Protecting the Body, Living the Good Life: Negotiating Health in Rural Lowland Laos

Abstract

Abstract In rural lowland Laos, aspirations to a good life and visions of well-being are defined and impacted by the process of negotiating health. The state of sabai  (well-being) situates the person in relation to their family, social, and spiritual worlds, and the associated practices have taken on increasing importance as new vulnerabilities and social struggles emerge in the late-socialist era. Traditional healers are rapidly disappearing while public biomedical health services have not yet fully evolved into a trusted alternative, leaving rural people in a healthcare gap involving complex care-seeking trajectories at high personal and familial cost. Differing experiences of the therapeutic encounter show how healthcare choices are closely associated with relationships. These experiences are influenced by the practitioner's motives for providing care, guided by the desire for a life that is both meaningful and judged as “good” according to social principles. Although lacking in financial compensation, providers who feel otherwise rewarded are likely to provide care that is acceptable to the patient and allied with the production of well-being. Village healers find satisfaction in personal and spiritual attainment and occupy a high social status where they experience reciprocity through care from others, while rural health staff lack agency and professional reward. Achieving a “good life” in rural Laos is thus highly interdependent with the good lives of others.