1. The field research reported on here was conducted over 18 months in five visits to Ponam between 1978 and 1983. I would like to thank the University of London Central Research Fund and the Papua New Guinea Department of Education for their financial assistance, Manus Province and the Papua New Guinea governments for permission to do the research, and the people of Ponam Island for their patience and interest.
2. The term “Western medicine” is particularly inappropriate in this context for Ponams do not perceive that there is anything inherently Western about it other than the fact that it was first brought to Papua New Guinea by people with European ancestors. In their belief, Western medicine is God’s medicine, provided by Him for all people. The fact that it emerged in the West rather than somewhere else is entirely incidental. The term “Western medicine” is conventional however, and I use it in this paper.
3. I use the past tense to describe Ponams during the period of my fieldwork between 1979 and 1983 rather than the conventional ethnographic present. I do this in order to emphasize that the events and beliefs I describe are historically situated and not timeless or changeless.
4. There are about 200 Ponam migrants. Like other Manus they are elite migrants working almost exclusively in white collar jobs and able to afford medical care for their kin (see J. Carrier 1981).
5. While there has been a growing belief in the importance of non-physiological factors (especially psychological ones) in the development and cure of disease, there is as yet no general agreement about a physiological mechanism to account for this, and consequently its impact on medical research and diagnosis seems not to have been profound, though recent concern with the doctor-patient relationship and similar aspects of medical care do reflect the awareness of these factors (see Armstrong 1983:Ch.ll).