This paper reports on health beliefs and their influence on treatment decisions and behaviour among the Esan people of mid-west Nigeria. The sources for the study are my own experience of growing up in Esan society, anthropological field work, and focus groups. The research revealed a transitional society where both traditional and modern medicine are employed and where the choice between them is determined by belief systems which are themselves in the process of change, as well as by distance and costs. The traditional health-belief system was one which placed most responsibility and blame upon women, and a system of social control over the adult female population. Changing health beliefs are less the result of the introduction of a new health philosophy than of the retreat, under the impact of Christianity, of traditional religion which embodied the older health philosophy.
PIP: An anthropological examination is made of the Esan population living in Ekpoma, Egoro-Haoko, OkhuEsan, and Ubiaja in Edo State, Nigeria, during 1988-89. The focus is on the Esan perception of illness, the Esan health behavior, and the treatment of illness. The sample areas are not densely populated due to migration to urban areas. Traditional or Christian religions are practiced. Piped water, good roads, and electricity are inadequate. Polygyny is widely practiced. The Esan people believe illness is caused by people or natural or supernatural forces. The most common illnesses among children are measles, convulsions, and headache, which are attributed to supernatural factors. Diarrhea, vomiting, malaria, smallpox, chicken pox, pneumonia, and tetanus are thought to be due to natural factors. Child mortality due to witchcraft is reduced through the taking of oaths at shrines. Christianity has helped to protect people from the power of witches and wizards. In traditional times, natural illnesses were attributed to poor sanitation, poor nutrition, and lack of good water. Presently, women believe that natural illnesses occur from environmental factors such as overgrown weeds or poor water drainage. Many health programs have improved the situation for prevention and treatment. Adult male illnesses are reported as back and waist pains, sugar disease, hemorrhoids, blindness, and sudden swelling of the body, legs, and knees. Blindness occurs due to supernatural forces caused by a lack of maintaining traditional customs, such as adultery of a wife. When a husband dies of a supernatural illness, the wife is frequently held accountable. Adult females report illnesses from pregnancy, childbirth, and postpartum. Miscarriage, hemorrhage, retention of the placenta, and obstructed labor are considered to be due to supernatural factors subsequent to such behaviors as having sex in the afternoon or in the fields. Traditional treatment is dispensed according to the type of illness and is mainly used by adults. Children are treated more quickly than adults. Cost and distance from health services affects use of modern medicine. Mixes of modern and traditional practices are common.