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Women's health

Perinatal disorders in Cambodia

Background. Perinatal and postnatal disorders are widespread across cultures, but little is known of the indigenous taxonomies, explanatory models, or the local treatment methods used to ameliorate or prevent them.
Method. An ethnographic study has been under way for 12 years, involving a sample of approximately 200 traditional healers (monks, kruu, traditional birth attendants, and mediums) who treat women with perinatal disorders.
Findings. Two main conditions are identified. ‘Incompatibility illness’ (toah) is a chronic state in which a woman developed chronic symptoms including fatigue and headache, as a result of premature overwork, violation of food proscriptions, or forced premature sex with her husband. ‘Madness of the puerperal bed of fire’ is an acute onset of florid disorder with agitation and psychotic thinking, believed to be caused by the spirits attacking residual blood in the womb.  Discussion. ‘Incompatibility illness’, a local equivalent of a chronic somatoform disorder, demonstrates the role of childbirth as a trigger for possibly lifelong disorder associated with a woman’s becoming a mother. ‘Madness of the puerperal bed of fire’, as an acute psychosis with a probable organic cause and locally interpreted as spirit attack, is more dramatic and is self-limited. Perinatal disorders, as partial solutions to sociomoral predicaments, provide women in developing countries (who have few options over how they work, eat, and cohabit), with a socially acceptable way to signal their distress, and to find partial support from the traditional healers.
Researcher: Maurice Eisenbruch, (Chou Sam Ath, Naren Cheth, assistants)