Education And Debate

Letter from Brasilia: Some primitive peoples of the tropics

BMJ 1994; 308 doi: (Published 23 April 1994) Cite this as: BMJ 1994;308:1095
  1. P D Marsden
  1. Nucleo de Medicina Tropical, Universidade de Brasilia CP 10 2382 CEP 70840 Brasilia DF, Brazil.

    Few “primitive” peoples now exist, as Western communications, material goods, and forms of transport have swept the globe. Through studying malaria I came into contact with several primitive tribes, including the people of Wingei and Wam in the Sepik area of New Guinea and the Brazilian Indians of the Amazon. The Brazilian Indians are true environmental ecologists, wasting nothing and knowing how to conserve stocks of fish, animals, and fruits. All these primitive groups seemed to suffer from tinea imbricata, caused by Trichophyton concentricum and characterised by whirled fungal scales over the skin and often a smell of gorgonzola cheese.

    “Primitive” people are rapidly disappearing as Homo sapiens creates a global monoculture based on such material values as television, refrigeration, and transport modes. My first contact with tribal primitive man was while driving through the Congo basin rainforest in 1963. On a straight stretch of dirt road I saw a man lying prone in the path of my Volkswagen. He seemed to be dead so I stopped and went forward on foot. Suddenly he sat up and at that signal more than a hundred pygmies emerged from the forest and surrounded my car. They were naked except for a small genital cover and carried spears and bows and arrows. There were many women and children. I spent the rest of the day negotiating my right of way (in Swahili) over this stretch of public road by payment and by treating sundry ailments. Hardly a primitive people!

    New Guinea

    My next contact was in 1965 while working among the people of Wingei and Wam in the Sepik area of New Guinea. Within a week I had changed my environment from New York to a guest hut in the Sepik. The first night, dogs got into the hut and broke my malaria slides. After that, on the chief's order, a fire was lit before my hut and I had a watchman. These were indeed stone age people - no written language, no iron, no concept of the wheel, no farm animals apart from the pigs that represented wealth. Every woman had a pig value. Small money took the form of sticks of strong tobacco. Pigs were suckled at the breast by the older women - the breast remained a functional organ all their lives. In the early morning, as the swirling mountain mists dissolved in the strong sunlight and the birds of paradise took to the trees, activity could be seen in a village of huts far below. The tribe of which I was a guest did not know that village's name or speak its language. There were then 400 languages in New Guinea.

    Part of the culture in the Sepik valley was based on the yam, a giant sweet potato. It grew exceptionally large - one tuber would last a man a week. A ceremony which I did not witness was the yam competition with prizes (in pigs of course) for the largest male (three roots) or female (two roots) yam. At the end of my field research on a chronic malaria syndrome I left via Lae and Port Moresby airports. At both, cargo cult personnel were in evidence, noting every “valuable” I was taking from this island, the second largest in the world.

    Along the Amazon

    It was malaria which also took me on Amazonian trips. During these extensive river voyages I came to know something of the Brazilian Indians, a most resourceful group. Perhaps their most impressive feature is the care with which most of them husband their environment. They waste nothing and know how many fish they should take from the river, wild animals from the banks, or fruit from the forest so as not to prejudice the resource. These genuine Brazilians are probably the first environmental ecologists. This care of nature has always been their habit, even though they burn off small patches in the forest to plant mandioca. They are skilled rivermen and woodsmen, and the environment is a friend, not an enemy.

    Preserving fish

    Brazilian fresh water icthyology is the most varied on this planet and one example must serve. The pirarucu (pira, fish; urucu, red in the Tupi language) has a long, red fleshed, virtually boneless fillet that you can salt, roll up, and cut off for meals on a boat for days. Brazilians call it their cod (for they value European dried cod to an extraordinary degree; it is a common Christmas present). Pirarucu has a strong fishy taste and I prefer more subtle Amazonian fish flavours.

    This fish has a lung as well as gills so it must surface to breathe. It reaches three metres in length and can weigh over 200 kilograms. From a canoe it is easily visible as it rises to take air and is killed with arrow or spear. It cannot be taken with rod and line. It is the largest member of the primitive Osteoglossidae family and known as Arapaima gigas. Its bony tongue can be obtained free from the fish market in Manaus at 4 am. The true Amazonian Indian knows where these fish are situated in the igarapes (riverine lakes) around his home. He husbands them with care as a rich protein source.

    Medical concerns

    Although my voyaging has ceased, I still see many Indian patients, for our university hospital in Brasilia has a contract with the Brazilian Indian Foundation (FUNAI). Although most of the Indians have never entered a ward before, they rapidly adapt to showers and knives and forks, as do their accompanying relatives. Only remnants of the great tribes are left but fortunately, thanks to governmental action, the Indian population is growing. It had fallen to 4% of the 6 million calculated when Cabral first landed in Brazil in 1500.

    Common to all these three groups was tinea imbricata (caused by Trichophyton concentricum) known by a variety of local names. It was most severe in the New Guinea people, who seldom washed owing to scarcity of water. Often the body was totally covered with the clinically characteristic discs of whirled fungal scales. Such patients had an aroma of gorgonzola cheese. Affected women were known as “puk puk maris” (crocodile women) because of their roughened skin. They fetched a lower bride price in pigs.

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