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Healing the whole: Questioning the boundaries between medicine and religion in Rakhine, Western Myanmar

Published online by Cambridge University Press:  29 July 2020

Abstract

Based on fieldwork conducted among the Buddhist population living in Rakhine State, Myanmar, between 2005 and 2011, this article elucidates how people deal with health and illness and related uncertainties by relying on a multiplicity of conceptions and practices associated with Buddhism, astrology, spirit cults, as well as indigenous and Western medicine. This article unpacks this plurality to show how different components contribute to the healing process in complementary and yet hierarchical ways which hold to a nexus of political, social, medical, economic, cosmological, biological, and environmental factors. It also questions the boundaries between the religious and medical, Buddhist and non-Buddhist, worldly and otherworldly, and natural and supernatural.

Type
Research Article
Copyright
Copyright © The National University of Singapore, 2020

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Footnotes

The author would like to thank the three anonymous reviewers of this article for their insightful comments and criticisms.

References

1 Coderey, Céline, ‘The (Buddhist) grammar of healing: Building therapeutic efficacy in the pluralistic context of Rakhine, Myanmar’, Asian Medicine 12, 1–2 (2018): 233–64CrossRefGoogle Scholar.

2 Augé, Marc, ‘Ordre biologique et ordre social: la maladie comme forme élémentaire de l’évènement’, in Le sens du mal: anthropologie, histoire et sociologie de la maladie, ed. Augé, Marc and Herzlich, Claudine (Paris: Archives Contemporaines, 1985), pp. 3592Google Scholar; Golomb, Louis, Anthropology of curing in multiethnic Thailand (Urbana: University of Illinois Press, 1985)Google Scholar; Fassin, Didier, Pouvoir et maladie en Afrique: Anthropologie sociale dans la banlieue de Dakar (Paris: Presses Universitaires de France, 1992)Google Scholar.

3 Fassin, Pouvoir et maladie, p. 23.

4 Appadurai, Arjun, Modernity at large: Cultural dimensions of globalization (Minneapolis: University of Minnesota Press, 1996)Google Scholar.

5 Lambert, Helen, ‘Plural forms of evidence in public health: Tolerating epistemological and methodological diversity’, Evidence & Policy: A Journal of Research, Debate and Practice 9, 1 (2013): 43–8CrossRefGoogle Scholar.

6 Edwards, Penny, ‘Bitter pills: Colonialism, medicine and nationalism in Burma, 1870–1940’, Journal of Burma Studies 14, 1 (2010): 2158CrossRefGoogle ScholarPubMed.

7 If in this work I sometimes speak of ‘Buddhist’ or ‘non-Buddhist’ practices, ‘medical’ or ‘non-medical’ practices, it is only in reference to my informants’ perspectives.

8 Bourdieu, Pierre, ‘Champ du pouvoir, champ intellectuel et habitus de classe’, Scolies 1 (1971): 726Google Scholar. See also Loyola, Maria Andrea, L'esprit et le corps. Des thérapeutiques populaires dans la banlieue de Rio (Paris: Éditions de la Maison des Sciences de l’ Homme, 1983)Google Scholar; Samuelsen, Helle and Steffen, Vibeke, ‘The relevance of Foucault and Bourdieu for medical anthropology: Exploring new sites’, Anthropology and Medicine 11, 1 (2004): 310CrossRefGoogle ScholarPubMed.

9 Kleinman, Arthur, Patients and healers in the context of culture: An exploration of the borderland between anthropology, medicine, and psychiatry (Berkeley: University of California Press, 1980), p. 24CrossRefGoogle Scholar.

10 Monnais, Laurence, ‘Medical traditions in Southeast Asia: From syncretism to pluralism’, in Dictionary of medical biography, 5 vols., ed. Bynum, William F. and Bynum, Helen (Westport, CT; London: Greenwood, 2007), pp. 6777Google Scholar; Owen, Norman G., Death and disease in Southeast Asia: Explorations in social, medical, and demographic history (Singapore: Oxford University Press, 1987)Google Scholar; Laderman, Carol and Esterik, Penny van, eds., ‘Techniques of healing in Southeast Asia’, special issue, Social Science and Medicine 17, 8 (1988): 747–87CrossRefGoogle Scholar.

11 Zupanov, Ines and Guenzi, Caterina, ‘Introduction’, in Divins remèdes: médecine et religions en Asie du Sud, ed. Zupanov, I. and Guenzi, C. (Paris: Éditions de l’École des Hautes Études en Sciences Sociales, coll. Purusārtha, 27, 2008), p. 11Google Scholar.

12 The fact that in African and Amerindian studies this split was much weaker is likely to be related to the absence in those societies of text-based religions and medicines.

13 de la Perrière, Bénédicte Brac, ‘An overview of the field in Burmese studies’, Asian Ethnology 68, 2 (2009): 185210Google Scholar.

14 Spiro, Melford E., Burmese supernaturalism: A study in the explanation and reduction of suffering (Englewood Cliffs, NJ: Prentice-Hall, 1967)Google Scholar; Spiro, M.E., Buddhism and society: A great tradition and its Burmese vicissitudes (London: George Allen & Unwin, 1971)Google Scholar; Nash, Manning, ‘Burmese Buddhism in everyday life’, American Anthropologist 65, 2 (1963): 285–95CrossRefGoogle Scholar; Nash, M., The golden road to modernity: Village life in contemporary Burma (New York: John Willey & Sons, 1965)Google Scholar.

15 Céline Coderey, ‘Les maîtres du “reste”: la quête d’équilibre dans les conceptions et les pratiques thérapeutiques en Arakan (Birmanie)’ (PhD diss., University of Aix-Marseille, 2011); Skidmore, Monique, ‘Contemporary medical pluralism in Burma’, in Dictatorship, disorder and decline in Myanmar, ed. Skidmore, Monique and Wilson, Trevor (Canberra: ANU E Press, 2008), pp. 193207Google Scholar.

16 Nash, The golden road to modernity; Brohm, John F., ‘Buddhism and animism in a Burmese village’, Journal of Asian Studies (JAS) 22, 2 (1963): 155–67CrossRefGoogle Scholar; Pfanner, David E., ‘The Buddhist monk in rural Burmese society’, in Anthropological studies in Theravada Buddhism, ed. Nash, Manning (New Haven: Yale University, Southeast Asia Studies, Cultural Report Series, 13, 1966), pp. 7796Google Scholar.

17 Obeyesekere, Gananath, ‘The great tradition and the little in the perspective of Sinhalese Buddhism’, JAS 22, 2 (1963): 139–54CrossRefGoogle Scholar; Ames, Michael, ‘Buddha and the dancing goblins: A theory of magic and religion’, American Anthropologist 66, 1 (1964): 7582CrossRefGoogle Scholar; Kirsch, Thomas A., ‘Complexity in the Thai religious system: An interpretation’, JAS 36, 2 (1977): 241–66CrossRefGoogle Scholar; Tambiah, Stanley J., Buddhism and spirit cults in Northeast Thailand (London: Cambridge University Press, 1970)Google Scholar; Terwiel, B.J., Monks and magic: An analysis of religious ceremonies in central Thailand, 3rd rev. edn (Bangkok: White Lotus, 1994[1975])Google Scholar.

18 Nash, The golden road to modernity, p. 166.

19 Melford E. Spiro, Burmese supernaturalism and Buddhism and society. On the need for a paradigm shift, see Brac de la Perrière, ‘An overview of the field’.

20 Brac de la Perrière, ‘An overview of the field’.

21 Leslie, Charles, ‘Medical pluralism in world perspective’, Social Science and Medicine 14B, 4 (1980): 190–96Google ScholarPubMed.

22 Leslie, Charles and Young, Alan, Paths to Asian medical knowledge (Berkeley: University of California Press, 1992)CrossRefGoogle Scholar.

23 Golomb, Anthropology of curing; Pottier, Richard, Yû dî mî hèng: ‘être bien, avoir de la force’. Essai sur les pratiques thérapeutiques lao (Paris: École française d'Extrême-Orient, 2007), pp. 433, 477Google Scholar; Guillou, Anne Y., Cambodge, soigner dans les fracas de l'histoire (Paris: Les Indes savantes, 2009)Google Scholar.

24 Leslie, ‘Medical pluralism in world perspective’; Connor, Linda H., ‘Healing powers in contemporary Asia’, in Healing power and modernity: Traditional medicine, shamanism and science in Asian society, ed. Connor, Linda and Samuel, Geoffrey (Westport, CT: Bergin & Garvey, 2001), pp. 321Google Scholar; Lock, Margaret and Nichter, Mark, New horizons in medical anthropology: Essays in honour of Charles Leslie (London: Routledge, 2002)Google Scholar; Broom, Alex, Doron, Assa and Tovey, Philip, ‘The inequalities of medical pluralism: Hierarchies of health, the politics of tradition and the economies of care in Indian oncology’, Social Science and Medicine 69, 5 (2009): 698706CrossRefGoogle ScholarPubMed.

25 Skidmore, ‘Contemporary medical pluralism in Burma’, p. 202.

26 Skidmore, ‘Contemporary medical pluralism in Burma’; Coderey, Céline, ‘Accessibility to biomedicine in contemporary Rakhine State’, in Metamorphosis: Studies in social and political change in Myanmar, ed. Egreteau, Renaud and Robinne, François (Singapore: NUS Press, 2015), pp. 260–87CrossRefGoogle Scholar.

27 Coderey, Céline, ‘Toward “health for all”? The reform of the Myanmar health system (2011–2016)’, in Routledge handbook on contemporary Myanmar, ed. Halloway, Ian and Simpson, Adam (London: Routledge, 2017)Google Scholar.

28 Ratanakul, Pinit, ‘Buddhism, health, disease, and Thai culture’, in Cross-cultural dialogue on health care ethics, ed. Coward, Harold and Ratanakul, Pinit (Waterloo: Wilfrid Laurer University Press, 1999), p. 22Google Scholar; Monnais, ‘Medical traditions in Southeast Asia’, pp. 67–77.

29 Similar aetiologies are attested elsewhere in Southeast Asia and South Asia, where Buddhist medicine and Ayurvedic medicine spread. See Zimmermann, Francis, Le discours des remèdes au pays des epices: enquête sur la médecine hindoue (Paris: Payot, 1989)Google Scholar; Monnais, ‘Medical traditions in Southeast Asia’; Samuel, Goeffrey, ‘Introduction: Medicine and healing in Tibetan societies’, East Asian Science, Technology and Society 7, 3 (2013): 335–51CrossRefGoogle Scholar.

30 The same linking of the planets and karma has been attested in central Myanmar by Nash (The golden road to modernity, p. 185), as well as in Sri Lanka by Gombrich, Richard (Buddhist precept and practice: Traditional Buddhism in the rural highlands of Ceylon [Oxford: Clarendon Press, 1971], p. 172)Google Scholar, and in India by Pugh, Judy F., ‘Astrology and fate: The Hindu and Muslim experiences’, in Karma: An anthropological inquiry, ed. Keyes, Charles. F. and Daniel, E. Valentine (Berkeley: University of California Press, 1983), p. 135Google Scholar; Chenet, François, ‘Karma et astrologie: Un aspect méconnu de l'anthropologie indienne’, Diogène 129 (1985): 104Google Scholar.

31 Nash, The golden road to modernity, p. 185.

32 Spiro, Burmese supernaturalism; Coderey, ‘Les maîtres du “reste”’.

33 The fact that the boundary between these two kinds of disease is not so clear is attested by other scholars working on other Southeast Asian societies. See for instance Pottier, Yû dî mî hèng, p. 142, and Monnais, ‘Medical traditions in Southeast Asia’, p. 72.

34 See also Spiro, Buddhism and society, pp. 155–6.

35 For instance, Paul G. Hiébert, ‘Karma and other explanation traditions in a South Indian village’, in Keyes and Daniel, Karma, pp. 122, 124.

36 Hiébert, ‘Karma and other explanation traditions’, p. 125.

37 See also Owen, ‘Death and disease’, p. 21.

38 Meditation by laypersons is usually the thamahta (pāli samatha, ‘concentration’) meditation practised by focusing on the breath.

39 Spiro, Buddhism and society.

40 Schmithausen, Lambert, Maitrī and magic: Aspects of the Buddhist attitude toward the dangerous in nature (Wien: Österreichischen Akademie der Wissenschaften, 76, 1997), pp. 4356Google Scholar, describes how compassion protects from dangers represented by the natural elements and notably wild animals. Yet my fieldwork shows that the protection issuing from compassion goes beyond this and covers not just natural but also supernatural dangers.

41 Tambiah, Buddhism and spirit cults.

42 Kammerer, Cornelia Ann and Tannenbaum, Nicola, eds., Merit and blessing in Mainland Southeast Asia in comparative perspective (New Haven, CT: Yale University Southeast Asia Studies, 1996)Google Scholar.

43 Spiro, Buddhism and society; Tannenbaum, Nicola, Who can compete against the world? Power-protection and Buddhism in Shan worldview (Ann Arbor, MI: Association for Asian Studies, 1995)Google Scholar; Saddhatissa, Hammalawa, ‘The significance of paritta and its application in the Theravada tradition’, in Buddhist thought and ritual, ed. Kalupahana, David J. (Delhi: Motilal Banarsidass, 2001), pp. 125–6Google Scholar; Gombrich, Precept and practice; Tambiah, Stanley J., ‘The magical power of words’, Man 3, 2 (1968): 175208CrossRefGoogle Scholar.

44 This is reminiscent of Tambiah's description of the monks’ consecration of amulets in Northeast Thailand as the ‘sedimentation of power’ or ‘objectification of charisma’; Buddhism and spirit cults, p. 208.

45 Khaing, Mi Mi, The world of Burmese women (London: Zed, 1984), p. 2Google Scholar; Spiro, Melford E., Kinship and marriage in Burma: A cultural and psychodynamic analysis (Berkeley: University of California Press, 1977), pp. 236–7Google Scholar.

46 Nash, The golden road to modernity, p. 136.

47 Spiro, Burmese supernaturalism, p. 151.

48 The same technique is attested elsewhere in Myanmar. See Sangermano, Father, A description of the Burmese empire (London: Susil Gupta; Santiago de Compostela, 1966 [1833]), p. 148Google Scholar; Yoe, Shway [U], The Burman: His life and notions (London: Macmillan, 1910), p. 43Google Scholar; Spiro, Burmese supernaturalism, p. 36. See also Eisenbruch, Maurice, ‘The ritual space of patients and traditional healers in Cambodia’, Bulletin de l’École française d'Extrême-Orient 79, 2 (1992): 299Google Scholar.

49 A detailed description of diviners and astrologers can be found in Coderey, ‘Les maîtres du “reste”’.

50 Ibid., pp. 172–4.

51 These associations and use in astrological practices come from Hinduism and have been described in detail by Caterina Guenzi in ‘Destin et divination: le travail des astrologues de Benares’ (PhD diss., École de Hautes Études en Sciences Sociales, Paris, 2004).

52 This discrepancy has been reported also by Laderman and Van Esterik in ‘Techniques of healing in Southeast Asia’ for other Southeast Asian contexts.

53 Naono, Atsuko, State of vaccination: The fight against smallpox in colonial Burma (Hyderabad: Orient Black Swan; Wellcome Trust Centre for the History of Medicine at University College London, 2009)Google Scholar.

54 Another version of this case has been published in Corderey, Céline, ‘Uncertainty and risk related to health in Rakhine (Myanmar)’, in Health, Risk and Society 17, 3–4 (2015): 263–84CrossRefGoogle Scholar.

55 Khaing, The world of Burmese women.

56 Skidmore, ‘Contemporary medical pluralism in Burma’, p. 196; Guillou, Cambodge.

57 Pottier, Yû dî mî hèng, p. 141.

58 Golomb, Anthropology of curing, p. 277.

59 Gombrich, Precept and practice.

60 Coderey, ‘The (Buddhist) grammar of healing’.

61 Csordas, Thomas J. and Kleinman, Arthur, ‘The therapeutic process’, in Handbook of medical anthropology: Contemporary theory and method, ed. Sargent, Carolyn F. and Johnson, Thomas M. (Westport, CT: Praeger, 1966), p. 19Google Scholar.

62 Hayashi, Yukio, Practical Buddhism among the Thai-Lao: Religion in the making of a region (Kyoto: Kyoto University Press, 2003)Google Scholar.

63 Clifford, Geertz, ‘Religion as a cultural system’, in The interpretation of cultures (New York: Basic Books, 1973), pp. 87126Google Scholar.

64 Gombrich, Precept and practice.