House of Spirit: Perspectives on Cambodian Health Care

1988?

Directors: Ellen Bruno & Ellen Kuras

Produced by the American Friends Service Committee

The film introduces briefly the recent history of Cambodia and sketches Cambodian culture. Many of the beliefs of Theravada Buddhism are directly relevant to health, particularly the Taoist yin-yang oppositions, the importance of a balance between hot and cold, and a balance of the four elements (wind, water, earth, and fire). Sickness is understood to be the result of falling out of balance, and health care consists of restoring balance, often by calling on traditional practitioners call Krou Khmer.

Much of the film is a visually rather static series of talking heads, but what they are saying is dynamite. Khmer (Cambodians) and Americans in effect carry on a dialog about how to combine the traditional medical care of the Krou Khmer and the modern Western medicine of the M.D.s. Although neither of the two Americans physicians ever mentions the world anthropology, they are obviously talking about using ethnographic insights to understand the Khmer culture of medicine. Only then can they really help the refugees.

Dr. Denise Rogers says, “We need someone who knows the culture.” Dr. Thomas Jones says, “Be sure the communication systems are really working.” A Khmer says, “We have to treat not just the disease but the whole person.” (Heider 1997: 312).

The film begins with background on Khmer traditional life, especially Buddhism and the beliefs system relevant to health ,a mixture of Theravada Buddhism and Southeast Asian spirit beliefs. When peoples’ maladies are caused by bad spirits, they call in specialists healers, Krou Khmer, for diagnosis and treatment. Rubbing a person’s skin with a heated coin is a common treatment. Cupping can also be used: a short candle is stood on the forehead and covered with a small glass. The candle creates a vacuum, sucks the skin up into the glass, and creates a red mark (From burst capillaries) that lasts for a week or two. The French introduced their medicine during the colonial period, but after independence in 1953, Cambodian medicine combined Western practices and traditional healing. (Heider 2001: 422).

Setup Questions

1. What are the particular cultural problems that physicians need to take into account in working with Khmer patients?

2. What is the role of translators?

3. Should the Khmer continue to use their folk medicines?

4. How are medicine and religion connected?

5. What is karma, and what does it have to do with health?

6. What is the meaning of the title of the film?

7. What do the Krou Khmer do?

8. Think of the burning, the coin scraping, the cupping. Is this medicine or magic?

9. Why does Dr. Jones keep talking about communication?

10. How does the concept of cultural relativity come into play for these American physicians> Does this concept have any limitations?

11. How doe Khmer schemas about illness, health, and life in general affect their attitudes toward American medical care? (Think of pregnancy, a person’s blood supply, use of medicine and so forth).