As a religious and social centerpiece of countries with an Islamic culture, cleanliness or purity (tahara) has a particularly strong emotional charge and is publicly enshrined. This is true in Indonesia, as concept m’s Rochus Winkler reports. The whole structure is frequently thrown in jeopardy by a fungal infection.
Cleanliness is half of the faith. This is what the prophet Muhammad said, as recorded in the Q’uran. In Indonesia, just under 90% of the inhabitants are Muslims, while Hinduism is practised on Bali and Lombok and most Christians live in the eastern part of the country. Islam dominates public life, and cleanliness is seen as a basic requirement for adequate performance of religious rites. It is not unusual for people to shower twice a day. Particularly before prayer, the face is thoroughly washed, especially ears and eyes, to ensure the proper spiritual condition for prayer. Hands, feet and arms are also washed, because – as the teaching goes – only prayers in a state of cleanliness are heard.
However, requirements for cleanliness can become rigidly dogmatic. A fungal infection – whether on the feet or in intimate areas – can become a sign of shame, bringing the whole balance of cleanliness into disorder. At concept m, we wanted to know how people deal with skin infections in such environments. The study was carried out in Indonesia, but the results certainly apply to other Islamic countries. We carried out long depth interviews with 40 respondents, and discovered unexpected attitudes.
The stigma of a fungal attack is seen as a sign of personal fallibility. A lack of knowledge about risks of infection mostly leads to an irrational judgement of the situation, where personal flaws are the reason for this “punishment”. The fungus is often concealed, under the threat of mockery and exclusion. It can lead to loss of self-worth – “When you have it, you lose your self-confidence”. This can be accompanied by fear of transmitting personal impurity to the family – a personal stigma is also a stigma for the family. Possible desperate efforts to come up with a reassuring reason for the unexpected attack:
Foot fungus is also seen as a threatening stigma of the lower class, and the quintessence of being filthy, and ultimately threatens important social and personal opportunities of advancement. Many aspiring Indonesians see such an infection immediately as associated with hard physical labour, connected with dirt, sweat, stinks – a disease of labourers like dockers or rice pickers. The start of professional treatment of a fungal infection can be described as a traumatic experience of submission, so that treatment is not always consistently followed. Many preparations require a high degree of discipline, and have to be applied regularly over an extended period. This particularly applies to nail fungal infections, which can be extremely stubborn.
An emancipated approach to infections is also severely complicated by the strict requirement for a public display of cleanliness, leading to an urgent need for self-justification, combined with shame – particularly for women. The religious and social system of values makes special demands on women. This is a culture with a conservative tradition of gender roles. A woman should function in the various roles of woman, mother, daughter-in-law, daughter, member of the community. A woman is only seen as complete if she is fertile and can service her husband sexually. This leads to even more rigorous requirements for cleanliness for female genitals. The importance of the vagina to women is shown in quotes like “Even you cannot see it, the v-zone is important like your face!” Given the religious charge in the clash between “cleanliness (next to godliness)” and “dirty (divine punishment for improper thoughts)”, it is particularly difficult for sufferers to deal with a fungal infection repeatedly and over long periods. People would prefer to pretend it “never happened” and shut their eyes to the attack. Before confiding in a doctor or a woman friend, women try first to self-medicate. They try naturopathy and home remedies like herbal baths they can squat over for their intimate zone. Many Indonesians also believe they can atone for their own failings by prayer, and combat the cause in this way. Excuses and justifications to the point of abjectness emerge in sentences like: “It is because I´m so dirty in my soul!” or “If you are so filthy and don´t take care of yourself. I am guilty, I should not think of other men.”
In the probing discussions with Indonesian sufferers, another and completely different aspect emerged. A fungal infection also makes possible an attitude of opposing the strict demands and social shackles. In a strictly regulated culture, the infection is a medium where you can watch uncontrolled growth run riot. The infection doesn’t go away overnight, it stays with you in daily life. Like a mushroom in nature that can split stone, people pit their individuality against cultural pressures. This conflict, which is unaccustomed because it is either not allowed or treated with suspicion, has a certain attraction for many sufferers. It is a way to experience something like your own genuine nature, without having to worry about others.
This article was published on August 9th in the P&A.
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