Culture Specific Diseases

There are some diseases that have very limited distributions around the world due to the fact that they are caused by unique combinations of environmental circumstances and cultural practices.  These are generally referred to as culture specific diseases or culture bound syndromes.  Some cause relatively minor health problems while others are very serious and can even be fatal.  An example of a relatively harmless culture specific medical condition was "rave rash" in England during the late 1990's.  This afflicted young women who went to "raves", or large-scale pop music dance parties that went on all night long.  Aggressive dance motions without wearing a bra sometimes led to a painful rash on their nipples--hence "rave rash."  Another more recent culture bound syndrome is "toasted skin syndrome".  This is a result of excessive use of laptop computers resting on the lap.  The heat from these devices over time can cause a mottled discoloration of the skin on the legs.

  Map of the Southwest Pacific showing the location of the South Foré in New Guinea

Kuru click this icon to hear the preceding term pronounced is a fatal culture specific disease of the brain and nervous system that was found among the South Foré click this icon to hear the preceding term pronounced people of the eastern New Guinea Highlands.  Until recently, it was thought that kuru is caused by a virus with a prolonged incubation period.  Evidence now points to prions as being the cause.  The symptoms include palsy, contracted face muscles, and the loss of motor control resulting in the inability to walk and eventually even eat.  Kuru victims become progressively emaciated.  The South Foré called this disease "trembling sickness" and "laughing sickness."  The latter description was due to the fact that the face muscles of victims were constricted in a way that looked like a smile.  Death almost always occurs within 6-12 months of the onset of symptoms.

Kuru was first recorded among the South Foré at the beginning of the 20th century and it progressively became more common up through the 1950's.  At its peak, it mostly afflicted women in their 20's and 30's.  This caused major social problems.  Normally, men had several wives and children were taken care by women.  Now, however, there were too few marriageable women, and men were left with the child care duties.  Men were resentful and confused by their situation.  Since the South Foré had a personalistic explanation for illness, they logically assumed that Kuru was the work of witches who used contagious magic.  As a result, people became very careful at cleaning up their house sites to make sure that witches could not obtain any of their hair, fingernail clippings, feces, or personal belongings.  Witch hunts were organized and former witches were forced to confess and then join anti-witch cults.  None of these steps slowed the rate of increase in the number of Kuru victims.

In the early 1950's, a team of Australian doctors began working to discover what caused kuru in hopes of finding a cure.  Anthropologists traced cases of the disease in family lines to see if it was hereditary.  Other field workers collected water, soil, plant, and animal specimens to test for environmental toxins.  All of these attempts failed to discover the cause.  In the late 1950's, an American pediatrician named Carleton Gajdusek came to Papua New Guinea to try to solve the problem.  Through the microscopic examination of tissue from people who died of kuru, he discovered that the disease organism was carried in the blood and was concentrated in brain tissue.  The means of transmission was cannibalism.  The South Foré ate their dead relatives as part of their funerary practices.  Women butchered the corpses and were the main cannibals.  They also gave this meat to their children.  Men generally thought that it was unmanly.  They had pigs to eat, while the diet of women and children was normally animal protein poor. 

In the early 1960's, cannibalism was outlawed in Papua New Guinea.  Since then, the kuru rate has dropped off significantly but has not yet disappeared because of the very long incubation period for this disease.  Between 1996 and 2004, 11 people were diagnosed with kuru.  Apparently, all of them were born before 1950 and had contracted kuru before the end of cannibalism.  This meant that the incubation period was 34-41 years in these cases.

NOTE:  Kuru is closely related to two other well known fatal diseases that affect the brain and nervous system.  They are scrapies click this icon to hear the preceding term pronounced in sheep and goats and Kreutzfeld-Jacob click this icon to hear the preceding term pronounced disease in humans.  The latter disease is now popularly referred to as "mad cow disease" since it is a variant of the disease in cattle (bovine spongiform encephalopathy click this icon to hear the preceding term pronounced).  Beginning in 1986, there was a minor epidemic of it among cattle and people in Western Europe, especially in Britain.  More recently, there were several cases among cattle in Western Canada.  The human form of "mad cow disease" has been connected to eating beef from cattle that had acquired the disease as a result of eating food supplements made from ground up dead sheep and perhaps other farm animals.  The official response has been the isolation and slaughter of several hundred thousand cattle and other farm animals in Europe and Canada.  This drastic measure apparently has prevented a widespread epidemic.  Variants of "mad cow disease" are known to exist in at least 10 wild mammal species including deer, elk, bison, kudu, oryx, mink, and cats.  In these species, the disease is commonly referred to as "chronic wasting disease."

Culture Specific Mental Disorders

Apparently, mental illness is present in all societies.  However, the frequencies of different types of mental illness vary as do the social connotations.  What is defined as a mild form of mental illness in one culture may be defined as normal behavior in another.  For instance, people in western societies who regularly carry on animated conversations with dead relatives or other supernatural beings are generally considered mentally ill.  The same behavior is likely to be considered healthy and even enviable in a culture that has an indigenous world-view.  Such a person would be thought fortunate for having direct communication with the supernatural world.  Traditionally among many Native American societies, dreams and the visionary world were, in a sense, more real and certainly more important than the ordinary world of humans.

  Map of South Asia showing the location of the Saora in Eastern India

Among the Saora click this icon to hear the preceding term pronounced tribe of Orissa State in India, young men and women sometimes exhibit abnormal behavior patterns that western trained mental health specialists would likely define as a mental disorder.  They cry and laugh at inappropriate times, have memory loss, pass out, and claim to experience the sensation of being repeatedly bitten by ants when no ants are present.  These individuals are usually teenagers or young adults who are not attracted to the ordinary life of a subsistence farmer.  They are under considerable psychological stress from social pressure placed on them by their relatives and friends.  The Saora explain the odd behavior of these people as being due to the actions of supernatural beings who want to marry them.  The resolution to this situation is to carry out a marriage ceremony in which the disturbed person is married to the spirit.  Once this marriage has occurred, the abnormal symptoms apparently end and the young person becomes a shaman responsible for curing people.  In the eyes of the society, he or she changes status from a peculiar teenager to a respected adult who has valuable skills as a result of supernatural contacts.  This Saora example suggests that some minor mental illnesses could be better viewed as ways of dealing with impossible social situations.  In other words, they are coping mechanisms.

What a culture defines as abnormal behavior is a consequence of what it defines as a modal personality.  People who exhibit abnormal behavior in western societies are usually labeled as being eccentric, mentally ill, or even dangerous and criminal.  Which label is assigned may depend on the subculture, gender, and socioeconomic level of the individual exhibiting abnormal behavior.  In North America, the public acts of poor mentally ill males are sometimes seen as being criminal.  This is especially true if they are ethnic minorities or living on the streets.  In contrast, similar abnormal behavior by rich males is likely to be viewed as being only eccentric.  In the former Soviet Union, important people who publicly opposed government policy were sometimes considered mentally ill and were placed in mental institutions where they were kept sedated "for their own good."

Map of the Americas showing the location of the Yanomamo, Chippewas, Ojibwa, Cree, and Pueblo IndiansThe standards that define normal behavior for any culture are determined by that culture itself.  Normalcy is a nearly meaningless concept cross-culturally.  For instance, in the Yanomamö click this icon to hear the preceding term pronounced Indian culture of South America, highly aggressive, violent men are considered normal and such individuals are often respected community leaders.  In contrast, the same behavior among the Pueblo Indians click this icon to hear the preceding term pronounced of the Southwestern United States was considered abnormal and dangerous for society.  People who exhibited these traits were avoided and even ostracized.

Many psychological anthropologists believe that the most meaningful criterion for defining mental illness is the degree of social conformity by an individual.  People who are so severely psychologically disturbed and disoriented that they cannot normally participate in their society are universally defined as being mentally ill.  For instance, individuals who have difficulty relating to other people because of their intense hallucinations, paranoia, and psychotic defenses will very likely be defined as mentally ill and potentially a danger to others in all cultures.

While mental illness is found in most, if not all, societies, there are unique culture influenced forms that these illnesses can take.  They are culture bound syndromes.  An example is Windigo psychosis click this icon to hear the preceding term pronounced.  This condition was reported among the Northern Algonkian click this icon to hear the preceding term pronounced language group of Indians (Chippewa click this icon to hear the preceding term pronounced, Ojibwa click this icon to hear the preceding term pronounced, and Cree click this icon to hear the preceding term pronounced) living around the Great Lakes of Canada and the United States.  Windigo psychosis usually developed in the winter when families were isolated by heavy snow for months in their cabins and had inadequate food supplies.  The initial symptoms of this form of mental illness were usually poor appetite, nausea, and vomiting.  Subsequently, the individual would develop a characteristic delusion of being transformed into a Windigo monster.  These supernatural beings eat human flesh.  People who have Windigo psychosis increasingly see others around them as being edible.  At the same time, they have an exaggerated fear of becoming cannibals.  A modern medical diagnosis of this condition might label it paranoia because of the irrational perceptions of being persecuted.  In this case, it is the Windigo monsters who are the persecutors--they are trying to turn people into Windigo monsters like themselves.  In contemporary North American culture, the perceived persecutors of paranoids are more likely to be other people or, perhaps, extra terrestrial visitors.  Victims of Windigo psychosis experienced extreme anxiety and sometimes attempted suicide to prevent themselves from becoming Windigo monsters.

Another example of a culture bound mental syndrome is koro click this icon to hear the preceding term pronounced in China and areas of Southeast Asia where Chinese culture has diffused (especially Vietnam, Malaysia, and Singapore).  Koro is an irrational perception that one's prominent sexual body parts are withdrawing into the body and subsequently being lost.  In the case of men, the concern is that their penis and testes are shrinking.  For women, the focus is on the perceived shrinking of the vulva and breasts.  In both cases it is a fear of the loss of masculinity or femininity followed by premature death.  Koro is traditionally believed to be caused by "unhealthy sex" (e.g., masturbation or sex with prostitutes).  It also thought to be caused by "tainted" foods.  An example of the latter occurred in Singapore in 1967.  A newspaper reported that koro had resulted from eating pork that had come from a pig that was given a vaccination against swine fever.  This sparked an epidemic of hundreds of cases of koro.  More recently, another epidemic occurred in coastal Vietnam when some mothers were shocked to see that the penis and testes of their children had shrunk after swimming.  This created a widespread panic among mothers in a number of coastal communities.  In some cases, the mothers tried to pull out the penis and testes with their hands and even hooks in order to make them larger.  This resulted in the penis being torn off some of the boys.

Many culture bound syndromes have been reported around the world by anthropologists and medical professionals.  The following list includes the commonly reported ones:

Latin America and Latin derived cultures of Europe:

Africa and African origin cultures of the Americas:

Middle East:

South and East Asia:

South Pacific Ocean:

Native America:

To learn about the symptoms and presumed causes of these culture bound syndromes, go to the Related Internet Sites section of this tutorial.


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This page was last updated on Thursday, October 07, 2010.
Copyright © 2002-2010 by Dennis O'Neil. All rights reserved.
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