Obeah is the local spiritual system that relies upon the use of herbs as well as sorcery and spells. Obeah reappears many times in the novel from the way that Mrs. John takes a bath, to the healing of Annie, to the Obeah blessed clothing that Annie wears on her way to England. Obeah is a powerful part of the native culture that remains, despite the cultural dominion of the British Empire. In particular, Obeah links the Caribbean culture its pre-colonization people, while simultaneously suggesting the blend of Amerindian, African, and European cultures that make up the islands. Obeah particularly is intimately connected with strong female characters. The male figures in the novel, Annie's father and grandfather, both shun it. Annie's grandmother particularly seems to dwell in a mystical world of obeah that fully defies the logical world of the colonial culture. She arrives and leaves Antigua on days that the ferry does not run, for example. She is the only one to be able to heal Annie, despite the efforts of the obeah woman and the local Doctor. The existence of obeah in Annie's world demonstrates the power of the local spiritual beliefs to survive, despite the colonial conditions.
Water reappears through the novel as a powerful natural force that helps to both heal and transform. Its ability to heal can be seen in the baths that Annie and her mother take at the beginning of the novel. The salt water of the ocean likewise strengthens Annie's kidneys. The rainstorm that persists during Annie's illness cleanses and transforms the island while providing a nourishing environment for her to recover. Finally, the ocean allows for Annie's ultimate rebirth by pushing her on her way toward a new life in England. Kincaid's use of a powerful natural element as a fictional tool carries an edge of magical realism that is consistent with a Caribbean setting in which magical practices such as obeah play such an important role.
Annie obsesses over death in her opening chapter and initially, the idea of death portends the possibility of separation that Annie fears. As the novel continues, the idea of death reappears amongst the tombstones upon which Annie and her classmates usually sit during recess. These tombstones belong to old white people, meaning former colonial slave owners, who once governed Antigua. The young Antiguan girls now sit on the tombstones and sing dirty songs or show each other their body parts while making inappropriate comments. Here the image of death is placed next to the idea of life and seriousness of these old men's death seems joked upon by the fact that barely teenage girls are primping on their graves. The constant return of the girls and the narrative to the tombstone area testifies to Kincaid's ironic commentary upon the history that these colonial masters represent.