Ritual care: how the Akha take care of their small kids? Cuidado ritual: como os Akha cuidam das suas crianças?

This article draws on long-term fieldwork materials to explore a cosmological approach to the process of childcare among the Akha, an ethnic minority community in southwest of China. The article introduces the Akha definition of childhood in relation to their cosmology, showing how cosmological forces are vital to a child’s survival and health, and how this perception shapes villagers’ childcare practices. Children are viewed as creatures of both the human world and the ghost world, and human parents have to fight with ghosts to protect the life of their children. Two pairs of gods and goddesses of children pose additional threats to children’s survival and health, but they also bestow blessings and protection at ritual and daily occasions. Meanwhile, because children are born with souls, they might fall sick if their


Introduction
When I first saw an Akha grandfather offering his cigarette lighter as a toy to his infant grandson, who then put the lighter in his mouth to bite it, I was shocked and could not stop myself from snatching the cigarette lighter from the child.I was also shocked when a four-year-old boy happily picked up and played with a dead rat from the roadside, while the adults around him showed little concern.This was the summer of 2012, and I was a young and inexperienced Chinese Anthropology student who grew up in a Han-dominated area and was based at the Max Planck Institute for Social Anthropology in Germany.Back then, I could not help but feel confused and somewhat astonished by some of the Akha childcare practices.My experience was not entirely different from Western anthropologists such as Charles Stafford who while doing fieldwork with Han Chinese in rural Taiwan in the late 1980s was struck by the extent to which very young children as crianças nascem com alma, elas podem adoecer se suas almas ficarem assustadas.Finalmente, existem dois seres hostis associados a grupos étnicos vizinhos que causam doenças, ou mesmo a morte, a crianças vulneráveis.Para proteger as crianças de todas estas múltiplas forças cosmológicas que ameaçam a vida, os Akha desenvolveram várias práticas rituais de cuidado, tais como atos diários de cuidado, talismãs protetores e rituais de cura.Estas práticas destinam-se a lidar com forças cosmológicas e, como tal, transcendem dimensões mais seculares do cuidado corporal e emocional (incluindo formas biomedicalizadas de cuidado), ampliando assim o significado e o alcance daquilo que se entende convencionalmente como incluído no trabalho de cuidado por parte de cientistas sociais e profissionais médicos que abordam o assunto com um paradigma estritamente secular.
Palavras-chave: Crianças; saúde; cuidado ritual; cosmologia; inseguranças.souls are scared away.Finally, there are two hostile beings associated with neighbouring ethnic groups that cause disease, or even death, to vulnerable children.To protect children from all these multiple life-threatening cosmological forces, Akha villagers have developed several ritual care practices such as daily caring acts, protective talisman, and healing rituals.These practices are meant to deal with cosmological forces, and as such, they transcend more secular dimensions of bodily and emotional care (including biomedicalized forms of care), thus broadening the meaning and the scope of what is conventionally understood to be included in the work of care by social scientists and medical professionals who approach the subject with a strictly secular paradigm.Keywords: Children; health; ritual care; cosmology; insecurities.
were allowed to play with firecrackers and to wander into the street in the middle of motorcycle traffic (Stafford, 1995: 21).My feelings in 2012 echoed those of Charles Stafford almost thirty years earlier: «there seems to be a lack of concern about child safety» (Stafford, 1995: 21).
This feeling quicky dissolved when I started to notice that Akha parents and grandparents were concerned about their children's safety and health in a different way.On one occasion, my host family's little girl kept crying and demanding for a chance to visit the county seat with me, but her family did not allow her to go.I thought they did not want me to have to worry about taking care of the girl, or perhaps that they thought I was too young and inexperienced, so I repeatedly assured them that it would be my pleasure to take her with me and I promised to look after her.Eventually she joined me on my trip, but when we returned to the village, her grandfather immediately tied a thread around her wrist and gave her a boiled egg.He explained to me that he needed to call back the little girl's souls from the county seat, lest she fall sick if her souls remained there.That had not been the only peril of the trip to town: another villager later told me that the girl's family had been reluctant to allow her to go to the county seat because there are hostile nonhuman beings hidden in the crowds and these beings can damage a child's health.
These stories of threats to children's safety and health and the corresponding care practices form the starting point of my research on Akha kinship and childcare practices (Wang, 2019;2021).Taking seriously the Akha perception of cosmological threats to children's safety and health requires broadening our understanding of notions of care, health, and well-being.More specifically, it requires looking at childcare from a more holistic perspective that situates children in relation to larger cosmological framings and ritual procedures aimed at securing their survival as well as their health and well-being.
The article will proceed as follows.I first engage with the theoretical discussions of care, children and insecurity.I then introduce the Akha definition of a child in relation to their cosmology, examine how various cosmological forces are seen to be connected to children's survival and health, and how this connection shapes villagers' childcare practices.Finally, I discuss the meaning of ritual care and I reflect on the larger anthropological significance of Akha ritual care practices.
The research presented here is based on long-term field research conducted in an Akha community in Yunnan Province.The Akha are a transnational ethnic group spread throughout Yunnan and Southeast Asian countries like Myanmar, Vietnam, Thailand, and Laos, comprising a population of about 650,000 in total (Yang and Yu, 2010).The group in China, also named as Yani or Aini, is mostly settled in Xishuangbanna Prefecture, Lancang County and Menglian County in Pu'er Prefecture.I conducted fieldwork between July 2012 and September 2013 (Wang, 2019) among a cluster of Akha villages located in Menglian, a multiethnic county on the border between China and Myanmar.There are 41 Akha villages with a registered population of 9,585 (2010) in Menglian, spreading over highland and, in some cases, valley areas.I spent most of my time in a hill village called Hakaq and in a valley village called Kekaq.In the summer of 2017, I revisited Hakaq and Kekaq, staying for over two weeks catching up on the latest changes. 1oth Hakaq and Kekaq are mediumsized villages by Akha standards, with respectively twenty-nine households of four patrilineal lineages and twenty-three households of five lineages.Each has a registered population of over one hundred people.Their resident population is often much less, changing along with the number of those migrating to cities.People staying in the village mainly include: the old, the married, children, and a small number of young people who are not attracted by the outside world.These villages had historically developed a mixed agricultural subsistence, combined farming, gardening, raising livestock, hunting, fishing, gathering, handcrafting, and trading.Thanks to state-run projects to reduce poverty and the increase market need in recent decades, various cash crops, such as corn, sugar cane, tea, and coffee, have gradually becoming their most significant way to make money.
Despite their deep engagement with the outside world, Hakaq is often considered 'conservative' by its own people due to the slow speed of cultural change there.There are more than twenty elders who are professed to hold traditional knowledge, and they mostly to adhere to the Ahka li (SC.礼), the traditions that define the Akha way of life.By contrast, Kekaq is considered to be a 'young' village because there are fewer elders, and they are much younger than those in Hakaq.They tend to make relatively aggressive changes in terms of their living environment, dressing style, livelihood, marriage, etc.Following the networks and contacts of these two villages, I also paid short visits to other Akha villages in neighbouring areas.These villages are all connected through ties derived from the Akha patrilineal descent system and/or though ties derived from the Akha asymmetric alliance system.The two villages have been living according to the Akha li, albeit adapting the Akha li to natural and social changes at a different pace.
All villagers speak Akha, a tonal language of the Sino-Tibetan family spoken by groups in Yunnan, eastern Myanmar, northern Laos, and northern Thailand.In recent centuries, the Akha of Menglian have maintained close ties with their ethnic Wa, Lahu, and Dai neighbours, which means that most elderly people in and around Hakaq and Kekaq are able to speak these languages, albeit imperfectly.
Younger people also know these languages, yet they are far less proficient in them.They speak the Yunnan dialect of Chinese much better than the elderly.During my stay, I learned some Akha, but the language I used most, especially in interviews, was the Yunnan dialect of Chinese.
During my field research, I participated in the daily and ritual life of households, particularly as it concerned small children, in order to observe their childcare practices.I started in-depth work with my host family from morning to night, having meals with them, going to the fields along with whoever was taking care of their child, weeding, harvesting rice, corn, coffee or cotton with them, recording the interactions between the child and adults.The same pattern was also applied in other households with children.I conducted formal interviews with elderly people knowledgeable about Akha cosmology, kinship systems, and ideas about children, etc.I also informally interviewed youngsters about their personal experiences and opinions and what they knew about Akha traditions and general social life.Except for some of the timid ones, most villagers were willing to share their ideas and experiences.

Care, children and insecurity
This article will illustrate the cosmological approach to Akha materials, but before proceeding to the ethnographic discussion, I would like to situate my approach in a larger field of cosmology-fo-cused theoretical discussions of children and childcare in anthropology.
Care is well-known as essential to the elderly, the sick, the handicapped and children, and has come under widespread academic attention.As Tatjana Thelen (2015) summarises, scholars such as neo-Marxists, feminists, experts in disability studies and social security studies, and anthropologists specialised in kinship and exchange research have all made contributions to our understanding of care.Their debates over care involve various aspects of life, such as the public state, the private market, the intimate family and other close personal relations.They also shed light on the emotional side of care, which gives rise to love and affection, and good or bad feelings flowing through the process of care practices.Unlike those Thelen considers, she herself insists that care practices should be taken as the central element of social organization.Her statement brings us back to one fundamental question: what practices could be counted as care?
Medical anthropologists like Arthur Kleinman (2015: 240) and Annemarie Mol (2008: 1) both agree that caring acts are often centred on physical acts such as curing, dressing, feeding, lifting, touching, toileting, washing, and so on.Childcare undoubtedly engages with all these kinds of caring acts.However, taking care of children is far from a purely physical business, but is embedded as well within a broader cosmological world.
The concern for the physical survival and health of children is identified by Robert LeVine (1977: 20) as the first universal goal of child-rearing which parents strive to fulfil, and the most fundamental priority; it is a prerequisite to all other goals.Yet there are significant cross-cultural variations in childrearing practices.Comparing ethnographic materials drawn from different contexts, anthropologist Heather Montgomery (2009) shows some of these cross-cultural variations, while drawing attention to the linkages between childhood and personhood, and in particular the special relation between children and spirits.David Lancy (2014) explores this cosmological approach in more depth.Lancy reviews over 200 ethnographic and archaeological accounts of infancy to conclude that in most societies infants are believed to be suspended between the human world and the world of spirits, ghosts, ancestors, and gods, and are thought to have no intention of becoming fully human.Infants' essence as part human and part spirit underscores their vulnerability, and this vulnerability helps understand why various kinds of ritual activities need to be performed to protect infants.In societies holding these two-world models, illness in infants is seen to be caused by the separation of the body from the soul or by the invasion of evil spirits.Accordingly, caregivers often turn to supernatural forces for the corresponding remedies.For these reasons, Lancy makes the case that anthropologists should place children and childcare in a larger cosmological context, where invisible nonhuman beings such as spirits, ancestors, ghosts, gods, and souls exist and act.
Health-threatening insecurities from the cosmological world also have been demonstrated in numerous ethnographies written from the perspective of both medical anthropology and the anthropology of religion, which overlap in their concern for exploring the causes of illness and death.A rationale for this overlapping interest can be traced at least to the 1920s.In his famous book Medicine, Magic andReligion, William Hallam Rivers (2001[1924]: 7-22), one of the founding figures of medical anthropology, analysed the widespread nature of belief systems attributing human and supernatural causes to illness.Forrest Clements (1932) further specified these supernatural causes of illness as sorcery, breach of tapu (taboo), disease-object intrusion, spirit intrusion and soul loss.By giving an extension table showing tribes or regions of the world and the distribution among them of these five categories, Clements concluded that supernatural forces are universally believed to pose threats to people's health.
These concerns with health-threatening cosmological insecurities are very salient in the ethnography of the Akha living in the highlands of Southeast Asia, who also perceive their cosmological world as a cause of illness (Lewis, 1969;Goodman, 1996;Mansfield, 2000).This cosmological perspective is also very salient among the Akha minority communities in Southwest China (Zhang and Zhang, 2011;Wang, 2019;2021), and is shared by many neighbouring ethnic minorities such as the Dai (He, 2006) and the Lahu (Ma, 2013).Cosmological beings such as gods, spirits, ghosts, ancestors, and so on, are not just sources of insecurity, they are also sources of protection and blessing -the divine favour -mainly associated with prosperity, fertility, and security (Du, 1996).In a word, when doing research among the Akha on matters of health care including childcare, it is practically impossible to overlook the question of cosmological insecurities caused by nonhuman actors on the one hand, and their protective effects on the other.
In this article, I follow Lancy, among others, in my approach to childcare as a sociotechnical system that involves multiple actors including multiple invisible non-human actors operating within a larger social and cosmological environment (see for example Gottlieb, 2004;Topley, 2011;Gottlieb and DeLoache, 2017;Santos, 2017;2021).If people perceive ritualistic protection and blessing as a favour that improves their health and security, it should be counted as a type of "care".I refer to it as 'ritual care' .Differing from those secular caring acts like feeding or washing, ritual care refers to caring acts that engage with cosmological forces, such as healing rituals, talisman, amulets, and other protective devices or activities.When parents or grandparents draw on these religious resources to ensure their children's survival and health, they are providing ritual care.
The importance of ritual care has been widely documented by religious and medical anthropologists working in a wide range of contexts, but it is less prominent in ethnographies of affluent modern societies shaped by secular cosmologies.This article seeks to contribute to studies of childcare by exploring the cosmological aspects of care practices and calling for a rethinking of secular approaches to insecurity and care (see for example Topley, 2011).

Children in Akha cosmology: creatures of two worlds
Children are often not only a member in a family in this world but are born into two worlds.This is the case with the Akha.The term "children" (zaq 2 ), in the Akha community, refers to people under the age of fifteen.Before this age, people are taken as half-human and half-naevq; they have not yet "become a person" (SC.chengren, 成人).According to the Akha's best-known myth, the supreme god Apeimiye is the creator of the world.He 2 All local expressions are cited in the Akha language except where marked with SC for standard Chinese or Putonghua as spoken by Akha people in Yunnan province.The orthography used to transcribe Akha terms in this article follows the most recent romanization system developed in December 2008 by Akha scholars from China, Thailand, Myanmar and Laos, a system that is becoming increasingly popular in these countries.The Yunnan dialect of standard Chinese spoken by Akha people is transcribed in the official Pinyin system in the article along with the corresponding Chinese characters.created Tsawrhaq (meaning "human"), the ancestor of all human beings, and Tsawrhaq has a cosmological brother called Naevq, meaning "ghost". 3Tsawrhaq and Naevq share one mother called Tanqpanq Aqma.After their mother died, everything was divided between these two brothers, and henceforth that which was "good" belonged to Tsawrhaq while the rest, the "not good", went to Naevq.Eventually, the pattern of the divided but paired worlds between Tsawrhaq and Naevq was formed.The world of Tsawrhaq and his offspring ("the human world") is separated from the world of Naevq and his offspring ("the ghost world").When humans do something wrong to naevq4 or when naevq comes into human territory, various forms of harm can result leading to destructive effects on human lives and property.Thus, the Akha people carefully maintain the boundary between human and naevq by employing a variety of rituals and taboos.
Since children are taken to be halfhuman and half-naevq, humans have to fight with naevq to keep their children in the human world.The first step to protect children is to give children a name before naevq do.Hence, paternal grandparents always think of names for their future grandchildren as soon as they 3 I translate "naevq" as "ghost" because villagers often translate "naevq" as "ghost", but the word "ghost" here does not refer to the ghost of dead people as is the case in Han Chinese popular religion.learn of the pregnancy.When a child is born, grandparents, mostly grandmothers, or midwives5 , immediately give the baby a name.If they fail to do so, naevq will name the child and take it away, that is, the child will die.Here a name equals an identity: infants named by humans are accepted as human children.Since 2013 villagers have been obliged to give birth in hospital instead of at home by the local government; the Akha grandmothers or midwives usually accompany the delivery women to hospital so that they can name the newborns in time.If the Akha refuse to name an infant, they basically refuse to take it as a human.This is what happens with abnormal births of twins and deformed infants who were traditionally killed at birth (Wang, 2021).Nor are aborted foetuses or stillbirths named; and even a live birth that dies before being named is not given a name subsequently.All such infants are excluded from the village cemetery.Generally, they are buried in the wilderness.By contrast, named infants, no matter how long they have lived, all qualify for a proper funeral.
The second thing that needs to be done to keep children safe is to avoid scolding children as naevqzaq ("ghost children").This stands in stark contrast with Han Chinese cultural practices in rural areas.For example, Han Chinese parents in rural Taiwan often call their children "little ghosts" (SC.Xiaogui, 小鬼) (Stafford, 1995: 54).This would not be possible in the Akha cultural context.The specialist in rituals Aqbawr Pu repeatedly highlighted this taboo: We must not say that any child under fifteen is like a naevq.It is forbidden to say anything related to naevq.We definitely cannot say that.Unreasonable people might say it does not matter.However, parents should never scold their own children saying, "Are you a naevq child?Are you trying to be sneaky like a naevq?"Don't say such things!We Akha parents absolutely do not scold our children like this!As Aqbawr Pu explained, such scolding will make naevq think that parents do not want their children, and they will take the children away.Adults are not endangered by comparison with naevq in the same way.For example, Akha husbands normally scold their wives as naevq women (naevqmiza) or wild women (yasaqstawhaq), because in a myth Akha's first wife came from the wild and was considered naevq.Aqbawr Pu was pretty sure about this, "Only the Akha scold their wives in this way, other ethnic groups do not.
Wherever the Akha come from, they all scold wives like this!I know it!".
But children are vulnerable in ways that adults are not.Similarly, one should never scold children under age of thirteen with bad words, such as "dumb", "stupid", or "insane", lest they develop accordingly.A child who is often told s/he is stupid will become a stupid person.Here too, it is naevq at fault: "words are followed by naevq" ("do maenmr naevq cawr"), to quote an Akha adage; they are able to hear when humans scold a child.Naevq take the scolds seriously and make things happen according to what a human says.Thus, a simple scolding becomes a curse that may well come true.
Though all agree that it is better not to scold children, it is sometimes necessary.Children deserve a lesson when they behave improperly, upsetting adults, and adults need to give vent to their anger.So, the Akha scold their children with a very limited vocabulary.Akha people, no matter whether old or young, parents or not, mostly scold children with the one word, "zaq (child)!"If they are annoyed, upset, or disgusted by a child or an adult from a younger generation, they say, "ah zaq ah (ah, child)"; or if they are strongly annoyed, "ahmamamama zaq ah" (ah, you child), or "tsawrhaq zaq ah" (ah, human child).Other reproaches to small children include ma lya (not well-behaved) and ma tinghua6 (SC.不听话) (not listening to words, disobedient).Seen as a whole, the various expressions used by adults to scold their children have nothing to do with naevq or other nonhuman beings.Moreover, the expressions do not question the child's human nature.Their focus is on practical matters, and this implies that the child is a human (not a naevq) child and that he or she has merely done something wrong.
At the same time as keeping children separate from naevq, the Akha parents have to deal with the gods in order to secure their children's well-being.

The gods and goddesses of birth and of children
Everything, including human and naevq, has its own spirit or god called yasanq.Yasanq are omnipresent.Once wronged by people, a yasanq will cause pain and illness which can only be healed by ritual sacrifice.In this cosmological system, there are two pairs of deities who oversee pregnancy, birth, and children, Zaqghen Zaqsan and Ghesan Gheje.These two gods and two goddesses take care of children from the moment they are conceived until the age of fifteen.
Zaqghen Zaqsan are the goddesses who make pregnancy happen by putting children into women's bellies.When a woman gives birth, Zaqghen Zaqsan stay around and take care of them.Because of their presence, the woman's mother and other members of her natal family are forbidden to come and stay with her.If they do, the woman will be unable to deliver the child smoothly, or she will suffer more pain and the baby will cry more.This rule is strictly observed, even as women are now required to give birth in hospitals.In one case, a woman suffered a lot when giving birth to her son in the hospital.The doctor told her that "there was a bone in her cervix, and the excessive amniotic fluid could choke the baby".Thus, the doctor proposed a Caesarean section.During this process, her husband's family was with her, waiting outside the delivery room, while her natal family members did not show up at all.Her mother was worried a lot, but also was afraid that her presence would make the labouring daughter and the newborn baby suffer more.Therefore, she waited at home and only went to visit her daughter the next morning.
Zaqghen Zaqsan continue to protect children after birth.Aqbawr Pu claimed that because of their protection, children will not be injured even if they fall off of a balcony, which is normally two metres off the ground."Nothing will happen!" he said."Try it if you do not believe it!Nothing will happen if children fall off![But] just imagine what will happen to our old men if they fall off of the balcony?[The children are not hurt] because Zaqghen Zaqsan are protecting them!"Indeed, while I was in the field a one-year-old baby boy did fall to the ground from an unfenced balcony and received only a bump on the head.However, the grandfather soon built a bamboo fence around the balcony to guard the little boy from future falls.But in most cases, adults paid little attention to toddlers playing on unfenced balconies, even if they were standing right at the edge.Many times, I became very anxious in seeing small kids playing or urinating at the edge of a fully open balcony.I was always worried by what I saw as dangerous situations, but Akha adults expressed no concern.They just replied casually when I reported the event to them, "Oh, let it be".
Due to the protection and care from the goddesses, Akha parents are forbidden to call their children's real names in the first year, or to teach them to walk, or to sing them traditional lullabies.These tasks are generally taken up by grandparents.The deities are upset when the parents undertake such tasks, but they do not mind if grandparents train infants to walk or sing them lullabies.Somehow, I was not satisfied with the explanation of why parents should not do these things, but the only answer I received was that the goddess would be upset.I kept asking why they would be unhappy and what would happen, but villagers just burst into laughter and replied, "upset is upset".Though they failed to give me a "sensible" answer, in practice they strictly followed these rules, even young parents who had been educated in school, travelled to big cities, and worked in them for years.
Ghesan Gheje are a pair of gods in charge of children's wellbeing.They look after young children, from birth to fifteen years of age, but especially children under the age of ten.Children's health depends on the favour of these two gods.Aqbawr Pu firmly stated, "Nothing will happen to children unless Ghesan Gheje do harm to them!"I was confused: "They are the gods of children, so why would they harm children?"He insisted, "It is impossible for them not to harm children!" Being aware that I was unlikely to get a direct answer to the question "why", as it had occurred many times before, I had to switch the focus to "How do they harm children?"Using this question, I collected massive amounts of data.
Ghesan Gheje can claim children's lives if they think parents are raising them in an improper way.More often, Ghesan Gheje cause various sicknesses in children.Some, like ghedm, may be fatal.This is a serious disease that makes children moan, and when it becomes fatal, it also involves nosebleeds.Other illnesses manifest with various levels of severity.Ghemula refers to pains in the body shared by both children and mothers.Ghewawdzaw involves needle-like pain.Gheke is a trachea problem; ghepije refers to diarrhoea and breathing troubles.Ghelaba results when the souls of a woman are scared away during her pregnancy or labour.
Although they cause sickness, Ghesan Gheje are healers.They withdraw harm from children when they are satisfied with the animal sacrifices made to them.On this point, Aqbawr Pu gave me a very clear answer, "Only Ghesan Gheje can heal sick children, even if they have problems with the inner organs, like heart, liver or lung.
If they do not care about you, you will not be cured." I curiously asked, "How about going to a hospital to buy some Western medicine?Does it help?"His answer did not change, "Western medicine is useless except for diminishing inflammation.For children, injections and medicine do not help if Ghesan Gheje do not take care of them." Here it should be noted that villagers never completely rely on healing rituals for children's health problems.In fact, they draw on a variety of medical resources, strategizing according to situations and needs.In addition to healing rituals, Akha parents may rely on official biomedical resources from local clinics and hospitals, just as they may seek the use of other traditional medical techniques such as herbs.
Preterm infants often need a healing ritual to survive.As Aqbawr Pu said, "Sometimes a child has an incomplete heart, which is determined by Ghesan Gheje.Preterm infants, those who are born at the seventh or eighth month, always have this problem, an incomplete heart.But you have to protect them well, hold proper rituals for them, and their hearts will gradually grow completely.If you properly perform rituals, which work on Ghesan Gheje, their hearts will be fine." He kept citing an example to me: "Aqzawr Ju's sister was born in the seventh month.The elders all said that she was too tiny to survive.Thirteen days after her birth, her family asked a nyirpaq 7 , also a relative, for a diagnosis, and it turned out to be caused by Ghesan Gheje.At that time, we were in the cooperatives, and all ritual performances were forbidden.However, Aqbawr Ge, a pima master, was working at the village office.He was also a barefoot doctor.He secretly performed the ritual for her.It was done secretly, so that the girl survived and grew up." 7 Nyirpaq is a shaman-like figure in the Akha community.They have the ability to see through the spiritual world, thus can find out the spiritual cause of sickness.
Generally, if parents notice their children often feeling uncomfortable, having no appetite, and becoming thinner and weaker, they turn to experts in ritual for a diagnosis.Sometimes, they turn to healing rituals if western medicine and herbs proved ineffective.During fieldwork, I recorded six cases of sickness attributed to Ghesan Gheje.Three of the afflicted children were girls and three were boys.Two were one-year-old infants, one was a two-year-old toddler, two were threeyear-old toddlers, and one was a fifteenyear-old teenager.Smaller children mainly suffered from long-lasting colds and diarrhoea that western medicine failed to cure.However, the full range of their different symptoms were discovered by ritual experts to originate in the imprisonment of their souls by Ghesan Gheje, or by the covering of their eyes or blocking of their throats -all by Ghesan Gheje.The teenage girl had a belly pain which could not be identified in the hospital.She told me that she went to the hospital several times, but doctors failed to find the cause of her pain.Then her family asked Aqbawr Pu for his diagnosis; he said something which the girl did not understand.At last, the healing ritual to Ghesanq Gheje was to performed for her.
Though powerful, these gods and goddesses of children by no means solve all the health problems of children.Children's souls also need to be treated carefully.

Souls that cannot be lost
It is one of the fundamental beliefs in the Akha community that beings have souls (savqlavr sulavr).Human, animals, and plants all have souls.Humans possess souls as soon as they are born.There is no chance at all for newborn babies to survive if they do not have souls.Thus, Akha villagers always welcome every newborn by repeating the same sentence, "savqlavr sulavr ta baq dey".The phrase means "souls, do not go away to the other world, please come back quickly!" or "souls, do not be scared away".This is a good wish, asking the souls of newborns to stay with the owner.
Souls of living people seem powerless: they are incapable of doing any good or bad to other beings, and they are unable to protect themselves on their own.But they often turn out to be victims of other cosmological beings.Gods, spirits and even ancestors often imprison them, block their throats, cover their eyes, etc., so as to ask for a sacrifice from the human world.They are very timid, easily scared away from their owners by fearful beings, accidents, and events, such as thunder, fights, and attacks.They are also childish, always attracted to nice things and places.Once attracted, they forget to accompany their owners, and rather stay wherever fascinates them, wander around in the fields, hide underground, or stay in the water, and eventually get lost.In each situation, the loss of the soul always causes pain and sickness to the souls' owner.Thanks to the easy virtue of souls, people can easily hold onto them by offering nice things, for example, a boiled egg.Even if souls have already gone away, it is still possible to call them back via sacrificial rituals at different levels.
Children's souls, in particular, are weaker than others.They are too vulnerable to resist any frightening or attractive distractions.Hence, Akha people pay great attention to keeping souls together with their children, especially during short or long journeys, to other villages, to the hospital, or to the county seat.If children, along with their parents, visit their relatives in another village, they always receive many boiled eggs before they go back home.Parents would feed their children an egg at the moment of leaving, to ensure that their children's souls return with them.When crossing a river on the way, picking a pebble from the river is a very efficacious way to keep souls of children with their owners.When passing by a market, buying a small gift, such as a mirror, is sufficient to lure souls back home.Traditionally, Akha children were hardly ever brought to markets in town until the age of thirteen.When they reached thirteen, their parents would take them to town and buy a valuable gift for them.After coming back home, parents were required to kill a chicken to call their souls back.Due to the socioeconomic development in the local society, villagers as well as their children have started to visit markets more frequently than before.Nowadays, villagers have lowered the age limit to one year, while still performing the same ritual of calling souls back after children's first visit to town.Similarly, if children go to hospital for health problems, ritualistically calling souls back is also necessary.Otherwise, their souls might stay in the street or in the hospital.
As a knowledgeable elder Aqbawr Gu mentioned, souls can be scared away by something horrible, such as fighting or killing.He further explained that "You will know if your souls go away when you are dreaming.If you are scared somewhere and you dream of that place at night, it means your souls stay there…Souls will run away when they are terribly frightened, but they still stay with you when only slightly scared." Aqbawr Bu posed a simpler version of soul-loss: "you lose a soul each time you are scared".In reality, there is no clear-cut measure of fear levels, but I found that the seriousness of the situation could be distinguished through the treatment of each case.The lowest level is where there is possibility that one's souls might be frightened away.For example, during the Swing Festival in August, villagers play on a swing over ten metres high.As they sit or stand on the swing, they shout aloud, "Souls come back" (salasula wo la ley) before swinging.That is because the swing is so high that souls might be afraid, so it is better to call them in advance.
When something terrible really occurs, the minimum form of treatment is to give the victim a boiled egg in his or her right palm, then for any nearby elder to tie a thread around the victim's right wrist.The boiled egg is to lure souls back; the thread serves to reel them in and tie them to the victim.Its purpose is, first, to tie a person's souls to the body so as to maintain the person's health; second, the thread warns naevq-ghosts that a person is a member of the human world whom they should not harm.Ultimately, to tie a thread is to protect a person from the cosmological beings who cause illness and pain.The colour of thread could be dark blue, black or white, according to the targets of rites, the seriousness of the sickness, and seasons of the year.This is a very common situation in the Akha's everyday life.In one case, a five-yearold girl in Kekaq village, accidently fell from a rubbish tank when playing with her peers and cried out, which caused her grandfather to believe that her souls had been scared away.He immediately tied a thread around her wrist to ensure that her souls didn't leave her.In another case, a three-year-old girl in Hakaq village witnessed her drunk father beating up her mother, an incident of horrible domestic violence that terrified her.She slept with her grandmother at night and screamed with bad dreams.When I saw her the next morning she was in her grandmother's arms.Her eyes were still full of panic.Her grandmother put a boiled egg in her right hand, and tied a thread around her wrist explaining that, "Dad fighting with mom frightens the little girl.Souls don't be scared away!Grandma is here, grandpa is also here.Souls don't be scared away!"If something worse happens, then a ritual called lakuku (calling souls back) is necessary.The ritual is a specialised one utilizing soul-calling chants, normally conducted by an elder.I encountered several such cases in the field.In the first case, a three-year-old girl, who suddenly behaved abnormally on a rainy day, was believed to be enchanted by a hostile being called lapya.Fortunately, Aqbawr Gu successfully drove the lapya out of the girl.After the healing, Aqbawr Gu was invited to perform a lakuku for her.During the ritual, he explained to me that the souls of the girl were scared away since lapya had invaded her body, thus it was necessary to call them back.In the second case, a teenage girl had a long-lasting fear of thunder, and she was also too timid to stay at home alone on windy days.Once, it thundered when she was on the way to the fields, and she was so scared that she instantly fell down on her knees and started crying.Hence, her parents invited an elder to perform a lakuku to call her souls back.
Despite the apparent invisibility of these various nonhuman entities, their existence and influence remain real to Akha emotions and childcare practices.In addition to these various cosmological forces, there are two other powerful entities.Unlike gods or ghosts, these cosmological entities are connected to human beings, but possess ghost-like evil powers that are capable of harming the most vulnerable, particularly children.

Piser and Lapya: hostile beings to small children
Piser and lapya are the best-known hostile beings threatening people's lives, sometimes causing death.In official Chinese language (Putonghua), piser and lapya are given the same name, pipa gui (SC.琵琶鬼), a kind of ghost.The fear of pipa gui is shared by most ethnic groups in Menglian.Most documented cases of pipa gui all come from the Dai community (Wang, 1998;Zhao, 2010;Liu, 2013), but they can be found in most local ethnic groups, including the Akha, Lahu, Wa, Dai, and Han.
Akha villagers believe that the Lahu are the group with the most piser because piser are indispensable in founding a Lahu village.For this reason, it is said that there is at least one piser in every Lahu village.The Han are seen to be the group with the second highest number of piser.As to the Wa and the Dai, they are said to have piser, but only very few.
To Akha, piser refer to people whose souls are able to come out of their body through the forehead.Once out, the souls transform into visible animals, wander around, and harm people, especially the most vulnerable, when they are sleeping.Piser eat dead animal corpses, blood, and the weak, such as infants and the sick.Women delivering babies are also in danger from piser because they like to drink blood and to eat newborn babies.An old woman Aqmee Ku recalled that before the only piser in a local Akha village was chased away, infants in that village had hardly ever survived.This piser ate all the babies.
Thus, the Akha have developed measures to protect their vulnerable members from the threat of piser, especially piser coming from nearby Lahu villages.One of the protective measures is the usage of a wild botanical hard shell with sharp hooks, called pisermaqdo, literally meaning "Piser does not bite".It is said that the vicious piser will not come to bite and drink the blood of one who possesses this shell.Pregnant women always keep such a shell by their side when giving birth, at home or in hospital.Shellac is viewed as the best "medicine" to protect against piser.Akha parents or grandparents always make bracelets and tiny medicine bags out of shellac for newborn babies.The shellac bracelet is made by a father for his newborn children during the naming ceremony.The drug bag is a tiny bag of roughly foursquare centimetres, made of red cotton cloth.It is filled with various drugs against piser, among which shellac is indispensable.Generally, this drug bag is made by grandparents or great-grandparents for the newborn.Infants are supposed to wear this tiny bag in the first year, and then their family may remove it at will.As long as they are wearing this drug bag, infants and sickly adults are secure to travel around.Despite the protection, a middle-aged woman still emphasised that they rarely bring their young children to markets because there might be piser in the crowds.That was why my host family were reluctant about me taking their little girl to the market.However, one old man told me that going to the market nowadays might not be as threatening to humans as in earlier times because the market now has a bigger meat department that allows the piser to satisfy their desire for drinking blood.
Like piser, most lapya are known to come from the Lahu and Han groups.Compared with piser, the soul of a lapya is invisible.It invades a person's body through the fingers and toes, takes up residence, and drinks its victim's blood.After two days or so, the victim's finger and toes will curl up.Meanwhile, the victim behaves like another person, speaks whatever language the lapya speaks, and falls sick.Eventually, the victim dies.Since lapya are capable of attacking even the strongest man, they are considered more threatening than piser.Fortunately, the lapya soul may be driven out of the victim by healers who have the right knowledge and medicine.Accordingly, lapya fear all healers, and are scared to look straight at them.
When I shifted research focus to Kekaq village in July 2013, villagers were eager to describe a recent event of a lapya invading a 3-year-old girl.The girl's parents had taken her to a clinic, but they had forgotten to bring the small drug bag which protects children from piser and lapya.That night, the girl had suddenly lost consciousness, her lips had become black.In the following morning, she behaved in a totally different manner.It was raining heavily, but she refused to use an umbrella or oilcloth, and was just walking in rain.Villagers tried to test her by asking the same questions in the Akha, Lahu, Wa, Han, and Dai languages, to check in which language she replied, so as to tell from which group the lapya was from.Aqbawr Gu, the most knowledgeable elder and a good healer in the Kekaq village, was invited to expel the lapya from the girl.Aqbawr Gu uttered a certain incantation, the girl felt very uncomfortable, and rushed alone into the sugarcane field next to the village.Villagers, under his supervision, shot their hunting guns three times around the girl, in order to scare the lapya away.If the lapya speaks his or her own name, it will be easy for healers to drive him out.Aqbawr Gu explained, "If the lapya speaks its name, I will address it directly when uttering the incantation.Then no matter where the body of the lapya is, in the human world or the naevq world, it hears me, and realises that we know it." Because the lapya did not speak his name, Aqbawr Gu had to try other treatments.He prepared some herbal medicine, and then put it and a lot of chilli into the fireplace.Above these, he placed a large steamer.They put the girl into the steamer.She did not suffer from the heat or the strong smell of chilli, but other men in the room could not bear the strong smell.Aqbawr Gu realised that the lapya was a very powerful one.Then, he took the herbal medicine out from the fireplace, soaked it in boil-ing water while uttering incantations, fed it to the girl, and then showered her with the leftover water.Then she fell asleep.When she awoke, she had recovered.
After the event, people were still shaken.The girl's grandfather, Aqbawr Hu, explained why: "We have to be very careful regarding lapya.People, children or adults, will die two or three days after being attacked by them." In this case, the lapya was expelled and the girl recovered.But, not all attacks can be resolved.According to Aqbawr Gu, a man from a neighbouring Akha village had died from a lapya last year.His covillagers clearly knew that this man was attacked by a lapya but failed to expel it.Aqbawr Gu also stressed, "This is the first time that a lapya has come to our village.We have to chase it away, otherwise in the future it will come back again and eat more people.If you completely defeat it at the beginning, the lapya dare not come again." It seemed that his expulsion had been completely successful, but the danger was not passed.If nothing else, the girl would remain vulnerable.As Aqbawr Gu explained, if a person is attacked by lapya three times, even if he is cured through incantation all three times, his or her brain will be partly damaged, and he will become less intelligent than before.Because of all these threats and damages, villagers paid a lot of attention to protecting their small children.In general, infants, without exception, wear similar handmade hats with a tiny red drug bag attached, a shellac bracelet which protects them from hostile beings, and a bunch of dark-blue threads around the right wrist to tie their souls to their bodies.

Conclusion
Anthropologists who specialize in studying children bring us insights into childcare from other cultures across the world, from Portugal, the United States, China, to Somali, Peru and so on (Gottlieb and DeLoache, 2017;Lancy, 2017).All of these cases are telling us a simple fact: raising children is a culturally and socially constructed process.It involves family and other social relationships, demands money and love, often is regulated by governmental polices and is coloured by religious beliefs.Accordingly, parents need to provide different types of care to raise their children, such as daily care, health care, and emotional care.My account has focused on ritual care practices aimed at securing the health and well-being of children.Such ritual care practices have obviously been noted and highlighted in previous anthropological studies of childcare, but this focus on ritual care practices remains marginal.And yet, it has long been suggested by anthropologists working at the intersection between medicine and religion that ritual care is a vital component of childcentred practices of healthcare.
This research presented here reveals that the Akha villagers in Menglian mainly sense uncertainties and insecurities from the cosmological world and these uncertainties and insecurities are seen to par-ticularly threaten the health and well-being of vulnerable children.Indeed, the cosmology defines what a child is, and helps to shape the corresponding childcare practices.Thus, I argue that the perceived cosmological insecurities should be taken into consideration in the field of childcare.
To protect their children from these malevolent cosmological beings, Akha have developed a shared collective pattern of ritual care.Compared to adults, Akha children have closer connections with the cosmological beings because their personhood is not fully developed, and they are more vulnerable.Until they are thirteen years old, children are viewed as half-human and half-naevq, creatures of both human and ghost worlds.The essence of children greatly defines even the most fundamental practices of childcare among the Akha.Giving children names at birth before the naevq can do so, and never scolding children as "naevq children", are practices of ritual care that help maintain the necessary boundaries and balance between the human and non-human worlds.
From the moment of conception, Akha people depend on the particular protection of two pairs of deities, Zaqghen Zaqsan and Ghesan Gheje, to take care of babies and children.These gods and goddesses are meant to protect babies and children from dangers such as falling down from a balcony, but they also cause illnesses which can only be cured through healing rituals.This work of protection as well as the threats the deities pose to ba-bies and children play an important role in defining villagers' childcare practices.Moreover, villagers put much effort into protecting newborn infants and toddlers from hostile piser and lapya, by dressing them with talismanic nuts, bracelets, drug bags, and so on.As for those powerless, timid and restless souls that children are born with, villagers work hard to tie them to their rightful owners, using techniques like tying threads around the children's wrists, attracting the children's souls with gifts or food, calling back these souls through rituals.
All in all, Akha villagers need to constantly provide ritual care to their babies and children from the time they are conceived until they are born and after, so as to protect them from threats posed by cosmological beings.Here so-called ritual care distinguishes itself from caregiving activities at the physical, social or secular level.First of all, unlike body-centred acts such as washing, dressing or feeding, the Akha health caring acts does not necessarily centre on the physical body.Practices such as asking grandparents to name a child, avoiding the use of the term "ghost child" to refer to one's child, or avoiding taking small children to markets, are all practices of ritual care that are not centred on the body and are meant to ensure children's survival and health.
Second, their caring acts always engage with some cosmological beings.For example, naming a child is not only to give a child social identity, but a process of distinguishing him or her as a human.Feeding a child with a boiled egg is not always for good nutrition, sometimes it is intended to attract the child's soul back.Practices like picking up a pebble from a river that children cross, buying a gift from a market that children pass by, tying a thread around children's wrists, and performing healing rituals to call the soul back are all practices of ritual care that engage with cosmological beings in an effort to keep children's souls in the right place with their owners.That is, to insure their good health.
Finally, ritual care is provided by both human actors and non-human cosmological beings.Humans such as parents, grandparents, and fellow villagers can offer a favour or observe a taboo, thus providing their ritual care to children through all these caring acts mentioned above.Meanwhile, these caring acts, particularly healing rituals that make sacrifice to gods, demand blessing, protection and support given by gods.In other words, non-human cosmological beings are also believed to take care of children through rituals.In the case of goddesses of children, they also offer everyday protection to infants.
Undoubtedly, ritual care plays a central role in taking care of babies and children among the local Akha community.It compels us to reconsider the question of what care is.It is not merely physically centred acts, souls need to be cared for, too.It is not merely human acts directed by religious values, but socio-cosmic activities accomplished together by human and cosmological forces.This research suggests that besides bodily care or emotional care, there is another type of care that deserves to be deeply studied.