THE RECOGNITION OF PSYCHIATRIC DISORDER IN BRITISH HONDURAS

by
MARY KENYON BULLARD

A DISSERTATION

Presented to the Department of Anthropology
and the Graduate School of the University of Oregon
in partial fulfillment
of the requirements for the degree of
Doctor of Philosophy

March 1973

TABLE OF CONTENTS

Chapter 
 
1INTRODUCTION
 The Nature of the Problem
 Theoretical Implications
 Methodology
 Organization of the Study
 
2BRITISH HONDURAS: THE LAND
 
3BRITISH HONDURAS: THE URBAN SETTING
 Residential Patterns and Housing
 Dress
 Employment and Other Sources of Income
 Family Economics
 Family Structure
 
4BRITISH HONDURAS: THE RURAL AREAS
 The North
 The Western District
 The Southern Area
 
5SOME FACTORS RELATED TO HEALTH
 
6THE HISTORY AND NATURE OF INSTITUTIONAL CARE FOR THE MENTALLY ILL
 The Facilities in Historical Perspective
 The Hospital and Patients
 Hospital Personnel
 The Relationship of the Hospital to the Community
 
7PATHS TO INSTITUTIONALIZATION
 Admissions Resulting from Police Action
 Referral by Relatives
 Self-commitment
 Admission by Pretence
 The Effects of Institutionalization
 
8ABNORMAL PERSONS IN THE COMMUNITY
 Physical Handicaps and Low Intelligence
 Non-institutionalized Cases of Psychiatric Disorder
 
9RECOGNITION OF MENTAL ILLNESS
 Folk Symptomatology
 Folk Psychogenic Theory
 Abnormal Behavior not Regarded as Psychiatric Disorder
 Neuroses
 Depression
 Drug and Alcohol Use
 Ideas of Reference and Paranoia
 Religious Fanaticism
 Culturally-defined Illnesses
 
10TREATMENT OF PSYCHIATRIC DISORDER
 
11DEVIANT BEHAVIOR AND ITS EFFECTS ON THE RECOGNITION OF PSYCHIATRIC DISORDER, PART I: GENERATING FACTORS
 Childhood Experiences
 Deviant Careers
 Concepts of Responsibility
 Boredom
 
12DEVIANT BEHAVIOR AND ITS EFFECTS ON THE RECOGNITION OF PSYCHIATRIC DISORDER, PART II: REINFORCING FACTORS
 Particularism
 Strength of Family Ties
 Geographical Mobility
 Weak Social Controls
 
13CONCLUSIONS
 
13BIBLIOGRAPHY
 
 
LIST OF TABLES
Table 
1SOME PRICE-CONTROLLED ITEMS
2ONE DAY'S FOOD PURCHASES FOR A FAMILY OF SIX
3COMMONLY CONSUMED FRUITS
4MORBIDITY RETURNS: BRITISH HONDURAS, 1965
5HOSPITAL POPULATION, 1907-1967
6ADMISSIONS AND DISCHARGES, SEAVIEW HOSPITAL, 1907-1967

CHAPTER ONE
INTRODUCTION
The Nature of the Problem
It has become obvious that definitions of health and illness incorporate cultural and social values as well as objective conditions. The wealth of material collected in Jaco (1959), Freeman et al. (1963), and Apple (1960) well establishes this point. Several social and cultural factors influence the perception and treatment of ill health: (1) whether the symptom or complaint is regarded as "normal" or unavoidable or as one which should be treated (Clausen 1963), (2) the right of a person to assume the sick role and his willingness and ability to comply with the rules governing it (Parsons 1958 and Mischel 1959), (3) the possibility that the symptom may be regarded as a desirable departure from the normal, (4) belief in sickness as divine retribution, caused by a supernatural agent, the result of witchcraft, etc. , (5) failure to distinguish between causes and symptoms. One or more of these factors is involved in any person's becoming ill, and in certain illnesses, e. g. , psychiatric disorder, these aspects can constitute very nearly the whole of the disease itself (Szasz 1970, Scheff 1966, and Sarbin 1969).

As mental illness is inextricably bound to social and cultural norms, research in this area will be more likely to expose the abovementioned factors than would an examination of somatic disease where these norms are neither so crucial nor so operationally extant. Several major epidemiological studies of mental illness have established, if not the extent and gravity of the problem, at least the enigmatic aspects of it. Eaton and Weil (1955) studied the incidence of mental illness among the Hutterite s in the United States, Hollingshead and Redlich (1958) explored the relationship between mental illness and social class, Leighton et al. (1963) described psychiatric disorder among the Yoruba in Africa, Jaco (1960) mapped the incidence of mental illness among Texans, and Srole et al. (1962) found very high rates of mental illness in Manhattan. Partially a s a result of these surveys, there has been an increasing recognition on the part of these and other researchers that the nosological designations, behavioral definitions, clinical categories, etc. utilized in survey techniques often fail to encompass all of the mentally ill for the purposes of the research. Conversely, they may count sizable numbers of people who are not, by common definition, mentally ill at all. This has led to an interest in the processes by which persons are labelled as mentally ill and the behaviors and perceptions which initiate the processes. Lemert (1962) and Goffman (1963), for example, focus on how other people react to the first signs of psychiatric disorder in a person. The literature reflects a great amount of formal disagreement among professionals as to what counts as a case of mental illness (Plunkett and Gordon 1960 examine the "case criteria" in a number of survey studies and they are widely divergent), yet it has been shown that this published disagreement is somewhat irrelevant to the real problem--isolation and description of the lay diagnostic and labelling procedure. Scheff (1966), in his examination of commitment proceedings stresses that it is the community which decides who the mentally ill are, and professionals for the most part acquiesce to this informal lay decision-making. Mechanic (1962) finds that the crucial factors in enumerating and defining the mentally ill are those which are operating in the average person of any society, the friend, relative, or co-worker whose common-sense criteria of a person's mental health or illness are the determining factors in the assessment of sanity. Edgerton (1969), using the concepts of "negotiations" in the diagnosis of mental illness in an African society, also views the community process of identifying and labelling the mentally ill as one which cannot be ignored in any examination of

The general aims of this research were to discover and describe the definitions of and attitudes toward psychiatric disorder in British Honduras, and to relate these to other aspects of social life. This entailed an examination of many aspects of the social system, beliefs and values, patterns of interaction, as well as a great deal about disease in general. In this investigation of the attitudes which British Hondurans have toward psychiatric disorder, both the cognitive and affective components of attitude will be described. I will catalogue the information the populace learns and shares about causes, manifestations, and prognoses in mental illness. The basic premise upon which this research is based is: Social and cultural factors greatly influence the definition, perception, and treatment of psychiatric disorder, and these factors will vary in importance and effect among peoples with different cultural heritages. Related questions to which the study is addressed are:

1. What are the factors which contribute toward certain kinds of behavior being called psychiatric disorder, and why is it these and not others?

2. Are there any broad similarities and consistencies in the behavior of the mentally ill pointing toward a great deal of learned behavior and a good understanding and performance of the role in persons so labelled?

3. How are the forces of society organized and activated to label and isolate the mentally ill?

4. In a given societal context, how necessary is institutionalization of the mentally ill?

5. Can some forms of deviant behavior, especially those called mental illness, contribute to the stability and cohesion of a society?

Theoretical Implications
Although this study is an investigation and description of folk models of psychiatric disorder, and perhaps as such might be called "ethnopsychology, " there is still the problem of placing the emic data in a familiar and more scientifically acceptable etic framework. 2 Toward this end the data are presented and explained in the context of British Honduran life and thought, and clarified when necessary by references to theory in the social sciences. The information is also compared implicitly with the general emics of Western Civilization in the area of mental illness and deviant behavior. Thus there are examples of behavior which, although they are not thought to be pathological by British Hondurans, would nevertheless be judged so by both psychiatrists and most lay persons in the Western world. These examples are provided as evidence of etically deviant or bizarre behavior which is emically normal or at least acceptable in British Honduras. Although it may at first appear illogical to apply etic standards of behavior 3 as a measure to the emic standards of society in an area as contextually relative as mental illness is usually thought to be, it can be justified. First, pragmatically speaking, one must start somewhere in the descriptive process; and, second, there are certain broad standards of behavior (referred to in the final chapter) the violation of which would be considered as abnormal almost anywhere. These might be called the universal emics of sanity. Third, in any area such as psychiatric disorder, etics--which are the nosological definitions of psychiatrists and psychologists--are no more than the emics of the scientific community.

Throughout this study there will be many implicit and explicit assumptions made and some of the more crucial ones will be examined here in order to place the data in better theoretical perspective. Perhaps the major assumption involved is that there exists such an entity as "psychiatric disorder" and that it has "sociocultural aspects. " The reality of psychiatric disorder has certainly been questioned although most frequently under its alias of "mental illness. " Thomas Szasz, in his widely reprinted essay, "The Myth of Mental Illness, " makes a strong case for just such a situation.

... In contemporary social usage, the finding of mental illness is made by establishing a deviance in behavior from certain psychosocial, ethical, or legal norms. The judgment may be made, as in medicine, by the patient, the physician (psychiatrist), or others. Remedial action, finally tends to be sought in a therapeutic--or covertly medical--framework. This creates a situation in which it is claimed that psychosocial, ethical, and legal deviations can be corrected by medical action. Since medical interventions are designed to remedy only medical problems, it is logically absurd to expect that they will help solve problems whose very existence have been defined and established on non-medical grounds (Szasz 1970:17).
His main thesis is that persons now called "mentally ill" would be better described as having "problems in living" and should be jailed if found guilty of crimes and otherwise left alone unless they seek help themselves. He, of course, advocates that persons with behavioral manifestations of organic problems should be medically treated as well, but as the majority of persons in mental hospitals are judged to be in "sound body" as far as current knowledge permits, this proviso would not affect a great many people. One of the main tenets of the "mental health movement" is that persons with apparently severe mental problems probably have some chemical, metabolic, chromosomal, etc. abnormality, which is as yet undetectable by medical science. This however, if it were established, would still not explain the content of various kinds of psychiatric disorders and would render largely inexplicable the previous and current successes of non-chemical therapy. Clearly this is far too large a problem to be thoroughly discussed here but it is one which has been kept in mind throughout. For this reason, I have chosen to use the term "psychiatric disorder" which, although it is certainly not theory-free, at least addresses itself to the usual mode of correction rather than postulating a cause or locus of involvement.

That such an entity as psychiatric disorder has socio-cultural aspects is fairly certain in all cases except perhaps those in which a person declares or decides himself to be disturbed based solely on introspection and contemplation of his mental state. 4 Indeed with the problem of community recognition and treatment of persons who appear to be unbalanced, these may be the main aspects. There has been a conscious effort, for several reasons, in this study to eschew psychological explanations and psychogenic causes in the cases of psychiatric disorder presented. Primarily, the behavior manifested can be considered sui generis in the cultural context, and the social reaction to it will be very nearly the same whether it is ultimately produced by unresolved conflicts of childhood, homosexual panic, "mental fatigue, " paranoid ideation, or, for that matter, a chemical imbalance. This is especially true in any area where most of the populace have never been exposed to these terms and the ideas and theories which have produced them. In fact, this innocence of psychoanalytic theory allows British Hondurans much more freedom of expression when talking about their childhoods, dreams, private opinions, and personal thoughts. They do not fear revealing "latent impulses" and various kinds of "complexes. " Such things are not part of their universe of explanations and need not be referred to in a study of them, in the same way that one can describe and interpret the effects of the tides without mention of the moon. It is refreshing to live among people to whom there are no phallic symbols, oral fixations, anal retentive traits and the like. Freud and his followers may well have done us all a grave disservice in transforming flag poles, cigarettes, and red plush chairs into expressions about human nature which they were never meant to be and very likely are not. For British Hondurans, unsophisticated in matters of the "unconscious, " deal with themselves and others in a direct and explicit manner with no preoccupations about what the artifacts of behavior "really" mean.

Much of the discussion of psychiatric disorder to follow takes place in the context of deviant behavior and the theoretical problems involved in confining the concept in this way should be briefly mentioned. That this restriction is also used by persons who endorse the "mental illness" metaphor is interesting because of its inconsistency. Persons with other types of illnesses are not usually thought of as deviants, yet people whose locus of "disease" is in their heads and manifested in their behavior are almost always considered so. I believe this is essentially a misclassification if one believes that there is a physical basis to psychiatric disorder. Traditionally in the United States, persons who are legally insane by definition do not know right from wrong. Therefore their abnormal behavior, no matter how heinous, does not have the same moral implications as that of a sane person. They, in effect, can do no wrong and, like the girl sleeping under the bar, are more to be pitied than censured. In fact, in the current trend of thinking in the United States, it is almost a de facto conclusion that a person who commits a shockingly outrageous act must be insane--the act is viewed as so wrong that it would be unthinkable for a person of sound mind to perform it. This is exactly the opposite of the situational assessment of deviance that sociologists usually assert, that no act is in itself deviant. In reality, some acts are so deviant in themselves that the actor is automatically placed beyond the pale of deviancy into the category of maniac where the act, not an audience, defines the assessment of the actor. There is a relationship between deviant behavior and psychiatric disorder but I do not believe that it is simply that the latter is a type of the former. 5 Rather it appears that a high level of etically abnormal behavior which is not viewed by the community as deviant tends to make the recognition of psychiatric disorder less immediate. This will be amplified in the concluding chapter.

These points illustrate the difficulties in utilizing sociological theory to interpret folk conceptions. Social scientists define deviant behavior in statistical or operational terms as exemplified in the following statements: "... social groups create deviance by making rules whose infraction constitutes deviance" (Becker 1963:9). "Deviance is not a property inherent in certain forms of behavior, it is a property conferred upon these forms by the audiences which directly or indirectly witness them" (Erikson 1962:11, emphasis in original). "An item of behavior, taken in and by itself, cannot be labelled either conformity or deviance. There is no such thing as conforming or deviating behavior in the abstract" (Sherif 1961:159, quoted in Jessor et al. 1968:24). None of these statements has a moral or ethical base even though the usual use of the word "deviant" connotes behavior that is wrong or bad as well as being a serious departure from the norm. Thus a sociological definition of deviant behavior which is totally relative and contextually based cannot be proximate to the definition or emic concepts being used by the vast majority of people even though it may encompass roughly the same behavior. Also the moral vacuum in which the definition is founded removes the rationale for one of the usually defining characteristics of deviant behavior--the use of negative sanctions. The forces of social control are brought to bear on many individuals because their actions are believed to be morally wrong as well as abnormal in a statistical sense. The importance of this moral or ethical component in folk conceptions of deviant behavior will become clear in the following chapters.

Methodology
My fieldwork was begun in August, 1971, and completed in September, 1972. During this period I resided in three locations. My initial location was in "Little Town, " chosen largely on the basis of my previous residence there during 1969. The people of the village were already familiar with me and I knew several families there who would be reliable informants. After several weeks of residence there, several potentially undesirable features of the locale became obvious. The main drawback was the extreme atypicality of the village, evidenced, for example, by the virtual absence of any of the varied racial elements which are so characteristic of the country as a whole. The preponderance of men working outside of the village itself made it difficult to observe complete family groupings, and generally produced the illusion of a whole town composed of women and children--a picture at complete variance with the rest of the country where men are everywhere and at all times in great evidence on the streets and in business establishments. Finally, although throughout most of British Honduras almost all health care is provided by government hospitals and clinics, there was in Little Town a clinic run by a Protestant missionary sect. Even though the administrators of this clinic were much more receptive to my plans of observation and study than their governmental counterparts, I eventually decided that it would be at best misleading to base my study on this unusual situation.. . . At the suggestion of personnel in the Medical Department in Belize City, I moved to Belize in order to be closer to the mental hospital and the general hospital. After a rather long and frustrating waiting period of several months, I realized that although my relocation in Belize had indeed brought me geographically closer to the centers of medical and psychiatric care, I was in reality no closer to the information I was seeking. These months were largely spent in observing and interviewing those persons who were receptive to my inquiries. This was never an easy task. I was continuously an object of observation myself and my social visibility was so extreme as to make it impossible ever to mix naturally with Belizeans. As an unattached female in a city where foreign women are eminently "fair game, " men tended to regard me in terms of a potential romantic liaison and women received me with a latent hostility as a possible disruptor of already established relationships. During this period I lived alone in a small flat in the center of town as my initial inquiries about room and board with a local family were met by reactions of shocked incredulity. This is due to a marked reluctance on the part of Belizeans to accept foreigners on an equal basis. The very people whose approval I was seeking would have disapproved of my taking living quarters in a "typical" Belizean home, and they would have been most suspicious of my motives. Or worse, and more likely, I would have been treated with a certain contempt for lowering my standards and "going native. " Likewise the local upper-class and expatriate communities, upon whose goodwill and tolerance my very presence in the country depended, would have found such behavior on my part most unsuitable. This subtle but very real isolation from the population was a problem never satisfactorily resolved during the period of my fieldwork, but it was largely mitigated by my leaving Belize and settling in an area where there were not so many pre-conceived ideas about how foreigners should behave.. . . Probably this problem of proper role-identity could be resolved, at least in Belize, by the researcher having a more visibly 'sensible' 6 task than that of the rather abstract study of human nature and society. With a more understandable purpose, such as a job, there are many more natural ways of meeting people and gaining their friendship and trust. Without establishing some sort of local credentials that tie one in a concrete way to the society, the social scientist inevitably is seen as some sort of die-hard tourist or hanger-on in this country where foreigners either work or just casually pass through. For Belize is not a small village where daily face-to-face contact with the inhabitants produces its own form of acceptance and role establishment. In Belize, people need not tolerate and finally welcome the stranger. They can, if they choose, have very little to do with outsiders. One solution to this dilemma is to pay people for their conversation. I resorted to this strategem with varying results. Since much of the information I was seeking is of a rather subtle sort, best revealed in fairly natural conversation, direct and formal interviewing was only occasionally productive. Also people found it most odd that I would pay them for 'lone talk' and never ceased to wonder when I would ask them to do what I was "really" paying them for. This was markedly alleviated by giving these paid informants odd jobs and small services to perform for me, grossly over-paying them by local standards, and taking up their time with interminable questions and 'visiting. ' This method worked so well, I continued to use it after moving to "Small Town" although my relations with informants there were much different.

In summary, Belize presents special problems for the anthropologist in the establishment of a workable and pleasant rapport with the populace. I feel that it is not merely happenstance that virtually all of the ethnographic work done in British Honduras has been done outside the city itself. One has to be able to endure many rebuffs and open hostility in order to win the confidence and friendship of a few Belizeans. Some parts of Belize are almost totally unapproachable and Belizeans themselves go out of their ways to avoid certain neighborhoods. There are elements of the population which would challenge a researcher of the utmost charm and tenacity. Even though the anthropologist considers himself a special kind of foreigner, this distinction is lost on many Belizeans; and much of the time one is faced with intense frustration in even the simplest personal contacts.

This is not the case in the 'out districts, ' which is all of British Honduras except the city of Belize. In Small Town where I spent the last half of my stay, there were very few problems, and none of an important nature. The people were mostly of mixed Indian descent speaking both Creole and Spanish. There were representatives of all the ethnic groups found in the country and it was a "complete" community in that there were schools from primary to secondary levels, various denominations of churches, many government offices, a hospital and clinic, and a large sugar cane refinery where most of the population earned its livelihood. Neither was the area so economically depressed as to distort family living patterns. The people of Small Town showed a lively curiosity about me when I arrived and watched me with interest during my whole stay there. However, after it became clear to them through their close observation of me that I had no startlingly peculiar habits, they began to relate to me in a fairly normal manner. Upon my arrival I moved in with relatives of some friends I had made in Belize and stayed with them some weeks. When the chance came to rent part of a small house in their neighborhood, I transferred my belongings and, although I slept and worked in my house, I spent all the rest of my time with this family. Here I became part of the household, eating meals there, helping out in their small general store, making an economic contribution, and assisting with child care and other household tasks. As a result of helping in the store, I made the acquaintance of most of the neighbors and spent much time discussing things with them over their purchases. Many people in Small Town came to think that I was somehow related to this family, and it was an ideal situation for fieldwork.

In both Belize and Small Town, my informants were for the most part "ordinary" people. While I tried to select people as representative as possible of the various ethnic groups and levels of economic and scholastic achievement, I also looked for other qualifications.

People with high intelligence and good verbal expression coupled with the experience of living in several different parts of the country appeared to yield the best information. In this way, I was able to gather case histories of individuals beyond Belize and Small Town. I consciously avoided persons who had spent any time in the United States or whose command of English indicated considerable experience dealing with foreigners. The most important factor they all had in common was their naivete; they had no previous experience as informants and did not really understand the purpose of many of my questions. If there is one underlying bias to the data I collected from them, it is their commendable attempt to emphasize the good and pleasing aspects of life in British Honduras and gloss over what they considered to be "bad, " especially if it involved a relative or friend. As much of my questioning and curiosity was involved with deviant behavior, it is inevitable that some stories remained untold. But British Hondurans have a matter of fact acceptance of life which makes them certainly less shy than most Americans about divulging the details of many lurid events. Certainly there were times when my informants' responses exceeded in frankness anything I had expected. Perhaps the only hindrance throughout all the interviewing was the inevitable dead-end reached when abstract thought was required. British Hondurans argue by analogy and explain by example. They seem to seek the most proximate explanations for actions and events. They neither seek nor postulate grand causal schemes and any attempt to elicit them is very nearly always fruitless. I came to regard this kind of thinking as one of the most salient features of British Honduran life and will argue later that it has a pervasive effect on their views of human nature and how they interpret the actions of others.

Very nearly all my data, as stated above, have come from non-professional people. This is an inevitable result of the difficulties I had in establishing a working relationship with the medical profession in British Honduras. Most health care and all the hospitals save one are administered through the Ministry of Internal Affairs and are under the supervision of the Chief Medical Officer. Although my relations with all the persons I met in their official capacities were very cordial, it was never possible to do the kind of observation and data collecting I had planned. Government representatives exhibited great hesitation, to the point of refusal, in allowing me to tour treatment facilities and examine medical records. Perhaps fearing what they thought would be an inevitably negative comparison with similar facilities in the United States, they chose to deny me professional access to all but Seaview Mental Hospital and I was never permitted to examine any medical records.

During my days of observation at Seaview I found the personnel to be courteous and helpful but markedly evasive about questions of length of patients' stays, medications, etc. On one occasion when an attendant was showing me a list of the patients and their diagnoses, she closed the note book and concealed it when another employee appeared. The problem of medical records was of a different nature in Small Town where on various visits with people to the doctor, I could see that he kept no records on out-patients and few on those who were hospitalized. My knowledge of the workings of the'~ various medical facilities are as a result based on what I could observe as a "visitor. " Needless to say, I rarely missed an opportunity to visit a friend or neighbor in the hospital and I was always available with my vehicle to take persons to and from the doctor. I also have as source material the reports of lay-persons about their experiences I with the medical establishment but these can hardly be taken at face value. My impressions of Seaview Hospital lead me to conclude that, considering the resources available, the government is doing a commendable job with health care and that they need not fear "foreign inspection" of their facilities. However that does not alter the lack of statistical data from which this research suffers and the kind of informed speculation which must be the result of working where a government follows a policy of quasi-secrecy about matters which elsewhere are handled in a more open manner. Had it been made clear to me upon my arrival that all these crucial sources of data would be completely unavailable, I would have completed the study elsewhere. By the time it became obvious that this was the case, far too much time had been invested to make it feasible to relocate. Some inaccuracies under these conditions are unavoidable, but those that follow are largely the result of my being unable to correct the misinformation and errors of my informants with first-hand observation of my own. If a statement is not so, it is at least what the people of British Honduras believe to be so, and thus has a validity of its own in this study of folk models of psychiatric disorder.

This study will be comparative, although not formally so, as the only way to deal with unfamiliar phenomena is to interpret them according to those with which one is familiar. As with most anthropological material, the ways of British Hondurans which are at variance with American or English middle-class procedures will be those emphasized. Indeed similarities between groups of people are often the most difficult to perceive. While it may not be quite so interesting to report that British Hondurans lock their doors and windows when leaving their houses as it is to note that they carefully prevent any fresh air from ever entering a sick room, the former fact is not less valuable than the latter. I have tried wherever possible to enumerate those instances in which these people behave as most of us do in order to avoid representing them as far more exotic than they really are.

Organization of the Study
The study consists of an examination of causes, recognition, and treatment of psychiatric disorder in the context of the culture and society of British Honduras. It is assumed that, in the same way medical problems are differently perceived or perceived not at all in various human groups, the phenomenon usually referred to as "mental illness" would exhibit certain characteristics closely related to the nature of the society in question. The principal aim of the research is to describe the folk model of psychiatric disorder in the context of British Honduran society, and to interpret the local attitudes and beliefs which influence it. The information was gathered during a period of thirteen months divided between Belize City and rural areas. British Honduras is a very small country having both a small land area (8, 866 square miles) and a small population (130, 000). The economy is presently oriented toward export commodities (sugar, lobster, and citrus) and much food and most manufactured goods are imported. The population consists of four linguistically-defined groups 23 -- Caribs, Creoles, Maya Indians, and Spanish--plus an assortment of persons of various European, Asian and American extractions. These groups tend to live in particular parts of the country, with the north and west being largely Spanish and Indian areas, Belize City and the adjacent coastal and riverine settlements predominantly Creole. Caribs are settled in the southern areas. Information about life in Belize, sanitation, housing, clothing, employment, family economics, social organization, and a section on rural life are included. A detailed description of the aspects of life which directly influence health is provided with the emphasis on personal hygiene, waste disposal, food preparation, diet, and sources of contamination and infection.

Psychiatric disorder is described in a section on the history and function of Seaview Hospital accompanied by a description of the facility and patients as they are today. Information about physically handicapped and mentally retarded men and women is also provided to illustrate how abnormal persons are integrated into the community and the manner in which they can lead fairly normal lives. Behavioral traits believed to be symptoms of mental illness are discussed in Chapter Nine.

One of the main contentions of this study is that high levels of deviant behavior affect the perception of psychiatric disorder and information relating to this is presented in Chapters Eleven and Twelve. Chapter Thirteen presents the conclusions. The findings of the study are that British Hondurans perceive psychiatric disorder in a significantly different way than does much of Western society. Their beliefs as to its causes, manifestations, and prognoses can be related to other aspects of the social milieu and some of their attitudes traced to a more general view of man and his place in the universe. The situation there indicates that it is at least feasible to restrict institutionalization to only the severest cases of psychiatric disorder and that there may be some positive effects in tolerating the slightly to moderately disturbed in the community.

NOTES
1. Throughout this study such terms as "psychiatric disorder, " "mental illness, " "disturbed, " etc. will be used interchangeably for stylistic reasons. The special or restricted use of any of the terms will be indicated by double quotation marks.

2. Harris's definition of emics will be used here: "... logic empirical systems whose phenomenal distinctions or 'things' are built up out of contrasts and discriminations significant, meaningful, real, accurate, or in some other fashion regarded as appropriate by the actors themselves" (1968:571). Etic statements as made in the study "... depend upon phenomenal distinctions judged appropriate by the community of scientific observers" (575).

3. Extreme relativists would deny that there are ethic standards of behavior, but this would be argued by those who believe in the existence of moral absolutes. Although the former opinion is more commonly held by social scientists, neither position is empirically justifiable.

4. Here the consequences are purely personal if no one else judges the individual to be disturbed. Much psychoanalytic treatment takes place under just such circumstances.

5. Thus I associate psychiatric disorder with deviancy because it is theoretically traditional to do so, but the emics of the situation in British Honduras do not agree with this classification.

6. Throughout the work single quotation marks will be used for British Honduran words and phrases.

CHAPTER TWO

BRITISH HONDURAS: THE LAND
British Honduras is located on the southeastern coast of the Yucatan peninsula and lies between latitudes 18° 29' and 15° 24' North and longitudes 89° 9' and 88° 10' West. Roughly the size of Massachusetts, the country has a total area of 8, 866 square miles of which some two hundred square miles are made up of off-shore islands called "cays. " It is bordered by Guatemala on the west and south and by Mexico on the north (British Honduras, An Economic Survey, 1971:1). The terrain varies greatly throughout the country from the extensive mangrove swamps on the coast, to broad plains in the north and central areas, and the rugged Maya and Coxcomb Mountains in the south. No more than ten per cent of the territory is cultivated or cleared (Development Plan 1964-1970, 1964:57), the remainder being dense forest and low scrub. The land is drained by several major rivers, the New River in the north, the Belize or Old River and the Sibun River in the central portion, and the Monkey and Rio Grande Rivers to the south. In addition, the southern and northern territorial boundaries are formed by the Sarstoon (Sarstun) and Hondo Rivers respectively. The climate is sub-tropical and quite pleasant. The nights are cool and high temperatures during the day are usually tempered by trade winds in coastal areas. Although the coastal temperature rarely exceeds 96° Fahrenheit, it is often substantially warmer inland. There is a dry season from February through April and occasionally a short dry period in August. During the other months of the year it is rainy, most markedly so from June to December. Rainfall varies throughout the country from about sixty inches per year to one hundred and sixty, generally increasing as one goes south (Romney, 1959). British Honduras lies in the hurricane zone and is occasionally visited by these powerful storms. Most of the coastal towns have been leveled at least once, and the former capital, Belize, has been destroyed twice in the last fifty years by hurricanes (Waddell, 1961).

For administrative purposes the country is divided into six districts: Belize, Corozal, Orange Walk, Cayo, Stann Creek, and Toledo. The capitals of these districts are towns which bear the same names as the districts excepting Punta Gorda, the capital of Toledo District. For an account of local government in these districts, see I Grant (1967).

Until recent years the economy of British Honduras has been dependent on forest products, but depletion of natural resources and development of synthetic substitutes have forced the country to turn to other sources of income. Currently, sugar cane, citrus, and lobster are the mainstays of the export economy. Although agriculture has traditionally been of secondary importance and interest to British Hondurans, it is likely that there will be great expansion in this sector as a sizable proportion of foreign investment goes into plantation type crops and livestock breeding. Also the current government encourages local food production by making land available to the populace if they will clear and plant it.

The outstanding characteristic of the economy of the country is the small absolute size of the population (currently estimated locally at about 130, 000) which severely limits the supply of labor and the size of the local market. Practically all items must be sup-_ plied in small and costly units, and services are so under-utilized that frequently they cannot be provided at all (Waddell 1967). British Honduras does not generally suffer from great extremes of poverty nor does it have a particularly depressed standard of living according to regional standards. Income per capita compares favorably with surrounding countries and is higher than that of all the neighboring republics except Mexico, Costa Rica, Trinidad, Jamaica, and Barbados (Tripartite Report, 1966). Yet statistics on average earnings and employment rates are not gathered in such a way as to make them a reliable index and they may be somewhat lower than reported.

It could be said fairly that wealth is evenly distributed in British Honduras--few have any. 1 Most of the large lucrative businesses are owned by either British or American firms, and most of the prosperous merchants and landowners in the country are expatriates or of recent foreign extraction. There are several exceptions to this generalization and most are found in the commercial areas of importing and exporting and rum distilling. The majority of the populace live rather frugally and if not from day to day, little better than week to week. Briefly, the financial condition of British Honduras is an economist's nightmare with the country almost totally dependent on imports, and on the production of commodities which must be sold on competitive and wildly fluctuating world markets. Without its current protected access to United Kingdom and United States of America markets for citrus and sugar respectively, the country would not have even the pretense of a viable economy. Waddell (1967) stresses this problem and feels that the country is over-populated as well. Carey Jones (1953) and Clegern (1967) both deal extensively with the economy of British Honduras and neither comes to an optimistic conclusion.

British Honduras was first settled in the seventeenth century by British buccaneers and loggers who were concentrated in the coastal areas, only going into the interior during the dry season to cut dyewood and later mahogany. 2 Permission was granted to the British by the Spanish Crown to operate in the northern areas principally between the Sibun and Hondo Rivers. Later, however, as the lumbering operations became more profitable and the northern forests were depleted of trees, the loggers spread further south. In 1798, after the Battle of St. George's Cay between the British 'Bagmen' (or loggers) and the Spanish, the British occupied the southern area between the Sibun and Sarstoon Rivers, claiming the land by right of conquest (Humphreys, 1961). At present, British Honduras is still a colony of Great Britain although it is internally autonomous, and complete independence is pending. However, Guatemala has always maintained that British Honduras is illegally occupied by the British, and is, in fact, part of Guatemala. The increasing autonomy of the colony has led to an intensification of these irredentist claims, and although few people expect a Guatemalan invasion, it is not viewed as an impossibility. Mexico has also claimed certain northern areas of the colony although not so vociferously as Guatemala. The twin issues of independence from England and the Guatemalan claim form most of the content of local politics with each of the several sides reiterating the same arguments--all "for" the former and "against" the latter. In conclusion, it can be seen that British Honduras is in a rather unique position, not only because it is the sole English enclave in Central America, but also because of the number and variety of its problems which run the gamut from having its major city periodically blown away to being claimed as a whole by another country.

NOTES
1. I was informed by several sources that there is no more than nine million dollars (B. H. ) in circulation in the country. Also the highest denomination of the currency is a twenty dollar bill. $1.00 (U. S.) = $1.65 (B. H. ).

2. Although it is not directly relevent to the material in this study, the political history of British Honduras has been of much interest to scholars because of the conflicting English and Guatemalan claims. The definitive work is Humphreys (1961) although Caiger (1951) and Clegern (1967) are useful.

CHAPTER THREE

BRITISH HONDURAS: THE URBAN SETTING
This chapter furnishes information about the setting in which one third of all British Hondurans live l and which virtually all visit occasionally. Belize City is the most developed and Westernized area of the country, the major port, and the quintessential expression of Creole culture. It is West Indian in appearance and character and quite different in size and atmosphere from other areas of the country. Some of the characteristics of the city and its people will be discussed here to provide ethnographic background for the more specific information on psychiatric disorder to follow. Although life in Belize may superficially seem relaxed and casual, there are many stress producing situations and life is not easy. Belizeans do not often appear to be particularly harried or distressed when observed in neighborhood situations and at work because they learn early that worrying about their problems does not help. Neither, however, do they forget them; and the data presented here will help to give the reader an idea of what Belizeans are thinking about.

Residential Patterns and Housing
The small population of British Honduras is concentrated in coastal and riverine settlements and inland in the northern and central areas. Furthermore, the people are distributed in fairly discrete ethnic divisions, creating a situation where most villages and towns are composed of a single dominant ethnic element with varying numbers of other groups present. Belize, the old political capital, is predominantly Creole 2 although all local racial groups are present here. The populace is literally packed into a small (about four square miles) drained and cleared peninsula in the Belize River delta. Although this density of 10, 000 persons/square mile does, not compare with urban densities in the great cities of the world, it is nevertheless high and equals such areas as Berkeley, Detroit, and St. Louis. It should be kept in mind that this density is achieved with no "high rise" buildings, and that most multi-family dwellings have no more than three or four units. There are several distinct neighborhoods: the Barracks, Mesopotamia, Yarborough, Queen's Square, Kings Park, Cinderella Town, Hone Park, The Southern Foreshore, Ex-servicemen's's Area, Lake Independence, and 'town, ' the commercial center of the city. Some of these once had ethnic associations, such as Yarborough, which was predominantly East Indian at one time; and a few still have definite class connotations, the Southern Foreshore, Hone Park, and the Barracks being high-status addresses. The critically needed room for expansion has been in Kings Park, Ex-servicemen's Area, and the most recently drained Lake Independence where land fill is proceeding at a rate determined by the amount of garbage discarded by the populace. With no "clean" land fill available, garbage is used and then topped with rice chaff. This method, slow but effective, has been much criticized by the Medical Department as providing breeding grounds for rats even before the land is inhabited by humans. However, it will likely continue. Belize is suffering from a severe housing shortage with people usually waiting months to find a place to live and houses and flats being passed from one set of tenants to another without the actual property ever being on the open market. Thus families who are able to build in areas like Lake Independence after living four and five to a room in tiny dwellings with several other buildings between them and the street are not likely to complain too loudly about the nature of the land fill.

In the older parts of Belize blocks are solidly covered with buildings. There are few yards or open areas and a network of narrow alleys crisscrosses the neighborhoods. Space is at such a premium that sidewalks are rare. Buildings are set flush against the street with only a small open drain to separate them from vehicular and pedestrian traffic. Over-crowding is an understatement for conditions such as these, and frequent quarrels between co-tenants and neighbors attest to the social strain produced by such close quarters. The transfer of several thousand civil servants to the new capital of Belmopan, fifty miles to the west, has not alleviated the press in Belize. Although the government is encouraging resettlement in Belmopan 3 few persons without government jobs have left Belize to take residence there. Belize Creoles are emphatically urban people; they prefer the lively atmosphere of the busy shops and overflowing streets to the relative calm of the 'out-districts.' 4 For them, life outside of Belize is characterized by 'hard work' with little remuneration.

Along with and directly related to the oppressive crowding in Belize, the next most striking feature of the city is the untidy appearance of the streets. The drains are usually filled with broken bottles, soggy papers, discarded fruits and vegetables, and every other conceivable type of garbage. To compound the effect of these small street drains, there are four large open canals running through the city which carry all the waste material, most particularly raw sewage, into the 'river,' actually Haulover Creek. It is a part of the Belize River delta and divides Belize into its northern and southern halves. This waste disposal system is not maintained by choice. It is rather a reflection of two important aspects of Belize: the lack of government funds to make necessary improvements and the marshiness of the sub-soil. The city itself is so low-lying--no more than a foot above sea level--that latrines are not feasible because they would simply fill up with water. Indeed, it is against the law to dig a pittype latrine. If a person can afford a flush toilet for a building, there is the additional expense of a septic tank because there are no underground sewage pipes. These are not the kinds of septic tanks with drainage tile for the seepage of liquids out of the tank, for exactly the opposite would occur. Rather they are sealed holding tanks which must be pumped out as needed, again at great expense to the owner. It is possible to run a sewage pipe directly into a canal or the river but only if the building is situated directly on one of these bodies of "water. "

The only possible solution to this problem of waste disposal for most Belizeans is the 'bed bucket. ' Small lean-to's are built outside of the building (the distance from the building is not regulated by law, only that it must be outside) and five-gallon buckets or cans are placed in these huts to receive solid waste. Liquid wastes are collected in smaller buckets in the house and emptied in the yard. The outside buckets are carried to the nearest canal when full, only between nine o'clock in the evening and six o'clock in the morning (it being against the law to empty buckets at other hours), and emptied. This service is usually paid for, as many women (men never carry bed buckets) are afraid to walk on the streets during these hours. The canals also happen to be more dangerous than many areas because some of the rowdier elements collect around the public toilets that over-hang the canals, using them as places to hide while smoking marijuana. The canals apparently remain uncovered because of the expense involved in sealing them with wood or concrete. They seem to be a necessary evil, given the present situation in British Honduras; and, in truth, only the people who live very close to them suffer directly from their effects. They are kept open by schools of millions of government-protected catfish who consume much of the offal. Presently children swim in the river, its water is used to wash tables in the market, and it flows directly toward public beaches. Waste disposal facilities are lacking everywhere in the country except Belmopan, but nowhere is the situation more critical than in Belize. The sanitary problems in Belize can only be solved by the installation of a sewer system, the closure of the canals, and the building of a sewage treatment plant to keep raw waste out of the river. Realistically though, nothing will be done soon or perhaps ever since the government has shifted its interests and energies to the new capital where the sewage flows underground.

Aside from these unaesthetic aspects of the city, its climate is pleasantly warm all year round and prevailing sea breezes keep odors and flying insects to a minimum. As in most other areas of the country, the kinds of clothing and shelter are dictated more by personal preference, social convention, and economic status rather than any real need to protect one's self from extremes of climate.

The usual dwelling-type in Belize has long been a raised wooden house with a peaked roof of corrugated 'zinc. ' The house is set upon sturdy rot-resistant wooden posts at least two feet above the ground. After the framework is completed, usually in the form of a cube with angled supporting beams in the corners, it is finished with a wooden floor and horizontal wooden siding. Windows are placed between vertical studs and are finished with outward opening wood-slat shutters instead of glass panes and screening. After the roof is added, the resulting attic is sealed with a wood or wallboard ceiling and is used for the storage of household goods. Rain gutters are always present if the family can afford a water collection tank, but often the water will have to be carried in buckets from the nearest 'stand pipe' or public water faucet. Usually some electric wiring is done with a few drops and outlets for light bulbs and appliances. Rarely will any plumbing be needed, for even if there is a large rain water tank or stand pipe in the yard, Belizeans do not feel the need for running water inside a house if there is a source close by. This is especially true if the property is being rented, as are most houses in Belize. The tenants will hardly put in running water and the landlord knows the house can be rented with no 'conveniences' at all.

The interiors of houses are divided into a few rooms--usually a 'parlour, ' one or two bedrooms, and perhaps a kitchen--by wallboard partitions that do not extend completely from the floor to the ceiling. This provides for maximum air circulation but very little privacy. Doors may be used inside the house but long cloth curtains also serve the same purpose. The house itself usually has both a front and rear entrance, with the rear door used for throwing out used water and garbage. A parlour often contains a set of wooden or upholstered chairs, several small tables, and many decorative objects. The walls may be practically papered with miscellaneous post cards, photographs, old calendars, pictures cut from magazines, various certificates and diplomas, and many small wall hangings featuring artificial fruit and flowers. The tables or hanging shelves will contain more of the same with the addition of sea shells, china figurines, and seldom used small ashtrays. This plethora of diverse objects creates a somewhat erroneous impression of clutter in these invariably neat and spotless homes. The kitchen and eating area usually has a wooden table and several small stools, and perhaps a wooden 'safe' with several drawers topped by glassed-in shelves for the storage of eating utensils, ornate glassware, a special plate or dish, and food which needs protection from rats and insects. Cooking is most frequently done on a kerosene stove although many people now own bottle-gas ranges and a surprising number of people still cook on a fire hearth. Any baking to be done is accomplished with the use of a modified metal drum in which wood or coconut husks are burned. The bedrooms hold as many beds as possible, the number being determined more by the affluence of the household than the sum of people customarily sleeping in the house. Pallets are made on the floor and many sleep in hammocks. As it is seldom cold enough to require a blanket, most mattresses are covered by only one sheet usually made from flour sacks sewn together. People sleep under these in their clothes or underwear. There will be a chest of drawers or two, if finances allow, but most clothing is hung high in the corners of rooms, stored in boxes, or kept on racks nailed to the wall.

Bathing supplies, a bucket for water, a place off the ground to stand, and perhaps a small bench or box to sit on, are kept in a little 'bath-house' outside the house, usually near the lean-to for the bed bucket. Bathing the body is customarily done in the bath-house; other personal hygiene is done in the house or yard. The interior of the house is typically painted in several bright colors, with many Belizeans showing a preference for doing each wall in a different color. Where possible linoleum in vivid hues covers the wooden floors and greatly facilitates the frequent job of sweeping as the green lumber used to build the houses soon shrinks leaving wide cracks between the floor boards. "Luxuries" to be found in some homes include one or more of the following: refrigerators, electric sewing machines, record players, an upholstered sofa with matching chairs, Formica-covered dinette sets, and a t porcelain sink which may or may not have a water supply and drain pipes. Most homes have at least one inexpensive radio. Houses are generally quite small, a house with floor dimensions of 18' x 22' being of average size for a large family. Moreover when this small floor area is divided into at least three rooms and often four, which are then filled with furniture, the amount of space left for moving about is small indeed. It is not surprising that many Belizeans do not spend a great deal of time inside their houses. As a rule men are gone much of the day and night, children are in school, and women do all washing and some cooking in their yards. Also many houses have a 'verandah, ' a narrow roofed porch running the whole length of one side of the building which is left open except for low railings and perhaps a gate for confining children. Here a hammock will be hung and many hours spent doing light work, eating, sleeping, and watching the streets and neighbors.

It is obvious that Belizeans build small houses because of lack of money and space. They are not "small" people in any physical sense, and even though they are not particularly tall, many of them, especially women, are so obese that they must move about with care in their cramped houses. They often complain about overcrowding in particularly tiny dwellings and when Belizeans become affluent, many of them move as soon as possible into larger quarters. Very rich Belizeans build and live in huge houses with large rooms containing so much more space than they realistically need that it is startling to enter them. Yet most Belizeans, when planning a new house, will intentionally build a smaller dwelling than they desire because they are all too familiar with the likelihood of running out of money before a large house is completed. 5 This is a common phenomenon when people build with concrete, the most expensive building material. A partially completed wooden house can perhaps be finished with scrap lumber, but an unfinished concrete block house will remain exactly that, there being no "scrap" concrete. Little thought is given to strength in a house (concrete is chosen not for its strength but for its durability) even though hurricanes are frequent hazards to life and property. The most recent large hurricane in 1961 destroyed most of Belize City but, as people always recall, many frame buildings were left standing. People even build houses from wallboard, estimating its life expectancy at about ten years, barring a disaster.

One important aspect of housing in Belize is that a Belizean does not necessarily view his house as a reflection of anything about himself. This is probably a truism wherever most of a group of people live in rental housing. Some people live in tiny dilapidated dwellings when they could afford better because they cannot find a better house. Although the inside of the house will be immaculate, the outside is often unpainted and patched with used lumber. Belizeans generally view a person's wardrobe and personal appearance as more indicative of his socio-economic status than the condition of his house. In the end, the generally impoverished look of Belize City, created primarily by the tiny ramshackle houses in the neighborhoods, is partly a misleading one. These are generally rental properties which neither the tenants nor landlords will improve. True, there are many low-income families in Belize but the condition of a house is by no means an accurate reflection of the economic situation of its occupants.

Dress
Dress is much more succinctly described. At home children wear odd assortments of old clothing and often when very young (about one to three years) will wear little more than cloth pants. When taken out to visit or to 'walk,' 6 girls are elaborately dressed in frilly little dresses with lots of lace and ribbon trim. They have on socks, shiny shoes, knit hats, and often carry tiny purses. Small boys are dressed in shirts and short pants and also wear shoes and socks. These clothes will be immediately removed as the hot and uncomfortable child arrives again at home. Mothers usually carry extra pants for the children as diapers are rarely used on a child over six months of age. The cotton briefs for boys and nylon panties for girls are far less trouble to launder and more can be stitched from a square yard of cloth. Not as absorbent as diapers, these thin pants require changing immediately after being soiled, so many people put rubber pants on the child to save themselves the trouble.

Men attire themselves in old clothes for everyday wear, usually a pair of worn long pants and a faded shirt or white tee-shirt. Shoes are worn and socks are optional. For week-end and special occasion wear, young men lately favor printed long-sleeved shirts with French-cuffs left open at the wrist, worn with bell-bottom trousers featuring tricky belt loops and pocket trim. Older men generally dress more conservatively and in a style that would render them inconspicuous anywhere in the Western world--dark pants and a white shirt worn with a tie. Young women now are wearing very short, tight-fitting dresses usually sleeveless and wide-necked. To give a dress some individuality, it will be trimmed with sequins, beads, braid or ribbon. Shiny glittery fabrics are preferred, especially in the brightest colors. Some are able to afford ready-to-wear garments, but most I wear dresses sewn either by themselves or a seamstress. Dresses such as these can be had locally for about four dollars (U. S. ) including fabric and labor while even "cheap" imported clothes are expensive, fifteen dollars (U. S. ) for the lowest priced outfits. Much men's wear is locally made, especially trousers, although imported shirts are preferred and predominantly used.

Older and married women wear longer, fuller-skirted dresses of more subdued fabrics. Many females carry umbrellas to shield themselves from the sun and heads are often wrapped in scarves, although it often seems that the most common hair-do is 'rollers. ' Foreigners frequently speculate that Belizean girls never take their hair down out of rollers, and there are truly many that seem to require a very important occasion before they comb out their hair. However as mentioned above, great pride and care are taken of one's appearance in Belize and the abundance of rollers is a very direct reflection of this pride rather than carelessness. The girls are simply grooming themselves to look better later.

There seems to be no British Honduran "national dress" or regional style. As with many things, Belizeans wear what suits them with the main dictate of local fashion being that one look well-turned out, prosperous, and distinctive. Adhering to a particular style is not too important; in fact, nothing pleases a Belizean more than a unique garment of which there is no duplicate in the city. Sartorial splendor is largely a matter of newness and uniqueness. Belizeans spend very large proportions of their small incomes on clothing, and it often appears that they would rather be well-dressed than well-fed or well-housed. In a society where much emphasis is placed on others' assessment of one's appearance, this is a logical choice.

Few people will know what is cooking on the stove, but everyone can see a new pair of pants.

Employment and Other Sources of Income
However, acquiring the funds for even a new pair of pants can be difficult in Belize. Although the city is the population center of the country, there is no large source of industrial employment anywhere near it. The only industry of any kind is a clothing factory where some two hundred and fifty people are employed. Other than this and the fishing 'industry,' the only jobs available are those supplied by the government and those generated by the nature of a small city. The problem of what Belizeans do is a perplexing one when the unemployment rate seems to be so high. It is officially estimated at around ten percent, but most informed sources believe that the percentage of the work force with no full-time job is much higher, likely at least twice the official figure. What would suitably be called "unemployment" in Belize is far too difficult a question to settle here. Rather than enumerate the more obvious kinds of employment in a city of some 40, 000, it would be more beneficial here to discuss some of the less obvious ones and a few of the additional sources of income for those with regular employment.

By far the most common 'hustles' (ways to generate cash without steady employment) in Belize involve the selling of goods and services to people. Anyone can rent a stall in the market and start selling anything. There is one man who has supported himself and his family for years by selling only locally made cigarettes, matches, and chewing gum in the public market. One can also buy, build, or rent any of the several kinds of hand- and bicycle-carts, and either sell from them or transport goods. All kinds of seasonal fruit and especially peeled oranges are sold from these carts. Some carts are genuinely profitable enterprises, and one taco cart-man probably makes more per week than most salaried personnel in the city. He is, however, an exception, as there are few legal hustles which produce a large income.

An illustration of how commercially inventive Belizeans can be is the 'conch shell man. ' For years this man helped conch fishermen by removing the edible mollusk from the large shells and for his reward he claimed only the shells themselves. He saved the conch shells for years, storing them on a bit of land by the river until he had a near mountain of them. He was able to sell some of them for fill to people building in the recently cleared areas of Belize and he made a modest living. He was mildly ridiculed by some, but his vindication came when the new capital was being built in 1969. He sold his entire stock of conch shells to the government for a very high price and the shells were used as construction materials in Belmopan. He continues to save conch shells. There is also a story told about a man who used to pick up new nails he found on the street. He sorted them according to size and saved them in his house in barrels. When every merchant in the city would be out of one inch nails, for example, he would sell his nails--at his price. People also pick up manure on the streets left by the mule-drawn carts and sell it for a few dollars a sack. Scrap lumber is collected from sawmills and sold for firewood and construction. Antique bottles are searched out in the mud flats near Yarborough and sold as souvenirs and collector's items. Cowhorn is picked up from the slaughterhouse, carved into bird-like objects, and sold to tourists and affluent Belizeans. Coconut graters, valued at about forty cents, are made from scrap lumber and old tin cans. People who can afford it pay others to carry water for them, wash their cars, clean their yards, etc. Many of these small services are provided by children, always boys, but adults resort to them when the situation demands it. More permanent and regular hustles include 'scalping' movie tickets, selling lottery tickets or 'boledo, ' and guiding tourists. Except for prostitution, few opportunities are available to women save domestic service and food selling.

While these sources of income do not seem to be of major importance, a surprisingly large percentage of Belizeans support themselves entirely from such endeavors. One peculiar aspect of doing business in Belize is that one rarely buys an item from the person who owns or produces it. There is invariably a "middleman" or two who hustles it. Even though many small farmers bring their produce into Belize themselves, few actually sell it to the public. Rather they 'wholesale' it to street sellers or permanent stallholders in the market. Only when an item is so abundant in Belize that retailers cannot absorb the surplus, do people sell their own products. They can be seen all about the periphery of the market with gunny sacks full of produce in season, such as mangoes, corn, avocados, oranges, limes, and other tropical items that tend to be in great over-supply when in season. Fishermen who find conch pearls or valuable shells usually have someone else sell for them for a large commission. Workers in wood and cowhorn, whose primary targets are tourists, 'front' their wares through people who specialize in hanging around hotels and restaurants and selling things to foreigners. If there is a vehicle to be sold, the owner's proper course of action is to seek out the man who sells cars for people.

Presently the way the middleman system operates in Belize is for the owner of an item (an automobile, a boat, a piece of property, or a cowhorn bird) to declare the minimum or net price he will take. The seller then makes as much as he possibly can, usually well in excess of a usual ten per cent commission. Sellers often raise the price of the item 25 to 50 percent or even double it. The disadvantages of this system are obvious: the owner receives much less than the true value and the buyer pays more than he would have to. However the money is distributed farther than it would ordinarily be, and another person benefits from the transaction. In a society as small and poorly financed as British Honduras, this method of doing business redistributes cash in a monetary economy the same way mandatory sharing redistributes food in a hunting and gathering- or subsistence farming-based society. It also operates like a progressive income tax, in that only persons with sufficient affluence to own or buy major and/or luxury items are affected adversely by it as they essentially buy high and sell low. The poorer people who do all the leg work and talking to consummate the deal reap the benefits. It appears that theft, which will be discussed below, may serve a similar function in the society.

Family Economics
Although it would be difficult to provide a general picture of the economic situation in Belize, a few statements can be made. The average weekly wage is about $23. 00 (U. S. ) or $35. 00 (B. H. ) and a large family--up to two or three adults and as many as six or eight children--can be supported with this amount. While this seems to be an unbelievably low sum, it must be kept in mind that the cost of living is not high in Belize and is even lower in the out-districts. 7 Rents are quite low with a wooden three-room dwelling costing about $20. 00 - $30. 00 (B. H. ) per month, depending on size and location. This, of course, is unfurnished, and without any conveniences. Cheaper places can be found. All food items deemed necessities by the government are price-controlled and a partial list is found in Table One. The dietary staples vary from one ethnic group to another but Creoles will be used for an example here. Polished rice, red kidney beans, white bakery bread, lard, salted pork tails, and sweetened condensed milk form the basis of the diet. Using a family of six, two adults and four young children as an example, it can be seen from Table Two that it is possible for them to eat three times a day on about three dollars (B. H. ). 8

Families with low to average incomes usually buy food in small quantities and on credit. Except for a few condiments and seasonings, very little food is kept in the house, and even staples are frequently purchased daily. It might be assumed that food is not purchased in large quantities because of lack of refrigeration and possible insect or rat damage, but many other factors intervene. One is that there is little quality control of food sold in Belize and some staple items vary greatly in quality. For example, everyone wants fresh red kidney beans because they cook quickly thus saving fuel and preventing the household disaster of the beans not being done by twelve o'clock. As beans sell quickly and there is a high turnover in stock, there is an element of risk every time beans are purchased in getting 'tough beans, ' even though perhaps fairly fresh beans were sold in the same store the day before. No one wants to buy ten pounds of tough beans as some beans are so difficult to cook as to be nearly useless. Rice varies greatly too, especially the local rice which often has a lot of broken grains and unhulled grains called 'machos.' 9 If someone who does not know any better, for example a small child or myself, is sent to buy and returns with poor quality rice, the female head of the household will often send the rice back, complaining that it is too 'dirty.' l0 Lard may be rancid, pig tails may have too much fat, flour can be weevil-infested, bread is often stale, fruits are wormy, sugar is frequently 'dirty,' 11 etc. Belizeans are very concerned about the quality of their food and the slightest fault in it will be noticed and commented upon. And since any purchase is a gamble, Belizeans prefer to keep the stakes small. If it appears odd that there is so much poor quality food for sale in a city where people are most particular about what they eat, this is due to the prevalence of credit buying. The families who charge their food in a small shop are forced to take what is sold there--tough beans, rank meat, etc. --but they do not need to buy much of it. In any neighborhood in Belize all the ladies will always know which shop currently has the freshest beans and where the cleanest rice is to be found.

Aside from the uncertain quality of a food item (rice and sugar are about the only commodities that exhibit their quality in their appearance) another aspect of credit buying tends to keep purchases small. When one is only extended twenty dollars credit per week, it seems foolish to Belizeans to use a large percentage of it for only one item, for example, a can of lard. They instead buy lard "loose" by the ounce when needed. They certainly realize that it costs more to buy one onion for five cents when they could get three onions for ten cents if half a pound were purchased, but this is of no great import. The significant fact is that for the same ten cents, they could manage onion and bread when they want both; and besides, the cook may not want another onion for a few days. Generally the only times families stock up on food are for special occasions, usually around Christmas, and when a hurricane appears imminent.

The mechanics of credit loss and reestablishment are much the same in Belize as all over the country, and it is a frequent cause of worry and quarreling. A family begins by paying cash in a shop for their food and dry good items and soon asks the proprietor for credit. He will open an account for them by putting their name in the credit book and will extend them a certain amount of credit according to what they ask, his assessment of their ability to pay, and their previous credit arrangements with him or other shop-keepers. Usually the account will be paid in full when it is due, every week or fortnight, rarely as long as a month. If it is not paid in full the balance will be added to the next week's purchases. If this continues to the point where the balance is equal to the amount of credit extended, the shop-keeper will stop their credit until the balance is at least partially paid. As the family must buy with cash now, they often transfer their business to another establishment and soon ask that shop-keeper for credit. He will likely extend credit to them even though he is aware of their current grocery debts. This is a result of the abundance of small shops and stores all over the country. 12 There are so many of them, several to a square block usually, that most shop-keepers will take the risk because they need the business. They also realize that after selling a family hundreds of dollars worth of goods at the maximum price possible over a period of months, the shop can absorb a small uncollectable debt.

Even if a family leaves a trail of large bad debts wherever they shop, people will fault the store-keepers, saying that they should have known better than to extend so much credit. Some shop-keepers post a list of their non-paying customers proclaiming the family's name and the amount of the debt, titling the roster, "Hard to Pay. " But this is not a very effective strategy and few people would be very embarrassed to have their debts publicized. Shop-keepers are caught in a classic approach-avoidance or "double-bind" situation; they cannot stay in business without giving groceries on credit and they may go out of business if they do. Some attempt to control their customers' spending for them by not allowing such items as cigarettes, soft drinks, and liquor to be placed on account, but they often relent. Listening to a Belizean pleading for a drink or a package of cigarettes on credit is a moving experience. Few people grow up in Belize without experiencing some kind of deprivation and they feel a great deal of sympathy for a person who has no money and is deep in debt as well. In the case of groceries, shop-keepers are lenient with credit often because they pity the family of a man who spends much of his pay on personal enjoyment when there is no food at home, or 'not even milk for the babies' as they say. But any merchant's limit will be reached eventually and many families need to go far for their purchases because they have exhausted all the sources of credit in their neighborhoods. 13

Few families have much money left over after paying rent and taking care of their credit obligations. Enough may be saved to pay for a child's new shoes or for a few yards of cloth to be sewn at home or taken to a seamstress or tailor. There may be doctor bills or perhaps an obeah specialist is being consulted and needs to be paid. Small weekly payments are often due on a refrigerator or record player and there are usually a few personal debts outstanding to relatives and friends. Any major expenses such as serious illness, the replacement of vital personal goods or tools, a son's wedding, or a funeral create economic setbacks from which it takes months of deprivation to recover.

Every year indebtedness reaches its peak at Christmas. During and after the holiday, Belizeans are so financially strapped and so desperate for cash that the whole city seems to change. Burglary and petty theft reach their yearly highs, fewer men than usual are seen taking their ease on the street corners, and for a while the general populace seems markedly harried and hostile. The price of everything allowable goes up as everyone makes his last minute move to improve his situation. Shop windows are filled with home furnishings and toys of such a quality that not more than ten per cent of the populace could actually afford them, but far more than ten per cent will purchase them. And Christmas is not only a time for lavish entertaining and gift-giving, though this alone would be a crushing blow to most budgets. In addition, all necessary home improvements are made during this season. At times it seems like every person on the street is carrying a roll of linoleum and a gallon of paint. New curtains are sewn, furniture renovations made, and there must be new clothing for all. 14 People are eager to make a good impression on relatives who visit to share a few drinks or a large meal, as this is the only time of the year when Belizeans really "formally" entertain each other. Along with the home improvements, large stocks of liquor, from local rum and beer to the most expensive imported beverages available, are laid in and both a ham and a turkey are required for Christmas dinner. Expensive cakes are baked and imported apples and pears are purchased for display and consumption. There must be a decorated and lit-up Christmas tree and a present for each child. These economic excesses are characteristic of the poorest families equally with the wealthiest as Christmas is the most important holiday of the year, and any future deprivations are seen as nothing compared to the specter of a Christmas without literally all the trimmings.

During the months that follow, retail sales drop to their lowest points as people curtail all possible spending to pay their debts. Even the bars do less business than usual which is a prime indicator of the amount of belt-tightening in effect from January until April and May. In fact, the post-Christmas business slump is only remedied by the large end-of-season payments received by fishermen and cane growers. And so the yearly economic cycle evens out and there are about six months of relative normalcy before the Christmas extravaganza begins again.

No discussion of Belizean economics would be complete without some mention of 'boledo' and 'lottery,' the local numbers games. Boledo, played every week day, consists in the drawing of a number between 00 and 99. It costs five cents for one chance which pays $3. 50 (B. H. ) if the number purchased 'plays' or is drawn. Lottery is the Sunday equivalent of boledo and the numbers drawn, three of them, are between 0000 and 9999. It costs ten cents per ticket and the highest payoff is $150. 00 (B. H. ). Few Belizeans do not buy boledo occasionally and many buy every day. The numbers game in British Honduras is unusual in that although boledo and lottery are supervised and regulated by the government, the profits do not go to a national fund of some kind. Rather, even though the tickets are printed and distributed through governmental agencies, the actual game is run by merchants and boledo syndicates which take the bets and pay them off. The actual selling of the tickets is done by individuals who get a ten per cent commission on their total sales plus a five per cent bonus if they do not sell the winning number.

The average boledo purchase in Belize City is well under one dollar as most people seldom spend more than fifty cents on it per day. But some risk several dollars a day, almost always more than they can realistically afford, depending on how many numbers they are buying and how convinced they are that a certain number will play. Boledo functions like a regressive tax as poor people lose a larger percentage of their money to the system. Indeed many wealthy people, especially the foreign and expatriate merchant class, never buy boledo but only collect the profits. Neither boledo nor lottery can really change a person's station in life. A "big" boledo hit is not more than a few hundred dollars and even a lottery hit, which few persons experience in a lifetime, has only been over one or two thousand dollars a few times in history. Thus it is not like the Mexican national lottery or the Irish Sweepstakes. Some people are opposed to boledo and lottery on these grounds, saying that it only takes the poor man's money, and even if he wins, it leaves him a poor man still. Although the ethics of any government-sanctioned gambling game are debatable, one fact stands out--the people who can least afford to spare even five cents are the ones who support the system.

Family Structure
The economic situation of most Belizeans is inextricably intertwined with their patterns of social organization. 15 The severe housing shortage and general under-employment also intervene to considerable extents in this city where ideals about such things as post-marital residence and household composition can rarely be put into effect. Another important consideration is the dual and contradictory effects of having a large number of children--at some ages and in some circumstances they are a decided economic advantage while in other situations they are definitely a burden. Generalizations about Belizean social organization, at least those couched in the usual anthropological terms, would tend to be misleading and inaccurate. Most Belizeans order their lives by the methods that are the most feasible and available, almost independent of any ideal they are striving to attain or the moral desirability of acts. They simply cannot afford to choose the "proper" course of action where alternatives present themselves; they must rather select the most pragmatic solution to a problem based usually upon considerations of food, shelter, and comfort for themselves and their dependents. It is, as a result, difficult to summarize the situation because at times it appears to be almost a random system.

One of the most salient aspects of life governing social organization in Belize is the almost absolute inability of a woman, in the absence of a male provider, to support herself and her children adequately and to give them necessary attention and care at the same time. There is no true "welfare" system in Belize and there are no child care centers, free or otherwise. From this one situation almost all basic themes and patterns of family life and conjugal relations result. Thus any woman who has children and is without a husband to support her is dependent on the community and her family for either direct economic assistance, in the form of food and housing, or indirect assistance in the form of relief from the burden of child-care, freeing her to work for a wage. The mechanisms of this assistance, which primarily involve children growing up in households strikingly different from those which would be occupied only by their own nuclear or extended families, have far-reaching and tragic consequences. Some personal histories will illustrate both the mechanisms involved and the resulting situations.

A fifteen-year-old girl, Julia, became pregnant after a casual involvement with an older married man. Julia is presently living with her mother, her mother's second common-law husband, and seven younger children. The three oldest children are Julia's full brothers and sisters while the remaining four are related to her only through her mother. She is allowed to stay in the house until the birth of the child. After the child, a girl who is named Peggy, is born, the father contributes five dollars a week toward her maintenance. Julia obtains a job as a clerk in a small shop and seeks lodging with a female cousin who is also working. Julia leaves Peggy with her mother and 'step-father' 1 but visits them daily and gives most of the weekly five dollars to her mother. As Peggy grows up with her grandparents and young aunts and uncles, .she learns to call her mother "Julia, " as everyone else in the house does. She calls her grandmother "mother. " In a few years she will learn how she is related to all these people but she will not change her terms of address for them. Peggy lives with her mother's family for ten years during which time Julia has married and had four children. Now, as Julia and her husband are able to afford a small house on the outskirts of Belize, Julia takes Peggy away to live with her. This precipitates a violent quarrel but Peggy prefers to stay with her mother and finds that she must help with all the household chores, mind and care for the younger children, and run most of the errands as the shops are far. She is forced to stay home from school to work around the house and as a consequence fails several grades, and after three years drops out of school because her advanced age is unsuitable for the low grade she is in. Peggy is now at home every day, doing virtually all of the housework and child-care. By the time she is sixteen, she is so tired of doing her mother's work and listening to her step-father's insults, that she runs away with a young man she met at a dance. Peggy and Leroy get married and live for three years with Leroy's parents and siblings. Peggy has two children during this time and is pregnant with a third when Leroy leaves to work in a different part of the country. For a while he sends money to the family but in six months he has taken another woman and the money is sent only sporadically. Peggy now leaves her two older children with Leroy's family and gives the newborn to one of her mother's sisters with whom she grew up. Peggy is now working as a domestic and visits her children occasionally.

Jane, seventeen years old, living with her mother and three siblings, becomes pregnant through a brief affair with a young man. She decides not to marry him because she does not love him and does not want to 'get tied up' with him. Two years later, after having the baby and keeping it with her in her mother's house, she marries Jose, and goes to live with him in Guatemala, taking her first baby, Sally, with her. In Guatemala Jane has three more children and in fourteen years they all return to Belize because of economic problems in Guatemala. Jane and Jose rent a small house, and Jose obtains a job. One night, after drinking heavily, Jose returns home and sexually assaults Sally, his step-child who is by now sixteen years old and has a boy-friend. When Sally resists his advances, Jose replies that he has paid to raise her and he deserves first chance at her. Sally jumps through a window to escape him and breaks a limb. The incident provokes a mild quarrel between Jose and Jane but Jane takes no measures to prevent a recurrence of the assault. A week later, Sally marries her boy-friend and moves out of the house.

Lily, having grown up with her mother's sister and virtually raised her younger sister, lives with her aunt and sister making a small living by sewing. At 19 Lily marries a man who takes her to live in the southern part of the country. They stay there for a number of years and have two children. He dies and Lily returns to Belize where she finds another man, Frank, much younger than herself. She moves in with him, taking the first two children, a boy and a girl, with her. Lily has lived with Frank for five years now. He cruelly mistreats her oldest boy and takes an inordinant interest in the step-daughter. She has already observed him exposing himself to a young girl in the neighborhood and Lily fears for the welfare of her daughter. Frank also beats Lily severely and frequently when he has been drinking or smoking marijuana. Frank does not allow Lily's friends and relatives to visit her and he works only sporadically. Lily must still sew to augment the family income and she is looking for someone to take her oldest son. She has left the man on two previous occasions but each time Frank followed her and beat her until she agreed to live with him again.

None of these examples is atypical of life in Belize. It is frankly unusual to find a person who spent all his childhood years in one household, much less with his natural mother and father. Conjugal relationships, whether legal or informal, tend to be brittle and of short duration. Women bear children for a series of men and then must face the economic burden of their support alone. When they have found a man to support them, they are willing to suffer much in the way of physical abuse and ill treatment of both themselves and their children for the sake of the relative amount of economic security. Men tend to view women as faithless and scheming creatures who are interested primarily in a man's money and position, and they feel it is part of their prerogative to abandon them almost at will. This instability of family groups and its resultant effects have been well discussed in Judith Blake's Family Structure in Jamaica (1961). The situation in Belize and throughout much of the country is very similar. The multiplicity of types of conjugal unions, kinds of adoption, household compositions, etc. are so diverse as to defy succinct description or general classification. Nevertheless certain patterns appear and one of them is the strength of perceived family ties.

'Blood is thicker than water' is a much used aphorism in British Honduras and people feel very strong obligations towards their consanguineal kin. They often feel the obligations even though they have never been particularly closely associated with the kinsman in question. At this point a few remarks about kinship reckoning in British Honduras should be made. The most common system is generally of a bilateral type with a strong matrilineal bias. Although people have a perfect understanding of the biological basis of kinship and realize exactly with whom they share heredity, they many times 'feel closer' to matrilineal and matrilateral kin. This is usually due to the fact that children grow up spending more time in their mother's home and thus knowing these relatives better. Also, as British Hondurans stress, it is impossible to know who is your father, but one's mother can be identified with relative certainty. While this observation does not reflect very kindly on the conduct of British Honduran women, it is nevertheless true. When a woman has children by more than one or two men, there is good logical ground for questioning her assignments of paternity, and some men go through life denying paternity in one or more instances. However most people acquiesce to a woman's pronouncement as to the fathers of her children, even when there are reservations.

Kin terms are those generally used in the English-speaking world with few exceptions. 'Half' prefixing sibling terms is usually meant to indicate the father's children by another woman other than one's mother, while the usual sibling terms of 'brother' and 'sister' are used for both full siblings and any of the mother's other children. 'Cousin' is used to denote the children of parents' siblings, and parents' siblings' children's children, and parents' 'cousins.' 'First cousins' are only parents' siblings' children. Any perceived degree of cousinship farther removed than this will be called 'second cousin' or, more likely, 'some kind of cousin, I don't know. ' However even with distant cousins people can reckon whether or not they are truly blood kin. The distinction between affinal and consanguineal kin is important and many people will correct someone who assumes them to be related 'by blood' to affinal kin. British Honduran geneologies are often quite complex, there being much 'close' marriage, crossing of generations, and 'half' and 'step' relations. The terms they use are really inadequate to refer to some relatives and they use many descriptive terms, such as 'my mother's brother on-the-father's- side's wife, not really his wife but his sweetheart who had the three girls for him. ' Such circumlocutions are common as many persons who come and go as residents and visitors cannot be subsumed under the usual kinship terms yet they are somehow part of the family. It is however not these people to whom British Hondurans feel 'close.' They consider close relatives to be their mother's children, her siblings, and perhaps the children of one's mother's children. Women also feel close to their own children. 'Full' brothers and sisters feel much closer to each other than they do to other children of their mother's and father's.

These feelings of closeness are manifested in various ways-mutual visiting, selection of these persons as god-parents, exchanges of food, gifts, money lending, business partnerships, and the extension of whatever aid is possible in times of crisis. People will thus shelter a 'close' relative or sometimes the child of one no matter what he or she has done. If the person is a known criminal, drunkard, sexual deviant, psychotic, or any other kind of undesirable character, he will still be able to depend on his relatives for emotional support, financial aid, food and shelter, and even less purely humanitarian types of assistance. People certainly do not feel that their relatives can do no wrong but rather they see themselves as having to render aid and give support to them regardless of the degree of their nonconforming behavior. For even though parents will turn a particularly bad child out into the streets, they will always take him or her back again, if only on a trial basis. Thus when young girls become pregnant before marriage, their families usually permit them to stay at home and often will raise the baby as well.

With all of the above diversity, much Belizean social behavior seems incomprehensible in any terms until one understands the situations with which many Belizeans have had to deal almost from birth. Insecurity and hostility are often the emotions of childhood, not warmth and affection. Mutual suspicion coupled with calculated recriminations are characteristic of relations between the sexes. Relatives quarrel for years over property and miniscule inheritances. Neighbors will argue about the ownership of a few mangoes at the height of the season when mangoes are worthless and everywhere are rotting on the ground. But the vindictiveness and belligerence which seem so prevalent where Belizean society is closely examined are no more expressive of the "real" Belize than are the loud laughter and continuous joking which also appear to dominate at a superficial glance. Rather, few Belizeans have the opportunity in their lives to rise above the behavioral correlates of poverty. Many accept their lives with good-natured resignation, but others resent their situations deeply and harbor a poisonous envy that ultimately finds expression.

By fortune there exists a privately printed study of poor people in Belize done by a Belizean with a degree in sociology. Although the sample was drawn by selecting "... 115 of the worst households, judging by appearance ... " and the author was almost unable to elicit any useful information from males, the study has the benefit of being carried out by a British Honduran. As the survey and document were commissioned by a Protestant church group, there is some editorializing, but the findings are interesting and will be quoted at some length as the study is generally unobtainable in any library.

Perhaps the greatest drawback to this research is that it was the first one of its kind done in Belize City. Questionnaires were not easily answered and after they were answered one did not feel inclined to rely too heavily on the answers. The latter, however, does not necessarily apply to this research alone. The survey data cited tend to be biased in the direction of presenting better conditions than actually exist because people have hesitated to give actual extent of extra-residential mating and all illegitimate children (Price, n. d. :5).

The Household

Many households were headed by females. The fathers are seen usually at those times when they can receive sexual gratification from the female heads, needless to say that they rarely give any support to their children. In those homes where there is a male head the mother is still usually the head in charge of the general management of the house, for the resident father is marginal in his functions. He may also have fathered many other children in as many as eight unions and spends his spare time visiting, not so much the children of his other unions, but their mothers.

The Youth

The male youth, like the male adult, is sexually aggressive and has a tendency of being irresponsible. Because there are not sanctions against his behavior and actions, he roams about freely leaving a child here and there, even at this age, to tell that he has passed this way. Most young men expect to get a virgin woman for a wife but believe that they must have had previous sexual experience before they are really ready to enter into marriage.

The young girl on the other hand seems to be inadequately prepared to cope with this male aggressiveness. Besides this inadequacy, she possesses many misconceptions relating to pregnancy. Consequently, she enters motherhood, many times, not by choice, and therefore mentally premature. After the first child is born her chances of getting married become less. This point is the beginning of many promiscuous relationships for many young women. This sexual behavior may have some financial advantage for the time being, for she must get money to provide food for her child whose father may not even know that he is the father of another child. But very soon she becomes pregnant for another man and this experience repeats itself until her child-bearing age is passed.

The Community

Our society, including all the social institutions, seems to have accustomed to the widespread practice of common law unions and to their many consequences. This "accustomed attitude" fails to act as a check-point or pressure group to such practices. Someone once remarked to another that eight out of ten of our unions are common law unions. The other person then said, "We should be glad, it was once ten out of ten" (pps. 31-32).

The Conclusion

It is generally agreed upon that the base of our problem lies in the economic structure. The effects of poverty are poor housing, unsanitary conditions, overcrowding, not to mention the many evils these conditions propagate. It would be unfair, however, to lay the blame completely on poverty for some of the problems that confront our poor families are also problems of the well-to do families. Here are a few examples:

The first one is the lack of norms and sanctions which should regulate and control the behavior of people within our society. The second factor may be an outgrowth of the first, the development of unwholesome attitudes which ignore many existing moral values. So even though our economic structures may be greatly improved, that does not mean that our attitudes will be enhanced as a result ...

The family condition we have just described reveals a certain order within the context of unstable mating. Such order as there is, consists in a series of substitutes for unfaithful parental roles. The co-existence of unstable extra-residential unions, consensual cohabitation and marriage confuses definitions of parenthood appropriate to either form and produces substantial evasion or failure to accept the obligations of parenthood. The consequence, uterine and materine kinship ties are invoked by women as substitutes and they are especially important in providing alternative domestic placement for the issue of the broken unions. Men accommodate the kin and outside issue of their own kin, but very few of their children by former or other current unions. This accounts for the many children who live only with their mothers and the few who live only with their fathers. Also if a mother has other children by former unions, these children are often sent to live with their maternal grandmothers as some mothers feel that because the children are not for the resident mate he is not responsible for their care and upbringing. (pps. 34-35)

Mr. Price's substantive findings closely approximate my own and my inquiries were not limited to the lowest socio-economic groups. I did find, however, that in most cases a man is willing to support all the children that a woman has--once he has made the decision to support the woman and his children by her. As British Hondurans say, 'If you like the cow, you have to take the calf. ' Price sees forces of social control as weak and also concurs in my opinion that ideals concerning behavior are usually just that and not guides to conduct. He sees the beginnings of the cycle in childhood experiences, and stresses that children are not properly disciplined or given moral counsel. While his association with church groups makes this last item almost a foregone conclusion, this does not automatically disqualify it front being valid. It is the thesis of my study that factors such as this are related, although not in a direct causal fashion, to the recognition of psychiatric disorder, and this relationship is explicated in Chapter Thirteen.

NOTES
1. This is the percentage indicated by the 1960 Census and it is likely that it has not changed. There were then some 90,000 persons in British Honduras with 31,000 residing in Belize. Figures for the 1970 Census are not yet available but most sources estimate the total population at 120,000 to 140,000 with about 40,000 located in Belize.

2. "Creole" is used to designate both the dialect of English spoken in British Honduras and the people who speak it as a first language. The latter are racially mixed although most have African ancestry in common.

3. It should be pointed out that the government is now virtually the only employer in Belmopan, so employment is a problem (as it is everywhere) for all but civil servants.

4. "Out-district" refers to all rural parts of the country, i. e., every place but Belize City.

5. People do not build small houses to prevent relatives from moving in with them as lack of space is never an excuse when relatives arrive.

6. "To walk" refers to any kind of outing or travel, regardless of mode of transport.

7. The cost of living is low for the local standard of living but good housing and a variety of high quality foods are quite expensive. Consumer goods are all luxuries. When upwardly mobile Belizeans make the shift from average-local life-style to upper-class and expatriate life-style, their living expenses increase several hundred per cent.

8. Although this diet is hardly nutritionally adequate for either adults or children, it is supplemented by "snack" foods, candy, and a large variety of locally produced fruits.

9. These 'machos' and other foreign objects are carefully picked out of all rice before it is cooked--a tedious procedure. This is a good example, like the grating of coconut to make coconut milk, of the kinds of routine and time-consuming tasks which face Belizean housekeepers and keep them continuously occupied.

10. "Dirty" in this case refers to 'machos, ' stones, chaff, etc. rather than actual soil or filth.

11. Again, there is not dirt present. Rather the sugar has not been refined to near whiteness but is quite grey.

12. The abundance of shops is due to the lack of employment opportunities. Usually the more shops there are in an area, the more economically depressed the area is.

13. In situations like this families might want to move to another neighborhood, but the housing shortage usually precludes it. A family would move only if they could find a cheaper and/or better house, and in that instance they would move anyway.

14. This social obligation to re-do the home at Christmas is said to have its roots deep in the past when Belize was primarily the milling and export center for the country's tropical hardwoods. In honor of the holidays there was a major break in the logging season and as the men were all heading back to Belize with the coconut graters, washing bowls, bread boards, etc., they had made in the bush, the women were fixing up their houses with new curtains, rugs, etc. that they had purchased for the men's homecoming.

15. See Ashcroft (1966) for the only published work on Creole social organization. It, however, treats only rural peoples.

16. "Step-father" is used to refer to the man residing with ego's mother. Marriage and/or adoption are not implied.

17. The passages here are reproduced exactly as they are printed, except for the correction of spelling errors. I have not endeavored to correct the grammar or the "sense" of any of the sentences as the meaning is not always clear enough to make this possible. To keep the medium from interfering with the message, there are no "sic's" in the passage.

18. Here Price is referring to a survey on housing and residential groups done earlier by the Medical Department.

TABLE ONE
Some Price-Controlled Items

Pig tail, lb. 70 cents (B. H. )
Flour, lb..11
Sugar, lb..10
Rice, lb. .17
Red kidney beans, lb..28
Lard, lb. .38
Tinned potted meat, 4 oz. .28
Sweetened condensed milk, 12 oz..33
Evaporated milk, 12 oz..40
Canned whole milk, 16 oz..40
Margarine, lb..50
Bread, lb..15
Tea, 2 oz..17
Soft drinks, imported, 12 oz..15
Soft drinks, local, 10 oz..12
Coconut, select .9
Coconut, reject.6
Kerosene, fifth.9


TABLE TWO
Purchases for a Family of Six
Morning 'Tea':
kerosene (for the day)9 cents
sweetened cond. milk (for the day).33
bread.25
tea (for the day).17
cheese, 4 oz..25
sugar, 8 oz..05
margarine, 4 oz..10
 $1.24 (B. H. )
Dinner:
rice, 1 1 /2 lbs..26
red kidney beans, 8 oz..15
lard, 4 oz..10
pigtail, one of 8 oz..35
plantain, one.10
kool aid and ice.20
sugar, 8 oz..05
 $l.21
Evening 'Tea':
tea (see Morning).00
bread.25
eggs, 3.24
sugar.05
  $.54
Total for day: $3.09

CHAPTER FOUR

BRITISH HONDURAS: THE RURAL AREAS
As mentioned above, there are six 'towns' outside of Belize and these outposts of urbanization fill the financial, commercial, recreational, and medical needs of the people in the rural areas surrounding them. In these towns and villages, life is somewhat like that in Belize but there are many major exceptions. Diet is modified according to the larger variety and lower prices of locally grown fruits and vegetables. Creole is not always the most commonly spoken language as other ethnic groups (Caribs, Maya Indians, Spanish, East Indians, and Mennonites 1) tend to predominate in numbers and influence. Family life is more stable and abnormal behavior is not so often anti-social in nature. Incomes are lower, the birth rate is higher, and the people have less formal education.

The North Corozal Town, farthest to the north and on the Mexican border, is an attractively situated coastal settlement of about five thousand persons who are predominantly 'Spanish. 2 Much Mexican influence is evident especially in the layout of the town, the architectural forms of dwellings and stores, the cuisine, and the general demeanor of the people themselves. A near-by sugar refinery has greatly increased the prosperity in Corozal District; and, during the season, roughly from December to May, the roads are full of battered cane trucks carrying the crop from fields to factory and employment is high. Retail sales dramatically increase and establishments purveying alcoholic beverages show their greatest profits. The area of commercial sugar cane production extends south through Orange Walk District through a region of fairly continuous settlement consisting of small almost purely Indian villages on the side of the Northern Highway and on feeder roads going deep into the bush. In some of these villages dialects of Maya are still customarily used by older adults and little English is spoken or understood with Spanish being the main mode of communication among themselves and with others outside the villages. The culture of these Indians has changed greatly and it is possible to find only remnants of aboriginal life. Most will plant corn every year using the ancient slash and burn technique, and a few will even observe 'first fruit' rituals, but they will generally be more concerned about the success of the cane plantings than the condition of the corn fields. Some of these villages have been described, and Gann (1918) and Muntsch (1961) provide some ethnographic data.

Sugar cane has brought a relative prosperity to these villages and even in the most distant ones, new concrete dwellings are being erected to replace houses of pole and thatch. There are plenty of trucks and the shops are stocked with former luxury level imported foods. At the fiestas in these villages, most people have new clothes to wear and many now can afford to drink Scotch whiskey and beer instead of local corn- and sugar-based alcoholic beverages. Although these people have experienced great prosperity before, most notably in the chicle boom of the 1930's, it was not of a lasting nature and chicleros had a propensity for wild spending sprees which would quickly reduce them to paupers again. Social change is striking in this area and as the sugar company continues to transfer ownership of the cane fields over to the farmers themselves, it will increase as economic situations continue to improve and the people adjust to their rising affluence.

Conditions are very similar in Orange Walk District to the south. In Orange Walk Town, where there is also a sugar refinery, there are the same signs of new wealth and the corollary changes in life style. Here much more English is spoken and one can foresee the eventual abandonment of Spanish when school children are heard conversing with each other in Creole although Spanish is still largely spoken in their homes. There are sizable contingents of both Creoles and Caribs 3 who have been there for years and yet remain socially distinct from the much more numerous Spanish. East, west, and north of Orange Walk Town, there are to be found numerous small villages, most situated on rivers and lagoons, where the Indian inhabitants carry on small scale mixed farming and commercial sugar cane production. Here again some Maya is spoken but Spanish is much more commonly heard. Like similar settlements to the north, these villages are often quite open with large central grassy areas and towering ceiba trees shading the houses constructed variously of pole and thatch, wood, or concrete. Pigs, chickens, ducks, and turkeys roam the streets; and horses, still much in use as saddle and pack animals, are tied up here and there to graze. Almost every yard will have a well surrounded by flowers and herbs potted in old tin cans, buckets, chamber pots, and basins. Many will also have a large wood or metal vat for the collection of rainwater, usually preferred to wellwater or pipe-water for bathing, drinking, and cooking. Houses are kept spotlessly clean and uncluttered inside with the rooms sparsely furnished. There is often only a hammock in the largest room, tied up when not in use, a small table or two, and a few crude stools or chairs. Occasionally there will be a table with the large plaster statue of a saint, several candles, and other Catholic paraphernalia arranged around the image. Other smaller rooms, rarely more than two, will contain light bedding and storage places for clothing. Cooking and washing are done in small out-buildings usually behind and/or to the side of the main living quarters. Frequently there will be a large cluster of such buildings in a yard as one or more relatives are allowed to erect houses on that property.

The number of people occupying any one dwelling unit varies from small nuclear families to large extended groups of kin. When there are many it is usually a result of economic necessity. People who build on someone else's land usually cannot afford property of their own, or occasionally a woman will need help with child care and thus seek the aid of a close relative. It is often difficult to know exactly who is part of a household. Men may be there only for the duration of a job somewhere in the vicinity and usually one of the women and some of the children are only long-term visitors.

Men in these villages plant corn and also own and work in cane fields. Except for a few government jobs in each village, there are virtually no other sources of employment. Women busy themselves with domestic labor, much of it tedious and requiring a great expenditure of energy. Hours are spent daily in the preparation of corn-based comestibles; and, where there are many young children and no older girls, child care is a continuous task. Primary schools, through the sixth grade, give the children a working knowledge of reading and figuring, but for higher education it is necessary to leave the village and live in Belize or one of the towns.

Life in these villages is quiet, so quiet that few who have not grown up in one can bear to live in them. There are yearly fiestas, and occasional weddings, christenings, funerals, etc., but other than these rare diversions, there is little to do except the daily tasks. These people have no handicrafts to take up their spare time. The women neither spin nor weave and most sewing is of a fairly rudimentary nature and generally done on a treadle machine. Men do not produce any elaborate handmade items and tend to fill their many empty hours socializing with other males. On the week-ends especially, this socializing is usually augmented by liquor or marijuana or both. There are Saturday trips into town--Orange Walk or Corozal_ for shopping, banking, a dance, or the matinee at the local motion picture theater. But for the out-villagers, life has a continuing sameness that many of them try to escape by moving to the towns or perhaps even as far as Belize. Young men will find employment or learn to hustle a few dollars and few will return to the villages except to visit occasionally. A man with women and children to support will often work out and only return to his family in the village every week or fortnight with money to pay the debts the family has incurred since his last visit. This is an unsatisfactory but common situation and contributes to the brittleness of marriage in British Honduras. Often the whole family will move from the village; but women, with much more narrowly circumscribed opportunities for social contact than men, will become despondent without their relatives with whom to visit and associate, and may perhaps return to the village with all or some of the children.

Young girls too have opportunities to emigrate to the towns, usually working as domestics and receiving only room and board as pay. This is much more likely to happen to a girl who bears a child out of wedlock and hence becomes an unlikely candidate for marriage in the village of her birth. If she is lucky she may be taken in by a relative or perhaps even a stranger who will treat her and the child decently and give her a small wage. If not, she may be worked unmercifully and ill-treated as well. For the wages of sin in British Honduras are drudgery and unless a girl turns to prostitution or finds a husband who will support her, she will likely live out her life bearing a succession of children fathered by different men and cleaning, washing, and cooking for other people.

Thus, paradoxically while living conditions are improving in the villages, more and more people are leaving them, drawn by the diversions of the city and the hope of higher wages. Urban emigration acts as a population stabilizer in this case, drawing for the most part landless sons, errant daughters, and the highest educated children of both sexes. For although village families could be economically self-sufficient and were a generation ago, they now feel that goods which can only be obtained with cash are necessities. They no longer are willing to live on what they can produce themselves. Aside from foodstuffs which must be purchased such as polished rice, white flour, canned and dried milk, etc., they want radios, bicycles, china dishes, attractive fabrics, and other consumer goods. It is not usually possible to support a large family and have these things on a cane-cutter's wages. Thus unless one owns at least a part interest in the land itself or could arrange a loan for the purchase of a cane truck or cane fields, village life is economically a dead-end where one grows corn for personal consumption and works as a cane-cutter to obtain other necessities.

This is not a satisfactory outlook for persons who have acquired ambitions which include sending their children to secondary schools, living in a concrete house, and eating meat more than once a week. Hence, the increased prosperity has created a feeling of deprivation among many who, twenty years ago, would have accepted village life without question. It is likely that the problem of perceived poverty will not become critical in these villages for years. The new affluence is at present still too new, everyone remembers what it was like 'before the sugar company' and there has yet to be a generation grown up surrounded by cane fields. But when one has, the idyllic peacefulness of the villages may be transformed into a vicious resentment--such as pervades much of Belize City and is beginning to be seen in the towns.

In Orange Walk Town itself, people live in crowded neighborhoods around the central part of town and in equally small but less closely set houses in the newer areas. Orange Walk is expanding rapidly and newly subdivided areas are already assuming a dense housing pattern where there was virgin forest only ten years ago. The sugar refinery has provided the impetus for most of this economic growth as little else has changed in the town for generations. There is still much mahogany cut in the surrounding bush and chicle bleeding persists as a seasonal source of income. People are generally, dependent on sugar cane with most of the male residents having had work experience either in the fields or in the factory.

As the season opens and the factory starts receiving cane in December, the mature fields are burned, the cane is cut, bundled and loaded by hand into modified flat-bed trucks. It is tested and weighed at the factory and credit for the load is given to the owner of the field. He will be able to collect part of his money immediately and part in one lump sum after the end of the season. The factory is currently paying $16. 00 (B. H. ) per ton for cut cane and it costs approximately five dollars to have each ton cut, loaded, and transported. A good average profit from an acre of cane is locally estimated to be about fifty dollars (B. H. ) and people will own parcels of land that range from only a few acres to as much as several hundred. Much of the cane land is still owned by the foreign company that runs the refinery but it is gradually being turned over to the local people at reasonable prices so that in a few years the company will only refine and export sugar, it will no longer grow cane.

It should be emphasized that although there is a general prosperity in the two northern districts, there are as yet no local "sugar millionaires" or indeed any very wealthy persons whose incomes derive solely from cane. The most affluent people are still the old merchant families whose personal fortunes have increased greatly in the last few years. Most of the cane money--whether from growers, loaders, truckers, cutters, or factory employees--is spent in Orange Walk Town and Corozal Town in the same establishments that have been selling food and dry goods since the foundation of these towns. Thus although living standards have certainly risen in these areas, the money itself is accumulating in the hands of those persons who were already very wealthy, and this increase in their wealth serves to preserve the social and economic distance between them and other local people. This situation is such that although most groups have experienced an absolute rise in income, few have really achieved more than a relative rise in prestige.

The Western District
The prosperity of the two northern districts becomes even more evident when compared to the towns of the Western District, San Ignacio or Cayo and Benque Viejo del Carmen. Here in the rolling plains and large savannahs west of Belize City, people are generally engaged in small agriculture and limited beef cattle raising. The major sources of employment are the larger and foreign-owned orange plantations and cattle ranches, and the political capital of Belmopan where most residents are civil servants and shop-keepers. In Cayo District, a variety of crops are produced with most destined for the town markets and Belize. It is essentially an area of small cultivation where people are dependent on the exigencies of climate, transportation, and yearly production. The settlement pattern is similar to the one found northward with small villages stretched out along the edges of the Western Highway and other villages well off the roadside and back into the very rural areas. The population is largely Spanish, Indian, and Creole, with the Creoles living along the road and on the outskirts of San Ignacio. The Spanish people are principally found in Benque Viejo and San Ignacio proper, with the Indians encountered largely in the more isolated villages. 4 These Spanish and Indian people live in a manner not too different from the mestizo life styles described for the surrounding areas of Mexico and Guatemala. Corn and beans form the basis of the diet. The people are almost wholly Roman Catholic, marriage tends to be stable, social organization centers around the nuclear family, women and young girls are quite restricted in their contacts, and men are usually absent from the home whether working or associating with other men. The residents of this district, although they are living in an agriculturally developing area of the country, are largely cut off from any kind of regular wage-earning activity. Work in the few orange groves is seasonal and other kinds of agricultural work such as land clearing, cattle herding, crop picking, etc. is very low paying. Thus men must often leave the district to find work as in this region of subsistence farming and foreign homesteading there is no real source of employment which is capable of supporting large numbers of men with many dependents.

When the new capital was being built in 1968-1970 there was a relative amount of short-term prosperity and there are some newly constructed buildings to attest to this. But the bulk of the Belmopan payroll went to foreign laborers who were temporarily imported to fill the need for skilled construction workers. By now things have reverted to their former low level and the Western District still awaits some kind of industrial development which will create the critically needed jobs. For subsistence farming is not really satisfactory here, where people also view imported food items as necessities. Also all farmers tend to plant the same crops and each is faced with the discouraging situation of having corn to sell when everyone else has corn to sell, taking tomatoes to the market when there is a surplus of tomatoes, etc. This situation could be remedied by the farmers using simple irrigation methods, commercial fertilizers, and improved seed varieties, but few have the capital and even fewer would be able to take the risk.

There was a large fire in San Ignacio in 1972, in which half the downtown commercial area was destroyed. Re-building is progressing slowly but some businesses may never reopen. The government is earnestly encouraging agricultural development by local people and foreigners alike in the Western District but not even the relocation of the capital in the area has helped the sagging economy or greatly stimulated the local market. Clearly very little will change in and around San Ignacio until a major capital investment is made in the form of an industry that will create the scarcest commodity of all--jobs.

The Southern Area
South of Belize is the Stann Creek District where huge orange groves and a juice concentration and canning plant provide some measure of economic security to the basically Carib population. Most of the settlements are on the coast and, including the town of Stann Creek, the populations are almost purely Carib. There is much seasonal work both in the groves picking and in piece-work jobs at the juice factory. Whole families migrate to the area every year, living in the company-owned housing and patronizing the small shops and food-stands that spring up. If they live frugally and there are several members of the family working, a good wage can be earned during the season. Several hundred people, many of them women, work in the factory, but it too is seasonal employment.

During the off-season people return to their homes and some take up fishing and farming for the rest of the year. Others turn to whatever hustle seems likely, much the same as cane-cutters in the northern districts.

Toledo, the district furthest south, merits even more superlatives. It receives the heaviest rainfall, is the most sparsely populated, the largest in land area, the most difficult of access, has the most numerous aboriginal Indian population, and is the most unknown. Unreachable except by sea and air most of the year, Punta Gorda, the capital of Toledo District, has a very strong East Indian element in its population. 5 The agricultural base is well-developed here and much rice, plantain, banana, cassava, and other 'ground food' is produced. Most tropical crops are grown in Toledo and people who have lived there claim that the best fruits and vegetables in the country are grown around Punta Gorda. The lack of transport, however, prevents them from being marketed elsewhere. The employment possibilities in the district are limited to government jobs and seasonal agricultural work. There are no major sources of employment and one never hears of anyone going to Punta Gorda for work. In fact, one rarely hears of anyone going to Punta Gorda for any reason. The most-of-a-day-long truck (when possible) and boat rides are a formidable deterrent to anyone planning a journey there and many people who leave 'P. G. ' are never able to afford the time or the fare to return. The district is also noted for the high quality of its obeah practitioners.

In attempting to provide a broad-based picture of British Honduras, it is not easy to generalize from the particular nor to capture the "typical" in a country of so many diversities. There are sufficient unique characteristics to well differentiate the country from surrounding areas but it would be a nettlesome task to list the "essential" or "defining" qualities of either the people or the land. Many facets of life will be mentioned throughout this study and some will be chosen for discussion because of their unusualness. They will be so noted. Others will be used as examples of an ordinary situation. None should be construed as common to all British Hondurans or to any group of them. British Honduras is definitely not an area of homogeneous culture, and life experiences, attitudes, and beliefs there differ in the extreme.

NOTES
1. There are two large colonies of German-speaking Mennonites in British Honduras. Although their impact on the economic infra structure, particularly food production and marketing, has been great, the social effects of their presence are nil as they are geographically and culturally isolated from most local people.

2. "Spanish" is used to refer to persons who speak Spanish as a first language and most are racially mixed Caucasian and Maya Indian. Reed (1964) gives many details of the settlement of northern British Honduras as to years of immigration and the types of people involved.

3. "Caribs" are a phenotypically Negro group with a derived Arawak Indian language and culture. See Taylor (1951) and Gonzalez (1969) for a thorough description of Caribs in British Honduras.

4. Thompson (1930) and Reina (1968) both give brief descriptions of the populace of the Western District.

5. Holdridge (1940) describes an attempt by families from the United States to colonize Toledo.

CHAPTER FIVE

SOME FACTORS RELATED TO HEALTH
There are certain aspects of life in British Honduras that impinge directly on a medically oriented study. These will be mentioned in some detail at this point in order to place the information which follows in broader perspective. For the most part this section will deal with personal hygiene, waste disposal, diet, sources of contamination, and care of the sick. As the cultural definitions of what is "clean" and "dirty" differ somewhat by ethnic group in British Honduras, the data below are distilled into an interpretive summary rather than a catalogue. Likewise the dietary information can be considered a statement of what is available and generally consumed rather than one person's or group's special preferences.

British Hondurans are personally clean people by most standards. They bathe daily, change and wash their clothes frequently, and have a highly developed sense of what is 'nasty' or unclean as far as hygienic practices go. Although each person bathing in a household will use the same bucket for water and sit or stand on the same wooden platform, no one will use a towel that has been used before by anyone else or even himself. Bathing is accomplished by drawing water in a two to five gallon bucket, carrying it to the bathhouse, disrobing, wetting the body and hair using a cup or old tin can, applying soap by hand, rinsing, drying with a clean towel, and dressing in clean clothes which have been carried to the bath-house. The used bath water usually runs under the house or soaks into the ground of the bath-house. Children are often bathed in large shallow wooden bowls that are used to wash clothing. 1 The same towel may be used for several children but only if they are bathed in unison. After a towel has been used, it is immediately tossed into a pile with other dirty clothes which are usually kept in the house until they are washed, most likely the next day. Most people bathe in the late afternoon using water which has been placed in the sun to warm or adding water which has been heated on the stove. Few people bathe with cold water, even when it is quite warm, but those who do stoutly defend the practice. Rainwater is universally preferred for bathing and washing the hair by those who are accustomed to it as the soap lathers much more easily than in the limestone saturated wellwater and chemically purified pipe-water.

Clothing is washed outside of the house with two or three lathers being given. All clothes are washed together but children's soiled pants are 'half-washed' before they are soaked with other clothing. All of the wash is usually soaked in.strong detergent and chlorine bleach for an hour or two or even overnight before it is scrubbed on a scrubboard. Then the first water is thrown out, usually in the yard. 2 The clothes are then washed once or twice more, followed by a rinse in two waters with laundry blue being used in the last rinse. Rainwater is rarely used to wash clothes because most people do not have enough of it. Wrung-out clothes are hung to dry on low slack clotheslines which are then propped up with long sticks to keep the wash out of the way of traffic in the yard. In very rainy weather, clothes are dried under the house or in the wash house and are never worn until they are completely dry as wearing damp clothes would make a person 'sick.' Likewise people immediately change sweat- or rain-soaked clothing and will wear dirty clothes rather than wet ones, remarking, "Mejor tierra en cuerpo que cuerpo en tierra. "

As mentioned above, diapers are rarely seen on ambulatory children and as many children are not toilet-trained until two or three years (excluding nocturnal bed-wetting which commonly persists until a very late age) fecal contamination of the house and yard is common. Such messes are cleaned off floors and a conscientious housekeeper will disinfect the spot, if in the house, with pine oil. Urine is wiped off floors with special rags called 'floor cloths' which are reserved, usually for this purpose, in the bedroom on the floor, in the wash house, or on a step. These floor cloths are often not laundered but thrown away when their appearance becomes offensive, usually after a week or two. Bedding is not washed frequently, sheets being used two weeks to a month or longer unless they are badly soiled.

Garbage which is not thrown in the yard, such as tin cans and large papers, is carried to the household's 'dirt box' which will be emptied by a city truck. If there is not a household dirt box, all garbage is thrown in the yard and dogs will consume or carry off much of it. If an item is too odious to be tossed in the yard, it may be deposited in the bed bucket or thrown in the latrine. It will rarely be burned as people fear the personal consequences of burning bodily products. People living in the out-district villages have much cleaner yards as they usually pile trash in a corner and then bury it, throw it down an old well, or carry it back into the bush. But in Belize and some of the district towns, waste material and its attendant evils-stray dogs, rats, cockroaches, and flies--are ever a part of life. People certainly understand the relationships obtaining among open or loose garbage, flies, and disease, but maintaining the one clean yard in the block would hardly alleviate the problem for a family. In one instance where a man was told to seal his dirt box, he replied that he would seal. his when the city sealed a public dirt box a block away from his house. No further mention was made to him about his open dirt box. Also in Belize City, where the government expects people to build houses on piles of garbage, it would hardly be consistent to cite persons for dirty yards and unsatisfactory garbage containers.

Mention has already been made of the disposal of urine and feces in Belize City. The situation is different in the districts. In the towns, some people have flush toilets, again having to provide septic tanks and frequently their own water supply as well. But most dig pit latrines which are buried as needed. These latrines are used for the containment of solid waste and some urine. Men and boys generally urinate in the yard, and urine collected in the house at night is also thrown into the yard. People are afraid of both their bath-houses and out-houses at night and seldom use either after dark. They mention the possibility of encountering toads and snakes; but, in reality, they are simply afraid of any dark place, even their own homes which are often kept lit all night.

Food is prepared in the kitchen although some procedures such as grinding, baking, barbecueing, and salting can be done in the yard. Some foods are washed before cooking, such as rice, meats, chicken, and fish. Fish are sometimes washed with soap, lime and vinegar. Many foods are considered to have a 'rankness' which can be tempered by washing with lime or cutting out certain parts of the animals. 4 During time-consuming food preparations, such as kneading flour-based breads, rolls, and tortillas, food is kept covered with clean cloth to keep away flies, and whenever prepared food is carried from one house to another, it is always covered. Food dropped on a floor or on the ground is not considered to be inedible nor in need of washing. Fruits and vegetables are seldom washed before consumption unless they are visibly caked with dirt. Hands are not routinely washed before or after eating. Sometimes there is a towel kept hanging in the kitchen which is used by all members of a household, particularly the children, for wiping faces and hands. But often there is not, as with no water supply in the house, there is not a great need for towels. Dishes are washed after each meal in soap and cold water and left to drain dry. Pots are meticulously scrubbed to remove the soot of a wood fire or kerosene stove, and the whole kitchen and eating area will be put back to order. Any left-over food will be conserved in the pot in which is was cooked for the next meal or overnight; or it will be thrown into the yard or perhaps fed to a pig. British Hondurans do not care for 'stale food' and even when a refrigerator is present, it will never be used to maintain old food in the house. Eating left-overs or 'cold peck' is considered an indication of great poverty and few people do it. Food is generally cooked at very high temperatures, partly because kerosene stoves are difficult to regulate, and the most characteristic British Honduran cooking techniques are a high rolling boil and a fast fry in hot fat.

People generally eat the same foods every day. British Honduran housewives do not consciously try to vary daily menus or to experiment with new ideas and recipes. Some women have a reputation as excellent cooks and bakers but virtually every woman and many men are able to prepare the basic foods. Rice and red kidney beans cooked together with coconut milk and seasoned with salted pork tail is the most commonly eaten dish. It is cheap, filling, tasty, can be made in large quantities, and is fairly nutritious, especially when served with a raw cabbage-based salad as it frequently is. People also eat stewed red kidney beans with boiled rice quite often. On Sundays most Creole people will have 'rice and beans' with chicken accompanied by fried plantains, potato salad, and perhaps bread pudding or cake. Spanish and Indian households use corn tortillas to replace rice and they are eaten usually with beans, red kidney, pinto, or black. On Sundays these people will usually also have chicken but it will be stuffed and roasted for relleno, or boiled, roasted and seasoned with onions and vinegar for escabeche, and eaten with piles of tortillas. Meat is everywhere eaten sparingly and used more to provide flavor than as a main part of the meal. Caribs use more greens, tubers, and fish in their cooking, and boiling is the usual treatment for any food.

Generally speaking, meals in British Honduras, especially in Belize are starch-based, either bread or rice, with protein- and vitamin-rich foods used as seasonings, garnishments, or secondary accompaniments. The average meal is lacking in fresh vegetables in any meaningful quantity. This is partly because fresh vegetables are relatively costly but also because Belizeans, especially Creoles, reportedly sneer at leafy green vegetables as 'rabbit food' and 'grass.' They prefer them cooked to raw and seem to be able to do without them altogether. In fact, rarely are fresh vegetables found in the small credit-oriented shops where Belizeans and most British Hondurans buy. There are always onions and potatoes but seldom anything very perishable. Shop-keepers, many of whom have limited refrigeration facilities, cannot keep large stocks of tomatoes, cabbage, green peppers, etc. Hence they cannot buy large enough quantities to make a profit and still sell at a competitive price. Credit shoppers are unable to buy vegetables where they usually trade and must go to a market and pay cash. They generally do not. Thus the relative inability of many people to buy fresh vegetables is both a cause and effect of their allegedly not particularly liking them. 4

The same principal holds true with fresh fruits. A large and varied selection is available throughout the year (See Table Three) but they too must be purchased with cash unless they are gathered, stolen, or received as gifts. As fruits tend to be substantially cheaper than vegetables, they are much more frequently consumed. Many are eaten in prodigious quantities when in season and are purchased by the hundred. Some are cultivated but many grow wild in the bush and are gathered and brought to market by rural people. Several fruits are eaten green or pickled and many, to palates accustomed to temperate zone fruits, are quite unappealing, being sour, tough, and primarily skin and stone. Yet most British Hondurans eat almost any available fruit (some are commonly eaten only by children) and these frequently consumed items must be the main source of many vitamins and minerals in the diet. One of the main characteristics of the population is that they usually seem to be eating something: citrus fruits, mangoes, small plums, palm nuts, peanuts, candy, snack foods, etc. Whenever children are given a few pennies, they 'xinvariably buy cookies, candy, frozen sweets, chewing gum, etc. When travelling, British Hondurans stop frequently for food and no outing or occasion is complete without a meal. One result of this is that children consume many sweet foods with little or no nutritional value and thus have a poor appetite at meals. The "clean plate" is not present in British Honduras, and if children choose not to eat a meal, they are not forced.

Pathological malnutrition is not common in British Honduras although border-line under nutrition is. Children especially seem to have little resistance to disease, and when ill, quickly lose weight, become listless and pale, and take a rather long time to recover from the childhood diseases and 'colds.'

From the description of usual sanitary practices, it does not take a medical detective to find the sources and modes of contagion in the average household. The presence of garbage, fecal material, urine, and spittle in the yard attracts vermin and constitutes a reservoir of bacteria (maintained by constant moisture) readily carried into the eating and bathing areas on the feet, hands, and clothing of household members and visitors, especially children who play in these unsanitary areas. An open well could hardly remain uncontaminated when buckets are picked up off the ground and set on the well's edge, or worse, dipped into it. Although it is considered unclean to use a laundry or bathing bucket to carry water to be used in the kitchen, it makes little difference realistically. Wellwater is rarely pure to begin with, and rainwater is collected from roof tops and in gutters where birds, bats, and rats frolic. The many cracks and seams of wooden houses provide breeding places for great numbers of cockroaches. They crawl over everything at night, and if they feed on a particle of food adhering to a person's lip or finger, they leave a blister-like sore which takes days to heal. Rat-caused damage and injury are common as many rats, especially the bolder Belizean varieties, are not afraid of either light or human activity. Body lice, particularly head lice in children, are commonplace with 'searching heads' being a daily task in many homes.

Intestinal malfunctions, mild to severe, are so routine as to be viewed as being of little consequence, and every shop carries a variety of patent remedies for gripe, diarrhea, and constipation. Few cuts or abrasions heal without becoming superficially infected and every household possesses a tube of penicillin ointment for treating septic sores. Tetanus is a real danger and septicemia is occasionally a result of minor wounds. One reason why all snakes are thought to be poisonous is that virtually any break in the skin, whether an animal bite or stab-would, tends to become infected with systemic results.

Ill and infirm persons are kept in tightly closed rooms in closed-up houses, never bathed (mejor tierra en cuerpo ... ), and fed soup, if willing. A number of home remedies will be tried before the sick person is taken to a doctor. 5 There will be no effort to isolate the person's bedding, eating utensils, or food from the rest of the household. Others will not be protected from his secretions or breath. British Hondurans have some ideas about what germs are, but they do not really understand the nature of contagious disease or recurrent infection. A sick person is viewed as someone who needs company and should be visited and perhaps taken some food, not as a possible source of disease to be avoided. A family going to call on friends or relatives would not be deterred if they received word that the visitees are ill with measles or whooping cough.

This confusion about how sickness is spread coupled with the generally cavalier treatment of human and household waste makes it difficult to understand why there is not more disease in British Honduras, especially in Belize. It is likely that children either die or build up an acquired immunity to most local strains of bacteria during their many episodes of sickness as children, and adults are largely only susceptible to new or imported diseases. 6 For in spite of what appears to be strong odds against it, the people of British Honduras are healthy and fit. One does not see the results of years of physical neglect and rampant pathologies. Occasionally people are noted with congenital or traumatic deformities which could be surgically corrected, and some wasting, debilitating, and disfiguring disease goes unchecked or undetected. There are also cases of birth defects going long undiscovered. But there is professional medical care available at reasonable prices, and the populace avail themselves of it. 7 They use many herbal remedies on themselves which are probably efficacious much of the time, and they tend to live full active lives until very old ages. For a summary of the medical picture of British Honduras, see Table Four which is taken from the most recently published medical reports.

NOTES
1. Round 'bowls' are characteristically Creole, while the Spanish use a rectangular batea, more like a hollowed-out tray.

2.In Belize it is forbidden to throw water into the drains, and as few people live 'street side' near a drain they would not carry the water that far anyway.

3. "Rankness" is a rather elusive quality that British Hondurans perceive in many animal products. The Spanish believe that human beings also have a rankness which causes body odor. Shortly after a child is born they squeeze a fluid out of the baby's nipples which 'takes away the rankness' and prevents 'bad scent' later in life.

4. See Losconczi (1958) for a discussion on the difficulties of improving food habits in British Honduras.

5. Visiting medical doctors is viewed by some as a form of conspicuous consumption in British Honduras, and people may be criticized for spending too much money on medical care.

6. Mysterious 'fevers' are very common childhood ailments, and generally fever is thought to be a disease itself rather than a symptom.

7. By standards in the United States, the cost of government medical treatment in British Honduras is nominal. But an extra expense of even two or three dollars is a hardship on many families, and poor people regard all medical care as somewhat expensive.

TABLE THREE
Commonly Consumed Fruits

Local Name Scientific Name Remarks
craboo, nanceByrsonima sp.In season July-September
wild crabooMalpighia glabraseveral varieties, eaten both fresh and pickled
mangoMangifera indicaIn season May-September, at least a dozen varieties, eaten both green and ripe
hog plum, governor plumSpondias sp.In season November - February, eaten green, ripe and pickled
Coco plumChrysobalans MourbinYear round, edible seed
May plum, ChiabalSpondias purpureaMay-July
witi witi plum, grosellaPhyllanthus acidusApril, eaten green, ripe and pickled
guv apple, colchoAnona sp.August
kineps, guayasTalisia oliviformisIn season May and June
guava, guayabaPsidium GuajavaMay-January, green and ripe, has edible seed
marmey appleCalocarpum mammosumApril-December
custard apple, anonaAnona sp.April-June
soursapAnona muricataYear round
cashew, maranonAnacardium occidentaleIn season May and June, edible seed
pineapple, pinaAnanas comosusEaten green and ripe, year round
supa, cocoyolAcrocomia mexicanaMay and June, eaten green and ripe, has edible seed
tamran, tamarindoTamardindus indicaJanuary-May
marmey cirilaLucuma campechianaMarch and April
citronCitrus medicaYear round
orangeCitrus sinensisYear round
limeCitrus aurantifoliaYear round
grapefruit Citrus grandis Year round
tangerine Citrus sp. Year round
sweet lime Citrus sp. Year round
bitter and sweet orangeCitrus sp. Year round
sour orange Citrus sp. Year round
sapodilla Achras Zapota February-April
star apple Chrysophyllum CainitoOctober and November
sea grape Coccoloba sp.June-September
avocado Persea sp. June-November, several varieties
papaya Carica Papaya All year, several varieties
banana Musa sp. All year, several varieties
hamans, almendra Terminalia Catappa All year, two varieties, pulp and seed eaten
coconut Cocos nucifera Year round, eaten green and ripe
cohune nut Orbignya Cohune Year round
breadfruit Artocarpus communis Year round, green and ripe
watermelon Citrullis vulgaris Year round
cherry Pseudolmedia sp. (red berries)
grenada Hirtella sp. (small plum)
baboon cap Couepia dodecandra (smallish fleshy fruit)
bookut Cassia grandis in season April and May, (syrupy pod)
pixoy Guazuma ulmifolia (hard berry)
ziricote Cordia dodecandra Berries always stewed
pepino Momordia Charantia (melon-like)


TABLE FOUR
Morbidity Returns, British Honduras, 1965

Disease Number of Cases
(in- and out-patient)
Tuberculosis of respiratory system 85
Tuberculosis, other forms 48
Syphilis and its sequelae 517
Gonococcal infection 981
Dysentery, all forms 366
Other infective disease commonly arising in intestinal tract 120
Scarlet fever 5
Diphtheria 1
Whooping cough 37
Measles 105
Mumps 338
Typhus and other ricketsial diseases 12
Malaria 87
Disease due to helminths 3515
All other diseases classified as infective and parasitic 290
Malignant neoplasm including neoplasms of lymphatic tissue 122
Benign neoplasms and neoplasms of unspecified nature 307
Allergic disorders 470
Diseases of thyroid gland 129
Diabeti s mellitus 390
Avitaminosis and other deficiency states 1877
Anemias3468
Psychoneuroses and psychoses 707
Vascular lesions affecting central nervous system 119
Diseases of the eye 1278
Diseases of ear and mastoid process 1004
Rheumatic fever 65
Chronic rheumatic heart disease 302
Arteriosclerotic and degenerative heart diseases 373
Hypertensive disease 2748
Disease in veins 187
Common cold 9967
Acute pharyngitis and tonsilitis and hypertrophy of tonsils 2792
Influenza 2481
Pneumonia 257
Bronchitis 4308
Silicosis and occupational pulmonary fibrosis 2
All other respiratory disease 488
Disease of stomach and duodenum except cancer 1244
Appendicitis 374
Hernia of abdominal cavity 681
Diarrhea and enteritis 5051
Diseases of gall bladder and bile duct 274
Other disease of digestive system 667
Disease of genital organs 416
Diseases of male genital organs 719
Disease of female genital organs 1536
Complications of pregnancy, childbirth, and puerperim 1098
Boils, abcesses, cellulitis, and other skin infections 3283
Other diseases of the skin 1484
Arthritis and rheumatism, except rheumatic fever 2330
Diseases of bones and other organs of movement 230
Congenital malformations and disease peculiar to early infancy 81
Other specified and ill-defined disease 3292
Occupational accidents and occupational poisonings 708
Accidents and poisonings not specified as occupational 2346
Other violence 897

(Figures do not include the out-patients of doctors in private practice. )

CHAPTER SIX

THE HISTORY AND NATURE OF INSTITUTIONAL CARE FOR THE MENTALLY ILL
The Facilities in Historical Perspective The data presented in this chapter come partially from the files of old medical reports found in the "National Collection" of the Bliss Institute Library, Belize City. As the file is incomplete, there are some gaps in the history of Seaview Hospital as outlined here. There were also years when no medical reports were published and in some reports no mention is made of the mental hospital or the patients. The figures gleaned from the Medical Reports are found in Table Five which provides a tabular record of the number of patients per year for available years. Table Six illustrates the number of yearly admissions and discharges for available years from 1908 to 1967, the year of the last published medical report.

The first official mention of the hospital is the following paragraph:

... the existing arrangements are altogether unsuitable for treatment of the insane. This subject has been made one of report by me on former occasions; but want of funds has interfered with carrying out any measure. It is now contemplated to add to existing accommodation; and by the end of 1898 it is hoped matters will be more satisfactory (British Honduras. Medical Reports for 1897, 1898).
This asylum was apparently for males only as later it is noted that the former poor-house was converted into a "female lunatic asylum, " and that there was a 26% increase in the "number of diets issued" in the hospital between 1895 and 1899. Whether this indicates a corresponding increase in the patient population is not clear. By 1907 there are an average of fifty patients, a figure that remains a good average for the next thirty years. In 1940, the hospital contained about seventy five patients, the result of an upswing in admissions beginning in the 1930's. The number of patients is sharply reduced (perhaps to nil) in the next few years as a result of an abnormal number of deaths from 1941 to 1943 (112 deaths in those three years compared to earlier averages of five to ten deaths per year). There were severe flu epidemics in British Honduras during the war years and it is likely that the always crowded wards of the hospital made ideal conditions for the spread of the disease. At any rate, there is no mention of the hospital in medical reports again until 1949 when it is simply stated that an ordinance was passed changing the name of the "Lunatic Asylum" to "Mental Hospital. 11 No further statistics on the patient population are found until 1952 when there were about ninety inmates. This figure rises steadily until 1964 when discharges began to balance admissions and the patient population stabilized at around 150. In 1964 the facility was renamed "Seaview Hospital, " and for the first time in the Country's history, the post of "psychiatrist" was filled in the Medical Department. At present there are about 180 to 200 patients in Seaview Hospital of which approximately 60 are female.

The institution has always been located in the Barracks neighborhood of Belize at its present site. The buildings face the sea and there is usually a strong breeze keeping the area cool and insect-free except inside the buildings and in the lee of them. Presently, the "poor-house, " or "infirmary" as it is now officially called, is located slightly to the rear and south of Seaview Hospital itself but within the same compound and under the same administration. Here are several dozen old souls who have no family to care for them and the government sees to their welfare until they die. About half of these aged men and women exhibit severe senility. Cases of senile psychosis are not eligible for admission to the mental hospital.

With no psychiatrist present until 1964, treatment of cases must have been rare although there is one mention of "specific treatment of certain cases" in 1939 (British Honduras Medical Report, 1939). Largely the patients were confined and restrained and the number of formerly barred rooms at Seaview bears witness to the high security that was in effect. Surely the patients were tranquilized but electroconvulsive therapy and insulin shock did not seem to have been used. Most likely this is more an effect of the absence of qualified persons to administer the treatments rather than a professional decision not to use them. Neither was there any equipment for hydrotherapy. The institution, rather than a treatment and therapy center, served the country by isolating mentally ill persons from the community and safely confining them. It was also a place where per sons of suspected derangement were sent for observation before their court cases were heard. Admissions have almost always out-numbered discharges; but, it must be kept in mind that discharges were for the most part persons admitted for observation who were found to be sane and released. Also the patient population, and hence the number of officially designated "lunatics, " has always been determined by the number of beds available in the hospital rather than the general mental health of the populace. In 1964, there were 122 beds and 156 patients, and in the last published Medical Report, 1967, the number of beds has not increased.

The facility has always been the only place for treatment of psychiatric disorders and the patients there come from all over the country. They are usually brought by the police. Cases of "psychoneuroses and psychoses" are also seen in both out-patient clinics and hospitals throughout Belize and the districts. In 1967 hospital cases totaled 72, and it is not known how many of these were transferred to Seaview. Out-patient cases numbered slightly over one thousand but neither the criteria for diagnosis nor the qualifications of diagnosticians are known. In 1965, the total of such cases was 649. At that time there was only one psychiatrist, the Chief Medical Officer. It is likely that this dramatic increase in out-patient psychoneuroses and neuroses in these two years reflects redefinitions and improved case finding techniques rather than a true increase in mental illness as in 1967 there was a psychiatrist aside from the Chief Medical Officer, and psychiatric care was more available.

In 1964, with the arrival of a psychiatrist who was also Chief Medical Officer and hence in a better bureaucratic position to implement his policies, many changes occurred in national policy about mental health. Security was dramatically reduced at the then renamed 5eaview Hospital, and many patients were freed from restraints and their rooms unlocked. Programs of occupational and recreational therapy were emphasized and more responsibility was given to the patients. Discharges for 1964 are almost double any previous year and admissions also increased. The policy became one of hospitalizing only those who would respond to treatment, were a public menace, or were not able to care for themselves and had no relatives to 'mind' them. Many long-term patients were discharged, and although some would return occasionally, most remained in the community.

The Hospital and Patients
Today Seaview has a relaxed atmosphere where general security is low and any patient not individually confined could walk out through the gate. The two-story buildings are arranged in a U-shape with administrative and staff rooms on the lower floor of the central part with wards, kitchen, and laundry facilities taking up the remainder. The women's wards are on the north side where cooking and washing are also done. This is because there are fewer women patients and there is more room for them to perform these tasks here. A large open area between the buildings is divided by a wall, running east and west and separating the male and female sides of the compound. But there is direct access and men are frequently found on the women's side where occupational therapy takes place, again because there is more space available.

My first impressions of the hospital centered around the sameness of seriously ill mental patients which seems to transcend cultural boundaries. Many female patients were lying on the floor or stretched out on benches, rocking rhythmically, babbling quietly, staring with an expression of sightless searching so common to severely disturbed persons. Others were busy with bizarre gestures and manual activities understood only by themselves. They were neatly clad but the garments had the appearance of not being adjusted to fit or really "worn" by the women. They were clothed rather than dressed. One woman, in masculine attire, was loudly preaching an ominous kind of sermon in impeccable English. Many were excited by my presence and began doing whatever they were doing faster and louder. Others gave no sign of having noticed me and did not respond when introduced or addressed. Most of the patients were out of the wards and in the open area, but a few were permitted to withdraw to their beds where they lay curled up on their sides, trying to go back to that point of no return that the most regressed cases are seeking. The wards contained dozens of beds, scantily made and with a few possessions upon them. This was a quiet time of the day, and most were relaxing in their own worlds, waiting for evening 'tea' and the end of another day.

My tour of the men's wards created a great commotion and I did not linger there. The physical arrangement was similar to the women's section except there was room for many more patients and there were more individually lockable rooms. Although there were many men as seriously withdrawn and vegetating as the women, most of the male patients were definitely aware of their surroundings and the nature of their situation. Many of them responded in a quite normal manner to me and appropriate behavior and affect were exhibited by the majority of them. As not all the staff wore uniforms, I could not distinguish them from the patients. One man followed me and my tour guide about shouting creative and novel obscenities that were rather humorous and apt. His efforts were appreciated by many of the men. Perhaps a dozen men were locked into small barred cubicles but the general impression again was of relaxed relations and boredom.

During other visits I observed the patients in more active pursuits. Men made cups from polished bamboo and coconut shells. They sat at a table under a thatched roof, sanding, always sanding. Most looked straight ahead rather than at their work and their hands and arms moved with a mechanical rhythm making them resemble clock-work toys. It was indeed strange to see them come out of these trance-like states and speak or shift their gazes. Some of these mechanical men could converse almost normally and one had off-the-grounds privileges. Some of the women were making raffia hats with "SEAVIEW HOSPITAL, BELIZE" lettered on them, but only one was participating with much enthusiasm. The others would be busy washing bedding and other clothes, scrubbing the laundry very meticulously and then spreading it with great care on the grass to dry. Some helped in the kitchen area, setting the table (each place was set with a metal dish and cup and a large spoon), and washing the dishes afterward. Some would work for a while and then retire to their favorite spots, for a bit of contemplative rest before resuming the tasks at hand.

Few female patients were capable of normal conversation, and those who were at times seemed incapable of stopping. There were several young girls, one was nineteen. The others were also young and were distinctly Indian, not understanding any Creole or English and little Spanish. They were from Toledo District and seemed more retarded than mentally disturbed. They perhaps were epileptic as a good percentage of the patients were. A youngish woman sat beating her breasts and crying because she had "killed herself. " She had been there for four weeks and had not yet seen the doctor, so she was receiving no 'treatment. ' A grey-haired woman with many scars asked me for a favor in a mindless fashion but later turned out to be extremely perceptive and coherent when she chose. Her intelligence was obvious and she knew exactly why she was at 5eaview and why she would stay there. She generally preferred not to talk but rather spent her time in amused contemplation of the staff and patients. Another young girl appeared in the courtyard after changing her clothes for the fifth time in fifteen minutes. She was locked up in a small cell for that and began to cry.

Hospital Personnel
The staff too is similar to what is found in other institutions. Most have had little training in dealing with psychiatric patients and no other medical or psychological background. The only registered nurse at Seaview is the male supervisor of the hospital. His assistant, also male, is a licensed practical nurse. The rest of the staff is an assortment of young men and women who supervise the patients' activities, correct their behavior, and give them their medications--tranquilizers and anti- convulsants mostly. The staff members are proud of their roles and take pleasure in describing and performing their duties and responsibilities. In the female ward where so few patients are interested in their surroundings, most of the interaction is among the staff members themselves and between them and the more aware patients. One of the attendants had brought a radio to the wardroom and it was usually playing. As with most mental hospital personnel, the staff established and maintained themselves as authority figures. They ordered patients to run errands and perform small tasks for them. They teased them, sometimes encouraging bizarre behavior for their own amusement. Patients are physically punished by staff members for transgressions which upset the ward and create more work. The attendants confined patients when they deemed it necessary, and their keys, the symbols of their power to lock inmates up, were used and passed about with great show.

I attended a dance at Seaview Hospital one evening and found it to be quite a lively affair and it revealed much about the nature of the hospital and the patients. A popular local band supplied the music and the public was invited. The patients were dressed in their best clothes and virtually all of them behaved in such a manner as to leave no doubt that they were capable of normal affect and action when motivated properly. The ladies who usually were to be found lying on the floor with no thoughts about the arrangement of their clothing were all sitting up in chairs taking note of the activities, and being careful not to assume any unseemly positions. The men all acted with admirable restraint and conducted themselves gallantly with the ladies when dancing with them. As everyone was as well dressed as possible, it was generally difficult to sort out the patients from the staff and visitors on the basis of demeanor alone. A meal was served and all the patients showed considerably better table manners than usual. They listened politely to a small speech given by the temporary supervisor of the hospital and there was more dancing until many of the patients began to tire and the band played its last selection.

The evening was a great success and it was a tribute to staff members who had planned and executed the whole affair. They had managed to transfer their interest and enthusiasm about the occasion to the patients who responded by being well-behaved, cooperative, and as lucid as possible. The therapeutic value of such an event is great, and like much of what goes on at Seaview, the patients were encouraged and motivated to act normally--the usual goal of any program of psychiatric therapy. Thus even though there is little group therapy, individual counselling, or intensive analysis at Seaview, the staff members are eminently capable, as lay persons, of recognizing and encouraging normal behavior, just as they can properly tease and ridicule a patient for his or her peculiar habits and responses. This coupled with the atmosphere of light security and cooperative endeavor in running the hospital probably makes it an ideal recovery facility for British Honduras.

The Relationship of the Hospital to the Community
5eaview Hospital is not used as a collection place for various "undesirable" or troublesome elements of society. In Seaview there are no drug addicts, prostitutes, alcoholics, or confused old people. The permanent patient population is largely composed of intractable psychotics, many with organic complications, whose families are no longer willing or able to maintain them in their homes. Other patients that are there for short stays or who come and go are judged to be less severe cases and many can function for long periods of time outside the institution. Seaview Hospital does not realistically protect the society from mentally ill persons. The security is much too low and "escapes" too frequent. Rather the attitude manifestly is that the society does not especially need to be protected from these people (in some cases the reverse is true) but rather just separated from some of them. As some of the patients are able to leave the institution for work, shopping, visits, and general walking around, the separation is never too rigorous. Patients also participate in other activities outside the hospital. Seaview fields teams in such sports as volleyball, soccer, and boat racing, and they sponsor beauty contest candidates, domino tournament players and other participants in Belizean contests. The patients are entertained by local musicians, and have parties given for them by women's clubs.

After the reorganization and re-styling of the hospital in 1964, Seaview has become very visible and is an integral part of the community. The staff members and the former Chief Medical Officer were untiring in their efforts to advance the cause of the patients and improve conditions for them. The result is a clean, pleasant, relaxed environment where patients either rest and recuperate from the problems and worries in their lives before re-entering society, or spend their remaining days in a comfortable and genial atmosphere. All things considered, Seaview is a remarkably advanced institution and is a credit to the Medical Department and the people of British Honduras who have never protested the policies put into effect there.

TABLE FIVE
Hospital Population, 1907 - 1967

Year Male Patients Female Patients Total
1907 57
1908 55
1909 60
1911 42 21 63
1923 58
1925 30 22 52
1927 38
1928 36
1929 45
1930 55
1935 56
1938 29 26 55
1939 70
1940 75
1941 51
1942 59
1943 3
1952 44 40 84
1953 44 41 85
1954 51 42 93
1955 61 43 104
1959 75 51 126
1963 138
1964 98 58 156
1965 91 61 152
1966 93 65 158
1967 87 45 132


TABLE SIX
Admissions and Discharges, Seaview Hospital, 1907 - 1967

Year AdmissionsDischarges
1907 15 3
1908 10 6
1909 8 1
1911 7 7
1927 9 8
1928 12 9
1929 17 3
1930 24 9
1935 7 5
1938 22 18
1939 31 10
1940 24 14
1941 19 15
1942 48 10
1943 23 15
1952 46 28
1953 41 29
1954 30 17
1955 50 30
1959 53 29
1963 74 64
1964 104 104
1965 103 99
1966 116 103
1967 85 105

CHAPTER SEVEN

PATHS TO INSTITUTIONALIZATION
This chapter will describe the various ways a person can find himself in 5eaview Hospital and how the community reacts to deviant behavior which appears to indicate psychiatric disorder. Admission to Seaview may be "voluntary" or "involuntary" although the use of these traditional terms distorts the situation. Both will be discussed here as well as a special sort of voluntary admission in which the person feigns mental illness.

Admissions Resulting from Police Action
The usual immediate cause for a person to be sent to Seaview is behavior resulting in a disturbance in a neighborhood, store, work area, etc. in which the police are called. This disturbance may 45 take the form of violent destructive behavior in which persons are injured or property damaged, or there may be only a great deal of shouting or quarreling. The point is that someone will call for the police, or a police officer in the vicinity will hear the noise and investigate. Once on the scene, the policeman will arrest the person and he will be taken to police headquarters and charged with the crime which may be using obscene language, assault, destroying public or private property, disturbing the peace, drunk and disorderly conduct, indecent exposure in public, etc. The person can be freed on bail or may wait in jail to go to court on the day of his trial or pre-trial hearing. An exception to this series of events occurs when the person is acting in such a manner as to make it seem likely that he is mentally ill at the time he is taken into custody. In British Honduras a person is deemed obviously 'crazy' 1 if he is talking 'foolishness,' making bizarre gestures, is clothed in a peculiar manner, or has disrobed himself in public. When any of these conditions obtain, the person will be taken by the police directly to Belize General Hospital (if in the districts he will be given police transport to Belize as soon as possible) where he will be examined by a doctor on duty. There will be tests for alcohol, and the doctor will try to determine if the person has been smoking marijuana or taking any other drugs. If, in the doctor's opinion, the person is a bona fide case of psychiatric disorder, he will be taken to Seaview Hospital and admitted as a patient with no further legal process. It should be mentioned that the person, if it were so, would be very unlikely to protest the diagnosis of insanity and claim that he was 'alright. ' He would prefer the alternative of Seaview to a possible jail sentence and acquiesce to the doctor's decision. This is an important point and will be returned to frequently.

If, however, when the person is taken into custody, he appears alright, there will be no further legal questioning of his sanity until his trial. When he appears in court, if the possibility of insanity is raised by the person himself or his family, the magistrate (or judge) will send the person to Seaview for an interview with the psychiatrist. It is very unlikely that the person will, at this point, not be accepted by the hospital as a patient. First, the person will likely be glad to go to Seaview instead of jail. Second, the psychiatrist and the hospital administration do not want to risk rejecting the person as a patient, even though he may appear sane at the time of admission and interview, for fear of his committing another crime. If this happened, the psychiatrist and hospital would be blamed for permitting a 'crazy' person to go free and do damage. Third, British Hondurans believe that a doctor cannot know if a person is 'crazy;' only he himself can know and others must judge from his actions. If a person has performed a 'crazy' action, he is de facto crazy and no protest or temporary appearance of sanity will mitigate the consequences of the crazy act. Fourth, even though the person being sent to 5eaview knows he will afterwards be irrevocably identified as a crazy person, he will not fight his commitment for this reason. He reasons that people (i. e., his family or the police) already think that he is crazy, so he thus has little to lose by having the label formalized by hospitalization. Fifth, as in many parts of the world, declarations of personal sanity are interpreted as signs of insanity.

Throughout this section, it must be kept in mind that the situations described are not taking place in the anonymity of large cities. Rather these events occur in villages, small towns, and neighborhoods where people know each other well. If a person has been acting peculiarly for some time, e. g., neglecting his appearance, not doing his work, talking about unusual things, and this culminates in an episode where he intentionally breaks a window or starts shouting from his rooftop, this will likely be mentioned to the police when they arrive, or the police may know it themselves. Knowledge like this of a person's past behavior patterns makes it much easier to assess his sanity on the spot. Or the person may have suffered an important personal loss, such as the death of a relative or the loss of a spouse; there may be terrible financial problems or the fear of obeah. These things will be known by a man's or woman's family and will determine in large part their opinions. Thus the decisions made by the police, magistrate of the court, persons who give evidence at a hearing, are not based on snap-judgments of the person's general demeanor at the point of time in question. Rather these decisions will be based on a general knowledge of the person's background, usual personality, and former conduct. The person who will know the least about the prospective patient is the examining psychiatrist and his opinion is the least crucial in the chain of events that brings a person to Seaview.

Referral by Relatives
There are some persons who are taken to Seaview although they have committed no crime. Generally these will be men and women whose abnormal behavior is pronounced but not anti-social. Some of them may be seen on the streets quietly performing strange activities such as continuous and odd gesturing, or talking in low tones to no one in particular. Others stay at home and withdraw from the company of others, perhaps reading ceaselessly or just staring ahead and not reacting to outside stimulation. These prospective patients will be taken by spouses, parents, brothers or sisters, or other relatives to see a doctor. They may then be referred to 5eaview for observation and treatment. Or they may be taken to the twice-weekly clinic at Seaview itself and immediately admitted. These relatives will usually be motivated by the fear of the person's doing 'something worse' in these cases rather than feelings of being in some way burdened by the person's presence in the home. If, however, a person acts in a very peculiar manner in public and has no family to take him to a physician for a psychiatric examination, he will likely stay out of Seaview as long as he causes no trouble. Eccentric behavior or bizarre conduct is not, by itself, a usual cause for legal commitment. One sees many people like this, especially in Belize, and their presence in public places seems to offend no one.

Self-commitment
Voluntary admission to Seaview is rare. Although most patients do not protest their being in the institution, nearly all are brought there by relatives or the police. The idea of a person feeling crazy and going by himself to the hospital for admittance seems an alien one to British Hondurans. They are not introspective people, dwelling on their own states of mind and personal emotions. They do not concern themselves with the mechanisms of losing control and parting with one's senses. Psychological explanations for a person's actions are generally incomprehensible to them and most disturbed British Hondurans probably do not know they are disturbed themselves until they do something violent and/or inexplicable. For them, as will be explained later, psychiatric disorder is largely produced by outside agents acting directly upon a person's mind making him or her 'crazy;' and the evidence, indeed the substance, of the disorder is the act itself, not the mental state that produced it. I heard of only one case of a person committing himself to 5eaview and that case was aberrant in almost every detail, concerning as it did a highly educated man of recent foreign extraction.

Admission by -Pretence
Although very few persons would feel the personal need for institutionalization, there are many who actively campaign to get themselves committed. These are people who have been accused and/or convicted of criminal acts which carry long jail terms. If these people can convince the court or their jailors that they are crazy, they will be sent to Seaview. To accomplish this end, they will imitate the behavior of mentally ill persons or do things which would automatically indicate insanity. Predictably, they talk in nonsense words, make odd gestures, tear their clothes and hair, are said to eat excrement and generally try to make their behavior as unusual as possible. If they become a disturbing element in the jail, they will indeed be sent to Seaview to finish their prison terms. However Seaview is more pleasant than the jail and escape is much easier. Also spending time in Seaview gives one a 'license to kill' which will be described below.

The Effects of Institutionalization
Once a person is a patient in Seaview, there are many variables which determine the length of the stay. If he or she is admitted under non-criminal conditions and improves rapidly, discharge will follow in a matter of weeks. Others will take months to improve and, if they are re-admissions, the administration will take longer to decide that they are ready for release. If someone is there for criminal behavior which resulted in hospitalization rather than indictment and sentencing, the stay may be somewhat shorter than for a person who was transferred to Seaview from the jail (all other conditions being equal) even though they may have been involved in the same kind of misbehavior. I have no official statistics on average periods of hospitalization but from the figures available on admissions and discharges, it would seem that for most cases it is less than a year. British Hondurans usually estimate it at several months. If one stays in Seaview for purely psychiatric reasons for over one year, it becomes less likely that discharge will ever come.

In British Honduras it matters little how long one has been in Seaview Hospital, but the fact of ever having been a patient there carries great weight. As it is a relatively small place, it is not a fact that is easily hidden. After discharge, anyone who has been in Seaview is still a 'crazy person'--even more so than before admission. There is always a certain amount of doubt about the actual mental condition of a person who has never been hospitalized but everyone is certain of an ex-Seaview patient. Although various agencies and the psychiatrist himself will help the ex-Seaview patient seek employment, it is difficult for anyone in British Honduras to find work, and most especially so for a former mental patient. For British Hondurans believe that psychiatric disorder is never really cured. They view it as being like epilepsy, asthma, diabetes, heart trouble, tuberculosis--afflictions which according to local opinion are never really gone for good, but rather can occur again at any time. Thus people fear another episode of craziness even in a person who has been symptom-free for years, for he is still considered to be a disturbed person. Many men who have been to Seaview turn to hustling when they are discharged and never really find regular employment unless they know trades and can establish their own businesses.

British Hondurans fear mentally ill persons but for different reasons than one would perhaps think.They do not have an irrational undifferentiated fear of them as persons who are capable of any vicious act or violent crime. Rather they usually know them individually well enough to be able to sort out the harmless ones from the persons with a history of violent or offensive behavior. Thus if a person had been sent to Seaview for treatment of a disorder characterized by withdrawal and regression, he or she would not be feared as a potential axe-murderer. The actual reason for most persons choosing to avoid the company of the formerly-institutionalized mentally ill persons, is that no matter what the person does, there is no legal recourse.

This peculiar set of circumstances is generated by the practice of not bringing former mental patients to trial for any crime or wrong-doing. Rather they are immediately sent back to Seaview. Thus whether the ex-patient calls one names, damages property, or commits murder, there is no possibility of securing redress through the courts. Also a person can find himself in legal difficulties himself if involved in an altercation with a former Seaview patient. The courts would tend to fault the sane person in the event of a fight or argument, reasoning that one should have better sense than to bother with a person known to be crazy. This is the 'license to kill, ' a phrase which one invariably hears when discussing psychiatric disorder with British Hondurans. And they always stress that the person knows. that he can never be sent to jail for any crime and is therefore relatively fearless in some circumstances. This can be observed in some persons with a history of institutionalization. There is an infamous character in Belize who goes about the city doing what he wants wherever he goes. As he has a fondness for insulting people and snatching cigarettes and parcels, he is quite a liability in a commercial establishment. Yet few businessmen have the temerity to usher him out when he appears on the premises. They are afraid of him personally and of the kind of difficulties they might have if there were any serious trouble with him. Interestingly, many people do not believe this man to be really 'crazy' and they are particularly critical of his being loose with a license to kill.

Whenever a former Seaview patient is involved in an altercation or disturbance, he is immediately taken by the police back to Seaview and readmitted. He will not be examined by a doctor at the general hospital and there will be no case to go to court. It will be assumed that whatever wrong behavior caused the trouble is directly linked to the person's mental condition. This immediate recommitment procedure has a tendency to make the police ignore the petty crimes and misdemeanors of mentally ill persons. The individual policeman realizes that nothing will come from his intervention except recommitment, and perhaps feeling that justice will not be done anyway, the police allow known mental patients a much wider latitude of behavior than the rest of the populace--another aspect of the license to kill.

Institutionalization generally works quite differently in British Honduras than it does in the United States. The most fundamental difference is that only the most severe cases are hospitalized-those who cannot care for themselves and those whose proclivities toward disruptive behavior bring them into contact with law enforcement agencies. One result of this high level of tolerance is that few people ever protest their confinement, usually because they are far too ill to really understand their situations. Probably no one has ever been "rail-roaded" into 5eaview Hospital, and those patients who are quite sane are there by choice. For in British Honduras it is not an offense to society to be mentally ill, even quite obviously so, as many severe cases never see the inside of Seaview. People are generally quite free to express themselves in whatever unusual ways they find as long as they do not disturb other people--and Belizeans can be quite blase' about the odd behavior of their relatives and neighbors. Also there is rarely anything to be gained by committing a person to Seaview in financial terms. In fact, if a person of wealth or property becomes deranged, there will always be a relative to take care of him or her, hoping to inherit the money after the person dies. For sending a person to Seaview does not make him a legal non-person as does institutionalization in the United States. Rather when the person is discharged he is a more formidable force than ever.

The British Honduran example raises many questions about the value and effect of mental institutions, and some are answered in a most pragmatic fashion by the realities of British Honduran society. Their example indicates that it is possible to maintain a mental hospital with virtually no treatment given and still have a discharge rate of about fifty percent. It is also possible to have many patients referred and admitted without ever having their sanity evaluated by a professional person. The institution can be used only as a mental hospital without having to house other classes of deviates. It is possible to accustom society to the presence of persons who are mildly to moderately ill in the sense that they can still meet some role requirements. All of this is now present in British Honduras and the society does not perceive itself to be adversely affected by it. And it is possible that making mental illness a visibly undesirable state acts as a deterrent to its development. Thus instead of punishing and isolating cases of psychiatric disorder, the British Honduran system makes them useful examples of ways not to be. 2

NOTES
1. "Crazy" is used in British Honduras to describe persons who are perceived to have severe mental disturbances. The word is also used to describe the actions of persons who are not themselves believed to be crazy. The term itself is not a particularly negative one and is used in a factual rather than derogatory sense.

2. Erikson (1964) believes that deviancy may have certain positive effects on social life:

People who gather together into communities need to be able to describe and anticipate those areas of experience which lie outside the immediate compass of the group--the unseen dangers which in any culture and in any age seem to threaten its security. Traditional folklore depicting demons, devils, witches and evil spirits, may be one way to give form to these otherwise formless dangers, but the visible deviant is another kind of reminder. As a trespasser against the group norms, he represents those forces which lie outside the group's boundaries: he informs us, as it were, what evil looks like, what shapes the devil can assume. And in doing so, he shows us the difference between the inside of the group and the outside. It may well be that without this ongoing drama at the outer edges of group space, the community would have no inner sense of identity and cohesion, no sense of the contrasts which set it off as a special place in the larger world (In Becker (ed.. ), 1964:15).

CHAPTER EIGHT

ABNORMAL PERSONS IN THE COMMUNITY
At this point it would be useful to introduce information about other kinds of abnormal persons who remain in the community. Although many of these men and women have very restricting kinds of handicaps and defects, most are still able to live a more natural life than could be provided by institutional care. It can be deduced that British Hondurans are accustomed to persons who are not normal and regard the mentally ill as another category of human beings who will not quite "measure up" but will be tolerated and perhaps assisted as well in spite of limitations to normal performance.

As mentioned in the last chapter, there are large numbers of mentally ill persons who are recognized as such that are not in Seaview Hospital. Likewise there are everywhere in the country persons with physical handicaps, low intelligence, severe medical problems, etc. who are not hospitalized. One reason for this is simply the lack of institutional facilities to house these persons. This is partly a result of the limited funds available in British Honduras for medical care, and partly because the population does not feel that these people should be sequestered in special hospitals and cared for by the government or charitable organizations.

Physical Handicaps and Low Intelligence
There is at present only one institution in the country which accepts physically handicapped children, Stella Maris School in Belize City. Here blind, deaf, dumb, and otherwise handicapped children are taught writing, speech, reading, and certain social skills. Each year there are few openings for boarders and it is difficult to place children there except as day students. The school closes each year during the summer months and all the students return home for the vacation. Children who are not admitted to Stella Maris (mostly from the out-districts) stay with their families and grow up in the community almost like any other child. They will often not be accepted at the regular primary schools and will stay home all day or roam the streets looking for amusement or work.

The populace generally considers handicapped persons to be of two types: 'sensible' and 'not sensible.' By 'sensible' they mean roughly normal intelligence with no obvious mental illness. Sensible handicapped persons, especially if they are male, can often lead a fairly normal life in the community. Several personal histories will be given at this point to illustrate how these persons find their niches in society.

A man of thirty years or more with severe cerebral palsy affecting both his coordination and speech shines shoes for a living. His intelligence appears to be lower than normal but he is able to manage his business affairs and conduct himself in a socially acceptable manner. He is always well dressed and is the only shoe-shiner allowed in the more prestigious hotels. Most people in Belize know him and he is greeted warmly and treated in a friendly manner; and, even though few can understand his speech, anyone would converse with him briefly. He is occasionally given too much to drink in a bar or club and then teased by the girls working in these places, but he is very rarely made an object of ridicule. He is a happy, useful member of the community despite his severe physical disabilities.

A man, unable to speak, has a reputation as one of the best cabinet makers in the country. He is now about forty-five, is married, and has raised several children. He has a thriving business and is often mentioned as an example of how a 'sensible' person can overcome handicaps. He reads, writes, and knows sign language--all largely self taught, as when he was a child there were no facilities for the teaching of handicapped children.

A middle-aged man with mongolism or Downe's syndrome used to live in Belize with his family. He would wander the streets of Belize playing a mouth organ and was usually teased and ridiculed. He was noted for being able to extend his tongue to his chest and would do this on request. He would also twirl about, round and round, if one put a finger on the top of his head. He calmed down in his later years and became much less visible, ceasing to play his mouth organ and walking around more like a normal person until his death in 1972 when he was found stabbed late at night in the street. His killer was never found, and people were genuinely shocked by his death as he seemed to epitomize all that was harmless and amusing to them.

A deaf-and-dumb young man lives alone in Belize. He clothes himself by stealing laundry left out to dry and eats by going through garbage. He is well-known and many people will also give him cast-off clothing and left-over food. He is very active, walking the streets of Belize, night and day and hanging around in the market and in the bars and restaurants where he is tolerated. He is not 'sensible' but is able to run simple errands and perform menial tasks. He has a gift for perfect mimicry which makes him able to communicate quite well with persons accustomed to him and his gestures. Men frequently give him drinks and then laugh at the resulting behavior. He is obviously mentally disturbed but seems to have at least normal intelligence. He usually conducts himself with nonchalance but can become most tiresome and annoying, and I have seen him threatened, abused, and struck several times. But he manages to live unaided by any kind of formal welfare and most persons regard him with amused pity. Although never institutionalized, he is obviously 'crazy' and people tolerate a great deal of unseemly behavior and occasionally lewd conduct from him. They realize that he is not to be held responsible for what he does in the same way that other people are.

An eight-year-old boy has a congenital cleft lip and palate. There are no facilities for surgical correction of this deformity in British Honduras and there are not at present plans to send him abroad for treatment. He no longer attends school because the teachers could not understand his speech. He plays with other children in his neighborhood and is not teased or insulted about his appearance very often. Frequently he can be seen going about the town into shops and bars selling food his mother has prepared.

A family has a two-year-old child with a congenital heart defect. When the boy exerts himself or becomes upset he turns 'blue, ' as a result of the cyanosis produced by his blood being insufficiently oxygenated. His parents have a fair understanding of the gravity of the problem and are saving money to take the child abroad for a corrective operation. Meanwhile the boy is kept at home continuously, his movements are restricted and great care is taken not to upset him. He is already a serious behavior problem and almost runs the household. Had he been born into a poorer, less sophisticated family, he likely would not have survived to his present age.

A sixty-year-old man, crippled from birth with abnormally small arms and legs, has spent his life in a wheel chair. He has supported himself for years by begging and making wooden suitcases. He now lives with his children and is still active, propelling himself all over the streets of Belize. He has led a fairly normal life in view of the extent of his handicap and has never been dependent upon formal welfare or charity.

A woman of thirty-five years does not have the use of her legs. She uses neither crutches nor a wheelchair, rather pulling herself along the ground with her arms and hands. She has three children and cares for them all herself and takes in laundry as well. Her husband helps her with some tasks and works to help support the family but she manages most of the work herself.

Men with handicaps are generally more visible than women similarly afflicted because women tend to be in their homes most of the time and with handicapped or deformed women this is particularly so. As it can be seen from the illustrations cited, even abnormalities which greatly reduce normal function are not a particularly severe deterrent to ordinary life. People in British Honduras must learn some way to live and frequently have to support themselves as there is really no alternative in the society. 1 Those who are sensible usually find a means of overcoming their handicaps but those who are not, as noted in the examples, must depend on the goodwill of their families and the community. None of the patients at 5eaview appeared to have physical handicaps with the exception of one very old blind woman. There were several with convulsive disorders but this was not the sole reason for their confinement as most epileptics live normal lives in Belize. Rather persons with physical handicaps who are also mentally disturbed would be very unlikely to be sent to 5eaview as these people are so close to being complete social non-entities that they are hardly bothered with at all. The feeling is that being in 5eaview would not help them, which is probably true; and that these persons, never improving, would only be taking up room in the hospital which is needed by persons who are better prospects for a cure. An example follows.
A deaf-and-dumb man is employed by a close relative on a farm doing menial labor. He has a reputation for being very highly sexed and is usually unable to pay even prostitutes to have relations with him, so great are his demands. He has one child, but the child's mother left him and the child was raised by one of the man's maternal aunts. He is also a voyeur and an exhibitionist having been caught peeping at his own daughter after she matured. He smokes a lot of marijuana and masturbates frequently, sometimes in front of open windows. His habits are well-known by all his relatives but he is tolerated. He is described as very much not 'sensible' and is viewed as a nuisance and embarrassment rather than a threat.
This man has avoided institutionalization for several reasons. Primarily he is not considered to be too severe a case, as sexual deviation is not rare in British Honduras. Also his peculiarness is linked to his physical handicap, and thus mitigated by it. Importantly, his family is willing to provide sustenance in the forms of employment and housing for him so that, while living on the farm with relatives, he is not likely to come to the attention of the authorities.

Non-institutionalized Cases of Psychiatric Disorder
The above cases illustrate some of the aspects of a mentally ill person's situation which make it unlikely that he will be committed to Seaview Hospital. As mentioned in Chapter Seven, another important factor is the possession of wealth or property. Two instances are cited below.

A woman was disturbed from birth. Her mental illness was thus a 'natural'? one, and she was never committed. For fifty years she was cared for by her family, and then one sister minded her until her death at 86. Had the ill woman outlived her sister, a more distant relative would have stepped in to care for her, as she was part-owner of the house and land on which the family lived. Her main symptom was talking 'foolishness' to herself. She was never examined by a psychiatrist.

A wealthy merchant's wife became mentally ill and started talking to herself, tearing her clothing, doing 'strange things' on the street, etc. She was maintained in her home, where her children and other relatives cared for her. She has never been sent to Seaview as people in the upper classes prefer to keep their relatives out of 5eaview as long as they can be managed in the home and do not commit any crimes.

The ability of a person to function in his normal roles in spite of his psychiatric problems is a major factor in non-institutionalization. As long as a person can clothe himself, eat properly, and go about the town without getting into trouble, he will not be considered a candidate for Seaview. It may be this which produces the usual two to-one ratio of men to women in Seaview. While women are still able to carry on with housework and child care, neither intellectually or emotionally demanding jobs, they will not be sent to Seaview. Also as they tend to stay in their homes under any circumstances, they have fewer opportunities to become involved in public disturbances. Below are two cases which indicate how even a severe disturbance can be overcome by compensating normal activities.
A man, about thirty years old, spends most of each day walking the street of Belize singing hymns and exhorting people to "go to Jesus. " He sings quite loudly and usually uses broad generally appropriate gestures. He often pauses by a group of people, especially if they are young girls, and begins to sing in an even more animated manner. Sometimes he will be teased or told to move on but he is generally ignored. His mien is one of great happiness and contentment, and he always seems vastly pleased with what he is doing. Although he sometimes impedes pedestrian traffic, he is otherwise no problem. He supports himself and his family with the revenue produced by a mule and cart which he owns and hires out. Occasionally he rides on the back of the cart and vocalizes from there but he never forgets to charge the rent on it.

A middle-aged man works delivering soft drinks on a carrier bicycle for a local bottling company. He is a model employee and a generally unassuming person in his private life. His one peculiarity is that, fearing some kind of contamination (perhaps radio-activity) he covers every inch of his skin. He usually wears a pair of white trousers and a long-sleeved shirt, shoes and sox, and a pair of gloves. He wraps his neck with cloth and wears a plastic bucket over his head with eye-holes cut out. He always speaks sensibly and exhibits no other abnormalities, although he is rumored to go about nude in his home. He lives alone and never causes any trouble. He has been thusly attired for years but he keeps abreast of progress, having replaced a canvas bag he used to tie over his head with the bucket when plastics became generally available.

Aside from persons who have never been to Seaview, there are many who have been there once or several times but are not considered to be severe enough cases for long term or lifetime commitment. There are dozens of such persons in Belize and many more throughout the country. These persons are known to be mentally ill and frequently become local characters, with well known peculiarities and habits. Some case histories follow.
Albert, about thirty years old, is a well known figure about the town. He usually wears a turban-like headdress of brightly printed cloth, a cape-like shirt, and green knit pants with a sash. He tucks the pants into mid-calf high boots. When he desires, he carries a large black umbrella to shield him from the sun, or perhaps to complete his ensemble. He used to wear a leather tunic and sandals. He has recently built a small (ten feet square) house on the riverbank. The first story of the house is almost totally enclosed while the second floor is quite open, there being an arched window and one whole side covered by a turquoise curtain. Before he built this house, he had moved his bed and cooking supplies to the bank of the river, and was living there in the mud under a tree. He has another house a few miles out of town which looks like a small chapel. It too is quite open with an arched window and billowing curtains. Albert lives alone and does not work. His wife left him when he became disturbed and he allegedly receives a monthly sum of money from his mother who lives in the United States. Albert used to be 'quite a nice fellow, ' had a regular job, and was married to a nurse with whom he had two children. He became interested in the Bible and spent much time reading it. He then began to wear odd clothing and he made a burnt offering of a sheep he had, named Belmopan. One day he trussed up the two children, placed them on an altar he had constructed, and prepared to sacrifice them. The police were immediately called by neighbors and he was taken into custody. He escaped from the jail and ran to the Catholic church where he climbed up into the bell tower and jumped, a drop of some forty feet. He was shot by the police during the episode and injured. He was taken to Belize Hospital for treatment of the gunshot wound and from there admitted to 5eaview. He was released some months later and returned to his old neighborhood. His wife had left and taken the children. Albert generally minds his own business, but is very quick to take offense and frequently curses children and adults for real and imagined slights. Recently when the moon was full, he climbed to the top of his house and harrangued the whole neighborhood for two days and nights. He generally accused them of all manner of evil doing and made many obscene personal comments. Complaints were made but nothing was done even though the whole residential area was terrorized and few people dared to venture out of their houses. .

Everyone knows Joe too. He has been in 5eaview and will often mention that "they!' think he is crazy, and that they are trying to make him crazy by putting him in Seaview. He has certain peculiarities of dress, usually affecting some kind of unusual head gear. For a while, he was wearing a straw hat with pictures of the Premier and various Cabinet members attached to the crown along with a jack-of-diamonds. Most recently he has been wearing a bank money bag. He usually has a collection of small found objects, often metallic or marine, dangling from a cord around his neck. His manner is frequently manic and he speaks very quickly in a loud tone. He becomes even more intense when drinking or smoking marijuana. Joe hustles for a living, running errands for people, making and selling cowhorn birds, helping musicians set up, and generally making himself useful in miscellaneous ways. Most people have a genuine fondness for him and seek him out when they need certain tasks performed. Joe's intelligence is very high, and he is well-known for his infallible memory, acute perception, and intimate knowledge of Belizean society. Too intimate for some, and there are people who are very careful never to upset Joe for fear of what he might say about them. He has a remarkable facility for exposing pretense and affectation and he usually does it in a loud voice among a large group of people. He, because he goes so many places and says so much, is probably the best known mental case in the country, and he has become almost an archetypal example of craziness. People believe that everything he says is true and he engages in a very subtle kind of blackmail with acquaintances. They give him jobs, drinks, and money, and he says nothing bad about them. When a person falls out of his favor, he is likely to accost the person on the street shouting the details of some illegal deal or a summary of the person's illicit sex life. For this reason, no one would ever attack him bodily or harm him at all; they fear that he would say something even worse crediting him, as they do, with superhuman knowledge and insight. He lives with his family and although he is about thirty (he looks much younger), he never appears to have any relations with women.

George is similar to Joe. He too has been to 5eaview and now lives by hustling, often selling the food prepared by other members of his family. He used to be a boxer and people believe that head injuries sustained during one fight caused him to become disturbed. George usually acts fairly sensibly unless he is drinking and then he begins to talk almost exclusively about love. He also pretends that he is boxing and will bang his head against a wall, seemingly intrigued by the fact that no one else but he can feel the pain. People enjoy listening to Joe and George talk to each other and as the two are good friends, they exchange views often. George does not have the personal power that Joe enjoys and thus leads a more normal existence, being essentially a good-natured, hard-working fellow whose infirmity is regarded as regrettable.

These are only a few of the most visible cases in the country and others who could be described do not differ substantially from these. In general, these people's lives are as normal as they are. Few of them have regular employment and fewer still have spouses and children after their first psychotic episodes. They usually make their homes with parents and siblings or live alone. Their relationships with other people are always colored by their histories of mental illness, and some people would avoid their company. Attitudes toward them are mixed, varying with any one person's experience with mentally ill people and his estimation of how severe the disorder is. Some are feared, both for their physical capabilities and their penchants for untoward behavior. People exhibit sympathy for some, especially if they appear to have high intelligence and showed a promise of achievement in their lives before they became ill. Persons who have been to Seaview are not held personally responsible for any reprehensible behavior even if it occurs during periods of lucidity. Rather people grumble that 'something should be done' about them. During the full-moon period of Albert's last disturbance, the residents of the neighborhood generally blamed the police for not being able to control him. One policeman in fact lived in the immediate vicinity and his wife was frequently a recipient of some of Albert's more offensive remarks. Had a person with no history of mental illness created such a disturbance, he would have been arrested immediately and charged with the appropriate crimes. The truth of the matter was that the police, individually and collectively, were afraid of Albert. He is known to be an able fighter and reputed to have a nasty disposition. No one wants to provoke him even when he is calm, and certainly not when he is obviously disturbed. One of the neighbors said that one day Albert will "drop like a bird" from his roof, meaning that some one will shoot him. During the conversation, everyone present seemed to think that this would be a likely turn of events, and that if it did occur, nothing would happen to his assailant. Similar feelings are voiced about the person mentioned in Chapter Six, who goes about exuding hostility and openly threatening people. Although many persons do not consider him to be mentally ill, they feel that he should be controlled by the police and frequently summon them when his presence is unbearable. Almost everyone is afraid of this man, including the police, and he is frequently a problem and a public nuisance. Opinions differ as to whether he should be jailed or sent to Seaview. However neither seems likely. People have become accustomed to dealing with him, and although they blame the government they feel that nothing can be done about him and they try to stay out of his way.

The presence of both these violent and potentially dangerous men and several others speaks well for the forebearance and toleration of British Hondurans. They accept these persons resignedly, often saying that they are probably too much trouble to keep at Seaview. However although these ex-mental patients lead charmed lives when petty crimes and 'mischievous' behavior are concerned, any person in British Honduras would feel himself justified in killing a 'crazy' person who seriously threatened him or his family. It should be noted also that British Hondurans would feel justified in killing anyone who presented a real threat to them.

There is a general scarcity of serious crime in the country as a whole. A characteristic of British Honduran interpersonal relations is the avoidance of violent confrontation, and this trait may well persist in even the severely disturbed. There is also the possibility that some ex-mental patients are rational enough to be aware of the limits of their 'license, ' for it is only a phrase, albeit a revealing one.

NOTES
1. The lack of institutional care for severely handicapped persons places the entire burden of care on the family, and it is almost always accepted gracefully. Even though handicapped persons could live being entirely dependent upon their relatives, few elect to do so. Most master many very difficult skills, and an extremely capable and well-adjusted handicapped person is the rule in British Honduras rather than the exception.

2. "Natural" in this case is used to mean a disturbance not caused by any outside agency or a congenital one. The term is also used to describe the contagious diseases of childhood--they are 'natural sickness.'

CHAPTER NINE

RECOGNITION OF MENTAL ILLNESS
This chapter will deal with how mental illness is recognized in British Honduras and what people there think causes it. There will also be a discussion of several types of abnormal behavior, which although they are recognized as deviant and undesirable, or at least peculiar, are not believed to be an indication of craziness. Thus a folk model of psychiatric disorder will be presented as well as information on related topics which will serve, by contrast and comparison, to more fully delineate what would count as a case of mental illness to most British Hondurans.

There are probably not any universally recognized outer limits of human behavior which would in any society classify a person as "mentally ill. " Indeed, the concept of mental illness is one which appears to be absent from many tribally organized societies and nonliterate peoples. While organically related abnormal behavior must be a universally occurring phenomenon, in many societies these cases of derangement would be considered religiously inspired or evidence of other kinds of supernatural intervention in human affairs. Certainly the existence of the "functional" varieties of psychiatric disorder outside of Western civilization, where these concepts were first postulated, has been questioned. Here British Honduras presents an interesting juxtaposition of literate society and non-literate belief systems for although the country has the material and organizational trappings of the relatively advanced parts of the world, the people there order their lives and evaluate their situations in terms and concepts which might be more suitable in less sophisticated surroundings. For the legacy of civility and progress which the English colonialists left is primarily a veneer over the hardwood of customs and beliefs imported from pre-colonial Mexico, Africa, and the Caribbean. The primary education which almost all British Hondurans receive consists of years of assiduously copying off the blackboard what the teacher has written and parroting back words which the teacher utters, words often spoken in a language which the child does not understand. People are also trained by rote for jobs and nowhere is this more evident than in the Post Offices where many of the persons handling mail have never sent or received a letter in their lives and, indeed, do not understand the basic principles of a postal system. Although there is widespread professional medical care, many people will exhaust traditional remedies before they utilize it or will tolerate much bodily malfunction thinking that there is nothing that can be done about it. Thus in British Honduras one finds a good testing ground for questions about the recognition of mental illness as the populace has been exposed to two contrasting modes of thought: that of the Western world's medical practitioners which tends to interpret as symptoms of mental disturbance any abnormal behavior, and that of their own peoples which surely is less likely to find a psychosis or severe neurosis behind every wrong act. The reader can judge which is more utilized in evaluating the behavior of others and ascribing causes to it.

Folk Symptomatology
In British Honduras the most frequently given symptom of craziness is 'acting foolish,' but by this the populace means very specific kinds of behavior. They are talking about words and actions so bizarre that they can fit into no conceivable context. On the verbal level, they are referring to the babbling of nonsense syllables; continuous talking to one's self in the presence of other people; conversing on only one subject regardless of the content of the conversation; and saying things which, although they are grammatically correct usages of "real" words, convey no ordinary meaning. Importantly, expressing very odd opinions or beliefs not held by anyone else is not regarded as particularly strange. Verbal 'foolishness' then is generally an absence of meaning or context rather than the actual content, if it is decipherable. Thus a person can relate weird experiences and feelings which, although considered to be very unique, will not bring his or her sanity into question as long as he does it with normal conversational techniques. Non-verbal 'foolishness' generally covers gesturing. Erratic swatting or snatching movements of the hands are often given as examples as are rolling of the eyes and contorted facial expressions. These must be performed with regularity, however, and not be "nervous mannerisms" or linked organically to any disease. It must be stressed that if there is any knowledge or suspicion that the person has been drinking or smoking marijuana, 'foolishness' is attributed solely to the use of an intoxicating agent and not to the person's mental state, unless the person is known to be crazy, i.e., has been to Seaview. The sudden ability to speak and converse in Standard English as opposed to Creole is also regarded as a sign of psychiatric disorder especially if the person is not very well educated and has not done this before.

Aside from gross 'foolishness,' there are kinds of integrated behavior patterns which indicate mental illness to British Hondurans. One of these is excessive religious fervor. If a person reads the Bible 'too much, ' talks about nothing but God, goes to church 'too much, ' and makes drastic changes in his life for religious reasons, he will be thought to be 'getting crazy.' Thus if a person has been long only a nominal Catholic, Episcopalian, Baptist, etc. and suddenly begins to neglect other aspects of his life for religious behavior, people will suspect him of mental illness. This expectation will be lessened somewhat if the person is a recent convert to an evangelical sect; but, if the behavior persists for a long period of time (several months) his or her relatives and acquaintances will begin discussing the person in terms of a possible psychotic condition. Lack of interest in sex is also regarded as evidence of craziness. If a man leaves his woman and goes to live by himself for no obvious reasons, he will be regarded as 'getting crazy. ' Adolescents, both male and female, who show no interest in the opposite sex will be regarded with suspicion. Later, if they begin to indulge in bizarre behavior, it will be linked to their lack of sexual drive and will count seriously toward their being labelled as crazy. Related to this is any desire to live alone away from other people. Unless there is a logical reason in the person's life for going away from a town or village to live alone, this is viewed as very odd behavior. Building a house or a camp off in the bush except to clear land, bleed chicle, etc., and living alone in it would be regarded as a crucial indication of a person's insanity if he had been acting peculiarly before this. Variation from the norm in matters of dress is not taken lightly in British Honduras. The affectation of a "costume" of some kind, the selection of inappropriate objects for ornamentation, or the wearing of clothing of the opposite sex are all indications of craziness. Similarly the removal of all of one's clothes in public or appearing in public naked are absolute signs of mental illness, unless one's motivation is sexual, such as exotic dancing or exposure of only the sexual organs. Jumping off a bridge, either clothed or nude, is always a sign--particularly if it is the 'Swing Bridge,' the bridge in downtown Belize across Haulover Creek which links the north and south sides of the city. 1 A drastic change in food habits, such as eating only one thing exclusively or eating foods which were not eaten before is suspicious behavior. There are of course other kinds of behavior which would be considered as acts of only a mentally ill person, but rather than list these possibilities (most of which have never occurred) it would be more useful to examine locally postulated causal factors.

Folk Psychogenic Theory
Excess in something is a common factor in situations which British Hondurans believe cause mental illness, and 'too much' is a frequently used phrase when people describe what a person was doing before he was afflicted. Although the idea of moderation is not a pervasive ethic in British Honduras, it appears occasionally in a few contexts. In food consumption, for example, although people eat large quantities of ordinary food, they rarely will take as much of a luxury food as they want, even if it is available. Canned peaches and pears, chocolate bars, fancy cakes, imported cookies, and other infrequently purchased delicacies are eaten sparingly as people feel that too much of them will make them become ' clide of it. ' 2 When a food 'clides' someone, he stops eating it immediately and will not want it again for a long time. People also believe that too much of some common foods has bad consequences. For example, limes, if eaten in abundance, are supposed to decrease sexual drive or 'kill your nature. ' Inordinate consumption of hot chile peppers produces bad tempers; and too many mangoes, eggs, or avocados causes biliousness, it is believed locally,.. Too much sex causes a condition in males known as 'dry back' characterized by general weakness and genital malfunction. Too much sleep allegedly produces 'dropsy, ' a vague disorder involving retention of water and a progressive inability to do anything but sleep. Perhaps relatedly, excessive indulgence in certain activities is believed to produce mental illness. These are reading the Bible, studying black magic, smoking marijuana and drinking alcoholic beverages, and feigning the symptoms of psychiatric disorder or 'teasing. ' 3

There are people in British Honduras who believe that no one could understand the Bible, that it is too complex, difficult, and obscure for the human mind. Thus if one spends too much time reading and studying it, the power of its incomprehensibility is 'too strong' and the result is craziness. This is a direct consequence of trying to understand the Bible. Thus if a person begins 'studying Scripture, ' reads only books about the Bible and the Bible itself, and fills his conversation with many Biblical references, people will think that he or she is 'getting crazy;' and, if the person starts to act in a peculiar manner, local opinion will be that the peculiarness is caused by all the Bible reading. 4 It is possible that this idea is related to the influence of the Catholic Church in British Honduras. Most people attend Catholic schools as children where they are not encouraged to read the Bible which is described as a contradictory book filled with many things we mortals cannot understand. Later in their lives people think that something in the Bible is being hidden from them and they attempt to find it, often joining such sects as Jehovah's Witnesses, the Church of God, and other fundamentalist groups. This interest in the Bible is related to the use of black magic in British Honduras and the Bible is believed to be a 'guard' of sorts. People keep copies of the Bible in their homes and places of business to protect them from obeah or black magic, and some read the Bible to ascertain what is in it that has power over human beings.

Some persons study black magic itself. Many do it out of curiosity but others are seriously bent on using it to affect other people. Copies of Rosicrucian publications, books on magic printed in the United States, India, Mexico, etc., popularized historical accounts of sorcery and alchemy, volumes with detailed instructions for spell-casting and knowing the future--these are all found in British Honduras. Few people know who owns such books, and they are not commonly available as they are not sold in the local bookshops. But some people order them from abroad and study each one carefully looking for appropriate techniques of magic. The books I saw were largely incomprehensible to me and they must have seemed doubly so to many barely literate British Hondurans, being full of information about special spirits and the ways to summon and control them. Nevertheless they will pore over these books for hours trying to understand them. This in itself is believed to make them crazy. Also there are some who believe that these students of the black arts have actually summoned demons and that the sight of them caused the practitioners to lose their minds.

Thus it can be seen that definite limits to human understanding are assumed and that attempts to go beyond them result in derangement whether one's motives are curiosity or more expertise in directing human affairs. Many things which happen or are believed to happen in British Honduras are regarded as inexplicable and their very resistance to human understanding does not in any way diminish their reality or likelihood. When I would ask informants why, for instance, poisonous snakes are unable to harm a pregnant woman (a widely held belief), they would always reply that it was a mystery, something that no one understood. Other mysterious "facts" and happenings, many clearly impossible, were reported to me and the explanation was always the same, that these events were the results of forces and beings in the world which are not fully understood. If I pressed the point, I would be given a recitation of "un-understandable" things such as electricity, the conception of children, etc. 5 Living as British Hondurans do in a country where they are surrounded by many very real things they do not understand, it is not surprising that they accept much of life as inexplicable and postulate dire consequences for trying to get to the bottom of things.

Excessive indulgence in alcohol and marijuana is believed to be a precipitating factor in cases of psychiatric disorder and there are several rationales for this. People observe that drinking and weed-smoking produce 'foolish' behavior in users. Drinkers sometimes talk without sense, make scenes in the street, bother other persons, and do things not normal for them. The same is true of marijuana users, they act silly and laugh a lot, say the same things over and over, make absurd statements. They are also very volatile, going from good-natured camaraderie to acute hostility quite quickly and sometimes with no visible reason. They, in short, act like they are mentally ill. The populace reasons that if one indulges 'too much' in these pastimes, one will soon be unable to act any other way, even when abstaining. They believe that these patterns of behavior will become permanent and the person will have become crazy by acting crazy, even though under the influence of intoxicants, too much of the time. Pretending to be crazy is supposed to have the same effect.

People also believe that marijuana has a deleterious effect on the mind and that some cases of mental illness are produced, not by the person's having become habituated to `foolish' behavior when high, but rather by something in the drug itself which has damaged his brain. The same is believed of rum which, ingested in large quantities over a long period of time, is supposed to produce brain damage, craziness, and impotence. That the effects of alcohol and marijuana are closely connected conceptually to mental illness is illustrated by the fact that persons suspected of mental illness are examined by a doctor for the presence of intoxicants. Indeed persons with no history of psychiatric disorder seen acting foolish or in any abnormal manner,are always assumed to be either drunk or high on weed until it is established otherwise. Also it is universally believed that mentally ill persons become 'worse' when intoxicated by drugs or alcohol and some rarely show any symptoms otherwise. Many bartenders will not serve liquor to known mental patients; or, if they do, will cease serving them and throw them out of the establishment at the least sign of disturbed behavior, in this instance tolerating less peculiar or hostile behavior from them than from the general class of drinkers. With marijuana, the situation is different. Anyone who sells the illegal drug will sell it to anyone who wants to buy, regardless of his mental condition. Establishments where marijuana is sold and smoked permit anyone in any condition to stay even though they may be potential trouble makers.

How much of the intoxicants is consumed varies greatly among individuals and perhaps among ethnic groups and between urban and rural people. Generally rural Indians and Spanish men are believed to be the "hardest" drinkers and smokers, but this would be difficult to substantiate. They certainly seem to be visibly affected much more than Creoles or Caribs, but it may be only that the latter groups have better control of themselves when intoxicated. This whole subject will be dealt with in more detail below; and, for the present, only the usual outside limits for the country as a whole will be mentioned. 'Too much' marijuana smoking is daily use of the drug and 'too much' drinking is regular heavy drinking (to the point of drunkenness) on each week-end. If a person is observed to partake of drugs and/or alcohol this frequently, any irregular behavior indicative of mental illness may be blamed on his steady use of intoxicants.

Worry is believed to be able to drive a person crazy, especially if it is a continuing and permanent aspect of the person's life. If a family is constantly in debt, loses their grocery credit frequently, has many mouths to feed, must pay for expensive medical treatment or schooling, quarrels with neighbors and relatives, suffers from infidelity on the part of either spouse--some members of the family may begin to show signs of mental illness. If the person involved does not seem to have been indulging in any of the above-mentioned excesses, and is not considered to be a victim of obeah, worry may be cited as the cause of the breakdown. This is somewhat related to the 'too much' causes as worry is not viewed as being a particularly dangerous mental state unless it becomes a preoccupation with the person pondering his misfortunes or fears most of the time. Other kinds of mental preoccupations such as grief or 'missing' someone are also viewed with some alarm; but, they produce characteristic mental states which, although abnormal, are not in the same class as true craziness. (These will be dealt with separately below. ) Revealing lodge secrets is sometimes cited as a cause of mental illness with people generally believing that the 'lodge masters' cause the illness through the use of black magic. There are also ideas about contagion as a factor in the development of psychiatric disorder but it is usually associated with situations where two persons who live together both show the same signs of disturbance. It is thought that one learned it from the other or there is some kind of unconscious imitation of behavior. Heredity is not usually thought to be a factor when there is more than one case of insanity in a family. Rather people think that they learn it from each other or that obeah is involved.

If a person has a psychotic episode and none of the above mentioned causes appear to be present, then obeah may be considered to have been used to make the person crazy. The mechanisms of this are varied and will be discussed here in some detail as the concept of a person going crazy as the result of obeah is a very important one in this conceptual system. Almost every person in British Honduras believes that a person can affect others by supernatural means. They believe, indeed they "know, " that obeah in the hands of a skilled practitioner can cause illness, break up homes, drive a person crazy, make permanent changes in a person's abilities, habits, and personality, bring wealth, heal the sick, and kill. Some techniques may be used by any person and do not require great knowledge, power, or skill. Thus anyone could 'smoke puro' over another person. This procedure requires only that the person say the other person's name over and over while smoking a cigar and repeat what is wished to happen. The smoke is believed to carry the magic to wherever the person is. This is frequently used by women to try to attract a man when other means have failed. It is not considered very efficacious if the smoker does not know the proper 'spirits' to address. Also many people could use a wedding ring, a hair, and a glass of water to discover the identity of a thief. A simple incantation is chanted and names are mentioned until the wedding ring, held by a human hair suspended over the glass of water, starts to move. As the loop of hair is held by hand, it is not a particularly difficult trick and a similar one is done with a key and a Bible. These are practices within the range of anyone, once the incantation is known, but other techniques are believed to be much more complex and effective, and only paid specialists perform them.

It is believed that a person can be driven insane by obeah if a skilled practitioner is paid to do the task. Some instances where this would be likely are: (1) a young girl runs away with a man her parents or guardians do not like, and they might enlist the aid of an obeah man or woman to drive the man crazy so that the girl would come home again, (2) neighbors who are envious of a family's wealth or good fortune would pay a specialist to bring illness to the family, (3) a man who is in love with a woman who does not return the sentiment would seek revenge by having her made mentally ill. Exactly how this objective is accomplished by the specialist is something that no one knows, but people believe that it is done with 'black dollies' hidden under steps and in yards, much praying over black candles, and consultations with the spirits. They do not believe that part of the victim's body is needed. However a magical substance 6 may be put in food or drink or tucked into clothing left to dry outside. Consequently some people, men most especially, are very careful about what they eat and drink both in public and private places. They fear both being poisoned and ingesting magical substances that could harm them. People also wear guards to protect them around their necks and special finger rings. One might suspect that all this caution is yet another symptom of general insecurity but, in fact, obeah practitioners abound in the colony and they do a lot of business. Thus if a person inexplicably becomes mentally disturbed, obeah is a likely cause and one frequently postulated. It is also believed that a person can be seriously affected by seeing or coming into contact with magical objects meant for another person. When British Hondurans come upon a strange object that seems out of place where it is found (such as a ring, handkerchief, a lock of hair, a bottle with suspect contents on one's own property or on a path), they suspect obeah. Often they will make a joke of it and try to figure what boledo number it would indicate, but they always destroy it.

It can be seen that British Hondurans do not use psychological explanations for mental illness, although many of the causes mentioned here could be interpreted as that. The important point is that British Hondurans do not view psychiatric disorder as the culmination of insolvable or difficult personal problems. They rather believe that it is the actual act of reading the Bible too much or the hidden black doll itself which causes the illness, not the interpersonal problems that lead to these acts. People who are, by and large, perfectly normal do not spend their time poring over books of black magic. Neither do they drink to excess or fear obeah to the point of pathology. This much is obvious to an observer of British Honduran society, yet it does not appear so to British Hondurans themselves. Their standards of normalcy encompass all these kinds of excessive consumption and preoccupation and much more. It is only when a person engages in the kinds of frankly psychotic behavior enumerated above that he becomes socially defined as a crazy person. And furthermore, it is the unacceptable behavior itself which is the evidence of his derangement, not the postulated causal factors, although they will in hindsight be contributing factors in the lay diagnosis. It is as though no matter how many times British Hondurans watch religious fanaticism turn into even stranger behavior they still consider it to be a cause rather than a result or a symptom. The same is true of the other "causes" mentioned here, and this is the crucial point at which British Honduran attitudes and beliefs differ from those in the United States and probably most of the Western world. Their toleration of bizarre and anti-social behavior is so high that they consider it to be a cause of more severe forms of it rather than symptomatic of general psychosocial problems.

Abnormal Behavior Not Regarded as Psychiatric Disorder
To make this last point even more clear, this section will deal with various kinds of conditions and behavior patterns which although recognized as not strictly average kinds of conduct are not thought to indicate mental illness nor even to be similar kinds of afflictions. British Hondurans will often speak of a person as 'not so righted, ' 'half righted, ' or 'half light, ' or they will call these behavior patterns a person's 'style' or 'habit. ' When they use these terms they mean that there is something about the person which deviates from the norm but that he is not (yet) crazy. Persons so labelled are not shunned, ostracized, or in any way treated as anything but perfectly normal men and women. Nevertheless there is an awareness in the society of these peculiarities even though no negative sanctions are invoked. For this reason it is difficult sometimes to ascertain whether a person is generally viewed as crazy or not; and, with many cases, opinion is divided. A few examples will help illustrate this point.

Luis, about sixteen years old, passed Manuel's house, going through his property on the way, and Manuel's dog ran at him barking and snarling. Luis picked up a stick and clubbed the dog. This precipitated an exchange of insults between the two men. A few days later Luis came through the yard again and Manuel told him that if he came on the property again he (Manuel) would attack him with a machete, and Manuel promptly picked up two of them. A neighbor overheard the threat and advised Luis's father who got his boat and went to fetch Luis so that he would not have to cross the property on his way home. (This took place in a fishing village and Manuel's property was on the beach and frequently crossed as a path went through it. ) Luis boarded his father's boat but meanwhile Manuel had gotten into his boat and given chase. When Manuel drew close to Luis and his father in the boat, he threw both machetes at them and missed. He then picked up a hammer in the boat and threw it, breaking Luis's jaw. The police had by then been summoned and they arrested Manuel for assault. Soon afterward, Manuel's father went to the police station and gave a statement to the effect that his son was crazy.
In the various discussions of this incident, several aspects were emphasized as people would wonder who should be faulted and whether Manuel was crazy or not. All agreed that his father had made the statement only to save his son from a possible jail term. They also pointed out that Luis was part of a group of youths who often teased and provoked other people in the village and that Manuel had been annoyed by Luis and his young friends before. They felt that Luis had received more or less what he deserved and that anyone might have done it. There was much general discussion of Manuel's life and his habits in general as people searched for clues in his past to indicate craziness. All agreed that he was unusual in that he was extremely polite and exceptionally honest. They also pointed out that he was unmarried and did not 'fool around' with women very much. Someone recalled an incident where he inexplicably changed his mind very quickly. A couple of people thought he was perhaps 'half crazy' but all the others, after discussion, found him sane. Interestingly, one person thought that the only oddness about the incident was that Manuel did not attack Luis with the machetes when he had the chance instead of waiting and following in his boat. This seemed irrational and was more indicative of any craziness than the violent attack which was, after all, completely understandable and in no way the act of a deluded person. The consensus was that even if the courts were convinced of Manuel's insanity, he would not be made any different by going to Seaview; and, if he went there, he could kill the boy after discharge and expect nothing worse than another visit to the hospital.
A man used to practice running backwards until he had mastered the skill to the point where he could run backwards faster than many people could run forwards. He was a well known figure and could be seen practicing every morning and afternoon by the Barracks in Belize, occasionally looking over his shoulder or tilting his head all the way back until he could see "in front" of himself and avoid obstacles. He used to enjoy running away from people and laughing in their faces at the same time. He was a known burglar and thief and was occasionally arrested in connection with these activities. He also liked to gain entry to bedrooms and lie down beside sleeping women and 'feel them. ' When discovered, he would make a specially practiced exit-a clean leap through an open window. All of his teeth were pulled, this being done as the result of recommendations found in his study of black magic. Also, he would note, there was no danger of biting his tongue when jumping. He would practice crawling over people, betting someone that he could crawl over him without his feeling a thing. As a result of his prowess in running backwards, other persons became interested in the sport, and there was even a backwards race in Belize which he, of course, won. He was never thought to be mentally disturbed, his accomplishments were viewed as laudable, and he was considered a 'smart' man.

A middle-aged man who is widely known as a compulsive thief and a child molester divides his time between the small village of his birth and Belize. In spite of his occupational skills which would earn him a good living, he prefers to hustle a few dollars here and there at odd jobs. He is drunk much of the time. He is harboured and protected by his own kin in spite of incidents with two very close female relatives. He is also a voyeur, at one time taking a special interest in a young retarded girl living with neighbors. He has two male relatives with histories of homosexual involvements with young boys. He himself was jailed at least once for molesting a female child.

This man, although treated with a certain reserve by neighbors and some relatives, is nevertheless able to live in a normal fashion. Some people feel that his deviance goes far beyond allowable limits and a couple of villagers referred to him as "sick." 7 Yet he is usually thought to be 'bad' and not crazy. The members of the household where he resides feel as though they are 'stuck' with him and try to keep him out of trouble as much as possible to spare their own embarrassment. He has never been to Seaview and his ever being sent there is unlikely. In a situation such as this, the man's family cannot really protect him from the effects of his illegal behavior, but they can effectively keep him out of Seaview because, as noted above, it is usually relatives who bring persons for psychiatric examination if there is no police involvement. This particular person will be able to indulge in his peculiarities until someone, probably an enraged parent, demands his arrest or kills him. As he is outwardly perfectly normal in appearance and general demeanor, his eventual commitment is most unlikely. The presence in his family of two other sex offenders makes people think that his badness is 'in the blood, ' and, again, this takes it out of the realm of craziness. 8

Many people seem to feel that as long as a person has the capability for some rational thought, he is not truly crazy. None of the above three men is considered a psychiatric case although the backwards-runner and the kleptomaniac would surely be viewed as such in many other areas of the world. The man in Belize who sings hymns on the street is thought by some to be nothing more than a 'damn ass.' Another already described as hostile and a general nuisance is characterized by many persons as extremely 'bad-minded'9 rather than mentally ill. Even though he was sent to Seaview for personal assault, has broken windows in the main street, jumped off the Swing Bridge while dressed in only his briefs, and lain down in front of approaching automobiles, there is much feeling that he just wants to 'bother people, ' that he knows exactly what he is doing, and that he realizes he is never in any personal danger. Even though I have seen this man with glazed eyes shouting nonsense while posturing in odd ways and he appears to me and to some others to be a violent psychotic, it is his very 'badness' that mitigates the consequences of his more peculiar behavior. For anti-social behavior is not thought to be a sign of mental illness no matter how extreme or persistent. It is not 'craziness' but 'bad-mindedness' and hence an entirely different and totally unrelated concept.

Neuroses
Examples of obsessive-compulsive behavior are not related as evidence of a person's insanity either. There is a woman in British Honduras who will not eat any rice with broken grains. Every time she purchases rice, she and a couple of children she summons for the task sit and pick out every grain of broken rice. The broken grains will be used to feed chickens and she will cook and eat the whole ones. She never eats rice in a restaurant or in someone else's home. She also has had many strange personal experiences in her life and sees much evidence of the spirit world. One All Soul's Eve she saw a whole procession of dead people dressed in white and carrying candles to the burying ground. While she was watching the procession, a child left the group and gave her his candle. By morning the candle had turned into a bone. No one else saw anything that evening, but her story is widely believed and she is not regarded in the least as a mental case. Many people in British Honduras have seen 'little people' or duendes in the bush as well as a whole panoply of apparitions from Maya and Spanish folklore. Some persons see these kinds of things much more frequently than others but they are never suspect as a result of it. Other people rather accept the existence of these spirits and believe that they are seen occasionally. There is in British Honduras the idea of a person seeing things which do not really exist but it is never used to explain the visitations of spirits and ghosts. The result of this is that rather than having to question the sanity and mental balance of every person who has visions, British Hondurans assume that there are beings in the world which, again, cannot be understood. This is certainly a more proximate explanation, and is an example of Occam's razor in a situation where the explanation need not go very far. Another "case" is a woman who has a procedure for washing her dishes which certainly goes far beyond usual cleanliness. She first scrapes every particle of food from all the plates. Then she scrubs them with sand, rinses them, rubs them with ashes, rinses them, finally washes them in soapy water, and rinses them in water containing lime juice. She allows no one else in the household to wash dishes. One man always sweeps the dirt from his place of business out the back door to protect himself from obeah even though this method makes sweeping a rather involved task. Some people are actually incapable of walking about after dark, so great is their fear of ghosts and spirits. It has already been mentioned that many houses have a light burning in them all night (always if there is an unbaptized child or a sick person in the house), and if it goes out, almost invariably someone will awake in terror. Few people will sleep alone in any house, even their own, and should this become a necessity, a neighbor's or a relative's child will be sent for to spend the night. Yet none of this behavior is regarded as very strange and in the case of sleeping alone, not to fear it is abnormal. This is not to imply that these habits ought to be regarded as signs of insanity, but rather to suggest that they would indicate mild to severe neurosis elsewhere.

Depression
There are a few locally recognized and named mental states which although not considered to be insanity are thought to be abnormal. Three of these center around various disturbances caused by romantic love, and are types of depression. 'Watching-itis' is a kind of frustrated love for a person whom one can only watch. Usually there will be some kind of serious obstacle to the match, such as a close kinship tie, differences in social class or race, problems between the two families, or there may be simply no way to get to know the person. This romantic attachment becomes an obsession with the person and he or she lives only for the sight of the loved one, neglecting other duties and thinking of nothing else. Foolish behavior sometimes results. 'Macoby' is a depressed kind of condition caused by someone or something which is absent. Although it essentially amounts to 'missing' someone or occasionally homesickness, it is much more pronounced. The most frequent cause is the absence of a loved one, either a spouse or a lover. The loved one may have left the victim for another person or might have had to travel to another area. Macoby is characterized by flat affect, lack of interest in normal activities, withdrawal, and perhaps excessive drinking. The most severe condition of this kind is 'kabankah' and it usually occurs in men. It is most often caused by the death of a wife. The man then turns to heavy drinking, usually shows no interest in other women, becomes somewhat peculiar in other ways, and spends the rest of his life in this condition. Watching-itis and macoby are usually self-terminating conditions, but kabankah is difficult if not impossible to cure.

Drug and Alcohol Use
Overuse of alcohol and marijuana is not normal, although certainly the occasional use of both is common for men. Women do not usually drink except on festive occasions except for "B girls" and prostitutes who are often heavy drinkers. Likewise very few women ever smoke marijuana except again those who are classified as 'bad' and even many of them do not use the drug. Liquor is sold to anyone over eighteen years of age (and many under) and is freely available in bars, clubs, grocery stores, and restaurants. Beer is very popular as is Guinness stout even though both are relatively expensive, 50~ to 90~ (B. H. ) a bottle compared to local rum which can be had for ten cents per drink. British Hondurans have eclectic tastes in alcoholic beverages and some of them will drink anything. Beer and rum are the biggest sellers but also much whiskey and brandy are consumed. There are locally made specialties which are available such as fruit wines, fermented cane juice, and a light corn beer; but,these are rarely consumed except in the out-districts. A locally distilled concoction known as 'A and P' or aniseed and peppermint is popular with serious drinkers as it is cheap and is supposed to improve potency. All the local rums usually consumed are made from cane juice or molasses and are not aged. They are mixed at various strengths and sold at different prices according to taste, color, and strength. Most rum is about 20% alcohol although some people drink 'strong' which is probably 40% to 50%. Most drinking is done in bars and clubs where water, ice, and soft drinks are available. Men usually sit together around a table and purchase rum by the bottle (four ounces to a fifth of a gallon) rather than by the drink. Often they will invite one or two of the 'waitresses' to sit with them and they will buy these women liquor or other beverages and often a meal. A group such as this, depending on their finances, will go through several bottles and then go home when no one wants to or is able to buy any more. If they are on a 'spree' or a binge, and some one has the money or the credit, they will stay until closing (usually 2 a. m. ). In Belize there is always someplace open and men can drink around the clock there. In the districts men usually go home after closing.

Excessive drinking is a serious social problem in British Honduras, and there are men who have been drunk so long no one remembers when they were ever any other way. Men who have been drinking are often belligerent, violent, and cruel. They beat their wives, terrorize their children, and threaten neighbors. They spend badly needed money on liquor for themselves, friends, and other women. They become involved in fights which occasionally result in severe injuries and death. They make fools of themselves and are a source of embarrassment to their families. Yet people generally treat drunks with deferrence and kindness, helping them to get home and rescuing them from potentially dangerous situations. Men frequently have no memory of what they do or say when drinking; and, when they are sober, they disclaim responsibility for their drunken behavior. Other people cooperate in this aspect of the situation, seldom nursing a grievance against a person for 'out of the way' behavior related to liquor consumption. Men will laughingly inquire about what they did and when informed, usually treat the incidents as jokes or boast about how much they must have consumed to have been in such a state. Incidentally, they suffer from crippling hangovers, known locally as 'goma.' 10 Women usually are much less approving of drunken behavior and although they are powerless to alter the situation, they deeply resent having to tolerate and clean up after a drunken husband. They take revenge in subtle and secret ways and the resulting tension in the household creates an atmosphere of latent hostility and disguised hate which only makes the man more likely to drink more and seek the company of other women as well.

Yet steady and heavy drinking is not considered particularly reprehensible as long as the man is able to work, and especially if he supports his family. He will just be known as a man who 'likes his rum. ' Only when men become full time public inebriates are they thought to be really 'rum-soaked. ' These men are sometimes drunk for months at a time, live practically in the streets, and beg and hustle a few dollars a day. Thus though continual drinking to excess is thought to be a cause of mental illness, it is not regarded as a symptom of it or a first step in that direction.

Marijuana smoking rarely seems to lead to the same kinds of violent and anti-social behavior associated with alcohol use although it does occasionally. Marijuana is not a legal commodity for either sale or use in British Honduras but it is easily and cheaply available. It is grown in the districts and sold in increasingly smaller quantities as it changes hands from the fields to the towns. There is one area in Belize, Yarborough, where marijuana, both loose and rolled, is sold and smoked openly. It is the only drug usually available in the country although other locally occurring vegetable materials are also smoked. The use of marijuana, although so common among men as to be normative, does not create the same kinds of problems as alcohol use. For one reason, it is not such a financial drain on a family budget, as one person can get high every night for less than a dollar a week. Also, even though many men smoke together, they do not usually do it in the atmosphere of bars and clubs with all their attendant temptations. Many men smoke at home with the full knowledge of their wives and children.

As mentioned previously, 'too much' marijuana smoking is regarded to be daily or oftener use, and it is not unusual to find men who smoke this much. Some are virtually high all the time, smoking many different times each day. Cane-cutters as a group are said to be particularly heavy smokers and this may be due to their usual proximity to the source, or it may simply be an erroneous judgment. However there do seem to be more obviously high men about in the northern districts than in some others parts of the country. Excessive indulgence in this pastime is again believed to be a cause rather than a symptom of mental illness (although there is no evidence that it is either), but marijuana is believed to be a more potent affector of the mind than alcohol. Few persons would warn a heavy drinker about the possibility of getting crazy from rum, but many men are warned about the effects of marijuana when they begin to use it regularly in large quantities. Its overuse is also occasionally blamed in making men bad tempered and violent and sapping their ambition. However, occasional marijuana smoking is not generally believed to be particularly harmful or dangerous; and, even when it becomes excessive, the situation is not a cause for great concern.

Ideas of Reference and Paranoia
Well-developed paranoid ideational systems may be almost absent in British Honduras. There are persons who have megalomaniac symptoms. One such person was a man who used to haunt the market, telling everyone that he had donated funds to the government which made all the public improvements possible. He also proclaimed himself the last of Morgan's band of pirates. Yet ideas of reference, fear of being followed and watched, and other usual symptoms of paranoia are quite rare. The only related kind of behavior discovered was an exaggerated fear of obeah which some persons exhibited. People such as this are quite careful about all food and drink and rarely permit their personal effects to be placed where others could have access to them. They frequently retain the services of an obeah specialist to provide them with guards, work counter-magic, and right various ills and problems which they attribute to the effects of black magic in their lives. As with most kinds of paranoia, there is a logical basis for fears and beliefs of this nature. Therefore, in British Honduras, these persons are not regarded as peculiar or even over-cautious, and other people simply reason that there is a basis in reality for their preoccupations.

At this point, it should be made clear that anyone in British Honduras would do well to mind the sources of food and drink. There are some practices which although not strictly subsumed under the concept of black magic are intended to have a preternatural effect on the victim. The insecurity which many women in British Honduras feel about their relationships with men are reflected in a number of what might be called "methods of attachment. " Women, fearing that their husbands or providers will leave them, try to keep them by insuring that the man will always return or by attempting to render him impotent with other women.

In the first instance, women introduce into various food substances their own bodily secretions. Such terms as 'coco soup' and 'sweat rice' refer to these preparations. Women will squat over a pot of steaming rice and the resulting perspiration falls into the rice. Or they will rinse a cloth used to absorb the menstrual flow and use the resulting water in making soups where the liberal use of spices and seasonings would disguise the nature of the principal ingredient. Finely cut up pubic hair is another possible addition. Water used to wash the genital area (a separate part of bathing done daily before retiring by women) is also used for cooking. Another practice is to use a man's handkerchief for a 'time cloth' and then return it to him to use after laundering it. These are believed to be efficacious ways of keeping a man and a great effort is made to keep the practices a secret as any man would react violently if he were to find out. The rationale for these practices is the same one which produces a local belief that if you visit a place and drink the water there, you will return.

'Tying up' a man is another method, but this one is supposed to reduce or destroy potency with other women. In one variation, a woman ties a string around the man's penis while he is asleep. She then ties it around her own waist and afterwards buries it. It is also possible to measure the man's penis lengthwise with a string (again while he is sleeping), cut the string to that length, tie nine knots in the string, and then hide or bury the string. Women sometimes will tell a man that he is 'tied up' during an argument. A man can undo this type of harm by finding the string and taking it to an obeah specialist. But if he cannot find the string, he is supposedly doomed to live out his years in the desired condition. To illustrate how these techniques are related to mental illness:

A man, a blacksmith by trade and a prosperous one, had his own shop and employed a young man of about twenty years. Among the youthful helper's other tasks was that of fetching the owner's lunch every day from the owner's home to the shop. Occasionally if the black- . smith did not want the dinner, the helper would eat it. The young man became ill and eventually died. A couple of months later the owner 'got sick' and was sent by a doctor to Seaview. (He had previously had one peculiarity which was stressed by the informant--although he was wealthy and could have afforded much clothing, he always wore the same shabby clothes, even when he went out at night. ) The blacksmith recovered after two months in 5eaview and after he was discharged, a lady friend told him that his wife had been using the 'time cloth' in her cooking for years. When the wife reached menopause she substituted the oldest daughter's for her own. This was allegedly what drove the man insane and killed his employee even though neither of them was aware of it. When the man was advised of all this, he beat his wife severely and then left to live alone in the bush. He became an obeah man and started to purchase and study books of black magic.
Men also attempt to establish and maintain relationships with women by altering their food and drink, but they usually use a prepared mixture purchased from and compounded by an obeah specialist. Poisoning is also a danger in British Honduras. A small potato-like tuber found in the bush called 'camotillo' is supposed to be quite effective. 11 Strychnine, sold in pharmacies for vermin poison, is also rumored to be used. Although people cannot cite instances in which a person was brought to trial and found guilty of causing another's death by poisoning, everyone knows of cases where a person died from such a cause. The amount of actual poisoning which occurs in British Honduras may never be known but it is certainly a common fear, especially among men, who fear being poisoned by their wives. Also the recognition of a plant substance for only this purpose (camotillo is never used to poison vermin) argues for the existence of the practice. In all, with any case of a person with exaggerated fears of magical persecution, poisoning, and the like, it is wiser to withhold the diagnosis of paranoia until all the facts come to light, keeping in mind that many of the "facts" will never be known. Generally speaking, the idea of baseless paranoid behavior and thought is an alien one to British Hondurans. There is no corresponding local term for it and the concept is a difficult one to explain to the residents. They surely recognize paranoid conduct as an aspect of human existence but they feel that the person is justified in some way and that he or she is laudably realistic and properly cautious, certainly not deluded or insane.

Religious Fanaticism
Religious manias have already been discussed in terms of causal factors but beyond this they have little importance unless they reach the proportions of the two case histories discussed earlier. British Hondurans speak of many people as being very religious and indeed some of them are that. But as long as religious fixations, even to the point of seeing visions and believing one's self to be a messenger from God, do not interfere with the normal patterns of life, they are not regarded as dangerous or indicative of impending or complete mental collapse. With the exception of some devout Catholics and recent converts to Protestant sects, there is not generally an excess of religious fervor in British Honduras. However people view church-going and praying as fine activities and are not suspect of their sudden appearance in previously irreligious people. They merely feel that the person has experienced something in his life which has made him more 'godly.' Even if a person were to go from, for example, being a nominal Catholic to attending mass daily and keeping a santo (statue of Jesus Christ or a saint) in the house, this would not be viewed as being in any way related to mental disturbance. Likewise, 'too much' Bible reading is not considered a kind of crazy behavior or a precursor of it, but rather a possible cause. There are fundamentalist sects which hold services where people become very excited, preach, speak in tongues, faint, and generally act abnormally. Members of these denominational churches are not thought to be crazy although their behavior at services is described as that. This kind of behavior is deemed acceptable in this situation but would be thought of as 'real craziness' if it occurred outside of this narrowly defined context. When, however, persons such as this leave their spouses or families, declaring them to be too 'sinful,' eyebrows are raised and the person is considered well on his way to 'getting crazy. '

Culturally Defined Illnesses
There are certain conditions in British Honduras which are characterized by mental disturbances and bizarre behavior but they are not thought to be cases of mental illness. Mal aire is one of these and its pattern of incidence is largely limited to the Spanish and Indian elements of the population. Mal aire is believed to be caused by some kind of 'wind' which adversely affects the person or animal in its way. The 'wind' can go 'inside' in certain parts of the body, the head, heart, stomach, etc., and will stay there causing a variety of symptoms until its removal, usually by a local healing practitioner. Mal aire is usually characterized by sudden weakness, rolling of the eyes, mental confusion, peculiar gesturing, and perhaps somatic complaints. Two instances follow.

A young man, 28 years of age, unmarried and sole support of his maternal grandmother, mother, and sister and her nine children, worked as a ranch foreman,for an absentee landowner. He had the job for four years and was recognized as a hardworking and valuable employee and paid well. He began to develop a variety of symptoms, both somatic and mental, which caused him to neglect his work and eventually lose the job. He opened a tiny shop in his home to provide some income for the family. He has been treated--indeed hospitalized, once for heart and lung symptoms--by a variety of medical doctors and herbal practitioners. His condition improves but he suffers relapses, and plans to take a trip to Mexico to see a doctor there. He is not believed to be crazy by any of his relatives or acquaintances. His symptoms over the weeks were: a numb feeling and a sensation of swelling in the upper right quadrant of his head; the production, collection, and drooling of saliva from the right side of the mouth; sensations of warmth and burning inside the body; pain in the left pectoral area relieved by pressure or application of cold; weakness in left arm; difficult breathing; near fainting after exertion, sickness produced by use of cigarettes, Coca Cola, and liquor; confusion, depression, and thoughts of suicide; hot flashes and chills; loss of ability to write. He and the local practitioner agree on the diagnosis of 'bad air' and feel that he is 'lucky' because the air is still on the 'outside' where the condition is more receptive to treatment than if the air were 'inside.' The young man appeared quite well when I saw him, if a bit thinner, and did not seem to be suffering from any organic problems. He never had any 'attacks' when alone, and had his worst ones when there was a vehicle nearby to transport him into the nearest town. He is undoubtedly ill, but the affliction seems to be largely psychosomatic. 12

A fourteen-year-old boy was walking near the cemetery on his way home from the wake of a recently deceased resident of the village. (The decedent was incidentally the victim of a fatal stab-wound inflicted by a former 5eaview patient in a bordello. ) The boy had left the wake because he was 'feeling bad. ' He stumbled into an out-building, and attracted the attention of a woman. His face was contorted, he was walking sideways, and after he ran into the building, he began to froth at the mouth. The woman summoned the boy's parents and cared for him until they arrived. He was immediately taken to Belize and admitted to the general hospital. He stayed there for one month and even after discharge his face was still 'twisted.' However the torsion was not permanent. When he returned to the village he reported that he had seen a man in white during his seizure. It was assumed that he had seen the dead man (corpses are always clothed in white for wakes and burials) and that he had 'caught bad air' from him. (The woman who found the child and cared for him until the arrival of his parents was the same lady who sorts her rice and sees many visions. )

A woman also reported to me that she had been sitting near a doorway when a parrot near her suddenly became very weakened and soon died. She surmised that the bird had saved her from the Mal aire as it somehow took the sickness out of the air.

Other kinds of aires and winds are responsible for illness. Viento de agua, the strong cool breeze that often immediately preceeds a tropical downpour in British Honduras, can produce cough, fever, and upper respiratory involvement if the wind strikes one in a 'heatish' condition. Thus people who are overheated from exertion go into buildings at the first sign of it. One person reported swelling of the penis and bladder as a result of viento de agua. Batida de viento is is the general name for a condition resulting from being caught by air currents when one is 'hot. ' Mal aire is conceived to be an 'invisible whirlwind' and is different in character from normal atmospheric air movements and a much more serious threat to well-being. Regarding atmospheric phenomena, 'yellow light' should be mentioned. This is an uncommon (I saw it three times in thirteen months) effect occurring at sunset when all but the western part of the sky is overcast. For a length of time varying from one to fifteen minutes, everything is suffused with a clear bright yellow-amber-golden light coming from the west. It is very striking and quite lovely, yet it is the signal for many people to go into their houses. This light is believed to kill plants, spoil fishing, and make people who are 'weak' become swollen and/or jaundiced. Hysterical seizures or 'fits' are not unusual in British Honduras. While the populace generally does not distinguish between an excited outburst and an epileptic seizure, neither is considered evidence or a cause of mental illness. Occasionally during times of stress, danger, or great grief people will fall down, scream, grimace, froth at the mouth, and perhaps but not usually lose consciousness or become incontinent. Treatment is the same for all kinds of 'fits'--pouring salt into both hands. If a person were inclined to have fits, he would just be considered as a person inclined to have fits; and, unless they were very frequent, no medical attention would be sought.

Some of the classic psychosomatic illnesses are found in British Honduras, asthma, 'hives,' allergic rhinitis, nervous colitis; but they are not believed to be related to the afflicted person's mental condition. They are treated with a variety of patent and herbal medicines and are not generally anything more than annoyances. Even if a person exhibits a variety of rather bizarre bodily ills and complaints and takes many medications, no aspersions will be cast on his or her sanity, and there will be not the slightest mention of craziness. This will be true even if the person has visited many professional physicians and been pronounced to be in good health by all. This is related to a realization on the part of British Hondurans that there are some medical problems which cannot be treated in British Honduras because there are no resident specialists. Also they well understand that practitioners trained in the tradition of Western allopathy are powerless when faced with Mal aire, mal de ojo (evil eye), diseases caused by obeah, and, to an extent, craziness. 13

In summary, it can be seen that only very specific kinds of misconduct and deviant behavior are regarded as indicators of psychiatric disorder in British Honduras. These indicators are so gross that they would likely be recognized as symptoms of something gravely wrong in most parts of the world. Also there are only a very few assumed causes of mental illness posited by the population, and these are mainly non-psychological. Indeed some of them are almost mechanical in their explanatory capacity. Furthermore, much behavior that would herald severe neurotic and psychotic mentation in the United States is either hardly noticed in British Honduras or it is thought to be only an expression of a person's individuality. Although there are expressions which make it possible to describe the degree of a person's mental disturbance which run roughly from 'not so righted' to 'fucking crazy, ' the milder terms are usually used to describe persons of low intelligence or congenital peculiarness. They are not, for the most part, epithets applied to neurotics or incipient psychotics. There is a special reluctance to interpret antisocial behavior as mental illness, and there is a marked tolerance for deviant behavior in general. British Hondurans have a high regard for personal freedom and expression, and often refer to their diminutive homeland as a 'free country' in very emphatic terms. Later chapters will explore these attitudes toward conduct and beliefs in the nature of human beings and will offer possible explanations for them.

NOTES
1. Interestingly, age is the significant variable in this situation, as little boys--about eight to twelve--swim unclothed around the bridge, but for an adult to do this is clear cut evidence of insanity.

2. "Glide"is a Creole term which roughly approximates "cloyed. "

3. "Teasing" here means pretending to be crazy by various words and actions. It is called "teasing" because British Hondurans believe that for every face that is made or gesture acted out, there exists a real person who makes that gesture or face--even though he may be unknown to the teaser. It is thus a form of mockery.

4. Perhaps only Catholic priests could be excepted here as British Hondurans see an element of incipient craziness in anyone who spends a great deal of time reading the Bible--even ministers, although they would be allowed more latitude in this area than a lay person.

5. Once the discussion continued to the point where I revealed that in many parts of the world these things were understood and that some of them I understood fairly well myself. This statement was received with obvious scepticism.

6. The substance may be more than only magically efficacious. Many of the plants occurring in British Honduras have very real effects on mental and physical functions.

7. This was the only time I heard "sick" used in this context, and I never heard British Hondurans use it in this manner when `talking among themselves. I suspect it has been picked up in conversations with foreigners and from motion pictures.

8. As mentioned above, psychiatric disorder is not usually thought to be hereditary. In this case, it is the sexual deviation which is thought to be 'in the blood' and this is not viewed locally as psychiatric disorder.

9. A local term connoting spite, vindictiveness, envy, malicious interference in the affairs of others, also great negativeness in the area of personal relations. It is heard often as a mild insult and an explanation of many different kinds of behavior.

10. MacAndrew and Edgerton (1969) suggest that most effects of alcohol are culturally determined, especially the "mean drunk" syndrome. They also note that hangovers are not universally found where much alcohol is consumed and may be expressions of guilt.

11. Camotillo is Zamia furfuracea, a well-known poisonous plant in Central America. See Standley and Record (1936) for several others locally recognized.

12. The possibility of genuine physical involvement, such as a mild cerebro-vascular accident, cannot be completely ruled out here or in the other case. But in the instance of this young man, I feel it is quite unlikely. He was examined by several M. D. 's who pronounced him well. Also he had been living under a real and perceived strain for years and his assumption of the sick role provided him with a badly needed period of decreased responsibility.

13. Susto or espanto is not locally significant as the affliction occur only in very young children and is not, even in this instance, a well defined entity.

CHAPTER TEN

TREATMENT OF PSYCHIATRIC DISORDER
As far as most of the people in British Honduras are concerned, the 'treatment' for severe psychiatric disorder is to take the person to Seaview Hospital or to call the police. During my stay I neither witnessed nor heard of any specific curative for 'craziness.' Once a person's mental disturbance has reached proportions great enough to be recognized as a case for Seaview, people believe that only 'rest' and the 'treatments' given by the hospital will be efficacious. Consistent with the above, until the illness becomes grave, no treatment is deemed necessary. When an adolescent is involved, sometimes there is a wait-and-see attitude in the hope that the young person will 'grow it out. ' Even when it is supposed that the behavior is the result of a lack of interest in sex, a romantic liaison will not be arranged or suggested. If there are any physical symptoms involved these may be treated specifically.

There is a kind of violent fit which occurs when a person has been drinking called 'D. T., ' 'harahs, ' or chilillo. It is treated by applications of ice to the genital area. It is believed to be caused by 'too much heat' and the object of the treatment is to 'cool off' the person, literally as well as figuratively. Although this condition is not believed to be related to mental illness in any way, it does occasionally occur in mentally ill persons. It does not appear to be delerium tremens as it occurs while the person is drunk and still drinking, and is not regarded as a serious medical problem. It is more likely another culturally determined effect of alcohol similar to hangovers and black-outs.

If it is suspected or known that the mental illness has been caused by black magic, then there will be a great effort to rectify the situation. In many instances if it is thought that the illness is being caused by an object concealed where the person lives, the patient will be ignored as a search is instituted to uncover the harmful object. A whole yard may be dug up with special attention paid to underneath the steps, in paths, and near places where washing and cooking take place. The object will likely not be secreted in the house, so the dwelling place is not usually searched. 1 If the search yields no object, it will be conjectured that the black magic may be emanating from a distance, perhaps from something tossed out to sea or buried at a distance. But the object is usually "found" (and sometimes really found) by the obeah specialist near the house, and many times there will be a spontaneous recovery on the part of the patient.

For more difficult cases, the patient may be taken to a well known obeah specialist, often as far away as Merida, Yucatan. In these circumstances there is usually the belief that an 'evil spirit' is inside the patient and the cure will be oriented toward removing the spirit. These cures can take weeks and be very expensive, and they are occasionally successful. There are clinics of this nature too in British Honduras, some run by expatriate Jamaicans and Mexicans. The cure often consists of diagnosis with the aid of black chickens and eggs, 2 and treatments involve various herbs and the usual accoutrements of black magic: graveyard dirt, pigeon excrement, black cloths and candles, minerals with peculiar properties such as lodestones, etc. It must be stressed that all of this interest in curing the patient is present only when obeah is implicated. If there are other causes which seem more likely, then probably nothing will be done. These treatments are also expensive and many poor people cannot afford them. There are no instances of persons taking their spouses or relatives outside of British Honduras to see psychiatrists and neurologists or sending people to special clinics for the mentally ill in the United States or Mexico, although they do send persons abroad for problems caused by physical illness. Cases of psychiatric disorder are only sent to specialists for obeah-related cures of magical illnesses, never for per se psychological treatment.

Sometimes a priest or minister will be asked to pray for or over a crazy person, but this is usually the extent of the involvement of churchmen. More commonly, a member of the family may make a vow to be fulfilled when the person is cured, or will make a special series of prayers, using candles passed over the person's body, to a particular saint, apparition of the Virgin Mary, or statue of Jesus Christ. If a child is acting in a peculiar manner and its health is also impaired, then it may be 'consecrated' to the Virgin Mary or Saint Joseph for a specified number of years. The ceremony takes place in a Catholic church and is performed by a priest. The child is taken dressed in the appropriate colors--blue for the Virgin Mary and brown for Saint Joseph--and the child will be dressed in only that color and white until the years of consecration are over. 3 All of these methods of religious treatment will be much more likely to be used if there is physical involvement as well as mental illness. Thus persons with hysterical paralysis, sonambulism, 'fits, ' extreme weight loss, gastro-intestinal malfunctions, asthma, etc. will receive much more attention than those who have nothing more to exhibit than 'foolish' behavior.

Cures for culturally defined illnesses are much more standardized; and, although these cures are not considered to be a specific for psychiatric disorder, they will be discussed here because these culturally defined illnesses are basically disturbances in behavior with no known organic cause. Mal de ojo, while it usually affects only children and animals, has very specific kinds of treatment. Usually the diagnosis is made with the aid of a "fresh" egg which changes when the disease is present. The treatment for evil eye usually consists of applications and consumption of rue, 4 garlic, special oils; passing a duck or other fowl nine times over the body; and various other manipulations, rituals, and herbal medicines, the details of which vary from case to case. The best cure for evil eye is to take the afflicted creature to the person who eyed it and have the person touch the child or animal and perhaps spit in its mouth.

Mal aire is usually treated by 'bush doctors' or local curers, and in the case of the 28-year-old man cited in the last chapter, the following curative regime was followed. All the pulses of the body were felt and an arrangement of orange leaves formed into a cross was placed on the radial pulses. Herbal teas (the ingredients were unknown to the patient) were drunk in specified daily doses. The patient was advised to refrain from any work, not leave the house, and get plenty of sleep. The curer called on the patient at seemingly random intervals and hours and had charged one dollar for the diagnosis and a smaller sum for each treatment. He said special prayers for the patient and brought the herbs for the teas in very small quantities. Definite improvement followed.

Local practitioners such as these perform a valuable service in the community for they provide care and attention for those with diseases which medical doctors do not treat. However, they also keep many cases of contagious, wasting, and progressive diseases from being properly treated. Mal de ojo is often accompanied by gastrointestinal upsets, fever, and extreme dehydration; and, whatever it is, children die from it. Often they die because the dehydration, high fever, and. resultant convulsions are not controlled by immediate intravenous fluids and anti-pyretics. Ironically, it is precisely because mothers realize that mal de ojo is fatal that they do not entrust their children to a government doctor or a physician in private practice. They reason that the child's best chance is with a local practitioner who at least understands the nature of the disease.

While obeah specialists serve a similar positive function, their presence in the community and their techniques of drumming up business are frequently undesirable. They create a great deal of fear and tension by telling persons that they are the objects of black magic. They usually appear to be offering this information in a spirit of goodwill but they always make it plain that if their services are retained for a fee, the person can be protected from the effects of the obeah. With cases of illness, they sometimes come dangerously close to causing their patients' deaths. An example follows.

A 32-year-old woman, married and with three children, had a palpable and painful tumor in her abdomen. Fearing obeah she consulted a specialist who told her that if she went to a medical doctor, she would be operated upon and die, so powerful was the magic being used against her. She went through many treatments and spent a great deal of money. She reported passing through her bowels a lot of stingless bees at one time. On another occasion she said that she had passed a 'live toad with red eyes and skin like a newborn baby. ' Still her tumor stayed with her and became more painful. Finally, at her husband's insistence, she went to see a government doctor, had surgery, and was completely cured.
In another case a woman was pregnant fourteen months before she sought medical care and had the dead fetus removed. She feared obeah and was being treated by a local specialist for her symptoms were believed to indicate a magical object inside her. Her treatment had much in common with the case above as procedures for removing intrusive magical objects have similar characteristics. Usually the patient is taken to a clinic or is isolated from the family in his or her own house. The rooms are kept dark and the patient is given something to drink. Then the specialist goes into the room alone with the patient after warning the family that no matter what they hear they must not enter the sick room. While the patient and specialist are alone there is frequently a lot of noise--screams, chains clanking, sounds of a struggle, strange voices, and sometimes noises which seem to come and go from outside the house. After a while, the patient is put on a chamber pot and then is shown what was "passed. " Usually it will be a toad, a small snake, or insects of some kind. This is exhibited to the rest of the family who assume that now the patient will be well. Sometimes a cure follows and the patient will often have no memory of the curing sessions. If a cure does not result, the whole procedure may be repeated until there is improvement or another doctor, or perhaps another kind of doctor, is sought. Sometimes the specialist is not even with the patient during the cure.
A man accidentally saw something which had been 'set' for someone else. He immediately began to act very disturbed and soon was incoherent. A local curer was summoned who examined the man and prayed over him. That evening after the disturbed man went to sleep, he suddenly awakened screaming that a woman was molesting him. The next day the curer again examined him and she said that the patient had been bothered during the night and that it was the 'spirit' curing him. The man was by then totally recovered and suffered no further incidents of craziness in his life.
Supernatural cures of any disease are commonly reported in British Honduras. People who consult bush doctors and obeah practitioners usually have some faith in their powers and often have very little confidence in professional doctors. When a person has been treated by both medical doctors and local specialists, the specialists are usually given credit for any improvement or cure; and this is always the case with culturally-defined illnesses. For the mentally ill in British Honduras who do not respond to the rest, responsibility, and chemotherapy offered by Seaview, there is little left but obeah practitioners. There are no 'home remedies' or herbal preparations for cases of insanity. Mental illness is believed to be, in most cases, present for life and the prognosis for it is generally poor. One reason for these feelings about psychiatric disorder is the nature of the postulated causes. British Hondurans think that many persons have permanently 'weakened' minds as a result of previous practices. They feel there is obviously no real cure for a person who has lost his understanding from trying to understand too much or who has damaged his brain with alcohol and drugs. But if the affliction is a magical one, then there is only the problem of either ridding the person of the evil spirits inside him or finding the object which is making him crazy. For in these instances, the illness is not really a part of the nature of the person affected, it is rather something acting upon him from the outside which he is powerless to control or defend himself against.

NOTES
1. This is because it is difficult for an enemy or stranger to gain entry to the house. There is also the assumption that a member of the household will not be involved in this kind of magical harm. Methods of attachment, although somewhat magical in nature, are not thought to be types of obeah because they do not require a specialist. Very rarely will one member of a household employ a specialist to harm another person living in the same house.

2. The theoretical basis for these diagnostic procedures is that changes produced in normal objects--a healthy bird or fresh egg--are an indication of the extent and nature of the patient's illness. Eggs after being rolled over the body may 'boil' or froth when broken into a dish of water; they may be rotten; the yolk may be broken; etc. The fowl is passed over the patient or rubbed on the body a ritually-determined number of times and then its condition is investigated. Sometimes the fowl dies during the procedure. These tests are performed in front of the patient and any relatives present. It should be noted that the eggs and water are usually furnished by the specialist, and that the fowl is held by the neck and feet during the procedures.

3. This "consecration" is, in reality, a large economic burden as the consecrated child cannot usually wear hand-me-down clothes as they will not be the correct color. Therefore it must always have new clothes as it grows up.

4. Ruda or rue is the herbal specific for mal de ojo and is grown in most yards. It is Ruta gaveolens.

CHAPTER ELEVEN

DEVIANT BEHAVIOR AND ITS EFFECTS ON THE RECOGNITION OF PSYCHIATRIC DISORDER,
PART I: GENERATING FACTORS

This chapter will deal with certain aspects of British Honduran society which tend to produce deviant behavior. Workable standards for determining what is deviant behavior are difficult to establish in any situation and in British Honduras the problem is amplified by the existence of several different socio-cultural groups which have varying normative expectations about the behavior of others. Also, in a study of psychiatric disorder, there is the additional complexity of the conceptual separation of conduct which is simply peculiar from that which is viewed to be morally "wrong, " although both may be equally divergent from accepted standards. The discussion of deviance found in Jessor et al. (1968) contains a summary of the salient aspects of deviant behavior in the context of social research and will be quoted here as a useful introduction to the data to follow:

... deviance is a term reserved to the characterization of behaviors rather than persons; at the same time, deviance is construed not as a property intrinsic to any behavior but as a characterization arrived at by reference to some outside standard of evaluation. Among the alternative possibilities for evaluative reference, the one which places behavior most clearly in the context of ordinary social interaction processes is the social, rather than the legal or personal, norm. Social norms, in practice, generally accommodate a range of behaviors as more or less appropriate, expected, or acceptable. Hence, an evaluation of behavior as deviant requires that it lie outside this range-that it represent a substantial departure from what is socially defined as appropriate. Departures of such magnitude are usually identifiable by the corrective or controlling social responses which they mobilize. In short, deviant behavior is socially defined as a "problem" by society as a whole or by those segments of a society that confront it (27-28).
However, for the purposes of this study, there will not be such great emphasis placed on the mobilization of controlling social forces as, it will be demonstrated, British Hondurans are much more likely to feel that "something should be done" about something than they are to actually do it. This will be examined in detail in the next chapter where social control is discussed. It is the intent of this chapter to establish, by the presentation of ethnographic data, that several factors tend to produce behavior that is locally recognized as deviant and that other factors reward certain types of it. This is effected by practices which do not instill in each member of society clear and definite ideas about what is and is not acceptable behavior. In other words, many persons are not completely socialized in the areas of moral and behavioral norms. Also there are, in the British Honduran view of human nature, postulates which reduce individual responsibility, and therefore contribute to personal standards of conduct which are lower than social standards. Persons can thereby justify their own behavior in terms which would make them less accountable for their actions than the rest of society would be in a similar instance. Concommitantly, there are definite rewards for certain classes of deviant behavior and these serve to reinforce patterns of behavior which may only be opposed by non-activated legal sanctions and weakly expressed moral outrage. The implications of this for the sociological study of mental illness are that under conditions such as these the behavioral correlates of a person's ideational imbalance will need to be quite pronounced before they are recognized as such. Given this, one would expect recognized and labelled cases of psychiatric disorder in British Honduras to be rather severe, and this is very much the case.

Childhood Experiences
Some of the factors contributing toward deviant behavior are operant in childhood and are created by a kind of parental discipline which progresses from non-existent to random as the child matures. My interest in child-rearing practices was mainly in corrective techniques, systems of reward and punishment, and later socialization rather than infant care. I was concerned with social aspects of child-rearing, i, e., how the child is taught to adjust itself to the wills of others and how it is encouraged to conform to social standards.

The first few years of a child's life are rather idyllic; 'babies, ' as they are called for years, are allowed almost complete freedom and every effort is made to please them until they are about four years old. They are not toilet-trained by any regime which starts at a culturally determined age. Rather they are allowed to excrete at will until they are 'old enough to understand' how to use various sanitary facilities. Sometimes a slight effort will be made to accustom the child to a small chamber pot for bowel movements as no one really wants to have to clean feces out of clothing, off the floor, off the child, etc. for several years. Really strenuous efforts to toilet-train children at an 'early' age, one to two years, will be received with criticism from neighbors and friends and the diligent woman will be viewed as 'lazy to clean shit. ' The only discipline associated with the baby's excretion will be directed at older children, for failing to put the baby on the pot or for not cleaning up the mess themselves. Usually the child ' unde r stand s' the situation at about three to four years of age and will begin to use acceptable procedures for evacuation. However, nocturnal bed-wetting frequently persists for years after this and cases of it in eight- and ten-year-olds are not unusual. This is surely related to fear of arising in the night to use bed buckets in other rooms or facilities outside of the house proper.

Children are not really encouraged to walk or talk. Most children walk at one to two years but they are usually much slower in talking. If a child does not talk by three years he will perhaps be thought of as 'lazy to talk' but it will not be cause for alarm. Few children in British Honduras speak clearly before four or five years. They are not encouraged to repeat things until they say it correctly or to ask for things distinctly. "Baby talk" is a source of great amusement to adults and they encourage rather than correct it. 1 Even though very young children are deemed capable of running complex errands, their verbal abilities are such that they usually have to be sent with a note explaining the purpose of their presence. 'Babies' are not given lessons in eating and, after they begin to eat solid food, it is merely placed in front of them and they learn to get it from plate to mouth as best they can. By eighteen months, most children are eating with fingers and spoons and drinking out of glasses, unaided by adults or older siblings. They create much additional housecleaning with their hit-or-miss feeding techniques, but it is hardly 223 noticed in an average household, and certainly not sufficient reason to attempt to teach the child table manners. British Hondurans do not customarily teach their children to do anything but dance, and this they do as soon as the child can stand with assistance. Babies there do not learn "tricks" or games or special verbal responses. They are rather left to develop at their own paces, learning various skills by imitation and trial and error. Mothers do not compete with each other through the accomplishments of their children and if a child makes markedly slower progress than his peers, no special note will be taken of it as a child must be very severely retarded for it to be noticed before entry into primary school.

Children are disciplined so little during these first few years that it is a severe shock to receive the first few beatings. Even when babies damage or destroy a valuable item, they are not punished but there is rather an immediate investigation to discover who left the object within the child's reach or who should have been minding the baby. Breakage like this is an unusual occurrence however, as few homes have easily broken furnishings 2 and British Honduran children are not very curious or explorative in their youngest years. Typically children receive their first introduction to discipline when another child is born, and often it is in connection with hurting the younger child. Interestingly, "dangerous" objects such as knives, scissors, opened tin cans, carpentry tools, broken glass, objects small enough to swallow, matches, etc. are not taken away from children who sit alone playing with them. If, however, they would approach or threaten a younger child with a potentially injurious plaything, they will be scolded and struck immediately. Parents feel that it is the child's 'luck' if he hurts himself, but that they can at least prevent him or her from injuring another child. In British Honduras one sees very young children playing in yards and walking around neighborhoods with no adult supervision and traumatic injuries are common in childhood. Many children fall from high houses, ingest deadly substances, burn themselves badly, are bitten or scratched by animals, cut themselves, and the like. As they become older they are held increasingly more responsible for their own conduct and at the age of twelve or thirteen, they will be treated almost as adults.

The most drastic changes in a child's life occur between the ages of four and six when the child ceases to be a 'baby,' begins to attend school, and is expected to help with household duties. Children from this age group do much shopping, find and carry firewood, are sent out to sell things, wash dishes and clothing, and are responsible for much child-care. Boys are exempt from much of this work if there are older girls to do it, but in families with no daughters, even male children are forced to help with the women's chores. When children fail to follow their parents' or guardians' instructions or behave badly, they may be punished. They will almost always be threatened with severe punishment but it only occasionally materializes. If, however, they lose the change when sent to the store, accidentally injure themselves or a sibling, drop an egg, break a dish, soil a new outfit of clothing, or fail to sell all the tamales, a beating will be swift and sure. Discipline thus has almost a random pattern, being determined more by the mood of the punishing adult and the amount of material damage done than any inherent "wrongness" in the act or the intention of the child.

Children do not usually have a well-formed idea of why they have been punished, or understand why they are sometimes beaten for a certain act and not at other times. Threats of a 'lashing' are so frequently made and so seldom carried out that children do not really view adults as authority figures and arbitrars of justice. They see them as cruel and capricious task masters who are to be tricked and cheated when possible. They do not develop clear cut ideas about the propriety of much of their own conduct because they have never been explicitly taught and discipline patterns have not been consistent enough to offer more than a few clues. If children make an indiscreet or improper remark, adults either laugh or cuff the child. They do not explain what subjects are proper conversational material for children. Similarly, parents very rarely reward a child for good behavior. From their youngest days when even their worst behavior was a source of amusement to adults, to the middle years of childhood when they can sometimes do nothing right, children are faced with a bewilderingly disparate set of reactions to their conduct. They grow up to be sly, sneaky, and clever beyond their years. They are usually non-self-assertive, superficially obedient, well-behaved in public, and emotionally very dependent on their mothers. Incidently, they also become excellent marble players, hoop rollers, kite flyers, and sling shot marksmen. Their creative abilities are not developed and they show few abilities with drawing materials and plastic forms of expression.

To compound the sudden shift from complete permissiveness to desultory discipline, there is often the added factor of growing up in several different homes with a steadily changing cast of characters as children and adults both come and go according to the vagaries of their various fates. There is no strong community pressure which forces women to keep their children with them. While it is not always easy to give a small baby away, it is seldom difficult to place a child between five and ten years. Children this age can be of great assistance in a household and this is why childless couples or older couples whose children have all matured will take them. Such children are expected to do all the work they can and in return will be fed and housed. Many times a couple or a woman living alone will ask a woman with a large brood for one of her children. Or, if a friend or relative particularly likes one child, it may be requested even though the person seeking the child already has several of her own. Upon the death of a woman or her departure from home, the whole family will be parcelled out to relatives and neighbors. Children who grow up in such foster homes will often have even less interest taken in their moral and social education than if they were with their natural families. They are expected to work hard and demand little in the way of food, shelter, and dress. Little thought is given to how the child grows up because most people realize that the majority of these informally adopted children will return to their natal homes or close relatives when they reach their teens.

In effect, there is very little conscious moral and social training of children in British Honduras. They learn at home by imitation and in school by rote. They are not trained to reflect on their conduct or to reason anything else out. When parents perceive unpleasant traits in their children, they believe that it is due to the 'nature' of the child and not to any faults in the home. Raising children is not viewed as a "science" and no one worries about whether she or he has done a good job. A bad job is almost inconceivable although people do criticize the child-rearing practices of others. They will fault other people for not disciplining their children frequently enough, feeding or dressing them poorly, or not teaching them 'manners,' but they rarely examine their own children in these terms or consider the possibility that mischievous or incorrigible children literally do not know any better. This is particularly true with slightly to moderately retarded children. They probably never grasp the abstract notions of right and wrong as the lessons are offered in such a haphazard manner. They mature physically and learn that there are some things which they should never do, but many of them become sexual deviants and general problems in their neighborhoods. Some people never realize what is wrong with these persons and their presence in the community, unexplained as it is, merely serves to reinforce ideas about the rigidity of childhood traits and increase the amount of visible deviant behavior.

While there is at present little corroborating evidence on the effect of British Honduran child-rearing practices (see Chapter Three for one such study), Masland et al. (1958) provides an interesting example from the Trukese with these comments:

Why do the Trukese develop such a concrete and limited approach to problem solving? The answer must, as in our own society, be sought in childhood, the period when a person learns from the preceding generation the multiple facets of the cultural heritage to which he is born. Childhood for a Trukese is a period of freedom with almost complete lack of supervision by adults except for occasional, and inconsistent, reprimands and punishments. Children play in groups together and are given practically no systematic positive instruction. They are viewed by adults as irresponsible and, being unable to do responsible and useful work, not worth instructing. The word for "child" in the Trukese language in fact means "does not comprehend. " [cf "baby" for a four year old in British Honduras.]

This freedom and lack of supervision or direction, although it might be looked upon as utopian by a middle class American child, provides a very poor climate in which to learn effectively and efficiently to cope with problems or to profit from the wisdom of past experience contained in the culturally defined solutions to such problems ... . This freedom can also leave an individual drifting, uncertain, and without emotional support, a thesis developed at length for our own European society by Erich Fromm ... (285-286).

While the public primary schools could provide an alternative mode of socialization and enculturation, they generally do not. Their beneficial effects on children are undermined at home by parents and guardians who are full of criticism and complaining, usually aired in front of the pupils. The high cost of text books, uniform material, and education in general is a common conversational subject, and the less pious also have much negative to say about the Catholic Church in general. They gossip about the conduct of priests, nuns, and lay teachers and generally erode the images of school personnel in front of the children. Here it should be stressed that adults rarely modify their conversations when children are present and very young boys and girls, girls most especially, are quite as well-informed as their parents about most things. There are suggestions of financial improprieties and church personnel living in unwarranted luxury ~... while the poor parents of school children must deprive themselves to buy books, uniforms, pay fees, etc. This is a fairly accurate description of the situation but not an explanation as it is believed to be.

The children receive lessons in conduct from their text books, religion classes, and from the reaction of school personnel to their deportment. But these are not generally reinforced at home and probably tend to become regarded as is most of what is learned at school--repetitious behavior which is not clearly related to any other aspect of their lives. For although most primary teachers in British Honduras are local men and women who are locally trained, they are frequently of different ethnic affiliations than their students and often speak a different language. All instruction in British Honduras is supposed to be in Standard English as opposed to Creole, Carib, or Spanish, yet few adults and even fewer children in the country speak Standard English and most do not understand it very well. Teachers, of course, resort to the vernacular languages to make some points when theirs is the same as the students, but unless Spanish, Indian and Carib children understand Creole, or their teachers speak their own languages, the students will spend their first few years in school learning very little. They are taught to write, work with figures, and to read, but it is years before they can do so with any facility, and then they are obviously the products. of a rote-learning system. While it is possible to teach the basic skills of literacy in this fashion, it is an unproductive method for teaching morals and manners, a declared purpose of the primary school system which is administered by the government in cooperation with church groups, primarily the Roman Catholic Church.

Virtually all British Hondurans are exposed to formal religious teaching as children, and they have moral ideals which roughly approximate the Judeo-Christian ethic. Yet these moral ideals do not seem to have the force of behavioral imperatives even though there is a high degree of consensus about them. These teachings are too far removed from the social realities of much of the population to be considered as directives or goals. They are rather evaluative standards applied to others and occasionally one's self in the way that a garment is sewn and then tried on to fit. If the behavior fits the ethic, that is a desirable condition. If it does not, then perhaps there can be a few alterations; or more likely, one will hope for better results the next time.

In the same way that British Hondurans tend to find fault with the educational system, they enjoy pointing out the failings of their leaders, prominent citizens, and successful businessmen. As any person becomes noted for political, professional, or commercial achievement, there will be a great deal of discussion about his past and present wrong-doings. Illegal business deals, illicit romantic affairs, incidents of public drunkenness, accusations of theft and bribery, evasion of various taxes, scandals involving relatives and friends--all of these will be dredged up and become common "knowledge. " There are no public figures in British Honduras with unblemished records, if one would believe local gossip. And most people do. One of the many effects which this kind of name-calling and scandal-mongering has is to convince people that serious misconduct is not an obstacle to success in life. Rather it seems a prerequisite to it. No one really believes that an honest merchant will be successful or that a person unwilling to accept gratuities in return for 'favors' will ever make much of himself. And the seeming proof of this is the present situation, a self-fulfilling prophecy. Children do not grow up with such ideals as presented by American folk tales about Abraham Lincoln and George Washington. Rather they are told about various entrepreneurial types who illegally cornered a valuable commodity at a low price and sold it at a high one, or the man who was supposed to dispose of the old currency by burning but saved it himself instead. Men who find large sums of money and return it are ridiculed as fools as is anyone who prefers a clear conscience to success. British Hondurans, as a group, tend to feel that they cannot afford high moral standards and thus justify their perceived failing in this area in those terms. For the present, it will suffice to note that there is a dearth of good examples in British Honduras in the sense of people who are praised and acclaimed for their inflexible views on the subjects of right and wrong.

Deviant Careers
Linked to this is the number of available professions in the country which involve deviant behavior. Only theft and prostitution, both manifestly frowned upon and illegal as well, will be discussed. Theft is a profession, full- and part-time, in British Honduras although it is most extensively practiced in Belize City. Favored targets are tourists, expatriates, and the wealthy merchant class although any person with something valuable is a possibility. Thieves break into private homes, warehouses, automobiles, and places of business at any hour of the day or night. They also shoplift, snatch purses, steal from employers, and tear jewelry off the persons of women and children on the street. They do not generally "mug" people and during my stay there I heard of only one robbery accompanied by beating of the victim. Thieves generally steal for a livelihood rather than to possess the objects which they steal, consequently they all steal about the same things--items which have a ready market. These are radios, tape recorders and tapes, electric fans, jewelry of any kind, cameras, liquor, imported food, clothing, and truck and automobile parts. These items are either sold through a "fence" who specializes in such work or thieves sell the goods themselves. They do not generally steal cash unless they find it. There has been only one bank robbery in the country. It occurred in 1972 and the history making thief was apprehended within hours as, of course, he was recognized by someone while running away from the bank. There are several important characteristics of this profession. Primarily luxury goods are stolen and they are stolen from people who can usually afford to replace them. These goods are generally sold to ordinary Belizeans. The liquor is sold to bars, the food to grocery stores, and the other items to whoever has money to buy. As both thieves and their front men want to sell the goods as quickly as possible, the prices are extraordinarily cheap, usually about 25% of the item's retail value.

Most people in Belize know who the thieves are. A person who has no steady job but often has a costly item to sell is conspicuous in a city the size of Belize. Thieves are occasionally apprehended and this gives them even more publicity. But the people from whom the thieves steal do not know them, and this is how they are able to operate. They walk around the business districts and better neighborhoods waiting for an opportunity; seldom do they make elaborate plans. These thieves provide for a sort of redistribution of wealth which may serve a more positive function than it first appears. Their victims are seldom poor people, for obvious reasons. Rather it is these poor people who benefit from their activities. An electric fan is a fine thing to have in Belize, especially if one lives 'back of town' and not in the upper-class areas where there is always a breeze anyway. Radios are practically necessities for entertainment when one cannot afford the motion pictures or a week-end outing. And all Belizeans are fond of jewelry. Thus theft, while it is undesirable in the long run, does have short-term benefits. Although many tourists never come back and the expatriate upper-class has a generally poor opinion of the integrity of many Belizeans, sentiment among average people is that theft will inevitably occur and they do not object to being able to benefit from it occasionally. They feel that it is an impersonal kind of theft and, in some cases, not really theft at all. Employers learn to tolerate a certain amount of theft in their establishments, and indeed many businesses are run in such a way as to make it impossible to control pilfering. Clearly it is not thought to be a particularly heinous crime. Many British Hondurans declare that they would never steal a penny and they mean it. For most persons 'stealing' would be sneaking into the house of a friend or relative and taking cash--and it would only be stealing then if the person did not owe the thief money. Any other means of acquiring a person's property is not exactly stealing. Thus there is a tacit acceptance of all kinds of theft which are thought to be almost acceptable behavior by many persons--especially those who eventually possess the goods.

Prostitution too is present in British Honduras and many of these women are from the neighboring republics, brought especially for this kind of employment. Foreign prostitutes usually live in 'hotels' featuring expensive drinks and accommodations which are actually thinly disguised brothels. Although prostitution is not legal in British Honduras, these establishments are open to the public and conduct their business flagrantly. There are occasional public expressions of outrage in speeches, newspapers, and the like but these lucrative enterprises operate with apparent governmental and public assent. Few local girls live in these places, as they usually work the streets and ordinary bars. Local girls do not command the same high price as the imported prostitutes but they have correspondingly lower living expenses. The foreign women remain outside of society and are in fact almost totally isolated from ordinary people by living in the hotels. Yet British Honduran women and girls who turn to prostitution as a means of earning money live in the same neighborhoods as other people and frequently with relatives. They are not in any way ostracized by the general society but they do forfeit some rights which "honest" women enjoy. Many of them are girls who have borne a child out of wedlock and have drifted into the profession through casual relations with men who reward them materially for their company. Once it becomes known that they have accepted gifts as payments for their favors, they are sought out by other men and gradually become established as known prostitutes in the community. Others are introduced into the career by older men and women who recruit young girls for purposes of prostitution and profit from their activities. While it could be said that no woman is every really forced by her situation into prostitution, the profession has definite benefits as it is viewed locally. Prostitutes are widely admired for their stylish and lavish wardrobes, freedom of movement, and their 'powers' over men. They are also thought to have sizable incomes and good opportunities for meeting foreigners who often marry them and take them to live abroad. Although they are referred to as 'bad women, ' they are still socially accepted by most of their relatives and neighbors, and even their children do not suffer from a grave stigma. People simply do not fault the child for its mother's conduct, especially if the child does not grow up with its mother. Prostitutes, although their behavior is universally regarded as immoral and detrimental to themselves, are more than tolerated. They in fact enjoy privileges which other women in the society with more regular modes of employment never experience. They frequent the most prestigious bars, hotels, and restaurants. They mingle with some of the wealthiest people in the country and frequently enjoy trips abroad. The desire of a woman to avail herself of this kind of life which is almost totally unobtainable for an average British Honduran woman is more than understandable. It is forgivable, especially if the girl is from a poor background. Moralistic criticism is almost always directed toward the foreign 'whores' and little is said about the activities of local girls. This kind of deviant behavior is tolerated by the community and often ignored unless the effects of it are felt personally. There will then be outbursts in which feelings of hate, jealousy, and extreme disapproval are aired, but these feelings are normally controlled.

The above activities are examples of behavior which is proscribed by local statutes and thought to be undesirable by the populace in general. Yet as full-time occupations they flourish and involve many people in deviant roles rather than merely deviant behavior. In both, the principle motives which lead persons into these areas are economic. They are seeking to provide themselves and/or their dependents with a larger and more secure income than would be generated by the majority of regular jobs in the country. Each successful practitioner in these fields of endeavor reinforces the already present idea that one does not have to conform to normative moral expectations in order to have a prosperous life with normal social acceptance as well. In other words, just as in childhood certain punishment was not the consequence of forbidden or wrong actions, ;. so in adult life one may violate normal rules of behavior without swift and sure censure from society. Rather, the lack of concerted societal action toward violators of formally instituted norms encourages a laissez-faire attitude in both the general populace and the enforcers of the legal limits of behavior which tends to blur the distinctions between acceptable and deviant behavior. Thus, rather than low consensus, there is conceptual confusion about the nature of proper behavior.

Concepts of Responsibility
Certain beliefs which British Hondurans share about personality also influence the amount of deviant behavior and measures to control it. They are strongly fatalistic and see their lives as being greatly determined by 'fate,' 'luck,' 'destiny,' and other predetermining kinds of forces. They envision themselves as being acted upon by circumstances they cannot control, understand, or change. Each personal history to them is the sum of immutable events and unavoidable circumstances which have made the person what he is. British Hondurans feel that being born into a poor family is a reason for failure to achieve later in life. This is viewed as an almost insurmountable obstacle as it usually means lack of formal education, no useful social contacts, and insufficient opportunity in one's younger years to learn a trade. Related to this idea of non-control over one's fate is the notion of unchangeable personal characteristics. They feel that each person is born with a definite personality which will become evident as the child matures and that little can be done to change a person at any stage of life. Thus when parents or guardians notice that a child is selfish, gossipy, dishonest, sulky, bad-minded, cruel, etc. they will comment with regret on its character but there will be no concerted effort to modify it. They will criticize the child and perhaps beat it occasionally for its failings, but they will not think that they themselves could influence its development in any other way than that direction which it seems to be taking. Constructive corrective discipline is not part of parental behavior when the child is young, and even less when it is older. When a boy or girl reaches the early teens and is old enough to find itself in serious trouble for theft, sexual misconduct, fighting, etc., most people would despair of being able to control the young person. There is a juvenile corrective facility in Belize City but it receives only males and is not a commonly sought remedy for the situation. If the young incorrigible reaches fifteen or sixteen years and still behaves very badly, he or she will be evicted from the household. While this is a definite negative reaction to the teenager's deviant behavior it is not a particularly helpful or corrective one. This puts the burden of discipline on the whole society and, as will be indicated, collective discipline is not always forthcoming.

Usually by this time the deviant person himself rationalizes his behavior to the point where he does not feel responsible for it and views individual or concerted negative sanctions toward him as unfair or unjust. He will place the locus of blame on his background, recent misfortunes, uncontrollable temper, bad companions, or other mitigating circumstances. He or she will feel plagued by bad luck and cite evidence testifying to a whole career of misfortunes caused by outside influence. If the acts are performed while crazy, drunk, high on marijuana, or during a fit of anger or rage, there will be a general acceptance of the person's inculpability in the matter. Under conditions such as these, persons are not believed to be themselves or in any way in control of their words and actions. Hence the fault lies outside the person and is depersonalized into thin air with vague non-specific entities bearing the brunt of society's displeasure. Thus social forces which could bring the lost sheep back into the fold are dissipated rather than mobilized. Deviant behavior is thus more likely to be repeated and become habitual.

Boredom
Another factor should be mentioned in connection with forces which produce deviant behavior and this is boredom. With regard to drinking, marijuana smoking, and sex-related offences, the lack of alternative activity is cited by the people themselves as a cause. Whether in downtown Belize or in villages 'way back of bush, ' British Hondurans feel limited in ways to occupy their spare time. This is not so true with women who have household chores to take up all their waking hours unless they have older daughters, but with men it is perceived so. As mentioned earlier, they do not make any handicrafted items, and when they are manufacturing a piece of furniture or making repairs or additions to a building, they often do the job without attention to finishing details. As many men are not regularly employed, they frequently have whole days and nights as well to fill with some kind of activity. Men and boys gamble for very small stakes with playing cards, coins, etc. They drink and smoke marijuana when they have the funds, but often lack of money and nothing to do go together. They thus frequent bars hoping to find a person to buy them a drink or share some marijuana. In the villages, the situation is more acute as even if one has money to spend, there is little to spend it on except rum. Marijuana will usually be available gratis. In one such village until very recently, adult men could be seen every afternoon and evening playing with marbles and tops.

People who have never spent time in small villages with populations of only a few hundred souls are hardly able to appreciate the extent of the ennui produced. And in British Honduras where people are aware of the existence of motion pictures, pool halls, television, and other general leisure time activities in large cities, this is especially so. They do not have timeless cultural traditions which suggest ways to wile away the hours. Instead they are genuinely at a loss as to what to do with themselves and, as they say locally, 'they turn to mischief. ' They become involved in sexual dalliances with close kin and other forbidden partners. They spy on neighbors and roam the streets and paths in search of other sights. They in short do whatever occurs to them. This of course does not apply to all persons, many of whom read, work, and relax in their homes. Some hunt and fish to relieve the boredom, and there are naturally some who are hardly ever bored. But persons who are inclined to dissatisfaction with their lives and stations in society often have these tendencies aggravated and intensified by long periods of time with only their situations to contemplate. They react sometimes with anti-social or self-destructive behavior and their own later comments point to boredom as a causal factor.

The above qualities of British Honduran society and ideas in their conceptual systems are partly determining factors in the general level of deviant behavior. Other conditions contribute toward the tolerance of it and they will be discussed in the following chapter. The points which have been stressed in this chapter are that British Hondurans, practically from birth, are not given clear guidelines to behavior and that neither their own life experiences nor what they observe around them serves to reinforce what moral and social training they do receive. Just as mothers pick up a baby every time it cries to soothe and rock it, even when they know the baby is crying to be picked up, so do the collective attitudes of society forgive a person for deviant behavior and frequently exempt him from the responsibility for it when his motives are known to be self-advancing.

CHAPTER TWELVE

DEVIANT BEHAVIOR AND ITS EFFECT ON THE RECOGNITION OF PSYCHIATRIC DISORDER, PART II: REINFORCING FACTORS
Although the division of this discussion of deviant behavior into generating factors and reinforcing factors is primarily heuristic, k it is surely defensible to speak of factors which tend to produce it and factors which tend to make it tolerated, even though in some instances the same factors will be involved in both areas of discussion. As in any self-regulating system, which a society must be if it is to persist for more than one generation, the disequilibrium produced by a departure from the norm may either serve to activate a correctional change, or the feedback may produce a more pronounced deviation. In this chapter, it will be demonstrated that, in some measure, the nature of British Honduran social ambience makes social control difficult and serves to protect certain persons from the potentially negative effects of their own deviant behavior. Thus the corrective mechanisms of the society are not as effective as they could be if the society were organized along slightly different lines. Points to be stressed are the particularistic nature of social relations, high geographic mobility, and the presence of strongly perceived family ties, this last point persisting in spite of relatively unstable homes.

Particularism
In the now classic distinction between societies organized on the basis of achieved characteristics or "universalistic, " and those organized according to the ascribed status of a person or "particularistic, " 1 British Honduras falls into the latter category. In spite of the presence of such large-scale institutions as formal and chartered government, civil service, secondary education, courts of law based on written statutes, sophisticated financial dealings, etc. , such small-scale practices as valuing who one is rather than what one does prevail. The ascribed characteristics of a person's status which are given to them at birth are usually the determinants of the person's place in the society. Such qualities as race, sex, family ties, and appearance are far more important in personal and business relations than education, employment, travel or work experience, and the like. People who possess such favored traits as light skin, Caucasian type hair and features, expatriate ancestry, and wealthy, socially or politically prominent relatives will be markedly more assured of success in most areas of life than those of similar abilities who are not comparatively gifted on the ascribed level. Of these characteristics, with regard to social control of deviant behavior, well-placed relatives is the most significant. People are well aware that socially established persons 'get away' with infractions against the rules of society and a double-standard of justice is perceived by many. However most persons do not so much desire justice for all as immunity from justice for themselves. This greatly undermines the moral basis of formal justice and creates a situation where control of some kinds of deviant behavior is not demanded by the members of the society; but, rather, they demand the right to indulge in that deviant behavior themselves with impunity.

The particularistic nature of the society also makes it possible, as noted before, for persons with a history of psychiatric disorder, very low intelligence, or a physical handicap to commit minor crimes and do very peculiar things without concerted societal reprimands. These abnormal persons will be allowed a wider latitude of behavior precisely because they are not normal and are not expected to be as discerning in their choices of conduct as other people. This "stigma," in Goffman's (1963) terms, can only be operant at all times in a fairly small society where each person's business and history is well-known, and the "proper" societal reaction will be immediate and based upon all the salient aspects of the persons involved. Thus there will not be a report to the police of a disturbance involving an "unidentified" man or woman. If the report is made at all it will be regarding a crazy man or crazy woman, and then it can be dealt with accordingly. In this context mental illness is treated more as an ascribed than achieved characteristic; and, indeed as it is regarded as an immutable and permanent part of a person as soon as it is recognized and confirmed, this is consistent with other aspects of how this society reacts to psychiatric disorder.

Particularism, with regard to deviant behavior, creates a situation where although people might feel "something should be done" about a person or event, there is realistically very little that will be done or is possible to do. Its presence creates a general lack of faith in the efficacy of both formal and informal types of social control. People realize that desired standards of behavior can be ignored without dire consequences, and this leads by inference, to a realization that perhaps the deviant behavior is not so wrong after all. The implications of this possible conclusion will be dealt with in the final chapter, but for the present it suffices to reiterate that special treatment accorded to people by virtue of personal characteristics which do not directly impinge on the matter under consideration, can contribute toward higher levels of deviant behavior than otherwise would be the case if the person were corrected independently of extraneous factors.

Strength of Family Ties
As was indicated in Chapter Three, British Hondurans have strong feelings of responsibility and duty toward close kinsmen, and this greatly affects reactions toward deviant behavior when it is perceived in a relative. If criminal or deviant activities are directed only against members of the household, there will be no legal action taken. There may well be no action taken at all of any kind. Families will tolerate having stolen goods stored in their homes, marijuana sold on their premises, and various other illegal activities rather than reporting near kin to the authorities. The effects of this are manifold. Primarily the person engaging in deviant acts does not fear the loss of support from and contact with kin. Initial deviant acts which are tolerated by the family make repetition of them likely. Persons feel that, no matter how their behavior offends the community at large, they will still have a home and a measure of acceptance from at least some persons. Few people are ever really abandoned by their relatives no matter what they do. If the deviant person is also the sole or main support of the household, then his or her activities will go on unquestioned by the recipients of his income no matter how it is derived or how he conducts himself. Questioning the source of cash is a luxury which few people could risk without dire consequences to their standings in a household. For this reason some women see themselves as forced to accept all manner of abuse and ill treatment from their husbands, even to the point of allowing their daughters to be molested and raped at very young ages. So this feeling that relatives should be protected and their failings overlooked coupled with a reluctance to criticize a person who provides money, makes it possible for men and women to be relatively immune from negative sanctions in the home.

Geographical Mobility
Yet if even this haven of acceptance and tolerance should be closed to a person, he or she still has an important option available-going somewhere else. Although British Honduras is too small a place for a person's reputation not to follow him, there is still the advantage of striking out in new territory where the people may at least have no personal enmity towards him. Leaving Belize or any other place is rarely effective in evading a police warrant, but it can be a useful strategy for a person who has alienated many neighbors, employers, and relatives. It is not uncommon for men to disappear for a period of time after impregnating a young girl whose parents may be considering court action. By the same token, the girl herself may shift to a new locale after the birth of the child. People commonly will go to an area where they have relatives living and make their homes with these kinsmen on either a permanent or temporary basis. A female who will assist with household chores and child-care is a welcome guest as long as she is useful; and, she will be fed and housed in return for her services, often for as long as she wants. A male, while usually not quite so welcome, will nevertheless be taken in at least temporarily and, if he finds employment or another source of income, he will be permitted to stay as long as he contributes economically to the household.

A person with a history of deviant behavior, in these circumstances, will hardly be starting life with a clean slate, but people will definitely give him or her the benefit of the doubt if he or she causes no immediate trouble. He will be allowed somewhat less leeway in behavior in this new locale but the situation will not be markedly different from the one just left. This option of relocating will always be open to a person unless he becomes truly notorious throughout the country and disowned by all his kin. Significantly there are few men and women in this circumstance. The particularistic nature of the society insures that people will be treated and judged as individuals with specific family connections, racial affiliations, and unique personal histories. Wherever a person goes he will not merely be treated as a deviant possessing a past filled with unpleasant incidents and unsavory offences, but rather as a member of a particular family. This guarantee of non-achieved role labelling creates opportunities for persons to enjoy long careers as troublemakers while they are sheltered by their families from societal reprisals. Add to this the high geographic mobility made possible by seasonal employment and a large underemployed work force all possessing roughly the same skills (or lack of them) and one has a constellation of circumstances which makes deviant behavior very difficult to control.

Weak Social Controls
The general utility of the existing means of social control will be discussed in the light of the above information. Both formal and informal institutions 2 will be examined in terms of their efficacy and suitability to the local situation. Although there may be certain negative comments made in this section, they are not an implied or direct criticism of the ways in which British Hondurans order their affairs. Rather they are comments made in as impartial a manner as possible by an observer whose main task is to record the existing situation and to evaluate it in terms of what it is rather than what it might or ought to be. My main thesis in this section is that social control in British Honduras is generally weak and it is the effects of this weakness which are of concern here.

The main instrument of formal and legal control is the national police force which numbers about three hundred of which about two-thirds are stationed in Belize. Each district capital has a complement of fifteen to twenty, and the smaller villages rarely have more than one if there is one at all. Police are trained for six months before going on duty and the base pay is about $120.. 00 (B. H. ) per month.

Matters which come to the attention of the police may result in a 'case.' In these instances the person will have to stand trial before a magistrate (or judge) and perhaps a jury as well. There are at present four magistrate's courts in Belize and five others in the district capitals. There is also a Supreme Court which may be convened in Belize or the district capitals for appeals from Low Courts and more serious crimes. There are about a dozen lawyers in Belize City and they all handle criminal cases among their other duties. Persons rarely avail themselves of a lawyer for Low Court unless it is a very important matter involving personal property or a potentially long jail term. Based as it is upon English Common Law, the British Honduran legal system is not too different in design from that of the United States and thus is quite comprehensible to us. The main difference is that British Hondurans tend to be a rather litigious people and bring suits against each other frequently. Thus aside from police-charged defendants, the Low Courts' dockets are filled with various civil suits brought by personal parties, many amounting to little more than formalizations of fist-fights and shouting matches. These actions will be considered with informal social control rather than under police business.

It is difficult to discern what criteria are used by the police in the performance of their duties. At times they seem to enforce neither the intent nor the letter of the law. They direct traffic, do 'undercover' work, patrol the streets, investigate some complaints, man desks at the various police stations, maintain order at any public gathering, and take care of a host of administrative duties from vehicle registration to immigration. Many of them seem to function more like administrative bureaucrats than agents of social control. Individual low-ranking policemen do not seem to act independently against many offenders without first securing the approval of their superiors. They seem to view their roles as being determined more by governmental policy than by the printed statutes. This is, of course, very likely to be the situation with any national police force and British Honduran policemen seem quite unwilling to act without orders from above. Also, as with any local police in a small town, the police know and are involved personally with many persons with whom they come into contact during the pursuance of their duties. They will likely be more lenient with those whom they like while those out of their favor will suffer accordingly. People in British Honduras do not fear police, neither do they depend on them for the resolution of many problems. As a result of particularism, they regard the police in terms suitable to whichever policeman they happen to be dealing with, and the kind of rapport which they establish with him will influence the outcome of the matter more than the stark facts of the situation. This greatly reduces their effectualness as upholders and enforcers of the standards of the community. They are too often like the capricious parent--now reprimanding, then ignoring the offender. They do not view their role in the broad abstract terms required for an impartial treatment of those who commit or appear to be committing crimes. This kind of law enforcement does not realistically act as a deterrent to much crime or any other kind of anti-social deviant behavior because the activities of the police are only partly determined by the content of the laws they are enforcing and the kinds of activities with which they are faced.

The current situation with the system of courts is somewhat different. It is possible to influence the jurymen and those giving testimony, and courts are thus manipulated by the very persons against whom their activities are directed. These attempts to change the meting out of justice are widely viewed to be prudent and necessary. There are no cultural sanctions against them and they are frequently obvious to even a casual follower of current events. Very nearly everyone recognizes the same motivations in himself and finds nothing very unusual or reprehensible in this impulse to 'set things right' for one's self. In effect, this system of having to pay indemnities to save one's self from the consequences of illegal acts is in essence no different from being able to pay a fine rather than serve a jail term. The prescribed penalties for criminal acts in British Honduras are almost always jail terms rather than the assessment of monetary fines, yet the existence of informal exchanges of money to reduce penalties or have charges dropped approximates closely the American options of forfeiting bail or paying an assessed levy to the court. In fact the principal difference is that in British Honduras the funds are received and held by private parties while in the United States most payments go to the courts. The effect is exactly the same, that persons with sufficient means rarely go to jail at all or only for short periods. This means of negating the personal effects of criminal behavior is open to all who have access to large sums of money and if a poor person can raise the cash, he too will be able to materially affect the disposition of his case. This again undermines the abstract concept of justice, and leads to a toleration of criminal behavior and a lack of faith in the judicial system to right wrongs against society and the individuals who comprise it.

Another factor operating somewhat independently of this is the occasionally poor preparation of the prosecution case which makes it possible for persons to be found not guilty for reasons which do not reflect upon the integrity of the courts. Police who are under-trained and over-zealous can make errors of procedure, mishandle evidence, file reports improperly, and give counter-productive testimony. Cases like this, even when decided in the favor of a person who seems obviously guilty, do not rankle British Hondurans or cause them to criticize the government. Rather almost everyone enjoys seeing someone 'get away' with something once in a while, and cases which are badly bungled become favorite stories to tell and incidents to discuss. The heart of this whole matter lies in the fact that very nearly all British Hondurans (as almost all of humanity) want to be able to escape from the consequences of behavior that would ordinarily produce severe punishment. They therefore do not especially fault their legal system for making this possible because there is the likelihood that they might want to avail themselves of this opportunity some day.

There are times however when sentences given for serious criminal acts, principally those resulting in death of the victim, are so light that voices are raised against the leniency of the courts in newspapers and in general conversation. 3 The use of the death penalty was suspended some ten years ago and no one has been hanged since. Persons serving life sentences were formerly sent to Jamaica but whether this practice is still in effect is not known because no one has been sentenced to life imprisonment recently. Sentences for manslaughter and murder tend to run for several months to a few years, even when it is not the person's first capital offense. People are beginning to say that five or six years for murder is not too much time to spend in jail for ridding one's self of an enemy or malefactor.

By and large however, the mechanisms of informal social control are much more low key than murder. Most people are willing to tolerate a great deal of offensive behavior before they react. Women and children bear most of the brunt of anti-social and deviant behavior because they are the least able to defend themselves or do anything about it. Men are very reluctant to involve themselves in argument and ill-feeling for an offense against female and under age members of their families, especially if they have not witnessed the incident in question. This means that women and children out alone must be the recipients of hostile and malicious behavior as few men would annoy a man or molest his family in his presence. This greatly explains the tendency for women to stay at home most of the time and the efforts of some families to keep their children always in their own yards. They are trying to protect themselves from unpleasant incidents and avoid possible scenes on the street. That such a situation exists speaks eloquently for the amount of free-floating hostility and resentment present in the society. It should be kept in mind that it is not bodily injury or robbery which women fear for themselves and their children; it is verbal aggressiveness, personal insult, and obscene suggestions and remarks. The males who indulge in this kind of behavior are almost always young, have no regular employment, little education, and constitute one of the lowest levels of the society. They frequent specific areas of Belize and one of their haunts, the Pound Yard area, is so fraught with the certainty of unpleasantness that no one goes near the place unless it is an absolute necessity. This kind of universally offensive behavior could be controlled by either the police or the population at large, yet it is not. The police have not received orders to rectify the situation and frequent complaints from citizens are generally to no avail. Ordinary men have no wish to involve themselves with these unsavory characters as they perceive it to be none of their own business. They are, after all, rarely bothered by them. It thus falls to the weakest element of society to absorb the most obvious signs of social unrest and dissatisfaction. This prevents the matter ever being directly dealt with or confronted in its entirety by the whole society. It also precludes the resolution of this social problem.

There is evident throughout the country an unwillingness to involve one's self in a dispute which begins with other people, even when an apparently innocent party is easily getting the worst of it. Whenever a person is involved in an altercation over an insult, social slight, or point of honor, and things turn out badly for him, people will say, 'He looked for it.' By this they mean that the person was somehow seeking the beating, injury, or resulting arrest by merely defending himself. This kind of assessment of the situation does not encourage joining in on the side of right. Neither does it tend to make a possible agent of social control out of the man-on-the street. Far from it, as men greatly fear personal injury and trouble with the police as the probable outcome of any fracas. If person A provokes person B into a fight by any means other than assault and person B injures A, if and when the police are involved, person B will be charged with the offense, even if he is equally severely injured by A. This makes people very unwilling to place themselves in legal or personal jeopardy and hence creates an ideal situation for bullies and belligerents. If a citizen of British Honduras is wronged without a policeman present to make an arrest, the police will not later act on his behalf. It is not possible to go to the police station with tales of insult and injury and obtain a police warrant for a person's arrest, unless one is very severely injured. The only available means of redress is a personal suit, brought by the injured party, against the aggressor in Low Court. The outcome of this suit, if favorable to the wronged party, will be only a fine assessed against the offender and payable to the court. No jail terms are imposed if payment is made and it almost invariably is. It is not usually possible to collect personal or punitive damages. Most cases heard in Low Court are matters such as these, and this is really the only recourse which people have against acts of personal aggression and harassment. As nothing is materially changed by these cases, no matter what the outcome, they are primarily outlets for vindictiveness and a desire for personal revenge and public embarrassment of the offender. It is not an especially effective means of social control, for as long as a person can pay fines, he can be free to disturb the peace of the rest of the population. Some particularly quarrelsome and obnoxious persons make frequent appearances in court and are well known to all the participating personnel.

Throughout this section there has been an emphasis on what is not done to control deviant behavior rather than on the positive aspects of the situation. People are not openly terrorized on the streets and even the worse bullies cannot maim and injure at will. Yet there is still a great deal of anti-social and generally offensive behavior which goes unchecked. This is directly due to the prudence and restraint exercised by the vast majority of citizens and their respect for other people's rights. They try to mind their own business and avoid trouble. They well know that personal injury and a fine in court can be the result of taking up the challenge of a malcontent. This is on the whole an admirable impulse which tends to reduce violent altercations and resulting difficulties. I have seen many incidents in which British Hondurans indulge in unilateral or mutual provocation and 'baiting' and the encounter always seems to be on the verge of erupting into battle. Yet no one wants to strike the first blow, and usually it never materializes. They are content to express and exhaust their hostility through verbal invective and insult and they are masters of it. While seemingly insupportable remarks are hurled for long minutes and each principal faces the other with an actual or potential weapon (bottles are favored for threatening brandishment), the whole thing usually loses momentum after the worst has been said. By-standers seldom try to interpose themselves between the participants as this new development may upset the delicate balance between aggression and restraint and provide the impetus for actual fighting. They seem to have an understanding of the nature of the situation and know well how to deal with each other. An argument between a British Honduran and a foreigner will be much more likely to evolve into a physical battle than a similar altercation between British Hondurans. Thus men spend much of their lives being psychologically prepared for such crucial moments, and hesitation has survival value. For in a fight with broken bottles, knives, or machetes, not to mention the sudden appearance of a hand gun, there may not be a winner. Everyone recalls the fight in Corozal where both the men were dead from machete wounds when it was over. With women the situation is markedly different and as they are rarely able to defend themselves they do not learn to control their anger. They rather have frustrated desires to avenge themselves and these emerge at times with a terrifying intensity. There have been, in the last ten years, two cases of women murdering men by throwing gasoline on them in an enclosed area and then tossing a match. Several other women have severely injured men in this manner.

Such is the societal value in learning to dissipate anger verbally. But for this principle to be effective, other persons must learn to tolerate such outbursts. Hence the bully and the verbal provocateur have their positive functions. Likewise the nonintervention policies of the police make it possible for British Hondurans to deal with personal problems themselves and they thus become adept at handling difficult situations without the assistance of law enforcement officers. This is a valuable skill as one cannot always count on the presence of police to take matters into hand. It is possible to argue that the lack of social control in many areas of potentially disruptive behavior is an institutional expression of concern with other more serious areas of deviancy. For example, while marijuana smoking is common, the use of stronger or addictive drugs is unknown. There is much petty theft but very little embezzling, armed robbery, or grand theft. Verbal hostilities are heard shouted in every street and alley, yet serious injury or death due to fighting is rare. There are seldom more than a few murders a year and sometimes none--an amazingly low rate for a country where most men are armed in some way all the time. People destroy themselves slowly with rum, but suicide is an anomaly. The courts are often lenient but perhaps they do not view one man's punishment as a deterrent to another's crimes. Other aspects of the kind of minimal social control operant will be discussed in the concluding chapter. Here it is to be stressed that there appear to be some very positive effects.

NOTES
1. "Particularism" refers to relations among people which are based on the unique aspects of the relationship. They are typically "functionally diffuse, " have affective components, extend over a long period of time. "Universalism'' describes role relationships which involve only the situationally pertinent characteristics, typically achieved ones, of the persons involved. Hereditary qualities are stressed in particularistic relations, performance and efficiency in universalistic ones (Benedict, 1967b in Benedict, ed. , 1967a).

2. "Formal" social control here is construed to be negative sanctions brought by the society or community as a whole, through its representatives, against perceived offenders. These representatives are the police force, judges, and jurymen. The offenders are likely to be persons who appear to be guilty of public rather than private offenses. "Informal" social control refers to those sanctions which are initiated by an individual acting on his own behalf or on the behalf of a small segment of the society, such as a family group. Informal social control can be exemplified by such actions as ostracism, physical attack, poisoning, magical retribution, etc. It may also lead to bringing personal suit or summoning the police--in these two instances, informal social control may generate formal sanctions.

3. It would not be advisable to give specific examples of this trend as the persons involved in any of the cases could be immediately recognized, there being great attention paid to the few Supreme Court cases each year.

CHAPTER THIRTEEN

CONCLUSIONS
The nature of British Honduran society with a few regional exceptions, most notably the Indian villages, produces low expectations about the behavior of others. People are occasionally surprised but almost never shocked by news of what someone has done. Few people will ever send money or valuables by any messenger, even a relative. If someone is hired to do repair work and declares a part or tool is needed, he will almost never be given the cash to procure the item for fear he will steal or spend the money. Money is never given in advance for any pre-arranged service or quantity of goods. One is advised to check boledo and lottery tickets to make sure the vendor has not sold outdated and hence useless ones. People will hide money and jewelry from their closest kin. A man will make sexual advances towards any woman whom he finds appealing almost regardless of her age or relationship to him. Obeah specialists are hired to harm persons who would hardly suspect the instigator of wishing them ill fortune. Many women expect to be beaten occasionally by their husbands whether their own conduct provides the provocation or not. Men, on the other hand, suspect their mates of adding odd ingredients to their food, reducing their potency by magical means, and poisoning them. Belizeans learn to live with casual insult and obscenity. It is generally not possible to maintain public facilities such as pay telephones, toilets and baths, playgrounds, drinking fountains, vending machines, recreational areas, etc. in Belize City because of vandalism. There everyone takes precautions against theft. Pet dogs are poisoned by envious neighbors, but only the 'pretty' ones. In Belize adults take advantage of children out alone, taking money, purchases, and jewelry from them.

It should be remembered that these are not occasional isolated incidents but rather well-established patterns of behavior which people must sensibly guard against, because, if anything unpleasant happens, they will be judged to have 'looked for it' by not preventing it. Here it might be emphasized that the general feeling is not that one should not have to endure such types of behavior but rather that one must learn to adjust to them and be prepared if prevention fails. The onus is on the individual to protect himself and not on others to desist from anti-social behavior. Problems of vandalism and unprovoked hostility are usually not serious in the districts although they are not unknown there. Belize City is 'the home of it, ' as people say, and, according to local opinion, it is getting worse.

The important point is that the populace, expecting really so little of each other, tolerates a great deal of deviant behavior. A problem here would be whether or not this behavior ought to be called "deviant" since it seems to be accepted. The vast majority of the population feel that overt anti-social behavior is wrong, and this is related to their valuation of personal freedom as a vital part of life. They feel that persons should be able to go about their business without being 'bothered.' They want to be left alone by strangers and not 'studied' by neighbors and acquaintances. They try to avoid arguments and confrontations and this is one reason they do not attempt to control anti-social behavior themselves--they fear the consequences as being worse. Also, as noted earlier, much of this behavior is directed against women and children who are often powerless to avenge personal insult or harm.

All of these factors make it possible for some individuals to take 'advantage" 1 of the rest of the population and conduct themselves as they please, unhampered by forces of social control. This results in high levels of deviant behavior which are probably more indicative of the reluctance of people to assert themselves than their acceptance or condoning of the behavior. They tolerate it but they do not approve of it. Even some types of deviant behavior such as theft and prostitution which are well integrated into ordinary life are still fundamentally thought to be wrong. People do not encourage their children to go into these professions and are disappointed when they do, even when they are profitable. Few families would accept the earnings of a prostitute or thief if there were any perceived alternatives; they would instead encourage the miscreant to reform and do all they could to help. That these people are not made outcasts is an expression of poverty and strong family ties and not ideas that it is permissible to steal or sell one's body. As additional evidence, British Hondurans do not volunteer this kind of information about each other-they are ashamed of it. I never heard people describe, even matter of-factly, a relative or friend as a 'whore' or 'thief' although this was not an uncommon situation. It is this kind of reaction which indicates that British Hondurans feel that these activities are morally wrong.

However, that these persons with essentially deviant roles are permitted to ply their trades, as it were, with little or no interference from the rest of society is instrumental in the recruitment of others. There is thus present at any given time a pool of deviant roles to be assumed. The presence of these unpunished deviants and available deviant roles tends to blur the distinctions between acceptable and unacceptable behavior. When a society does not consistently enforce its moral and behavioral codes by publicly castigating those who transgress them, a certain amount of "grey" area must occur between the black and white of the forbidden and the prescribed. 2 People will begin to feel that some kinds of deviant behavior are perhaps not quite so wrong as they had previously thought. They may engage in testing the codes by progressively more bold assaults on the shared ideals of behavior, seeking a societal reaction which will indicate how far afield they may go with immunity. This is particularly likely to happen if there are material rewards for deviant behavior or if they are self-satisfying kinds of activities. Thus thieves find that they can pilfer from ships debarking cargo and burglarize houses but they cannot rob banks. . This blurring and continual testing significantly lessens the preventative a and corrective power of normative expectations, which is not particularly strong initially. Behaviorists tell us that intermittent or random punishment is not effective in extinguishing behavior. This must be doubly so when the person has some difficulty even in perceiving which kinds of behavior might possibly produce punishment.

An example of this would be in the area of sexual relations with young women. Sixteen years is the age of consent in British Honduras and any man who has carnal knowledge of a girl younger than this is liable to a court-ordered marriage (if he is single) or a jail term. Yet most families do not prosecute men who have relations with underage girls in their supervision. They do not want to 'shame the girl' in court, especially if the man involved is married and there is no possibility of a wedding. As most of the time there are no negative sanctions for this kind of misconduct, it is freely engaged in, albeit somewhat discreetly, by men who have the opportunity and inclination. As the age of sixteen is not strictly maintained by the society as the lower limit for sexual activity in women, it is in practice lower, and men openly admire and covet thirteen-year-old girls, although few would seduce a girl under fifteen. Men in British Honduras show a definite preference for very young girls as sexual partners, and as they are usually interested in these girls not as r potential marriage partners but rather only brief romantic liaisons, the community might be expected to provide a measure of protection for impressionable and easily influenced teenage girls. It however does not; and these girls, bored by a restrictive and unexciting home life and fairly uninformed in matters of sex, are easy prey for experienced men who begin by escorting them to movie theaters, restaurants, and taking them for 'rides' and 'walks.' Girls may realize the personal consequences of their conduct but they are not future- oriented and can easily be fooled by older men about the possible repercussions of their behavior. They have neither moral nor practical guides in this situation for older females do not provide them with any, and they can observe that the larger society does not unduly penalize females who have illegitimate children. Thus, although social norms do not admit the propriety of sexual relations for young girls, enough latitude is allowed in this area generally to withhold negative sanctions from being directed at either the females themselves or the males involved. The situation is tolerated to a point where moral imperatives are practically irrelevant because the ideal, virginity at marriage, is so seldom achieved; and the burden of the practical effects, a high incidence of bastardy, rests.on the community and the girls' relatives. It has become an area of conduct where ethical considerations are confused and no moral values have coercive power.

When situations such as this prevail, and there are very many similar ones, it has a significant effect on the perception and recognition of psychiatric disorder because persons who are afflicted with a disorder which produces anti-social behavior will have to be extremely deviant to be thought of as sufficiently abnormal to warrant suspicion of craziness. This means that where there is much casual "liberation" of property or theft, kleptomania will not be considered a symptom of mental disturbance. If there are not strong sanctions against sexual relations with young adolescent girls, men with an interest in female children will not be considered "sick" and in need of treatment, for their interests do not deviate too sharply from what is tacitly expected. When people try to harm others by secret and supposedly undetectable means, paranoid behavior does not seem pathological. If people tolerate physical and verbal abuse from one another, then excessive hostility is only that, not an indication of psychiatric disorder. If men frequently drink to excess and engage in anti-social behavior with little responsibility for the ensuing consequences, alcoholism will not be thought a symptom of psychosis. Women who seriously neglect their children or who beat them cruelly will not be viewed as crazy if they are in a society which does not stress parental responsibility for the well-being of children. It is not, after all, the 'luck' of some children to survive.

In British Honduras deviant behavior alone is never evidence of mental illness. It must be accompanied by the kinds of extremely bizarre or peculiar behavior which are only appropriate for severely disturbed persons. The situation is such that anti-social behavior tends to mitigate the implications of even the bizarre as persons will assume that weird speech and gestures are perhaps only another manifestation of 'bad-mind.' A manifestly 'wicked' or evil person is never thought of as approaching or exhibiting any kind of psychiatric disorder as the local term, 'bad-mind, ' describes this particular defect of character and it is not at all related to being crazy and no extreme of bad-mindedness is ever viewed as even mild mental disturbance. This is much the opposite of the pattern found in the United States where there is a tendency to view great malevolence as psychosis, assuming that any person to be "that bad" must be mentally disturbed. Obviously these contrasting views present very divergent assumptions about human nature. British Hondurans see man as essentially imperfect and not as innately "good,." an idea which may be related to religious views of man as fallen and sinful. This attitude could also partly explain their low expectations with regard to each other's behavior but more likely the two are mutually reinforcing.

Bad-minded or wicked persons, such as those mentioned in Chapter Nine, are far from rare in British Honduras and if they are found to be a serious threat to society, they will be jailed for their crimes and not placed in the mental hospital. The policy in British Honduras is to use Seaview only as a place for the treatment and confinement of those with perceived psychiatric disorder. It does not function as a catch-all for the troublesome or disapproved elements of society. They are imprisoned or left at large. This is one reason why it is possible to have such low security at Seaview and why there are no "snake pit" associations with the hospital. People do not generally fear the patients or any crazy person because psychiatric disorder is not closely related conceptually to horrifying crimes. Quite the opposite, for in the local frame of reference, those are the crimes of sane people who rationally set out to perform evil acts or who perform them when they are under the influence of alcohol or drugs. British Hondurans feel that anyone in sufficient contact with reality to try to conceal a criminal act or hide the evidence of his or her own involvement in it is not crazy. Crazy people act as if they do not know what is going on, and they do things openly which show they do not evaluate their conduct in the same way other people would. If a person assaults another or destroys property and openly defends his actions as justified by a very wrong idea or a bizarre one, then he is obviously not partaking of the same social reality as his neighbors and relatives. However if he performs these actions or any others, shows signs of realizing that he has done a wrong thing and then either says he does not care or defends himself in the same way a sane person would, he is likely to be considered only a vicious person, not a crazy one.

Insanity in British Honduras then is a violation of the unspoken and unconsciously known norms of behavior and interaction, the most basic guides to conduct, many of which are enforced in most human societies. These generally are centered around the presentation of one's person and one's comportment in public places and in inter-personal relations. A sane person is expected to be properly clothed, recognize the existence of other persons, live among human beings, take a mate, speak the language coherently, make reasonable kinds of body movements and gestures, and eat what is culturally defined as food. If we are ever consciously instructed in these things, it is at such an early age that our understanding of them is complete during childhood. These are the norms which crazy persons violate in British Honduras, not abstract ethical rules or detailed legal guides. They do not behave themselves like members of a society of humans and for this reason they are taken away if they become an impediment to the normal social interaction of others or a danger to themselves. Most of the non-institutionalized cases of psychiatric disorder in British Honduras are of two broad types: those with a physical handicap which removes them from the category of "person" to begin with and those with intractably erroneous ideation. The former are not expected to approach even baseline normalcy and so are excused and discounted if they do not, and the latter are able to interact in a fairly normal manner except for the bizarre content of their conversation. Persons who are unable to consistently appear like socially defined persons are generally s kept in Seaview or very much at home.

This is in marked contrast to the situation now prevailing in the United States where "standards" for insanity are so vague and diffuse that it has been recently demonstrated that even the staff-from psychiatrist to ward attendant--of mental hospitals cannot well differentiate the sane from the insane. By admitting eight sane persons to different hospitals as "pseudopatients" who escaped detection by the staff, but interestingly not by the patients, Rosenhan dramatized the conclusion long ago reached by Scheff, Szasz, Edgerton, Sarbin, Goffman, and many others--that psychiatric diagnosis is hardly an exact science (Rosenhan, 1973:252). As mentioned in the introduction, most psychiatric diagnosis is done by lay persons, and psychiatrists tend to be able to find anyone insane once that person's sanity has been impugned. It is therefore possible and indeed probable that there are many currently hospitalized persons in the United States who are not, except in a very limited and special sense, mentally disturbed. In the United States there are so many kinds of illegal and improper behavior which can be construed as symptoms of psychiatric disorder that it is possible for there to be much disagreement, especially among professionals, as to a person's sanity. Why this is so is not, I believe, well understood by anyone. My research indicates that it may be due to the increasingly universalistic nature of American society and the large number of roles each person occupies simultaneously. This proliferation of roles makes it more likely that some behavior can be construed as inappropriate to one or more roles and hence "abnormal. " Or the behavior may be within the parameters allowed by other roles and perfectly all right.. This makes profound disagreement possible about the appropriateness of a person's behavior and hence his or her sanity. Importantly this rarely occurs in British Honduras as only those persons who consistently display the symptoms of a severely disassociated psychotic are judged insane. People occupy fewer roles and most of these tend to be ascriptive and more compatible than a diversity of achieved roles. Rosenhan's "pseudopatients" would have been spotted immediately in Seaview and would probably never have been admitted. The situation in British Honduras indicates that there it is feasible to institutionalize only the severest cases of psychiatric disorder, whether this severity is expressed in anti-social behavior or merely the very inappropriate. For the most part, institutionalization follows when the person is either perceived as a definite threat to the community and/or is manifestly unable to care for him- or herself. This has a number of effects in turn which influence the recognition of psychiatric disorder. Primarily it creates an atmosphere of tolerance which encourages the general public to deal with the recognized mentally ill much as they would with a non-stigmatized person whenever conditions permit. 3 As they see much behavior which is elsewhere thought to be clinically characteristic of mental disturbances, they learn to accept it in a matter-of-fact way and they do not have an irrational fear of mental patients as they know from personal experience that most of them are not dangerous or violent. This kind of acceptance of moderate to severe cases makes those with only mild afflictions much less visible than if virtually every recognized case of psychiatric disorder were hospitalized. Also, as has been stressed elsewhere, there are many persons who, although they could hardly escape commitment in the United States are not even viewed as crazy and they are not considered by either the authorities or their neighbors to require confinement. So there are two aspects of this toleration of clinically defined psychiatric disorders--the absolute tolerance of perceived craziness and the relative tolerance of it in forms which are not locally thought to be indicative of mental disturbance. Both are closely related to other aspects of the society, and are, in a sense, the logical products of 1 their general assessment of human nature and the way things ought to be. For in any discussion of mental illness, it must be remembered that the imputation of mental illness is equivalent to a negative definition of the proper human state. The more exacting standards a society sets, the more likely it will be to have a high rate of mental illness simply because its definition of mental health will allow for little deviation. British Honduran society is not now so complex that each person must always function in terms of a multiplicity of tightly interlocking roles. There is still room for persons whose behavior is appropriate for no one except an eccentric or local "character. " This, coupled with their high regard for personal freedom and desire not to be involved in another's business, makes them unlikely to call for a psychiatrist the moment a person acts out the consequences of having ideas which differ from those of the other members of the society. Neither do they believe human beings to be so innately good that persons must be mentally unbalanced to perform bad acts. They rather think that he or she is a bad person. This is certainly not a simplistic view and is, in some respects, more sophisticated than a unified view of all humanity. It is a realistic one and eventually produces situations where persons may be condemned for the wrongness of their acts rather than the malfunction of their mental processes. This is a straight-forward moral judgment and one more likely to have a reinforcing and deterrent effect than the kinds which are indirectly made and treat every human failing as a "sickness" of some sort which needs medical care. If, as some sociologists have theorized, deviant behavior is necessary and serves positive functions in a society (those of marking out the outside limits of behavior), then these functions will be enhanced by morally-based reprisals. A person who had done wrong can suffer remorse, may be made an example to the community, it is possible to punish him, and he may be rehabilitated. However a "sick" person no longer must suffer the pangs of conscience and can hardly be put in the stocks to illustrate publicly the consequences of breaking the rules of society. He cannot redeem himself or make expiation for his sins. He, in the medical metaphor, can only be treated and perhaps cured. This is a strange fate indeed for those who were originally singled out for wrong conduct, often in a moral sense. British Hondurans clearly make the distinction between a morally wrong act and a very peculiar one, according to local criteria, and the societal reaction to either of these two classes of abnormal behavior is conceptually consistent.

There are many ways in which abnormal behavior may be handled in a society. It can be ignored, or abnormal persons may be killed or exiled. The requirements for survival may be so rigid that only the normally functioning can survive, and in this instance the problem takes care of itself. Abnormal persons may be summarily taken into custody and forever isolated from society. It is possible to punish them or they may be resocialized into normalcy. They may be treated as sick persons and put into hospitals. They could be permanently marked and always treated as pariahs. Some of these methods are only possible in large and complex societies, others would be workable in small-scale groups. So there is a measure of organizational appropriateness in the solution of the problem of abnormal behavior aside from the collective wishes of the society. In British Honduras people feel that a person with incapacitating psychiatric disorder should be cared for by the government and that others less severely affected should be allowed to lead lives in as ordinary a manner as possible, depending, if necessary, on the goodwill of the community and the largesse of their relatives. They thus indicate a willingness to tolerate odd behavior from other people to the point where it becomes annoying and offensive, and occasionally more serious than that. However this toleration has its own rewards in those culturally defined situations which allow even ordinary persons, most especially men, to indulge in unseemly behavior with virtual immunity from negative sanctions. Thus, British Hondurans, in more ordinary terms, get what they want, and also deserve what they get.

NOTES
1. This is precisely the term used locally, only there it is used as a noun or transitive verb.

2. This is part of the positive effects of deviant behavior--a limited amount of it, properly punished, keeps the "grey" area minimal.

3. This avoids the rejection syndrome described by Scheff (1966) in which a person's first odd behavior may precipitate mild ostracism and feelings of rejection which may intensify his mental problems and make him more likely to act oddly again, ad infinitum.

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