Trier Ethnographic Film Festival selected the Healer and the Psychiatrist for special attention because it touched the student organisers. They filmed a dedicated interview with questions they had about the film after three viewings and also asked some general questions about ethnographic filmmaking. The general questions and video answer are here.
The dedicated interview can also be viewed here.
The dedicated answers that I prepared for the interview are below. They don’t always concur exactly with the spoken interview. My answers address an audience not familiar with Tonga.
- How often did you travel between the two islands?
I went to Tonga first in 1998 and spent the first 5 months on the main island taking Tongan classes and shadowing Dr Puloka in the Psychiatric Unit. I spent 18 months on that first visit, and I think travelled twice between the two islands. On every subsequent trip in In subsequent research visits in 2004–2005, 2007, 2009, 2011 and 2018 I spent time in Tongatapu and Vava’u, but with the balance of time mostly in Vava’u.
- Recording video messages you mediate between the two medical systems. As in Nepeoiti Fonua’s case, the statements attack each other’s approach. How did the protagonists perceive this and what was this situation like for you as mediator and filmmaker?
Nepeoiti was a unique case, I was prompted to visit him because of asking the women who Emeline weaved with, who was someone that Emeline had successful treated. Nipeoti was the first person they volunteered. He was an incredibly generous man, supporting many churches with food grown on his plantation.
The conversation between them was edited down from a much longer 45 minutes, there was much more detail of the case. I do not feel that the statement attack each other approach, they merely present what they saw as their perspective. Dr Puloka, had actually not treated Nepeoti, he was away of leave, so his only resource was the medical records and what he remembered of the case. I now feel that Nepeoti’s case is one of spontaneous remission, precipitated by the powerful meaning and process he was led through.
The protagonists only saw the result once I showed them a first cut of the film, and both liked the result. There was no contestation. This form of video messaging was very easy for Dr Puloka and Emeline Lolohea. I was concerned about Dr Puloka as for him the transition was very clear, from seeing it initially as a very medical and biological condition to at the end something perhaps less clear. But for him it was always clear that a few number of people are effected by spirits, and he is very accepting of ambiguity and moving his diagnosis based on the most recent evidence he has. Neither of them saw the case as particularly contentious.
- What would a meeting between the healer and the psychiatrist look like in your opinion? Would it be characterized by antipathy or sympathy?
I think such a meeting would have to have an intention, a purpose, I don’t think a meeting for the sake of it would have much value. If it did happen it would most likely be cordial, as Emeline and Dr Puloka are consummate professionals and socially very astute. My feeling is that Dr Puloka spent a lot of time meeting with healers in the 1980s, his practice and translations are heavily influenced by those meetings. But at the time without supportive funding it was not possible to continue those collaborations. Both Emeline and Mapa are in their 70s and coming close to retirement, I think it is time for a younger generation to be inspired by their example and forge new and lasting collaborations and links. So I imagine there would be sympathy should they meet, but in a way the meeting has already happened through the film and my being connected to both.
- Do local people differentiate between mental illness and spiritual? What is your assessment?
They do, but that very differentiation has powerful consequences for people, as mental illness if defined as such is very much stigmatised. Spiritual explanations for the most part are not. According to Dr Puloka people are often very aware of hereditary factors in mental illness.
- The psychiatrist and his patients drink kava during the film. What is the background to this?
Dr Puloka has been part of very well established kava club in the centre of Nuku’alofa called Ulutea, it was there that he learned a lot about history and different terms to describe mental illness. It was there that he also tested ideas. Often previous and current patients would drink there and so he started to see the benefit they got from the supportive and convivial atmosphere and decided to introduce it to the hospital.
- Because of the subject of your film you are confronted with many sufferings and their culture-specific handling. Did you often find it difficult not to intervene and to keep the role behind the camera?
I had been working with Emeline for a long time before I started videoing, and so I was aware of what would and would not happen when she worked. There were actually very few occasions before I started filming when I would have wanted to intervene, and after neither. I did not feel I was behind the camera, rather the camera was facilitating and helping along a process of us telling a story and doing justice to Emeline’s and Dr Puloka’s practice. There was trust based on intention to create something of value, even though it took me 20 years to complete it.
- You mention that you helped Emeline with her healings. To what extent exactly did you participate?
In my first fieldwork, I would sometime help with massages, particularly with men, in places where massage was needed that might be uncomfortable for Emeline to do. More often, when I had transport or access to transport, I would help her get to the patients’ house.
- Tevita was not taken to hospital and died as a result. To what extent do you think this is connected with your departure?
I left in 2011, Tevita died in 2016. He was taken to hospital after I left and was treated. So my departure was many years before he died. I do think had I been able to go back to Tonga before 2016 I might have been able to help in some way, but then I don’t know what situation exactly he was then. The last year of Tevita’s life coincided with some big challenges in my life in the UK and a eco-village project I was involved in, and I was not as attentive to what was going on in Vava’u during that period. I regret that now.
Emeline Lolohea was not against the hospital, she recommended most of her patients to go to the hospital first. She knew about specific medical procedures, and questioned why they did not use them for Tevita. She still received a steady stream of patients with conditions that would be better treated at the hospital. The hospital was simply not holding onto the patients they could treat. People often joked that the hospital gave Panadol for everything, and increasingly the mistakes of the hospital that in tragic circumstance lead to premature death, are shared on Facebook that reach family in the diaspora. In 2016 I learned the news on Facebook that Tevita had died. I do not entirely understand the reasons why he was not re-admitted, but the absence of Dr Tangitau-he had returned to his post in Tokelau- and the fear that his leg might be amputated and then enter heaven incomplete played a role. He had been bed bound for more than five years.
- At the beginning of your film you talk about the healing of your illness. How did the experiences influenced your field research and filming?
I was at University studying Engineering when I first got sick. In retrospect I had something that I feel was somatised distress caused by unhappiness and feeling out of place and stressed in my first year of university, after having spent a year working for Rolls Royce Aero engines but also having plenty of time to hike, to be in nature, to rock climb and to socialised.
There was a way that the actual cause of my sickness was never addressed because of the need to give it a name of diagnosis that would hold some weight in keeping me at university and I guess was not stigmatising.
I think more than anything my previous experience made me critical of spirit explanations, a not uncommon response from non-Tongans living in the islands, imagining it is covering up something else. In the same way my own sickness could not really be addressed other than by identifying something biological. It took me some time, thanks also to two years of Gestalt therapy to move beyond the idea of spirit only as metaphor or actual ghost, that others can see.
- Do you also believe in the “spirits”?
In medical anthropology we explore the history of the idea of belief, and trace it use from a term that was more about trust or faith, in God, than a statement defining truth or personal truth value or creed which shift in the 16th century with the reformation. I feel belief is not a useful term to use to understand healing in Tonga.
I have not seen spirits myself, but I have spoken to many people who have experienced relationships with spirits. I am not sure how belief would fit into that picture. Evidently spirits (of relatives ) exist for many people in Tonga, it also depend on what you define as spirit. Most of us would not deny that we can continue to have a relationship with people who have passed away, but we might not identify a concrete spirit.
My sense is that when you live in a very community oriented culture, then the experience of spirit is much more likely in the intersubjective space you inhabit, where people are much more influential in how you experience yourself. Ancestral spirits are out of the category of what we typically would use the term belief for.
I find myself sometimes saying spirit are an effective metaphor to explain and deal with sickness, but that is also problematic because evidently in the experience of many people and Emeline they are real and not metaphorical.
- In the last scenes of your film we see your family in Tonga. When and how long did they stay?
My last trip to Tonga was from the 25th October to 30th November 2018, after several weeks in Auckland. They stayed and were supported to stay by the University for the whole time. It was very important for Emeline and the extended family for them to be there. It was the first time in 20 years, that I had come to Tonga with family. So while Emeline had known about my family she had never had the opportunity to meet them. They were treated extremely well and with great warmth and love. It was a very special time for all of us.