Ritual coordination of medical pluralism in highland Nepal: Implications for policy

In highland Nepal, just as in many other regions of South Asia, multiple indigenous healing traditions and a variety of traditional curing specialists co-exist in a pluralistic cultural environment. It is argued that the interaction of diverse medical traditions is a particular aspect of the more general tendency toward the accretion and super-imposition of cultural traits which has been a common feature of Hindu-influenced social systems. Allopathic medicine and its practitioners, therefore, are less likely to displace traditional curing practices than to become integrated into a network characterized by continued pluralism. To insure that allopathy is properly understood and utilized within the pluralistic context, the identification and training of coordinating personnel who may specialize in diagnosis or referral demonstrates promise. The traditional curing network of the Thakali people of Northwest Nepal is described, with particular attention to the mu tu ceremony of divination, as an example of an indigenous agency of medical referral. It is suggested that referral specialists such as the Buddhist monks who perform mu tu are particularly appropriate targets for health education initiatives aimed at familiarizing village populations with the role and proper usage of modern medicine.