Children with Failure to Thrive,Epilepsy and STI/AIDS: Indigenous Taxonomies,Attributions and Ritual Treatments

Abstract

International child mental health has few anthropological signposts. In most developing countries, there are no child mental health professions. Instead, the traditional healers deal with routine physical and emotional disorders. In an effort to better understand how Cambodian families feel about sick children, three child-hood conditions were considered. (1) The `good' or `bad' mother, through traditional diagnosis and treatment of repeated failure to thrive and dying babies; (2) mother-child bonding and interaction, through notions of the `preceding mother' as a cause of childhood epilepsy and techniques to break the child's bonds with its previous life; (3) genetics and inheritance of illness, through the understanding of the transmission from ancestors and parents to children of illnesses such as lameness, intellectual slowness, leprosy, furunculosis and STI/AIDS. Participant observation was carried out with 921 male and female traditional healers (kruu, monks, Buddhist ritual assistants, mediums and traditional birth attendants) from all provinces of Cambodia. Where possible, their diagnostic techniques and therapeutic rituals with infants and children were recorded. The healers' knowledge of local taxonomy, aetiology, pathogenesis, diagnosis and treatment, showed up powerfully the popular beliefs about the main conditions affecting children in Cambodia. The results also helped to identify the Cambodian logic of the child's mind and body; time, epigenesis and child development; cause-and-effect; and gender, guilt and responsibility for childhood illness. This information can improve the clinical management of troubled children of immigrants from Cambodia and neighbouring countries. It questions the headlong rush in the Asia-Pacific region to `modernize' child psychiatry at the expense of local systems. Beyond this, it will shed light on the cross-cultural psychobiology of child development.