Risk issue: the disruptive effects of serious illnesses

All societies experience and manage disease and illness. While minor illnesses can be and usually are absorbed within the flow of everyday activities, serious illness is not: it creates uncertainty and threatens the continued existence of normal life. This disruption is managed differently in different situations.

Managing the disruption of serious illness: risk and other strategies

While illness is a universal phenomenon, responses to it vary: they are shaped by social processes, the ways in which people live and interact, and cultural factors, collective beliefs and knowledge. These differences can be seen by comparing the responses to illness in small-scale intimate societies with those in larger scale societies of strangers.

Small-scale intimate societies were the focus of anthropological study during the 20th century. In these societies, individuals live in close proximity. Interactions take place between those whose duties and obligations are defined by kinship relations (Givon and Young, 2001). This proximity and intimacy means that when an individual becomes ill, the disruption tends to spread through the whole community. Lewis (2000) observed the ways in which serious illness disrupted life in small rural villages in Northern Papua New Guinea: ‘The spread of concern, the variety of constraints imposed on ordinary life – barriers to paths, a ban on dance and song, taboos on food or movement – the way they overcast and disrupted normal village life sometimes gave a public quality to the hidden suffering [of illness]’ (Lewis, 2000, p. 80).

In intimate societies, responses to serious illness are shaped by cultural factors, especially beliefs about the ways in which natural and supernatural forces interact with individuals and communities. Coderey (2015), in a study of Buddhist villagers in Rakhine State, Western Myanmar, found that illness was perceived to be an ever-present threat created by a disorder in the body or outside world that created an imbalance in the bodily elements of air, fire, earth and water. As the factors causing illness were everywhere and were unstable and unpredictable, they ‘represented a [continual] source of danger … villagers lived in a chronic condition of uncertainty concerning their vulnerability’ (Coderey, 2015, 269).