Abstract
In all cultures and regions, the concept of health varies, based on the type of environment and prevalent sociocultural traditions. The present study is conducted among the Lepchas of the village of Lingthem divided into two sectors—Upper and Lower Lingthem, Upper Dzongu, North Sikkim. This population comprising Buddhist Lepchas residing away from the mainstream through poor infrastructural facilities still maintain ethnomedical health care practices without influence of major Indian healing systems. Living in the area of Dzongu exclusively inhabited by Lepchas revival of ancient cultural practices is evident among Lepchas of Lingthem. The structure of religious beliefs prevalent among the Lepchas, including traditional animistic as well as Buddhist practices, greatly influence forms of treatment sought for specific ailments. Even today, the use and maintenance of traditional health care with syncretized Buddhist religious belief among residents of Lingthem act as a vital source for understanding the influence of religion on traditional health care practices. Despite the presence of a few modern health care agencies, the traditional treatment of Bongthing (Lepcha shaman) and Buddhist monks remain widely popular as primary means of health care.
Introduction
Regionally varied cross-cultural intrinsic religious beliefs occur based on cultural ecology, rigidity, adaptability, acceptance and rejection of varied cognitive structures. Religion as a set of beliefs, symbols and practices (e.g., rituals) is based on the idea of the sacred, which unites believers into a socio-religious community. For Tylor, animism is the foundation out of which all religions originated and is defined by ‘belief in Spiritual Beings’ (Tylor, 1871, 1903). According to Roger A. Johnson (1973) ‘Religion is an extremely complex phenomenon. It encompasses beliefs and doctrines, myths and rituals, sacred scriptures and cultic objects, and the manifestation of transcendence in these many aspects’. Religion practiced among the Lepcha Buddhists of both Upper and Lower Lingthem of Sikkim is the combination of animistic religion Bon with Mahayana Nyingma Buddhist practices. Traditional health care practices encompass use of gained knowledge as means of curing ailments (Tarafdar, 2007). Knowledge regarding use and practice of traditional medicine is handed down generationally through which existence of the same culturally persists. Medicine has been viewed as an institution in society through developing variegated thoughts, ideas, belief, values including biopsychical and physiological factors depicting social conditioning and worldview. Weitz (2015) states that when we talk of medicine as an institution, we refer to the world and culture of doctors as well as to the economic, political and social underpinnings of that world.
Study Area and Population
Following the technique of micro and intensive study in anthropology the present work has been conducted exclusively in the village of Lingthem, Upper Dzongu, North Sikkim divided into two sectors—Upper and Lower Lingthem; 27 households of Upper Lingthem with 77 males and 70 females, 25 households for Lower Lingthem with 80 males and 80 females comprise the population of 307, which have been covered during two months in two subsequent phases. Both sectors are exclusively inhabited by Lepchas located at a distance of three and half hours from the sub-divisional town of Mangan. Uncarpeted road assists people in connecting to the district Mangan serving as centre linking other regions of Sikkim. Overall condition of roads leading to Lingthem is highly deteriorative especially during monsoons. Two vehicles commute villagers to Mangan and other regions.
Lingthem is blessed with undaunted natural beauty through picturesque location at eastern face of the majestic Khangchendzonga whom Lepchas worship as Kongchen Chu (Kongchen—Lepcha synonym symbolizing divine protector bearing five jewels, Chu—Lepcha abbreviation for peak). Lingthem is derived from two Lepcha words—Lung means valley in Lepcha and Thyoum means cover. Longthem refers to ‘place covered by valley’. Original name of the region had been Lungtheyoung, Longthenkyoung, Sahyu, Sudang, Doshing, Longthem. Lingthem is associated with fables of malevolent spirit or Moong of Lingthem Aneu Puntdee, a famous and powerful widowed Mun (term used for addressing female Lepcha priestess) murdered out of jealousy by her seven brothers. She sought vengeance by turning into Ginoo Moong, female devil destroying prosperity of people.
Lepcha is the exoethnonym given by neighbouring people and most commonly known to outsiders (Bentley, 2007). Members of the community prefer endoethnonym Rong or Mutanchi Rongkup which means ‘sons of snowy peak or sons of god’ (Tamsang, 1983). Thakur (1988) stated that Lepchas identify themselves as Mutanchi Rong which implies to ‘people who wait for the blessings of the Mother’. Here, the term mother signifies divine mother creator of nature Itbu Rum considered to be supreme creator of all animate and inanimate beings. According to inhabitants of Lingthem the word Lepcha emerges from Lapcho ‘the place where ancestors of Rongs performed religious rites’.
Grover, and Das and Banerjee (1962) give two versions regarding the term ‘Lepcha’. The first one refers to the term ‘Lepcha’ meaning vile speaker by the Nepalese who came in the latter half of the reign of the king. The second version is based upon the nature of the fish found in Nepal called ‘Lapche’ which is very submissive in nature same as the mild and quiet Lepcha people.
Gorer (1938) stated that Lepchas have been greatly influenced and their ways of life much modified by the contact and pressure of their more highly developed neighbours, the Sikkimese, the Nepali, and above all the Tibetan. Lepchas are patriarchal following patrilineal descent organized as segmented clans Putsho having story of origin with varied myths, folklores tracing descent to specific Chu (peak), Da (lake) and totem. Chu (peak) and Da (lake) ‘function as entry points of the spirits into the realm of the dead’ (Bentley, 2007). The relation of the clan and that particular animal is explained by bonds of descent, the clan considering itself the descent from that species (Kumar 1996). Jerilmit Lepcha, teacher at Lingthem Junior High School in early fifties stated Putsho of Lepchas organize for maintaining solidarity. Her father, senior Buddhist monk at Lingthem organized people of Lingthem to donate money of cardamom cultivation for building school. As per her clan Heeyongming, members remember peak Pandim, Tingvong lake and totemic fish summoned during rites-de-passage, Tendong Lho Rum Faat and health related rituals. Members of Heeyongming refrained consumption of fishes as it was a totemic medium for sending ancestral prayers.
Few days ago, she felt severe pain in her hands up to fingertips and elbows. Being unbearable she consulted Leekup Mathyum (Bongthing). He performed divination stating that a small ritual was required for appeasing spirit of the woods Lungzee. Bamboo jar containing millet kept with flowers of Pagyurip pastedat border was used. Summoning of spirits was conducted by Bongthingusing Teetay Pati (Artemesia vulgaris; Medicinal plant leaves of which are believed to ward off evil spirits) waving smoke from incense over hand of Jayelmit. It was repeated thrice with jar kept at crossroads. On refusing cash she offered a fowl. She expressed healing of Bongthing not as myth but practiced due to efficiency, legends and faith of people. As part of familial tradition, she avails modern facilities only after resorting treatments from Leebaek Mathyum the Bongthing of Lower Lingthem.
Earlier, large section of people in Lingthem were monks but impact of formal education and globalization has diversified occupations as they now engage as teachers, few government workers, drivers, handicraft workers and shopkeepers. Previously, large areas of agricultural land were confined to cardamom crops providing great source of income. Later, rapid decline in production caused huge loss to the residents. Today, sugarcane has replaced cardamom. Various modern health facilities such as Primary Health Sub-Centre, ICDS (Integrated Child Development Scheme), ASHA (Accredited Social Health Activist) and VHSNC (Village Health Sanitation and Nutrition Committee) are available yet owing to strong cultural connotations and readily available services of traditional healers dominance of traditional health care practices as primary means of health care is evident in Lingthem.
Methodology
Dzongu is part of the protected area recognized for protection and maintenance of culture and heritage of Lepchas stated during session of Legislative Assembly of the Government of Sikkim from 21 to 28 February 2005 (S.G.P.G. - 384/Gazette/150 Nos./Dt:-18.11.2006) through discretion and approval of the Central Government of India. Outsiders without special permission are prohibited entry to the region. It is applicable to outsiders as well as non-Lepchas residing in Sikkim for ensuring autonomy. Lingthem falls in the region of Upper Dzongu. Location and history associated with infamous malevolent spirit Lingthem Anue Puntdee/Aneu Padim Lingthemkyu intrigued us to conduct the present study. The village mostly being cut-off remained connected through a single uncarpeted road. Contextual data were collected by filling schedules from households pre-marked by drawing village map. Administration of etic approach, direct intensive observation technique and open-ended questions with unstructured interviews were applied for accessing data. Use of genealogy method proved fruitful in selecting specific groups for detailed interview based on residence, age, education and economy. Application of stratified sampling was made based on education and economic condition for determining efficacy of traditional health care practices of Lingthem. Establishment of rapport and use of key informant interview proved vital.
Concept of Religion
Religion practiced in villages of Upper and Lower Lingthem follow subsequent sequence:
Animism → Buddhism + Animism
Syncretism witnessed in religious practices of Lepchas with major part of animistic beliefs is replaced by Buddhism yet existence of former persists. Lepchas simultaneously practice both Buddhist and traditional animistic religion by accepting features of Buddhism catering culturally constructed primary worldview of animistic religion. This religion is based on assumptions of a strong bond between Lepcha community and the environment in which they are living. This bond is expressed in terms of kinship with each clan associated with the various mountains of Kanchenjunga range (Lepcha & Torri, 2016). Practice of both these forms of religion without theoretical discomfort, two or possibly three mutually contradictory religion is found among the Lepchas (Gorer, 2005). This holds true for residents of both sectors of Lingthem simultaneously practicing animism and Buddhism, where syncretic elements of traditional animistic Lepcha religion are slowly replaced with acceptance of Buddhism. ‘The lama and the shaman do not contradict each other but co-exist as religious specialists due to a division of labour in their roles towards the individual, the family, the community and the polity’ (Arora, 2006).
According to this religion there exist two types of spirits:
Nature is highly revered among Lepchas considering it gift of mother creator Itbu Rum accredited to create animate and inanimate aspects of nature. Magico-religious practices of Mun and Bongthing play key role in regularizing religious life. Earlier, Lingthem had presence of Mun but later the practice stopped through prevalence of Bongthing. Mun is considered more powerful than Bongthing as former is believed to specialize in divination through ritualistic practice of black magic. A Bongthing is a male ritual specialist or the high priest who is regarded as ‘a shaman, a medicine man or an exorciser’ (Stocks, 1975). The word is a derivation of two Lepcha words abong and athing. Abong means ‘trunk, main, original’ while athing means ‘honourable, respected one’ so the amalgamation results in ‘the original highly honoured and respected one’ (Foning, 1987).
Practice of Mun is absent after death of ancestral Mun called Aneu Padim Lingthmkyu who turned into infamous Ginoo Moong. Duality of role is prevalent among Rum who is benevolent when rituals are provided timely through correct procedure enhancing prosperity and good health. But same Rum turns to malevolent Moong through irregularly conducted ritual or breach of stricture followed specific clan members or household trying hard compensating for conducting rituals. Majority of Lepchas identify themselves as Buddhists yet retaining animistic practices of the past. ‘Conversion to a religion is an irreducibly social act; one does not merely join a faith but one enters into a set of new relationships with members of a religious community’ (Buckser, 2003). The traditional Lepcha religion is officiated by mun and bóngthíng, or priestesses and priests respectively who act as mediators between God, men and spirits. It is from their very titles that derive the name munism and bóngthíngism for the traditional Lepcha religion (Lepcha & Torri, 2016).
Buddhism was introduced in Lingthem during contact of last Lepcha Chief Tekvong Tek with Bhutia King Khye Bumsa, later having three sons one of whom became the first Chogyal (Sikkimese term meaning king) of Sikkim. Lingthem ‘Chophel Dargyeling’ Monastery was established in 1857 AD by Lepcha Buddhists of the area as a branch monastery of Pemayangtse Monastery, West Sikkim, during the reign of Chogyal Tsugphud Namgyal (1793–1863). Gorer (1938) in his study on Lingthem village had a very important observation of the nature of Buddhism among Lepchas, ‘As a generalization it may be said that the Lepchas have accepted the ritual, the validated mythology, and the organization of Lamaism; what they have completely refused to accept is the ethic’.
Traditional function employing Bongthing during birth, death and marriage persists as both sectors employ Bongthing and Buddhist monks. Earlier a monk at Lingthem, 90-year-old Naetuk Lepcha of the hereditary family of Bongthing was requested by people of both sectors of Lingthem to perform important animistic rituals Chirim and Sukyu Rum Faat. Lepchas give honorary respect and reverence to Bongthing chosen by Rum whom they refer as Padim.
Bóngthíng and mun have a special power (tsat) which, after their deaths, is passed down to their grandchildren. Religious specialists are called on a number of occasions, but especially to perform ritual cleansing, annual ceremonies, healing rituals, exorcisms and delivering one’s soul after death (Lepcha & Torri, 2016).
Concept of totem is widely prevalent in both animistic Lepcha and Buddhist traditions. Thread crosses called Namgasago prepared by monks for wellbeing is placed outside Lepcha households represent aforesaid practices. Ritual of making effigies as flour cake called Torma offered as ritual food through employing tantric Buddhism is prevalent. Tree located in region of Upper Lingthem is considered highly powerful. It is believed to be the walking stick placed by earliest Mun of village Aneu Lingthem who turned into Ginoo Moong during escape from her brothers. People believe using branches of tree without seeking permission and forgiveness from Moong causes misfortune. Horoscopes of monks and divinations by Bongthing form preliminary stage for divining illness or ritual.
Traditional Buddhist and animistic Lepcha practices maintain balance with none overpowering other in rituals concerning individual or people of Lingthem. Religious practices of Lingthem retain identity through syncretic elements of pre-dominant Buddhist and animistic traits. Large scale presiding religious practices are slowly transitioning to Buddhism since few animistic rituals of Bongthing are employed. Traditional function of Bongthing as priests is mostly replaced by monks performing divinations relating sickness and subsequent cure. Although much animistic rituals get retained as part of identity unique to Lepchas, function of Lamas as priest is significantly pronounced in both sectors.
Rituals and Festivals of Lingthem
Few important rituals and festivals of Lepchas in Lingthem are:
Concept of Health
Health care system is concerned with ways and means of people organizing to care for patients. Traditional health care practices form important element of the cultural fabric of Lepchas. Uniqueness of traditional health care practices provides distinct identity to Lepchas reputed for powerful endemic shamanic healing practices of Mun and Bongthing. Conceptions regarding good and bad health accentuate worldview possessed by people acting as cultural models of sickness and treatments sought based on causes relating the same. Cultural structures and ecological setting of people directly or indirectly determine understanding of disease influencing pattern of health care. Knowledge regarding disease aetiology, symptomatology and resultant cures is vital. This is mainly because the cause of disease is inevitably related to nature of treatment.
Deb Burman (1986) has noted that the whole practice of such a concept of disease and its treatment seems an apparatus of exploitation which is warped by the customs and beliefs of the society.
According to Lepchas of Upper Lingthem good health is achieved by consuming good food, less Chi (traditional fermented rice drink), performing annual rituals Faat and worshipping Lord Buddha. One should refrain from Chi and Arrak (smoke) for attaining good health. Meals should be taken twice with beef, fowls and eggs. Timely homage to household deities is required failing which causes ill-health. Monthly and yearly donation to monastery provides blessings from gods ensuring vigour and good health. Regular lighting of prayer lamps called Tshumi ensures luck and good health. Reciting hymns of Guru Rinpoche and Green Tara is beneficial for general health.
According to Lepchas of Upper Lingthem, bad health occurs through intake of Chi, bad diet and failure in conducting rituals. Loss of vitality and withdrawal from work signify bad health. A 40-year-old Pintsho Lepcha, farmer of Upper Lingthem, married to Ongzey Lepcha with four children spent most time working in field tending cattle and job card provided through MGNREGA (Mahatma Gandhi National Rural Employment Guarantee Act). Earlier, he consumed Chi (traditional fermented rice drink) in huge quantities, large amount of dried smoked meat, slightly rotten meat and cottage cheese called Churpi. Later, he started having acute spinal pain and witnessed small amounts of blood on coughing. At first, he ignored the issue but later requested services of Bongthing of Upper Lingthem who conducted Lee Faat setting fowl free for his cure. Later, he went to the primary health care centre. The doctor was unavailable and health worker provided few iron tablets. Later, his brothers took him to Mangan hospital taking two and half hours. He was diagnosed with Tuberculosis and treated at Mangan District hospital within three months costing around Rs. 6,000–8,000. He consumed beef soup, avoiding rotten and dried meat as well as consumption of Chi, Arrak. He attended programmes for dots organized by ASHA and later got cured.
People of Lower Lingthem are entirely Buddhists with conceptions on health guided by animistic and Buddhist traditions. Good health is considered gift of god. It is achieved by scheduled diet comprising adequate meat, milk and vegetables. Good health symbolizes blessing of Lee Rum (household deity) offering protection, wellbeing and happiness of family. Living an active life and contributing to monastery ensures good health, prosperity and wellbeing of individual. Regular lighting of Tshumi, conducting ritual of Lee Faat, Pho Lha, Yangku and Green Tara bring good health to concerned person and family.
Bad health was due to bad lifestyle, deviations from Buddhist path of righteousness. Chi and Arrak harm person by disturbing families through loss of socioeconomic position. Dorji Ongmu, 13-year-old student at Mangan Higher Secondary school was tempted to pick tree tomato growing at her neighbour’s house. People of Lingthem believe eating or even picking fruits, vegetables of Lepcha household without prior offering garden deity causes ailments. She was sleepless with continuous sweating and body cramps. Family members sought Leebaek Mathyum, Bongthing of Lower Lingthem. Next day, he advised her parents to perform Sukyu Rum Faat for mercy and forgiveness from the wrath of Ami Moong (Orchard deity). Simple ritual offering fruits, vegetables, rice, Chi (traditional fermented rice drink), two eggs and lighting butter lamp was made. Contents were kept at crossroads as Bongthing refused money and dinner was offered. Both sectors resort using animistic Lepcha and Buddhist rituals as first-aid for ailing individual secondarily resorting to modern health care.
Supernatural Beliefs Related to Health
Supernaturalism forms integral fabric of traditional animistic practice of Lepchas in tune with Nyingma Buddhist practices integrating people. Villagers believe animal sacrifice wastes resources causing negative karma, mostly a product of Buddhist cognition but obligatorily perform sacrifices demanded by Rum. People of Lingthem state failure to conduct rituals known as Faat cause illness, misfortune, or death of family members and relatives. Ancestors are invoked once in three months, twice a year or annually. Inability to pay homage causes suffering. Children are forbidden from making noises at dusk which angers deity Kongchen Chu causing lightning. Children and women are prevented from walking in forest at dusk and night as devils cause high fever, soul-loss, insomnia, cramps, and deterioration of mental and physical health. Devils or Moong believed to roam in hills, streams, hillocks, bamboo groves, animal sheds harming unsusceptible humans coming in their path. During night residents of Lingthem avoid carrying meat from distant places as it attracts ghosts.
If Sur and Sang is missed guardian deities of household and hungry ghosts cause illness. People of Lingthem believe Ami Moong with both benevolent and malevolent characteristics invoked for offering gratitude, protection and abundance of crops. People of both sectors seek blessings of ancestors by Lee Faat for specific household invoking spirits of nature also jointly for protection against pestilence and diseases during Chirim.
Pregnant women are prevented from viewing lunar eclipses as it causes newborn to have abnormalities. Pemkit Lepcha, resident of Lower Lingthem, wife of Gyatsho Lepcha monk of Lingthem followed animistic Lepcha and Buddhist pre-post-delivery rituals. Pemkit stated performing rituals felt her child would be protected by Rum and Buddhist deities. During death people of Lingthem observe Chaam (Chaam-nyot: day of mourning, Chyam, Torhut, to close; Nyet: field, to stop work in the field (Stocks, 1975). During Chaam nothing is grown, field is not dug and no new clothes are worn. Taboo of travelling, consuming new fruits and food is imposed as soul of deceased start wandering after death.
Lepchas accept change availing modern medicine having culturally mediated intrinsic beliefs identifying and resolving issues for causation of sickness and sustaining good health. Two years ago, Kaden Lepcha, widow of 60 years residing with 22-year-old son Fuzong ex-Panchayat of Lingthem working at job card suffered from fever and severe backaches. She refused allopathic medication addressing relatives to call Bongthing of Lower Lingthem who performed Lee Faat for exorcising evil. Rituals for house and reading horoscopes by village monk were also performed. Later, her son and villagers took her to Mangan. She was referred to Anandaloke Hospital, Siliguri taking around eight hours. Entire expense was incurred by family and facility of ambulance was not provided due to shortage at hospital. Diagnosed with appendicitis and gall bladder stone two major operations with treatment cost of Rs 30,000 was made. She felt cured and stopped taking betelnut but still continues consumption of Chi.
Deities and Soul Related to Health
Conclusion
Mun and Bongthing of Lepcha tradition possess knowledge on myths, fables, history and indigenous system orally transmitted generationally. Causation of disease is believed through supernatural entities and treatment is mostly magico-religious. Form of treatment provided by traditional healer is based on animistic rites. Traditional healers provide familiarity and psychological bond (Tarafdar, 2004) by shared cultural worldview. They do not demand money which is a boon for poorer section who cannot afford elaborate rituals of Lamas (Buddhist monks).
Divination by rosary and empowered rice is used for minor illness but serious cases require immediate services of Bongthing. Egg and fowls are used with donations of villagers based on economic capacity. Part-time specialist Bongthing of Upper Lingthem a farmer engages in consumption of Chi (traditional fermented rice beer). Boongthing of Upper Lingthem primarily engages as a farmer continuing the consumption of Chi (traditional fermented rice beer) during his rituals. But the senior hereditary Bongthing being 90 years of age refrains consumption of Chi staying at home being accessible to people. He is commonly referred by the term Padim as a sign of respect by all Lepchas of Lingthem. Lepchas of both sectors give more respect to Bongthing chosen by Rum. They feel the cure is more effective through Bongthing chosen by spirits as he is believed to be endowed with blessings and powers by his ancestors. Bongthing of Upper Lingthem learnt the art without hereditary gift.
Lepchas of both sectors requested 90-year-old Naetuk Lepcha, earlier a monk at Lingthem belonging to hereditary family of Bongthing, for conducting annual rituals of village such as Chirim and Sukyu Rum Faat. Naetuk was chosen by tutelary deity Agendra Rum who visited him through visions and dreams. On consultation with Bongthing of neighbouring village Sakyong Pentong, it was clear that ancestral clan deity had chosen him. First, he was not full-time Bongthing and opposed to idea of animal sacrifice. But need of Bongthing for performing village rituals through persuasion of people made him quit monkhood and he became full-time Bongthing of Lingthem. Treatment of Bongthing of Lower Lingthem is sought even in case of minor ailments through effectiveness of his practices.
Despite prevalence of few primary modern health care facilities such as Primary Health Sub-Centre, services of ICDS and ASHA, absence of proper infrastructure and efficient health workers causes people of Lingthem to resort treatments offered by Bongthing of Lower Lingthem. Old age restricts Bongthing of Lower Lingthem from travelling unlike his Upper Lingthem counterpart mostly giving herbal concoctions to patients with required rituals. In his absence, right combination of herbs is prepared by his son, a monk at Lingthem monastery.
Few medical terminologies and ethnomedical applications are still evident in Lingthem (see Tables 1 and 2). Important rituals performed for both sectors include Chirim Faat (ritual for good harvest and protection against diseases), Sukyu Rum Faat (ritual for appeasing garden deity), Chu Rum Faat (ritual for worshipping holy peaks). He also treats victims of duk or kapat poisoning. Agendra Rum, his tutelary deity assists in divination and treatment. He also provides herbal cures for fever, dysentery, diarrhoea, measles, mumps, pressure, fracture, sprain, body ache and notorious cases of dukor kapat poisoning. Based on elements and Buddhist astrological signs people summon monks for conducting Buddhist rituals ensuring protection and good health. Hoisting Lungta (Buddhist prayer flags), preparing Namgasago (Totem comprising thread-crosses for protection against evil) form part of rituals conducted by monks. Lepchas of both sectors have rich cultural practices giving them distinct identity.
Some Medical Terminologies Among Lepchas of Lingthem.
Few Ethnomedicinal Applications Among Lepchas of Lingthem.
Although some of the Lepchas of Sikkim have embraced Christianity but the 307 residents of both sectors of Upper and Lower Lingthem, being entirely Buddhists are unaffected by the influences of Christianity and as well as outside the preview of Hinduism prevalent in other regions of Sikkim. Dzongu is a protected area for Lepchas and the people of Lingthem interestingly adhere exclusively to Nyingma Buddhist and traditional Lepcha animistic beliefs through practice of ethnomedical system long with tiny access of modern health care facility, and therefore no sign of influence by the great traditional Hindu medicine.
Changes occurring within respective sectors are brought by means of education, occupational mobility, network and extension of ties. Knowledge regarding understanding concept of health and disease of a population enables penetrating into their world view by attaining comprehensive idea of their intrinsic ideologies and social structure. It is instinctive and psychological for them to seek traditional form of treatment as modern treatments available to area cater few basic health needs, whereas for delivery, major operations, treatment for diabetes and heart disease are referred to the district hospital of Mangan and beyond.
Impact of formal education has brought changes in cognition and lifestyle of people. Major role in influencing treatment of people lies in hands of Bongthing, while Buddhist ritual ensures only well-being. Traditional treatment acts as preliminary first aid to people resorting modern treatments. People want to visit modern doctors but problems faced through uncarpeted road during monsoons mostly force isolation. During emergency people get compelled resorting traditional health practice as modern health facility often remains inaccessible.
Footnotes
Declaration of Conflicting Interests
The authors declared no potential conflicts of interest with respect to the research, authorship and/or publication of this article.
Funding
The authors received no financial support for the research, authorship and/or publication of this article.