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ISSN 1364-8470 。 2015Tay lor&Fr‘lI1CIS

ANTHROPOLOGY & MEDlCINE

Volume 22 Number 2 August 2015

CONTENTS

NOTE FROM TBE EDITOR

ORIGINAL PAPERS

Arran吕ing man"iage; negotiating risk: genetics and sociely in Qatur

97

s，ωÎe Kils!w1!I, Tasneem A! Raisi and Fouad Alshaban 98

Rural Christians' view ofsickness treatment behavior: a case study from a Shandong vi !l agc叼 China

Honge Zhe l1g, Wei Wang and Libin Wang 114

Mixing IÏrtfam and tablets. A healing proposal for mcntally ill patients in Gunaseelam (South India) Marie Caroline SIαg!io- Y(αIzimirsky and Brigitte Sébastia 127

Configuring the paticnt as clinical research subject in the UK national health servicc 品1m:v Adam.'i αnd Christopher McKevill 138

Implications of design on infiιction prcvention and control praclice in a novel hospital uni t: the Medical 飞IVard ofthe 21st CentLlIy Amandlα VanSleelan巾， Jolm Conly, l1'illiam GhαIi and Char!es Malher 149

Naturalncss as an cthical stancc: idea(l )s and practices of care in westcrηhcrbal medicinc in the UK Nina Nissen 162

Biographical similarities bctween spiritual healers and thcir clients in Gcrmany - a qualitative study Bm力ara MH Sföckigl, F/orian ßesch , F/oriαn Jes凹 ich. Chrisline Holmberg. C!alldia M l1'ill alld Michαel Telll 177

Undcserving mothct口 Shifting rationalitîcs in the matemal healthca陀 of undocumcntcd Nîcaraguan migrants in Costa Rica 5αra Leoll Spesny Dos Sanfos 191

COMMENTARY

The poJitics of publishing: debating thc valuc of impact faclor in mcdical anthropolo吕YRoberta RaJJaelà and Tanja Ahlin 202

TBE CANON -10 206

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Anthropology & M e dicine

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Amhropology & Medicine. 2015 Vo l. 22, No. 2，门 4一 126. http://dx.doi.orglI0.1080113648470.2014.985576 iE1111!里229

Ru .-a l Christians' view of sickness treatment behavior: a case study

from a Shandong village, China

Honge Zheng, We> Wang and Libin Wang*

ChÎnG Ag川口tllural Universily. Beijing, 100083. China

(Received 12 MI叩 2014;fillal versiol川 -eceived 5 November 2014)

There arc fcw studies of Christian views of disease and trcatment behavior in rural China. 8ased on Villagc G in Shandong Provincc, this paper dcscribes how, lInder conditions of rural social and medical dcprivation, Christians rcgard physical (rollli) and menlal Ui l/gshen) sickness as reslllting from disturbances 10 communal peace Sickness occurs when evcryday sinful words and actions allow the devil 10 cnlcr 01'

when God lISCS Ihc devil 10 test worshippers' beliefs. In either case , it is the devil who directly causes sickness. Christian Ireatment is through scriplure, communal and individual prayer, and expur.且ation. D旧gnosi s and treatment thus reflect bOlh thcodicy and the emergcnce ofa kind ofdevil culture in Ihc contexl ofrural social crises

Kcywords: rura\ Christians; views of disease; trcatment bchavior; the devi\

l. Introduction

A centuries-old Chinese mode of healing sickness through religious prayer, Qi and exorCISI啊， was regarded as superstition and banned by the new communist government of Chi l1a in 1949. However, since the government's policy of religious freedom in 1978, knowledge of such folk religion is to be preserved as a fonn of intangible cultural heritage but 110t applied. As regards actual treatment of sickness, people do sometimes sti ll res0l1 10 religious folk healing methods alongside other approaches, but Ihe govermnent legally recognizes only ‘ westem' biomedicine and traditional Chinese medicine (rCM)

According to Needham, wes阳111 medicine has been surpassing TCM since the second half of the nineteenth centuI)' and into the twentieth cen阳ry (Pan 1986). Chinese scholars argue 1l10reover that since the early t飞.ventieth century the academic status and increasing pop ularity ofwestem medicine or bioll1edicine has ended TCM's mainstream dO ll1 inance (Huang 2005), with the result that tlley constitute a binary pattem of modem Chinese medicine (Hao 2008).111 1949, there were 276,000 Chinese medicine doctors and 87.000 practicing Westem medicine doctors. By 2001 , the numbers were 334,000 and 1,751 ,000 respectively, a marked increase in biomedical doctors (H lIang 2005, 60). In addition，岛lk medicine is slill prevalent in rural areas and so is a third a1temative source of treatment for rural 阳siden阻， alongside biomedicine and TCM (Kleinman 1980; Xu and Li 2ω8; Zhang 2011)

1n 1978, the Chinese government 1ega1ized the ‘自ve' religio l1s of Buddhism, Taoisll1, Islam, Catholicis l11 and Protestant Christianity. Since then Christianity, especially Protestantism , has deve10ped rapid1y in China (Zhao and Liang 2011; Zhang 20 门; Zhang 2014). According 10 the 2008 - 2009 Chinese Christian HOllseho1d Survey, 70% ofChristians live in rural areas. 2 1.5% are in the youngest group (under the age of 14) and 78.8%

*Corresponding authoL Email: [email protected]

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ZL A川hl'opology & Medici l/e 115

in the oldest (65 alld over) (J in , 2010). More than two-thirds converted because of their Qwn or a fam i1y member's sicklless, an indication of how the Christian revival in China is related to peoples' health concerns (Qi , Liang, and Li 2014, 397)

With the worldwide rise of the Christian Charismatic Movement and its adoption of spiritual means of combatting sickness, spiritual healing has become increasingly valued by Christia11s. They oppose the view that sickness is se11t by God to enable individuals to complete their sanctification by submitting to personal suffering. They see this view as an obstacle to peoples ' Qwn use of sp iritual healing to combat sickness, which is 110t sent by God but arises from enslavement and bondage to Satan

Hunter argues that spiritual healing was the 11105t important factor in the spread of Christianity in China i11 the 1980s. He says that it echoes a key characteristic of Chinese folk religion , which calls on gods to treat sickness and expel devils ‘ ln Chillese folk religion, prayer îs essemially petitionalY, seeking health and wealth in particu\ar. This is reflected in the Chinese Christian tradition ' (H unt巳 r alld Chan 1993 , 7). Without elaborat ing on religious treatments geneω\y， Hunter c \aims ‘ We may also note that social change in the 1980s made spiritual healìng a popular recourse for the sick and their families' (Hullter alld Chan 1993 , 146)

This article aims to show how the definition and treatment of sickness by Christians in a village in Shandong Province , China , blend western Christian and traditional Chinese cultural beliefs. Rather thall deal only w>th the curative effects of religious treatment , the attic1e demonstrates how a Christian world outlook and change in values reflect the huge challenges confronting China's rural commllnities and rural governance as they lIndergo great social shifts and transition

2_ The de自nition of sickness among Village G's Christians

2.1. The Christitllls o[ Village G

Shandong was once central in the growth of Buddhism and Taoism , which remain popular ill Shandong together with many folk religions, including Dongyue Emperor, Bingxiayuanjll , and so on. From about 1820, Protestantism began to spread in Shandong. Jt was 自rst opposed, as in the Boxer Movement ill 1900 (Tao alld Liu 1995), a由er which Protestants sllccessfully adopted proselytizing strategies in Shandong, sllch as tailoring sennons to suit Chinese traditional culture and providing education , healthcare and charities. Christian charismatic movem巳nts were very popular in Shandong in the early twentieth centtuy (Hunter a>1d Cha l1 1993 , 129- 30; Tiedeman l1 2012 , 213). They show evidence of Hefner's three characteristics of Chinese Chri stian conversion (Hefner 1993, 290): beliefs conditional on other beliefs; conversion as additive; and a tendency to equate Christian gods with earlier ones , called ‘ pantheon interchangeability' (see also Lee 20 13; HlInter and Chan 1993; Kao 2009) Am句or c1aim of the Protestant m句ority of rural Chinese Christians is that a l1

believers have the right to spread God's doctrine of salvation and to become pastors，山 g-

ing self-realization through instructions drawn from the Bible, and pro l11oting its transla tio l1 and woridwide disl l' iblltion (Cheng and Ge 2007 , 51). Their Pentecostalism il1cllldes holy possession,‘speaking in tongues' , the view that the unredeemed shall suffer 011 earth, that inunortal souls should end up in heaven 01' hell after death , and that the holiness of Sunday derives from Jesus's resurrection

The new post-imperial republic of China of 1911 , and the Peoples' Republic of China (PRC) of 1949, treated Christianity as the twin brother of imperialism. Nevertheless,

116 Z. !-fonge et al

SQme Chinese Christians and preachers started speaking in tongucs, presenting themselves as the first charismatic Christians or providing the first evidence ofholy possession ln thcir preaching and at gatherings, Ihey would t\vitch, howl or laugh wildly and act unconventionally by singing, dancing, transferring Reiki (lil1gqi) and having strange visions. The many fonns of charismatic Christianity that spread to China, such as Cha risma , New Testament Apostles, Crown , Henotheism , Triple Servants, Shouters and 0凹，ciples, were banned by the Chinese goverrul1cnt as being cults masquerading under the namc ofChristianity. The impact ofthe charismatic movements 011 China's fural Christians can l1ot. however, be ignored

Village G is an independent administrative area in south-east Shandong Province. It is located in Linshu County, whose southem border adjoins Lianyungong City in Jiangsu Province. The village covers an area of about 200 km 2 and includes 320 households in three groups, comprising a population of 1200, of whom about 200 people are over the age of 60. Fieldwork in the village lasted Qver one year, involving the principal researcher Iiving at the home of the hOllse church leader and ministe r. Infonnation came from Ii fe histories and semi-structured interviews with 50 people, including ordained pastors (in Linyi city) , house church ministe凹， church members and people who do not attend church. Alongside participant observation at church meetings , data were collected on personal and family matters, 011 house church histories and on local religious and cultural issues. The co-author, Wang Wei , is from the village and speaks the local language. The vil1agers' inco l11e mainly comes fro l11 fanning, livestock breeding and working in cities Most vîllagers worship 01' venerate ancestors, narural ‘geographi旷日tes and spirits, and 1110st Christians have converted from a folk religion characterized by the custO I11 ofbu l11-

ing incense to worship Buddha. Non-Christian villagers do not think of Christianity as a 'foreign' religion because they regéll吐 Jesus Christ as a god similar to Buddha, Bodhisattvas and celestial beings

Although Christians accollnt for a very small proportion ofthe village's total popllla tion , they stand out and have an inordinate impact on the otherwise quiet village. Their regular, nightly gatherings for worship take place at the home of Wang Zheng's wi缸，who, as at 2013 , has been a believer for 25 years

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Anthropology & Medici l1 e 117

the tradition of exorcism , in that Christianity was also seen as protecting its believers against evil spirits by tllrning theÎr attention to divine signs

1, 1, T"e 111ψeacφIi (b叩illgal/) body

The spec泊c kinds of spiritllal healing that Christians believe can treat a range of physical (rout i), mental (jingshelI) and spiritual afflictions inclllde cO l11mllnicating with gods to release emotions or what else is suppressed in the sllbconsciolls , resoning to confidence in the 臼ith to enhance a patient's psychological sllggestiveness and to achieve self-healing, and relying on clergy to invoke and interpret divine signs , which can drive away evil spirits and bring recovely (Mursell 2001; Macnutt 1990; Keene 2005)

Village G's Christians de白ne and understand sickness generally from Bible texts and preachers ' pronollncements. They regard physical (routi) and mental (jiJIgshen) sickn臼S

as a kind of ‘ unpeace' (bupingα时， which can be explained by 'crim白， 1 (yOllZ川) against Christianity in daily speech and action. These are taken advantage of by devils , or occur as ordeals ordained by God to test believers' fai巾， just like the Bible-recorded temptations given by the devilllnder the order ofGod. 1n this Christian attribution of sickness to crimes (yOltZlli) or ordeals , the former need to be treated thrOl时1 confession, while the latter are passive destiny and glory granted by God , which can only be cured or reversed by persevering in faith and confidence. What cannot be ignored is that the two types of sickness involve the existence of Satan who will be used by God to give temptations and ordeals. As a result, it is Satan who actually infticts sickness

Christians' understanding of the relationship between the devil and sickness differs very much from non-Christians, who take sickness not as outside but as part of the body, in both traditional Chinese and western medicine. Traditional Chinese medicine dîagno ses and repairs organic imbalance through bodily appearance and emotional expression 但su 201衍， while westem medicine also starts with the body to :fìnd and eliminate the cause of sickness (Ma and Liu 2003). Before becoming believers, the villagers would tum to western or traditional Chinese medicine for help , but they now also and sometimes exclusively rely on the ‘ grace ofGod' , leading to a remarkable change i11 the de自nitionand cause ofsickness. This change happens peacefully, without violent clashes. What can be observed in the peaceful transition is the inftuence of inclusive Con且Ician culture as well as the adaptability ofChristia11ity to local culture

In explaining sickness as the result ofιcn

118 Z. Honge et al

instance, argues that Satan, the fallen angel , is 110t equal to God , and can only do things within a range permitted by God , and tl1at therefore Satan is 110t the complete 01' ultimate explanation of all evils (Liang 1998) oohil

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Many Christians in Village G suffer from hypertension , hyperlipoidemia , hyperglycemia. cancers, muscle and bone strains. When surveyed, believers said thal a sick Christian dif岛凹凸 0111 ordinary villagers in seeking help from God iI1stead of 白。m ‘ western' medîcine in a clinic 01' hospital as do 11105t vi lIagers. Some believers make this turn to religion aftel disappointment with biomedical treatmen t. Some are directed away from biomedicine at the outset. For example, Wang Xi鸣， a physically (rollli) sick Christian, had thought to use the New Rural Cooperative Medical System (NCMS) for scienti日c， biomedical treatment, but was persuaded by older believers to seek spiritual healing. They conveyed to Wang their attitude towards sickness and its treatment through divine signs, which , since Wang recovered, were seen to facilitale successfu! cure. Wang's is not an isolated case in Village G, and believers with long-standing religiolls backgrounds seldo l11 consider the option of going to hospital

Non-Christian villagers attend a county Or city mental (jil/gshel/) hospital for the treatment of mental (jingshel1) problems. Family con fl. icts were diagnosed as causing the afftictions of 自ve such patients, three of whom were hospitalized and then home-nursed for a long time. Two chose to vis it a famous ‘ witch' (w叩吟， who cO l1lmunicates with gods through incantations and buming incense , expels eviJ spirits and cures mental prohlems, with one patient improving and the other unchanged

Village O's Christians, however, see possession by the devil as causing mental sick ness and placing the patient at the mercy of Jesus , who alone can provide salvation. This happens in the absence in the rural area of psychological counseling for problems caused by complex family relationships and disputes. Peoples ' II盯elieved mental stress accumu lates as a crisis requiring treatment , but, being unable to afford a mental hospital , they tum to beliefs in Jesus for help

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The Christian villagers start by recalling and admitting personal crimes (yOUZIli), and then praying for God's forgiveness and the power to defeat and defend themselves against the devi l. Village G's Christians hold that everyone is born guilty but that, throllgh Christianizat ion , Jesus helps unburden one's sins. This means following the will of JeslIs, and the church rules and believers' code of conduct regarding words and behavior, violation of which is a crime (vollz lIi). lt is what keeps Village G ‘ peaceflll' and therefore free from the crime ú1ouzui) that !eads to disaster and sickne臼 While original sin is recognized, it is current behavior and practice that are the foclls of attention , so constituting a difference of emphasis 自 0111 what Hunter sees as more typical within the Christian tradition

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The notion of ‘ CI 川晤， (yoIlzlli) is by 110 means stra ightforward. Village G's Christians do not in prìnciple reject the scientjfic medical system , and there is even a saying that ‘ it' s not a crime (y ouzlli) to take medicine and have injections ‘ Wang Zheng ' s们飞川h

church head in the village , agrees wÎth this statement and says that whether or 110t one turns to science for medical treatment depends 011 the faith ofbelievers. That is to say religio Lls and scîentifìc treatments can complement each other

吼叫出 old people being the majority, many of Village G's Christians look to God to cure sickness. 111 2006, a rural cooperative medical care system and insurance greatly uηproved medical facilities. However, st ill lacking are subsidies and compensation for the treatment of serious, chronic illnesses such as diabetes, cerebral thrombosis, uremia ,

and heart disease. Nor, with the ever-increasing urban~rura[ gap , have 也rmers ' incomes improved significantJy. Many fanners therefore 3ttend hospitaJ for minor ailments but decline treatment for serious sickness, preferring to save for the education and marriage of their children. This being the case, spiritual healing is a good option for fanners. This means that the first impression of Christianity experienced by many locaJ villagers is that it does not use mcdicine or injections , the latter being seen as fa ll ing within biomedical science. ln reality Christians do somctimes also seek scienti白c treatment without trying or being able to justify this course ofaction. They do distinguish the two modes oftherapy bUl, except for long and devout believers such as Wang Zhe r毡's wife. most in practice combine religious and scientific therapy. Whi le differing in their reactions when sick ,

with some insisting on God's grace and others turning directly to science, they cite ‘臼ith'

as ultimately deter l1l ining their treatment paths While Village G's Christians do not in fact oppose seeking bio l1ledical treat l1lcnt, they

th ink that the sick should first turn to God's power and grace to dl;ve away demons and cure the disease. However, thereafter tuming to medical treatment because of insufficient and inconsistent faith is not seen to be going against the will of God. Village Christians also say that worshippers vary in the extent of their ‘ piety' and that this inftuences how much they seek scienti fic treatment. In general , the more piolls (i.e. the 1110re reglllar in church a

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Every nîght Village G's Christîans gather to interpret and disc lIss the Bible lInder the leadership of the church head or SO l11eone who has listened to preachings in another church. Few people can read 3nd ìnterpret the Bible on their OWIl. But the inte甲retation that man is bom guilty and that death enters life as a sickness is one that everyone will experience. Alongside belief in Jesus as the only basis of cure, believers regard a second and etemal life in heaven after death as inescapable bllt also as the greatest blessing and not to be feared

As well as Bible leaming, Christians enhance their faith and drive away demons by singing hymns ofpraise to the Lord and songs composed by l11 11sicians and othcr believers

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inspired by the Holy Spirit, sometimes created by adding l11usic to Biblical ve rses. An example used to drive away demons is the song called An Angel, the Iyrics for which come from Chapter 20 ofthe Book of Revelation

The casting out of demo l1s a1so accompanies healing prayers. Believers, either singly or with one 01' tWQ others, ask Jes lIs to pardon theìr sins 50 that, provided Jesus wills it, Satan retreats, 50 securing the ir salvation and peace. Village G's Christians regard prayel as communicati on with God , likening it to a phone call to Him. Following 8iblical interpretation, it enhances faith and draws on His spiritual weapons to expel Satan's demons This is the only way to eliminate those sicknesses, disasters and dangers that originate in confticts between God and Satan rather than from any so-called original sìn

An important analogy wi th preventive medicìne ìs that Chrìstian devotion and selfimposed requ îrements enhance immunity against the devil 's attacks and prevent the 'lInpeaceflll ' (bupingan) bodily conditions that allow the devil to enter. Routinized peI sonal prayers, daily thanksgiving, acknowledgement of gllilt and pllrgation are taken as serving the Lord well a!叫， being preventìve, preclude the need for confession and treatment

Other preventive behav i凹， as urged by the church il1 Village G, is that believers shollld not smoke or drink , or eat animal blood and blood prodllcts , no 1' aff1X poetic couplets (duiliall) and other red adomments (red is the symbol of blood). Nor should they ta lk wildly or comment on people and their private circumstances, 110r worshîp other religious icons or idols. Whi le believer矿山ily personal behavior is not st1'ictly prescribed , their general level of piety should be evident, to the extent that they should aim to pray five times daily，白 001 rising in the morning , before meals and retiring at night. A song before the morn ing prayer, namely,‘Jes lIs is a great doctor who can cure all kinds of strange sickness'. is a way of making the day over to God. Standing up straight, with their hats off, believers offer a prayer before a mea l expressed as ‘ thank God for giving me food , for letting the Holy Spirit stay in my healt, for granting me peace' J 50 ensuring that the whole family can eat, safe and sound. Their Christian rationale is that everything is owned by God, so whatever is enco untered or obta ined, believers should express gratitude to God in prayers anytime, anywhere

Christians should also follow 可he teachings of the

Case Olle. Reporled by Wallg 盯 's wife

ln the ycar when DT's wifc bcg<l ll to belicvc in Jesus. 1 [Wang Yi's wifc] was givcn a dream by God and saw a child with shit on his mouth , wh ich I was to ld 10 wipe off. Thc next day DT's wife camc to my hOllse asking me to pray for hcr. She explained that when persuading

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GS's \\Iifc , who was surrcring greal pain , 10 bclieve in Jcsus, shc made a miSlake by saying that GS should 510p lortu rin吕 hi s wife, and Ihut his chiJdren would burn paper moncy for him. DT's wifc in eJTecl spoke thc words of thc dcvil , because Jesus' s followers arc not allowcd 10 bum papcr lTIoncy. As a result shc 川so felt unbearablc pain. I told hcr 10 confess this 5in immediately, wbich she did , vowing nevcr 10 talk Iike that again or go 10 GS ' wifc. I thcn praycd for hcr, saying that she was only an ignoranl child and may God p盯don the sin on hcr mouth. Aflc r sevcra l prayers. her pain va nished. On leavin吕 the gate ofmy housc, she suddcnly Ihfew IIp , and 、，vcnl home recovercd

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It was interpreted that Wang Yi's wife cured another believer through power granted by God. The dream God gave her authorized her to enforce the law by llttering relevant words , w hich echo Biblical text. According to the Gospels , after the resllrrection , Jesus appeared before hi s disciples, and said ,

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Go into all the world and prcach the good news \0 all crcation. Whoever bcJicves and is baplized will be savcd, bu\ whoever does 110t bclieve will be condemllcd. And these signs wi l1 accompany thosc who bcJ icve; In my name thcy will dri ve out dcmons; they will speak in new tongues; Ihey will pick up snakes wilh thc ir hands; and when Ihey drink deadly poi so~， it will not hurt Ihcm at all; Ihcy wi l1 pJace their hands on sick people、 and they will get wcll.-'

What's different il1 the example is that power is not directly exercised on behalf of God, al1d be lievers in need have to ask God for the power themselves to cure sickness and drive out demons

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As well as the physical (/'o l/ /i) or mental (j illgshell) unpeace (bupillgω1) caused by Satan and demons in the wake ofbelievers' Christ ian cr imes (fallzui), there is that brought about by Jesus in the form of temptations, ordeals and tests. As well as driving out the demons causing sickness, believers must cope w ith lInpeace (bupinga1/) in three ways. They must first recall their inappropriate words and behavior; they must then, 011 thei r knees, confess their guilt to God and pray for forgiveness; they must persist in this until they 旬e l better, or, if experiencing no improvement, mllst且1 r阳e白ca州11 0叫tl仙h】c町rCfll川1mηnes臼s (仙/向加Uωω11阳J

W咄hile c∞on川川1η1t1川n阳u山川m吨n鸣g t阳o pra町y.l忖t can even happen t阳ha l川an削o创lh阳e町r p阳e町rs刚on'、s c口m】nm刀lme臼s (价/舟(1/切阳11旧阳1信凶z且t川(/叶i) cause one's suffering: in the early stages ofher belief in God , Wang Yi's wi也 was puni shed by Jeslls bec3 11se her husband at the time was not yet a believer, it presumably being her responsibility to convert him. Praye rs can be said a number of times daily in an effort to procure God's forg iveness. If ineffective through in su们百cient faith , be lievers aJ它 not deb31丁ed by God from seeking medica l treatmen t. Similarly, wh ile healing through exorc ism among Vi l1age G's Christians îs also regarded as 1可 ligiously acceptable and may be instantly effective through the use of simple rituals and spells (2hou , Sun , and Huang 2009) , prayer is regarded ideally as the most desirable and e ffecti ve ‘ therapy' for believers not at peace , given the immediacy of contact with God

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nVJos wan Soon after I camc 10 believe in the Lord, a grandma died. 110ld my husband [Wung Yil not to burn papcr or to kowto \V butjust 10 give J110ney. He gruntcd and said,‘how can J vis it a gravc without kowlowing?' Not bci ng a bclicver, he did kowtow berore the grave. I didn't think too much about il thcn, nol knowing what it might mcan. On his way back , hc round a pumpkin

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missing ncar our house. When he lold me that a purnpkin had becn laken , I said that wc should give thanks 10 God and, as a believcr, I didn't carc who took and ate Ît. With a quick tempcr and without faith in the Lord, hc said that J should thank the dcvi l. I 3150 1051 my tem. per and fircd back by saying that it was hc who should ihank thc devi l. That day rny arm hU r1 as if cut off. He wantcd the doctor 10 give me a shot. 1 said no ‘ because I must havc committed a crime [rOI口ti]. Peoplc said in Ihe church that they had witnessed arthritis bei吨 cured同and that my pain would bc Qver, 100. So I Ict my husband [刷，但盯] ask Wang Zhcl毡's wifc 10 comc Qvcr and pray for me, because, as a beginner, 1 didn', know how 10 confess and could on[y Irust othcrs 10 pray for God's forgîvcne55. Thcn Wan吕 Zhcn且 '5 wirc prayed ror mc , artcr whîcb , although I had not bcen able to stand berorehand , I could then do 50. dC5pite somc paîn. Imysclralso borc in mind a spiritual song , and kcpl singing it whcn walking or siltin旦，so thal my dcar, Holy Falher [God] mighl know the surrcrings or His childrcn [God's childrcn] and give me a way out orlhe laborin吕 in which I was trapped every day

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Thc next day, my husband had 10 go and build somebody else's housc after brcakra5t , and I had a calr al homc 10 feed. Since I needcd 10 get thc work done, I praycd to God again. At that time, 1 didn't know 10 pray, so I just stood with tcars in 什ont of the bcd and said what was in my mid. I begged JeSU5 10 sho \V mercy on my sinru\ se lrand gr..mt me the stTen且th to cut 50mc grass to fccd the calf, givcn that my husband was away. I Ihcn carried a baskel and limped outside, but the pain slopped completely when I cut gras5 in the 白cld， and I came back with a full ba5kct. Frol11 then on , the pain never camc back. This wa5 due 10 the 吕racc or Je5Us in whom I belicvc

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Wang Yi's wife here believed that her and her husband's crime (yollzui) had made them vulnerable to the devil who therefore took advantage ofher and caused her pain , but that her faith enabled God's words to defeat the devil , driving out demons lO ensure recovery. Her faith in the Holy Father was reinforced by this experience of prayer and confession securing His forgiveness and cure. Thus , this emerging Clu-istianizing of rural healing retains two distinctive Chinese characteristics: fu时， <the emphasis on the experiential immediacy ofthe supernatural' , which is a characteristic ofChinese Protestantis I11

throughout its history (Dunch 2001 , 203 - 204); second , believers' view that Christianity is very efficacious, and that 可he believed degree of efficacy' (ling) or 'efficacious response' (!ingying) is the most important determinant of a de町's ranking in the local world of spiritual power (Chau 2006 , 241). It is therefore ve,y dif白cult for local government to interfere with this healing approach

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A Pentecostal characteristic of the Village G church is tlle style in which the Gospel is promoted. As we lJ as powerful evangelism, spiritual songs , accounts of healing signs, and the use of miracles and \Vonders to prove what is preached, sick people are urged to believe in Jesus in order to be cmed, this being the main means of attracting believers. At church gatherings, they express gratitude to God for having been cured and tell stories of Jeslls's po、，ver

Conversion to Christianity in Village G is thus heavily associated with experiencing and addressing physical (1'0川) or mental (jiJlgs/i山1) sickness. The village's Christians are so tightly knit in their belief that Jesus cures that, when they regularly congregate in church and sing spiritual songs, physical and mental sickness is always a starting point for discussion and activity. It is understood as ‘ unpeace' (bllpingall) caused either by Satan exploiting a crime (youzui) committed by a believer's daily words or actio时， or by God's test or ordeal of a believ町's faith , where any deficiency enables the devil to bring abollt sickness. In both instances, tlle treatment is to drive out demons

123

Curative treatment through exorcism tU I11S to scripturc1 collective diagnosis , individual prayer and expurgation. But daily prayers and individual confession can in fact prevent sickness happening in the first place. Some Clu'istians may tum to biomcdical scientifìc treatment in addition to exorcism. Lcvels of faith inevitably vary. The local interpretation is that it is the most pious who choose faith-based spiritual healing, that somc less piOllS opt for either spiritl1al healing 01' biomedicine, while the least pious and most peripheral Christians tcnd towards greater reliance on biomcdicine and, in some cases, neglect spiritual healing entire\y

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In ignoring a classificatîon of sickness as either only physical, mental or spiritual, and by viewing it as resulting from Christian crim回收。IIz11i) committed by believers or fro Il1

failing God's tests of faith , Village G's Christ ians have 1l1ade this religious fOCllS on health care and sickness treat1l1ent their prÎ 1l1ary method ofspreading the Gospel

Their logic is that health means Christian virtue, while sickness is evidence of con'up tion and wrong-doing. A standard pllblic health expectation is that sickness diagnosis and treatl11ent should be part of an improvement in villagers' medical condition, bllt among Vi l1 age G's Christians sickness is attributed to individuals ' lax 1110rality for which they are sllbject to trial and punishment. Diagnosis and treatment are therefore expressed as being ofboth God and Satan, as both theodicy and diabology, and defined as symptomatic ofevil acts 01' words, for which the victim is subject to harsh assessment

Village G's Christians see the devil as trying to drive a wedge between God and man Peoples' evil ideas and practices derive from the devil , causing them to commit crimes (yollzui) against God and to drift away from Him , against which Christians I11 Ust instead follow God away fro111 the devil

Satan 01' the devil is regarded as being everywhere in the Christian world and is a teml ofreference whose frequency ofusage is second only to Holy Father or Jesus among local Christians. This is because any misfortune or sickness is ascribed to the work of Satan ,

whom those of strong Christian faith resist. They do not 岛ar him but are wary of the dangerous path through Christianity that the ubiquitous 气Jevil culture' may create

The converse ofthis devil cllltl1 l可 is the positive achievements that Christians attribute lo God , 011 whom they are totally dependent for solutions, given their own ulti l1late inability to cope with li旬 's difficulties. Their peaceful or peace-seeking mindset also has a tendency to fatalis l1l. The ubiquitous devil culture has deviated from the doctrine of Christianity

Unlike the claims of other studies, Village G's Christians see sickness as ‘ a result of their own sins and the wi l1 of God' (Qi , Liang, and Li 2014), rather than of origina l sin In viewing sickness as the consequence oftheir own ‘ cn l11白， (yollz lIi) (violating Christian doctrine) and pllnishment for failing God's test, believers' focus 1S rather on their own words and deeds. Believers are thus responsible for their own

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explanation of sickness and cure. The experience of this sma!! group of Christians is the tip of an iceberg, for they represent a reaction to continuing, inadequate rural health care They could be followed by others

This is because the current rural primary biomedical system is ofuneven quality, with great roO I11 for the improvement of techniques and service. Rural doctors are ageing and have outdated knowledge. The low salaries erode work enthusiasm, initiatives and theil sense ofpublic service. There is 110 emergency equipment nor inspection and tests ofvillage clinics, 50 that the only optìon 自or seriously sick patients is to attend city or county clinics instead. But even 50, people aI气e reJuctant to spend money 011 urban 1ηedìcal expertise that they do not trust, with the result that their untreated condit ions deteriorate. The rules for NCMS reimbursement are too complex fo 1' the villagers who find the different levels of hospital administration incomprehensible and for who l1l clear policies introducÎng and explaÎning the system are needed

There is neve!1heless a rising expectation that scientÎ白cally based health care should become a part of everyday rural li旬， given peoples' increasing longevity and higher rate of chronic sickness. While Christians have tumed to spiritual healin巨， non-believers in the village have 110t been able to identify with Christianity. Moreover, through their co1-1ective activities, Christians have created a sense of communal identity in the village, which has helped to solve the problems of community integration and 1'ole integration existing currently in 1'ural village governance in China (He 2012)

There is 且rst the question of comI11unity integration. 111 Village G, the house church not on1y compensates for the inadequacies of state medical care by o fTering be1ievers a l1

alternative therapeutìc community (Qi, Liang, and Li 201 4) , it also contributes towards building a community based on strong emotionaJ ties and mutual help, and faces challenges of life and death as well as exchanging needed goods (Tonnies 2002). Christians in Village G are thus like a big family , with long-standing converts offering such support to new ones

Second, there is the issue of role integration. Village G's believers suffering from chronic sickness do not conform to the expectations of Parsons's (1951) siclmess theory They lack the right to be exempt from social responsibilities and must play the role of good patients and such continuin

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culture in China. They are silent people who do 110t organize petitions Or public demon

strations, and 50 for a long time have been easily ignored by ruraJ socioJogy researchers, policymakers and practitioncrs. However, given a possible increase in their numbers and

influence, they dcserve the attention of schoJars

Acknow1edgements

This projcct is funded through a capacÎty buildîng iniliativc for Ecohcalth Rcscarch on Emer;吕11l gInfcCliolls Discase in Soulhc巩Sl 八sia supported by thc Internatìonal Development Rcsearch Centrc (l DRC), thc Canadian Inlemational Developmcnt Agcncy (CIDA), and thc Australian Agency fOl

IntcmatÎonal Developmcnt (AusA ID) in partnership with the Global Hcalth Rcsearch Iniliativc Thanks arc duc to thesc or吕anÎzalions and also 10 Hea !th 8urcaus in the location whcre Ihc authors' fìeld rescarch was undcrtaken. Finally, special grati lUde is duc 10 all mcmbcrs of the authors' rcscarch tcam

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Conftict of interests

There arc no connicts of inlercsl

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Ethics

Although institulional ethical approval was not deemed to bc required for this rcsearch, thc research fo lJowed Ihe ethical guidclines laid out by Association of Social Anthropologists of the UK and Commonwealth (ASA) for conclucting research, ancl infonlled conscnt was obtained from all partJcJpants

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Notes

1. Crime (1'OIl:::U;) is thc general tcnn used by the local Christians for words and actions that violate Christian doctrines

2. A local Christian exprcssion, lIsua[[y rcferring to inadequalc belicf in God 3. Thc Gospel oCMark , chapler 16, sect ion 14一 18

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