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Cambodians and their Doctors: A Medical Anthropology of Colonial and Postcolonial Cambodia

  • ID: 1556286
  • Book
  • June 2010
  • Region: Cambodia
  • 322 Pages
  • Nordic Institute of Asian Studies (NIAS Press)
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This is an anthropological study of ‘doctors’ and ‘patients’ in Cambodia. These two categories include the actors within the separate but coexisting medical traditions in Cambodia – the biomedical and the indigenous. Doctors in the biomedical tradition generally seek to cure the physical body, while indigenous medical practitioners seek to heal the social person. Ideally, both strategies for regaining health should be complementary, but medical doctors and indigenous healers have rarely collaborated. This book traces the social, historical, and political circumstances under which these two medical traditions have evolved and the opportunities and constraints which Cambodians have faced and still face when seeking healthcare.

Our study spans the colonial introduction of biomedicine into Cambodia in the late nineteenth century to the present. By anthropological standards this is a rather longue durée, also given that our own observations of Cambodian society go back a mere 13 years, and that most of our informants’ recollections hardly extend further than the 1960s. Our aim, however, is to trace the articulation of the two medical traditions from the beginning of their coexistence and thereby offer a colonial and postcolonial anthropology as well as a political economy of medicality.

Among the Asian medical systems, Ayurvedic, Unani, and Chinese medicine would represent the great medical traditions (Leslie 1976), comparable in many respects to the great, though much less ancient, European tradition of biomedicine. The notion of a medical system includes both theory and practice: theory as a more or less consistent body of medical cosmological ideas – a world view – and practice as an associated set of therapeutic techniques and technologies. Medical systems are by no means static, and changes within them occur to varying degrees and at a varying pace as a matter of course, precipitated, for instance, by globalization and indigenization. In biomedicine changes in technique and technology are virtually built into the system through the notion of continual scientific and technological progress, whereas changes in world view are considerably less perceptible and rather longue durée.

Key Points:

- Offers a unique blend of historical anthropology and contemporary ethnography.

- A key text for scholars and students of Cambodia and Southeast Asia in general.

- An important resource for development planners and aid workers in medical and related ?elds.

At face value, this book is about medicine in Cambodia over the last hundred years. At the same time, however, by using ‘medicine’ (in the sense of ideas, practices and institutions relating to health and illness) as a prism through which to view colonial and post-colonial Cambodian society more generally, it offers an historical and contemporary anthropology of the nation of Cambodia.

Rich in ethnographic detail derived from both contemporary anthropological ?eldwork and colonial archival material, the study is an account of the simultaneous presence in Cambodia of two medical traditions: the modern, biomedical one ?rst introduced by the French colonial power at the turn of the twentieth century, and the indigenous Khmer health cosmology. In their reliance on one or the other of the two traditions, to a large extent the Khmer people have been concerned about ?nding ef?cient medical treatment that also adheres to social norms (not least the emphasis on the morality of social relations). This concern is also evident in the prevailing medical pluralism in Cambodia today.

The authors trace the interaction (and lack thereof) between these two traditions from the French colonial period via the political upheavals of the 1970s through to the present day. The result is more than a work on medical anthropology; this is a key text that also makes a signi?cant contribution to the anthropological study of Cambodian society at large and will be an important resource for development planners and aid workers in medical and related ?elds
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Preface vii
Glossary xi
1. Introduction
2. Colonialism and Medicine in Indochina
3. French Medicine in Cambodia
4. The Khmer Rouge Medical Regime and Socialist Health
5. Indigenous Practitioners: Healers, Spirit Mediums and Magic Monks
6. Midwives and the Medicalization of Motherhood
7. Leprosy: Symbol and Social Suffering
8. Contemporary Healthcare Resources
9. Conclusion
Appendix
References
Index

Figures

Cover: Surgery at a provincial hospital; Performance of a spirit medium
0.1. Map of Cambodia xv
2.1. Adhémard Leclère
2.2. François Baudoin
3.1. Ang Duong Hospital
3.2. Hospital inauguration
4.1. The staff of Calmette Hospital
4.2. DK pharmaceutical laboratory
4.3. The main DK hospital on the Thai border
5.1. Indigenous healer
5.2. Spirit medium
5.3. Monk performing exorcism ceremony
6.1. Indigenous midwife
6.2. New mother resting over the fire
6.3. Maternity ward (nurse)
6.4. Maternity ward (parturient woman)
7.1. Inhabitant of the leprosy village
7.2. Statue of the Leper King
8.1. Pharmacy, a family business
8.2. Large private clinic
8.3. Patient at a private clinic
8.4. Elderly patient at home

Tables

2.1. Population and area of French Indochina, 1913
2.2. Population of Cambodia in 1911 and 1921
3.1. Number of consultations at the Mixed Hospital in Phnom Penh, 1908
3.2. Number of patients at the municipal clinics in Phnom Penh, 1911
3.3. Number of consultations at municipal clinics in Phnom Penh, 1911
3.4. Number of consultations at the clinic in Takeo Province, 1913
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The authors are associate professors of anthropology at Uppsala University in Sweden. They have been engaged in the study of Cambodian society since 1995.
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