Superstitious beliefs often only recourse for Cambodia's sick
In times of ill-health and hardship, many Cambodians turn to spirit mediums. Could these superstitious beliefs be a symptom of a failing healthcare system?
On a hot and dusty Saturday afternoon, Cambodian father and son Nget Bun Thoeurn and Nget Sy arrive at a one-room concrete home in Kampong Cham’s provincial capital seeking relief for several maladies afflicting Sy. The 20-year-old suffers from constant headaches, is stressed and doesn’t get along with his co-workers.
For the price of KHR10,000 ($2.50) and a large packet of incense they are seeking help from their local fortune teller, or kru teay, named Touch Sros. This is a first-time visit for the young man, but Thoeurn, 40, has been here several times for health or business concerns. “Sometimes, when I have sickness or [pain in my] limbs, I go to see the doctor and get injections. But when I come here, I want to know about dark magic [plov ngo ngit], which means it’s something that doctors can’t see and understand, only fortune tellers,” he says.
After praying at the shrine and having his fortune read, Sy buys a silver amulet for a small extra sum. Sros ties the green string that holds the amulet around his client’s waist while chanting deep incantations.
“The fortune teller tells me that my son is discriminated against and looked down on by many people wherever he goes. When I get home, I will do a ceremony according to what the fortune teller tells us. Later on, we will be fine,” Thoeurn says after the reading.
Sros, 46, may call himself a “fortune teller” but his work is broader than simply predicting marriages or job prospects. He dispenses herbal medicines, sells talismans, proffers life advice and tells his clients when they have angered their ancestors.
He is, in actuality, one of Cambodia’s legion of traditional spirit healers, known as kru khmer. They perform a variety of services, acting as something approaching a combination of doctor, therapist and priest, resolving issues as banal as personal conflicts between neighbours and performing complex rituals to remove powerful curses.
Cambodians are not unique in seeking out the spiritual as a salve to their problems. Traditional healers exist across Southeast Asia, as do deeply rooted beliefs in the power of spirits and ghosts. These beliefs are based on a system of faith that predates the advent of Buddhism and have survived by adapting to cultural changes over the centuries.
In Cambodia, supernatural beings are widely believed to be responsible for a range of health and spiritual problems, from mental illness to chronic pain. Kru khmer fill a critical need in a country chronically short on doctors and trained pharmacists. Despite the popularity of kru khmer, working with spirits and ghosts – essentially practising what Westerners might term ‘magic’ – can be a dangerous occupation for those accused of using bad spirits to stir up trouble.
In Cambodia’s spiritual universe it is easy enough to cross paths with one of the country’s thousands of spirits, such as those of the land residing in trees or mountains (neak ta), or powerful spirits (boramey) who were once important historical figures. These can include the ghosts of famous kings, monks and courtiers.
In this system, the “world of the living is bound intimately to the one of the dead… their roaming souls, if they are not respected, can always persecute the living”, wrote Didier Bertrand, a researcher and ethno-psychologist, in a 1998 paper comparing Cambodian mediums with Vietnamese healers. Angering a spirit can lead to a physical ailment, so treating it requires spiritual intervention through “offerings and some negotiations”, according to Bertrand. Kru khmer perform that service, and they may also prescribe a herbal remedy, talisman or purification ceremony.
At times, spirits can even possess them. Six-year-old Chhorn Kimleng, who lives in Thbong Ang village in rural Kampong Speu province, collapsed in the rice fields four years ago. When the unconscious boy started shaking uncontrollably, his grandmother took him to the house of the local kru khmer, an elderly woman named Khai Chem.
Chem declared that a neak ta residing in a nearby mountain had cursed the child. Chem conducted a ritual known as leuk riesey, purifying the boy with water. Kimleng awoke the same day. During these rituals, Chem says, the spirit of a local neak ta, or another spirit named Bothum Resor who originates from a nearby mountain, may possess her. “I feel shaken and the spirit speaks and I don’t [control it]. If they don’t come into my body, I don’t see anything. But if they do come, they can find out why people are sick. For example, if they get a curse the spirit can see it,” Chem says.
Curses are frequently singled out by kru khmer as the source of their clients’ health complaints. In 2005, Bertrand published a study of 105 mediums across Cambodia, in which he found that curses were cited in 30-50% of their diagnoses, while evil spirits (kmoach) were blamed in 22% of cases. Symptoms such as pain and swelling are typically attributed to curses from malefic spirits or witches (tmop), according to Bertrand. In other cases, mediums blamed conflict or other problems on ancestral or local spirits.
While many Cambodians genuinely believe in the power of curses and the existence of tmops, researchers have generally been hard-pressed to identify anyone actively practising black magic and putting curses on others, says Erik W. Davis, author of Deathpower: Buddhism’s Ritual Imagination in Cambodia.
“Although nobody admits to being a tmop, there is a complete belief that tmop are everywhere. And many people will have stories about them,” he says. “One of the most common types of curse is to magically feed someone, and the way that works is they will magically put knives or buffalo skin inside [the cursed person’s] stomach. So you can imagine how that feels for the patient who then oftentimes dies tragically.”
Being accused of practising black magic can land a suspected tmop in a traditional court if they are one of Cambodia’s ethnic minorities. For the less fortunate, it can end in violent tragedy. In January 2014, a 55-year-old man named Khieu Porn from Kampong Speu province was hacked to death with an axe by neighbours who suspected that he practised black magic. Several months later, another suspected sorcerer, 36-year-old Pov Sovann, was stoned to death by a 600-strong mob.
Kru khmer, by contrast, are deeply respected members of the community. While they are not the only source of healing Cambodians seek out, their methods are valued.
“Lots of times people get very poor healthcare. They go to the doctor, the doctor gives them the wrong medicine, or doesn’t give the right diagnosis and, as a result, they don’t get better. And then there’s an assumption made that this [illness cannot be] cured by modern medicine. It’s something else… it’s coming from a spirit,” says Ian Baird, an assistant geography professor at the University of Wisconsin-Madison in the US, whose research interests include the ethnic peoples of Cambodia and Laos.
This is perhaps the ghoul that curses every Cambodian: a healthcare system with one of the lowest doctor-patient ratios in the world, and where the vast majority of physicians are poorly trained, if they are trained at all. According to the most recent World Bank data, the country had just two physicians per 10,000 people in 2012. Add that to a poorly regulated pharmacological industry, which sees incorrect dosages and counterfeit medication being dispensed with alarming regularity, and it is easy to see why someone might turn to a spirit healer, says Baird.
That doesn’t mean it’s all just Khmer “snake oil”, according to Baird. After all, the placebo effect is a powerful thing. “If you really believe there is a spirit doctor coming and doing something and helping you, that can give you a really important lift mentally. That can be really significant in overcoming illnesses [with] the power of mind over body,” he says. “Sometimes these rituals can work. Sometimes it’s just by accident.”