The severed heart: dying and death among the Isaan of rural northeast Thailand

© 2001 Dr. Elizabeth Sutherland BennettThis study examines dying, death and grief among the people of Baan Yang Kham, a rural village in Northeast Thailand. Exploring its social and cultural context, I situate death as centrally important to the people of Yang Kham: despite the rapid social, economic, demographic and epidemiologic change experienced by the villagers, death, its meanings and its phenomena have changed little. I argue that death presents obligations and opportunities which are rooted in the social and cultural worlds of Baan Yang Kham. The rites of death provide opportunities both for the merit-making activities essential to auspicious transformation and rebirth, and as a means of engaging traditional constructs of community to re-emphasise the world of the living. The phenomena of death are laden with symbolism and retain a pivotal place in village life. Medical anthropology provides the disciplinary framework for this study, which focuses on the deaths of seven adults, each of whom died from cancer or AIDS. Employing the qualitative methodology of ethnography, I draw not only on the formal methods of interview and observation, but also the informal, ongoing relationships and experiences developed during a twelve-month fieldwork period when I lived in the heart of the village. Much of the data is presented in narrative form, and I employ the voices of the villagers and “thick” ethnographic description to contextualise dying and death. I acknowledge the value-laden nature of qualitative research and clearly position myself as researcher, identifying myself and my background, and my relationships within the village. I present Northeast Thailand as a region that has always experienced change, and emphasise the environment of transition which underpins social life in the village. In explaining chronic disease, its treatment and its care, the people of Yang Kham engage both traditional and modern discourses, employing biomedical and traditional treatment and situating the care of dying people in a social world of connectedness and obligation. However, death and its cosmological context, is located in traditional cultural understandings of transformation and transmigration of human consciousness. While at one level, Buddhist teachings about the impermanence of the body and the inevitability of death influence individual response and communal ritual, constructions of the unseen spirit world saturate the liminal period of death with danger and fear, affecting the experience and expression of grief. Because of its perceived contagion and offence, I present separately the issues in dying and death from AIDS. The thesis concludes with my telling of my own story of loss and grief in Baan Yang Kham