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“Now he walks and walks, as if he didn’t have a home where he could eat”: Food, Healing, and Hunger in Quechua Narratives of Madness

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Abstract

In the Quechua-speaking peasant communities of southern Peru, mental disorder is understood less as individualized pathology and more as a disturbance in family and social relationships. For many Andeans, food and feeding are ontologically fundamental to such relationships. This paper uses data from interviews and participant observation in a rural province of Cuzco to explore the significance of food and hunger in local discussions of madness. Carers’ narratives, explanatory models, and theories of healing all draw heavily from idioms of food sharing and consumption in making sense of affliction, and these concepts structure understandings of madness that differ significantly from those assumed by formal mental health services. Greater awareness of the salience of these themes could strengthen the input of psychiatric and psychological care with this population and enhance knowledge of the alternative treatments that they use. Moreover, this case provides lessons for the global mental health movement on the importance of openness to the ways in which indigenous cultures may construct health, madness, and sociality. Such local meanings should be considered by mental health workers delivering services in order to provide care that can adjust to the alternative ontologies of sufferers and carers.

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Notes

  1. One noteworthy example is by Scheper-Hughes (1988), who described how lack of food was translated by the Brazilian poor into the idiom of nervos (nerves), thereby medicalizing structural violence and denying the phenomenology of hunger. Food thus occupies a central place in her analysis, though interestingly its significance was effaced in the accounts of her informants themselves. In contrast, Brijnath’s (2011) discussion of the importance of food and its preparation to the relatives of people with dementia in India shows what an integral and explicit part it played for them in the maintenance of identity and continuity of relationships, and argues that this should be more frequently addressed in care interventions. Dossa (2013) also analyzes how food is bound up with self-identity and memory work for Afghan women coping with the effects of post-conflict trauma and social suffering. Pandolfo (2008), meanwhile, depicts how care through food can also feed conflict, as a Moroccan mother’s cooking becomes the site of contestation with her possibly psychotic son during a psychiatric assessment. For him, the food she serves him is emblematic of her “traditional” lifeworld, which he complains ensnares him and jars with his frustrated aspirations to a more cosmopolitan sensibility; there are also undertones of suspicion that she may be concealing magical charms in it.

  2. Ethics permission was obtained from the UCL Ethics Committee (Ref. 0649/002). Institutional support and permission in Peru were provided by the CMHC and San Antonio National University of Cuzco.

  3. Literally translated, yachaq means “one who knows.” In the context of healing, it refers to spiritual knowledge, often alongside some degree of expertise in herbal cures. Other terms for healers commonly used in the province include paqo, hampiq, and curandero.

  4. Some Quechua speakers object to the term “indigenous.” They feel it denotes a demeaning form of second-class citizenship and prefer to embrace a class identity, according to which they call themselves campesinos (“peasants”) to distinguish themselves from the mestizos. Though this view is not universal among Quechua speakers, out of respect for those who hold it I use the term campesino to refer to my informants. However, there are useful lessons to be drawn from these research findings for mental health work with groups elsewhere who auto-identify as indigenous, and in order to make clear the relevance of my discussion to them, I continue to make comparisons with “indigenous” cosmologies. I hope that this causes no offense.

  5. Ten of the afflicted individuals were male and 14 female. Many interviewees did not know their exact age, but they ranged from 12 years to approximately 60–70. All families lived primarily from farming, although for the poorest, this meant working on others’ lands, as they lacked enough of their own.

  6. See Classen (1993, pp. 88, 145).

  7. “Every time the doctors come here they want to know the children’s weight to know if they will get sick,” commented one young mother about the medical center workers’ community visits. “They tell us we are not feeding our families well,” added another. “That’s why our blood is weak here and we are unhealthy. Not like in other places.”

  8. In fact, use of this remedy long predates modern Andean understandings of vitamins (Valdizán and Maldonado 1922, p. 405). Seen in this light, it is interesting to note that black dogs were traditionally sacrificed as psychopomps when campesinos died. It is said that they are more effective in this role than other dogs because they are not afraid to get their coats dirty on the journey (Robin 2005, p. 61). Since madness is often conceptualized as the loss of the sufferer’s soul, which is thought to have wandered far from the body and be unable to find its way back, this may be part of the reason why black dogs are considered particularly appropriate for such healing purposes.

  9. Recent studies have explored the links between food insufficiency and mental health problems (Sohrsdahl et al. 2011; Weaver and Hadley 2009). However, findings such as these are far from being integrated into the mainstream of clinical practice at present.

  10. These may include flowers, mineral powders, animal fat, incense, perfumes, wool, seeds, coca leaves, figurines, bread, alcohol, and/or a variety of other substances, depending on the nature of the request and the preferences of the apu being petitioned.

  11. In this environment, where witchcraft and magical healing are part of everyday reality for many, this demand was not necessarily as delusional as it may seem. However, careful inquiries uncovered no evidence that Francisco’s father had ever practiced witchcraft.

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Acknowledgments

I am grateful to the Economic and Social Research Council for funding this study and to my informants for their patient explanations.

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  1. School of Education and Social Work, University of Sussex, Brighton, East Sussex, BN1 9QQ, UK

    David M. R. Orr

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Orr, D.M.R. “Now he walks and walks, as if he didn’t have a home where he could eat”: Food, Healing, and Hunger in Quechua Narratives of Madness. Cult Med Psychiatry 37, 694–710 (2013). https://doi.org/10.1007/s11013-013-9336-9

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