to

recommend medicinal curing in connection with mahamba as the

therapeutic treatment. The term mahamba (singular, lihamba)

refers to: (1) spirits through which the ancestors manifest

themselves and possess their descendants, (2) the ritual of

e::orcising one or more spirits, and (3) the cult of those people

who have been possessed by a specific spirit.

Luvale recognize two kinds of mahamba pbssession'--the traditional

ones from the ancestral shades and -the"new"ones believed to come

from the air. The former treat reproduction difficulties,

general illness, madness and hunting misfortunes. The latter

deal only with general illness and infection. The newer cults

still survive today, although they are less popular than they

i~ere in the 1930s and 1940s when they were extremely popular in the area

(White 1949). In examining over 100 cases of spirit possession

rituals, I found that these newer rituals almost never overlap

with the more traditional ones for reproduction.

Women go through the traditional rituals'for reproduction when

the women are married, living virilocally, and in their repro-

ductive period. As a woman grows older and is no longer in her

reproductive period, her illnesses are treated in a more general

way, and post-M.enopausal women who are often unmarried and living

in their own matrilineal village may have both kinds of mahamba

performed for them.

As this separation of ritual jurisdiction suggests, rituals

do not occur randomly nor do they occur only in response to

individual sickness. Rituals are coordinated with life and

reproductive cycles. The fertility and ritual profiles of women

that I collected show that certain medicines and rituals are

performed for certain categories of women at specific times in


their reproductive cycle. The onset of menarche sets the stage

for ensuring a woman's fertility, and the type of puberty ritual

performed influences the commencement of sexual life and marriage.

Throughout gestation and parturition the woman is ritually and

medically guarded from disaster--spirits that could cause

miscarriage, a stillbirth, or death to the infant. A difficult

pregnancy and birth requires special medicines, recourse to

divination, and rituals. During the'post-partum period, the
only by
interdiction on intercourse is guidedsritual proscriptions.

Private and public medications are administered for women'.s

diseases, including venereal disease. More and different mahamba

are performed for a variety of illnesses during the reproductive

period. If the woman has difficulties in menstruation or fails

to conceive, she will require numerous private medicinal

treatments and diagnosis by divination, starting a cycle of

minor rituals and spirit possessions to appease her ancestors.

A performance of Tuta will be required for the woman who bears

a stillborn or a, mutilatedd" baby, or whose infant dies shortly

after birth.

If an infant or child sickens, various alternative cures may be

used. depending on the child's symptoms and the mother's repro-

ductive history. The cure will more likely include an elaborate

ritual with a long quarantine period for the child if the mother

has experienced medicines and mahamba for barrenness, illness
livry, or has a record of infnt d
and delivery, or has a record of stillbirths'an.d infant deaths.


A successful mother is..likely ,to receive only medicines or have

a minor ritual without spirit possession. Outside factors of

wealth, marriage, and modernity influence all choices, but there

is ,a tendency to repeat the child-rearing rituals performed by

a woman's matrilineal kinswomen (living and dead) if they had

these rituals and were subsequently successful in bearing and

rearing children.

Rituals may be analyzed as indications of female reproductive

crises. The rituals are public statements, the expression of
private individual problems and illness. Although informants

may .n6t recall all of their past illnesses, they do remember

all of the rituals that were performed for them. Since each

minor ritual and lihamba is accompanied by its own set of

medicines, ritual performances are, therefore, clues to the

curing therapies and specific medicines that a woman has experienced.

Because' o this, the elicitation of a woman's ritual history

is essential in order to ascertain her medical history.. As

Rappaport has pointed out, "The occurrence of.the ritual may be

a. simple qualitative representation of complex quantitative

information" (1960:235). In this way, it is possible to deduce

the specific medicines a.woman has received, and their modes

and times of application.

Rituals not only record the medicines a woman has received and

her passage through life, but rituals also directly affect the

therapeutic style and, consequently, the performance of ritual
a, f

n purposiv.
and its A p structure (T, urner 1968:.-3) provide the mechanism

that regulates and sanctions medicinal use and medical behavior.

Therapeutic responses to individual crises, as well as the

temporal phasing of medicines within a curing sequence, are

influenced both by the structure of specific rituals and ritual

cycles,and by the necessity to sponsor the accompanying ritual

phases. Sponsorship requires the accumulation of the obligatory

'eer and capital, and this requirement takes time. As I-

mentioned before, each ritual is accompanied by its specific

set of medicines. Although substitutions of medicines do occur,

as individual herbalists and diviners vary in their practices,

the range and frequency of changes are inhibited because the

medicines are part of a set connected to specific rituals.

Similarly this ritual connection sanctions recourse to indigenous

medicine by threatening the fertility and health of those who

might deny its use and by rewarding with prestige and power

those who continue the traditional therapies.

Medicinal therapies and ritual occur both in response to illnesses

and the diagnosed displeasure of the ancestors and in order to

validate and commemorate each stage of the reproductive cycle

and the larger life cycle. Although there does exist a question

about the latent functions of a therapeutic style that acts to

inhibit natality, there e::ists no evidence at present to indicate

S that this limitation of population growth is an advantageous

or adaptive reaction to environmental conditions. From this

therapeutic style in its ritual context flow positive benefits

for individuals and for matrilineal solidarity, as well as negative

consequences for the fecundity and mortality of the group.


Luvale believe
all women are born with a snake-like creature (chisumi) in the

uterus. Before a woman matures, the chisumi is dormant, but it

is aroused by menarch'ey feeding on the blood, and.is only

permanently dormant again after the menopause. Chisumi is,

therefore, always present in a woman. Menstruation is itself

considered an illness (musonqo) caused by the chisumi.

At menarch'-ethe matrikin are responsible for performing the

standard girl's puberty ritual (wali) which ensures fertility

and prepares a girl for sexual life. During the actual seclusion

(lasting from three months to two.years) instruction is given

in dancing, medicines, and coital techniques. The girl elongates

her labia minora, learns pre-coital medicines for producing a

"v:arm, dry vagina" so as to avoid "vaginal frigidity"., and learns

procedures and medicines for menstruation. Whether married or

not, the girl must have her first intercourse at the conclusion

of the coming out phase as this action is considered part of

the ritual and essential for her subsequent fertility.

There are two variations of the standard ritual. In the more

lengthy'one, pre-pubescent girls enter seclusion to await

menstruation. The vagina may be "opened", i.e., the hymen

broken and vagina enlarged. The other is a shortened ritual

in which the girl is only secluded during her actual menstruation

which is followed sometime later by a coming out party.

In the latter many of the mystical aspects of the longer rituals

are omitted, but the labia are, elongated and medicines for

"warmth" and menstruation are still given. These variations are

justified by noting that a mother or sister had these rituals

and were fertile, or conversely, that they had the traditional

ritual and were not. The girl should then try a different

ritual or she will similarly have no children.

The shortened ritual is more popular among school girls who

simply obtain some medicines from Luvale school matrons.

Because there is a correlation between education and hospital

deliveries, more of the. Hospital Women have had the shortened

ritual although younger women in general are leaning in this


(In percentages.)

Villace Women HosDital W.omen Total
15-29 30-44 45+ 15-29 30-44

Standard Ritual 80.0 84.3 87.7 52.9 65.6 74.0
Pre-menarch:- Ritual 5.7 9.1 8.8 0 0 4.8
Shortened Ritual 14.3 6.1 3.6 47.1 34.4 21.2

Most Village Women married before they matured and the rest

married as part of the coming out ritual. In the hospital sample,

more women married some time after the ritual (whether long or

shortened) had been concluded. There is a trend among the

younger women in both samples to be married later. In terms of

puberty and marriage as well as education, the hospital sample

represents modern influences.


During subsequent menstruations when there are severe pains or

bleeding, it is considered that the chisumi has become too "hot"

and must be "cooled" with medicines. The theory of procreation

stresses the relationship between menstruation and procreation,

and menstruation that is unduly prolonged or accompanied by

severe abdominal pain is believed by the Luvale to interfere

with the woman's fecundity. If there are menstrual and repro-

ductive problems, chisumi is first suspected and appropriate

treatment started.

Every woman knows some of the medicines (which include intra-

vaginal applications as well as infusions to be drunk) for she

learned them in her puberty camp when she first matured. Her

female relatives and neighbors will contribute their suggestions,

some.being mentioned free of charge, others being purchased

for a price. The point is that, .

S" treatments are commonly available
and are women's concern, They 2o wmrn self-administered

medicines and continue with women herbalist experts who

require payment.

If these fail, then perhaps an ancestral spirit is.directing
Sthe chisumi.

A diviner is then consulted who may advise one or several of

the many treatments available, normally commencing with medicines
in which
Ato wash the entire body (applied with a live, white chic-ken),

the wearing of red beads, and the building of a small shrine

behind the woman's house, etc. If the problem continues,

various rituals may be performed to exorcise the afflicting

shades. The most notable of these possible rituals is a

performance of Kula (one of the mahamba), either by itself for

serious cases or, if the patient is a young woman in her

reproductive years, in combination with many other mahamba

that have been diagnosed as "tying up" her fertility.

An examination of ry data on long and heavy menstruation

correlated with ritual performances shows the following.

Among Village Women, there is a higher incidence of traditional

ritual participation than among Hospital Women. 40 per cent of

the Village Women over 45 years of age mentioned having been

troubled by long monthly periods. All of those women sought

medicinal and ritual help; all erected a shrine; all had a

mahamba performance that included Kula; and 28 per cent of them

had a performance limited exclusively to Kula. Younger Village

Women tended to have minor rituals and then mahamba performances

that included Kula. Among the women in the hospital sample,

although many reported having the same problems with menstruation,

no one had the minor rituals or a ritual exclusively for Kula

and only some had a mahamba ritual including Kula.


Most women conceive within two years after maturing. Although

younger women are tending to delay marriage, they continue


this tendency toward early conception, often being impregnated

by boyfriends shortly after maturing. In the hospital sample,

26 per cent of those who were delivering their first pregnancy

were unmarried. The following table shows the length of time

from physical maturity until first conception among the women

of completed natality.

(Not percentages.)

Live Birth Neo-Natal Death Stillbirth

1-2 Years 22 4 3
3-4 Years 7 -
5-6 Years 3 2
6+ Years -
No Information 5 3
No Pregnancy 8 -

Most women begin bearing children in their first marriage.
S a
.Gme continue in their second marriage, and few continue in any

subsequent marriages, as shown by women over 45 years.

Concomitantly, by the.second marriage, the majority have

finished with reproduction, and more than one third were
(10.2 per cent)
consistently childless. Only six women/were infertile in their

first marriage and fertile in subsequent unions; all other

women showed their highest-.natality in their first union.

The younger women (15-44 years) of incomplete natality,

especially the hospital sample, show the same trend of initially

highest natality declining in subsequent unions. But the.

generally higher level of natality among the younger women means


that their reproduction span is longer and they maintain their

fertility through subsequent marriages.

(Not percentages.)

Iarria ges
1st 2nd 3rd 4th 5th

Live births 37 14 3 1 -
(Neo-Natal Deaths) (5) -
Miscarriages/Stillbirths 4 5 3 1 -
No Pregnancy 17 33 19 11 3
No Information 1 1 1 -

White's contention that women wait for stable marriages before

conceiving is not borne out by my data, nor does his related

point that women begin bearing children relatively late receive

any substantiation. Iany pregnancies occur in early unions,

even those that are very unstable and brief.

Once a woman conceives, she is guarded through her pregnancy

by a variety of medicines and rituals. For the first pregnancy,

all women have medicines to cool the chisumi so that it will

quickly release the placenta. If the woman becomes ill while.

she is pregnant, other medicines and rituals may be used,

usually those in which offerings are made to the woman's

ancestors. During gestation, the woman is medicated vaginally
("to open the path") and anally ("to cleanse the mother's stomach").

The application of these medicines starts. about

the 7th month and does not require a medical or ritual specialist.

When labor pains begin, the specialist midwife is called. The

midwife immediately begins vaginal examinations to report on the

progress of the labor. Any woman who is older than the expectant

mother is allowed to attend the birth,'and everyone present

demands that the mother push, push, push, frequently when she

has not vet even dilated. Famous midwives are often barren


The greatest fear during childbirth is that all or part of the

*placenta will be retained. In fact, midwives do not wait very

long before starting intravaginal medicines for kusalaho (to be

left out or left over, i.e., the placenta). Medicines are

hastily prepared. The other women present try their techniques,

then the midwife uses her special medicines. Again and again

the placental membranes are pulled and pulled. Other more

distant midwives are brought into difficult cases. Hygiene
8 p
is very low at this time. For giving these "kusalaho medicines"

the midwife may demand a larger fee. If simply cooling the

chisumi with medicines does not make the placenta come completely

out, then it is believed that an ancestral spirit is causing

the problem, and a diviner is consulted, and a series of rituals

are carried out.

Post-partum maternal care is concerned with medicines for

chisumi, for cleansing the birth canal and uterus, and for

tightening the vagina. The latter tw.o involve extensive douching

with hot, very acidic (test brews gave readings of pH 1-3).

herbal prezarations. Some women report high fever and abdominal

pains after delivery, and the ones who are ill in this way

and go to the hospital for treatment are placed on antibiotics.

The Chavuma Mission Hospital specializes in maternity care and

delivery. As an alternative to delivering in the village, it

is widely used, and 15 out of-the 27 (55.5e sarce! census women

who delivered babies in 1971,,had their babies in the hospital.

Some village midwives send their patients to the hospital for

ante-natal clinic, although the women then deliver in the village.

Half of the women who attend ante-natal clinic actually do

deliver at the hospital. When the women in the hospital sample

were interviewed, they were asked a simple open-ended question,

"Why have you come to the hospital to deliver your baby?"

Their reasons as stated are given below.

(N=88 Hosoital v.omen.)

Escape high payment to midwives.
"Fear of retained placenta", i.e., poor techniques
in village.
Both of the above, i.e., "you will pay much if
medicine is aiven for retained placenta".
Nurses have good medicine/referred through
ante-natal clinic.
Previous difficulties in village deliveries.
Previous child died..
."Educated women should go to hospital."
"Too many fingers in the vagina make .it swollen."
If baby dies in womb in village, they do not know
how to get it out.
"They, make you push too hard."
"You may have to go for divination."
"I1o one to care for me in the village."
No Response




womne n











The post-partum taboo should ideally be kept by the parents

until the child walks. This interdiction appears to be broken

by many women unless they and their children are the subject of

special child-rearing rituals. Contraceptive medicines allow

the parents to resume se;:ual relations and still ensure that

their child will walk properly, a great concern to all parents.

(Luvale believe that the parents' sexual behavior can kill a

newborn, prevent walking, and cause malnutrition.) These

medicines are usually prepared and placed in beads that are

strung around the baby's waist and there is private magical

ritual for the parents. The "good father" should also practice

coitus interrupts until the baby walks. More traditional

parents sometimes wait 6-8 months before having this medicine

done and resuming intercourse, but modern parents wait only

2-3 months. With so many herbal medi.'- r that are inserted

vaginally, it is noteworthy that no medicines intended as contraceptives,

are administered in this mode.

Current cases of women who use abortifacients are those who have

broken the post-partum taboo and who are pregnant too soon,

or unmarried school girls. Fior -mob ortifacients. it is

known that if the fetus is in the second or third

trimester, the medicines will kill the woman. Although many

abortifacients are effective as poisons, but they were not

apparently in frequent or widespread use. I did witness

one case in which a woman died while attempting an abortion


by drinking medicines and inserting medicines intravaginally.

Perhaps the fear of thus accidentally committing suicide

diminishes the frequency. Stories of women who have died are

frequently told in cautioning young women. By interviewing

some herbalists, I found that some'medicines used to treat

venereal diseases and stomach pains were also used for inducing

abortions. These medicines are not supposed to be given to

pregnant w.-omen, but sometimes a woman being treated for another

disease is also in the early, unsuspected first trimester,

as was the case in an involuntary'abortion I witnessed.

!3.ARR .' ..

To cure barrenness (kusakisa) the curing treatment beginning

with private medicines must be sought by a woman's husband.

This medicine is given by an herbal specialist after a diviner

has been consulted. There are two parts to the medicine:

first, a potion to drink that is designed to "cool" the chisumi,

and second, intra.vaginal medicines to open the uterus (lichimbi).

These latter medicines are known to be very irritating, and a

patient may have to be restrained from pulling out the medicines

once they are inserted. 'oThen the doctor finally does remove

the medicines, a voluminous discharge comes out of the vagina,

according to informants. The following table shows how frequently

women in both samples have recourse to "kusakisa medicines";

the practice was more popular in the past. Hospital ; omen do

have better natality histories than Village '.omen, undoubtedly

reflecting their use of a variety of medical facilities,

including ante-natal clinics.



(In percenai.cges.)

Village omen Hosnita! T',omen
15-29 30-44 45+ 15-29 30-44

Obtained medicines 13 31 36 15 32

.Of those,
Remaining Barren 25 50 60 -
Conceiving 75 50 40 100 100

.If the woman conceives after the treatment a public spirit

possession ritual featuring mahamba for reproduction is performed.

If the woman has had previous stillbirths or neo-natal deaths,

a performance of the terrible and much feared lihamba, Tuta,

may be carried out. This lihamba is not caused by an ancestral

shade but by a rat that lives in the forest. It is believed

that the woman unknowingly stepped near the hole of this rat,

which is .why she is now afflicted, and the public performance

is carried out near such a hole.


Many women interviewed reported they had kalwena, "gonorrhea",

or pus in the urine, and, less frequently, unono, "syphilis",

or genital lesions. Some claim these diseases have interfered

with reproduction; others blamed chisumi and other illnesses.

There are so many different diseaseswhich Luvale recognize by

genital and urinary symptoms that without proper laboratory

diagnosis, it is difficult to know what they refer to. It is also


difficult to know whether venereal diseases are more prevalent
among the Luvale than among other Zambian tribes.

Younger women in both samples report fewer cases of self-diagnosed

venereal diseases; Hospital Women have lower incidences than

.their contemporaries in the village sample. These differences

may well reflect access and use of medical facilities and anti-

biotics as well as changes in disease categories.

(In percentages.)

Village Jromen Hosnital *'Jomen
15-29 30-44 45+ 15-29 30-44

8.6 48.5 59.3 3.8 14.3


Child rearing is closely connected with reproduction, and Luvale

women class together a fetal and infant death. Miscarriage,

stillbirth's, and infant'deaths up to one year are called kupihisa

(to be bad). The ancestors :nay cause disaster and sickness

at any stage from gestation through childhood. If the mother

has "a good reproduction record" and her young baby sickens,

perhaps the ancestors are not responsible and only medicinal

treatments will be suggested. However, if there have been

previous problems in either bearing or rearing children,

both rituals and medicines are required.

Seclusion in chicano. (fence) is the most elaborate ritual for

reproduction and rearing. Depending on past fertility and child

mortality (the various patterns are given below), it may be

divined that the woman should be secluded either before

parturition or with her newborn child. She enters seclusion

in a dramatic ceremony. During seclusion all kinds of medicines

and minor rituals are given, and many food/sex taboos are

prescribed. The woman may stay in the fence for a few months

or up to a year and a half (if she were secluded during

.pregnancy). When the child is ready to crawl or walk out of the

fence by itself, then there is another and more elaborate

coming out ceremony for mother and child. A minor variation

(chi.anao cha malala) is less restrictive for mother and child.

There is only partial seclusion, a tiny fence, and no spirit

1lj possession.

For all child-rearing rituals attention is suddenly focused

on mother and child. The woman gets voluminous amounts of

information o. child care by others who have had the rituals.

-Furthermore, the strict and partial seclusion act as quarantines

for the child. Few adults may handle the child, who is also

separated from other children.

In terms of fertility and child mortality, the noteworthy aspect

of these performances, especially the chipaneo series, is that

the woman's "luck" at reproducing and rearing seems to improve.

Many children have personal names that record their having been


through the ceremonies as a sm~ll child, and parents proudly

recall how, because they have had these rituals, they now have


Factors other than the past fertility history of the woman

.involved that influence the choice of performance/ceremony are:

the economic and marital status of the woman and husband,

previous fertility and ritual history of close relatives of

both w.:oman and husband, and degree of modernity of the couple.

'Divorced women with young children never have the full seclusion

of chipango, but usually only erect,a shrine. Poorer people

may choose to have one of the minor ritual sequences. As with

the choices between various puberty ceremonies mentioned above,

the choice of these ceremonies partially depends on the kinds

of rituals her female relatives have e:zoerienced and their

fertility performance.

Typical chioanco patterns are: (1) a woman had 1-3 miscarriages

or children who died, and at her next pregnancy she is put to

chiDanco. (In the past she might enter during her pregnancy

and deliver there. The modern pattern is to deliver at the

hospital and then enter.); (2)following E performance of Tuta

during pregnancy she enters before or after delivery; (3) the

woman has failed to conceive for several years, is given

kusakisa medicine, becomes pregnant and enters.


Typical chioanqo cha malala patterns are: (1) a woman had no

problems conceiving/bearing and her young child becomes sick;

(2) the sick child is older than a year, when it can crawl out

of the big chinanoo, and less than three years, when it would

be off its mother's back and the mother simply could dance

mahamba for it; (3) when certain circumstances, such as poorness,

immigrant or husbandless status, prevent women'with poor fertility

histories from having full seclusion; and (4) when the parents

think seclusion is old-fashioned.

Table 13 below gives an idea of the degree to which women in

the village and hospital samples have various mahamba, both of

the more traditional and the newer types, and chinanco ceremonies,

both the full and the abbreviated cha malala, for producing and

rearing children.


PARTJ.zP'1~Th -....- B !1~~ "r`U,`L.S ?OR REPRODUCTION

Village '.,omren
15-29 30-44 45+

Mahamba for Reproduction 15
Other Traditional Hahamba
(madness, death of
husband, illness) 1
New Mahamba 5
Total iahamba '21
No Mahamba 17

Mahamba for child rearing
Chipango 10
(Entered during
pregnancy) (4)
Chicanco cha m.alala 5
iahamba for sic;: child 1
Total 1-ahamba for
child rearing 16
No. women in category 35
* Note that a :woman may have more

21 41





Hospital ':oren
15-29 30-44

12 15

12 3 11

(5) (2) (4)
7 7 5
5 2 1

30 12 16
59 52 .35
one kind of mnh;irn.


In this paper it has shorn that natality" among the Luvale was

very low in the past and has been increasing in line with the

general Zambian-wide increase. Scme writers have explained

the low natality in terrs of malarial and venereal diseases,

diet, genetic factors, and the postulated use of abortifacients.

As a social anthropologist I cannot analyze the first three, but

I have 'examined certain medicinal and ritual customs 'in detail-

and argue that these are partially responsible for the low natality.

The therapeutic style of intravaginal application and midwifery

techniques contribute to sepsis and subsequent infertility

and increase stillbirths and neo-natal deaths.

Rituals work in combination with the medicinal treatments and

serve as reCulating mechanisms which temporally order the treat-

ments. Without rituals various treatments might be haphazard

or dispensed with altogether. Rituals also serve as a methodo-

logical aid to the anthropologist because they are public knowledge

and indicate when various medicinal therapies occurred and in

relation to what illnesses, whereas private women's therapies

are guarded.

A series of .medicinal treatments connected with reproduction

and se::ual life are interwoven with ritual performances.

Concern for fertility and child mortality, is shown in the multi-

tude of rituals, commencing with the girls' puberty ceremony


and continuing through the reproductive years with manamba

performances, with the chiango ritual being the most elaborate

and the most popular. Patterns of natality and child mortality

are reflected in the diagnosis and choice of rituals.

Samples of Village Women and Hospital ','omen have been used to

monitor natality, ritual participation, and modernity. The older

Village ':omen have the lowest natality and the highest reproductive

wastage. They have high childlessness and the most venereal and

other diseases. These women have the most rituals and the more

elaborate ones performed for them, and these women have undergone

most of the traditional therapeutic techniques for illness and

delivery. Younger Village '.iomen continue many of these charac-

teristics. They have moderate natality, high wastage, and fewer

diseases;. and they have undergone almost as many rituals and

therapeutic techniques, although they avoided some of the elabora-


The Hospital '?;omen have highest natality, least reproductiv-

wastage, and fewest diseases. They. have been educated, perform

few and less elaborate rituals, use traditional therapies rarely,

and use the hospital for illness and maternity. Younger Hosoital

Women tend to marry later but continue to conceive between one

-and two years after puberty, the traditional pattern. Among

women still in their reproductive years, natality may be considered

moderate and reflects greater access to modern maternity and general

medical facilities. Natality is expected to increase and approach

the national average with a continuation of these trends.

.* 41

OC 0:(7** t _0-).'"- .

1. I would lie to thank Art Hanson, Dr. Felicia Savage King,
Donald D2eGlopper and Mary Farmer for their critical reading of an
earlier version of this paper. I would like to express my
appreciation to the staff of the Chavuma Mission Hosoital.
Although I collected hospital records and case histories of
patients, no medical or laboratory studies were conducted.
Mr. D. B. Fanshawe of the Division of Field Research, Kitwe
identified the botanical specimens.
Field research .w-as carried out between 1970 and 1972 under
a grant from .IH Tr aining Program in A.nthropology-, (NIG M13-1256)
and the Department of Anthropology, Cornell University.
2. The simple fertility ratio (Child/'."om.an Ratio) relates the
number of young children in the population to the number of .;omen
in th- reproductive age croup. bhadike (1969:37-33) notes that
this ratio does not necessarily measure maternity because of
differential under-enumaration, childhood migration, and infant
and ear-ly childhood mortality. This ratio looks at fertility
in the -recent past, i.e., the last five years. It is used here
because comparative figures are available.
3. Unless an investigator is very careful, neo-natal deaths and
even deaths of chi ldren under tw.o years w'-l be recorded as
miscarriages, and the mother subsequently registered as "childless".
I intc-r e'.-ved many "childless" women :.ho, upon intensive cuestion-
ning, revealed that they had produced living children who had died
while young.
4. There are no Hospital l.'omen .who are over 45 years old as
maternity care co.mmenced in the area in the early 1950s. All
women inter-v'ewed in the hospital'sanle) had a successful delivery.
Women who de-livered a stillbirth or whose child died while still
in the hospital were not interviewed b"n my Luvale research
assistant but are included in the overall hospital statistics.
5. A list of Luvale female pharmacopoeia which includes, the
chemical components is in progress. Ph determinations ,were made
in the field.
6. Securidaca lon inedunculata. Death occurs within 12-24 hours,
although some women died as late as 14 days after application.
Post-mortems on women who committed suicide intravaginalIl showed
vaginal, liver and gum deterioration (Jatt and Brever-Brandwijk
7. The Hospital '.Jomen provide a partial test of this hypothesis;
they have much fewer and less elaborate rituals and medicinal
treatments, and their natality is double that of the traditional
Village ,.omen in the 30--144 .ears group.
8. A common basin of water is used to moisten the vagina and
placental membranes, and in one deliver,, the midlife washed her
feet in it as well$


9. Older ..or.n report tht thse cirlz are the very ones who use
abortifaci nts to rid th:. l~. es of unw.antoe prcgnanc s. B ut,
as stated above, 2-5 rer cent of the younger Hospital "';o:.on ar
unmarried and :nmany 'wre school irls.
10. Interestingly the Luvale ter: for gonorrhea, ka.lwena, is a
derogatory term for (:a)Luvale -eople.



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Gilges, W. 1955. Some African poison plants and medicines.
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Hudson, R.S. 1935. The human geography of Balovale District.
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King, M. ed. 1966. Medical Care in Developing Countries: A primer
on the medicine of poverty. Nairobi: Oxford University Press.
Lorimer, F. 1954. Culture and Human Fertility. Paris: UNESCO.
Mitchell, J.C. 1965. Differential fertility amongst urban Africans
in Zambia. Rhodes-Livingstone Journal 37:1-25.
Nag, M. 1962. Factors Affecting Human Fertility in Non-Industrial
Societies: A Cross-Cultural Study. New Haven: Yale University
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