Culture, Medicine, and Psychiatry

, Volume 37, Issue 4, pp 694–710 | Cite as

“Now he walks and walks, as if he didn’t have a home where he could eat”: Food, Healing, and Hunger in Quechua Narratives of Madness

  • David M. R. OrrEmail author
Original Paper


In the Quechua-speaking peasant communities of southern Peru, mental disorder is understood less as individualized pathology and more as a disturbance in family and social relationships. For many Andeans, food and feeding are ontologically fundamental to such relationships. This paper uses data from interviews and participant observation in a rural province of Cuzco to explore the significance of food and hunger in local discussions of madness. Carers’ narratives, explanatory models, and theories of healing all draw heavily from idioms of food sharing and consumption in making sense of affliction, and these concepts structure understandings of madness that differ significantly from those assumed by formal mental health services. Greater awareness of the salience of these themes could strengthen the input of psychiatric and psychological care with this population and enhance knowledge of the alternative treatments that they use. Moreover, this case provides lessons for the global mental health movement on the importance of openness to the ways in which indigenous cultures may construct health, madness, and sociality. Such local meanings should be considered by mental health workers delivering services in order to provide care that can adjust to the alternative ontologies of sufferers and carers.


Mental illness Global mental health Food Quechua Andes 



I am grateful to the Economic and Social Research Council for funding this study and to my informants for their patient explanations.


  1. Abramowitz, Sharon Alane 2010 Trauma and Humanitarian Translation in Liberia: The Tale of Open Mole. Culture, Medicine, and Psychiatry 34(2): 353–379.CrossRefGoogle Scholar
  2. Allen, Catherine J. 2002 The Hold Life Has: Coca and Cultural Identity in an Andean Community. 2nd Edn. Washington: Smithsonian Institution Press.Google Scholar
  3. Allen, Catherine J. 2011 Foxboy: Intimacy and Aesthetics in Andean Stories. Austin: University of Texas Press.Google Scholar
  4. Bass, Judith K., Paul A. Bolton, and Laura K. Murray 2007 Do not Forget Culture When Studying Mental Health. Lancet 370: 918–919.CrossRefGoogle Scholar
  5. Bourque, Nicole 2001 Eating Your Words: Communicating with Food in the Ecuadorian Andes. In An Anthropology of Indirect Communication. J. Hendry and C.W. Watson, eds., pp. 85–100. London: Routledge.Google Scholar
  6. Brijnath, Bianca 2011 Alzheimer’s and the Indian Appetite. Medical Anthropology 30(6): 610–628.CrossRefGoogle Scholar
  7. Cartwright, Elizabeth 2007 Bodily Remembering: Memory, Place, and Understanding Latino Folk Illnesses Among the Amuzgos Indians of Oaxaca, Mexico. Culture, Medicine, and Psychiatry 31(4): 527–545.CrossRefGoogle Scholar
  8. Classen, Constance 1993 Inca Cosmology and the Human Body. Salt Lake City: University of Utah Press.Google Scholar
  9. Counihan, Carole M. 1999 The Anthropology of Food and Body: Gender, Meaning, and Power. London: Routledge.Google Scholar
  10. Crandon-Malamud, Libbet 1991 From the Fat of our Souls: Social Change, Political Process, and Medical Pluralism in Bolivia. Berkeley: University of California Press.Google Scholar
  11. Dossa, Parin 2013 Structural Violence in Afghanistan: Gendered Memory, Narratives, and Food. Medical Anthropology 32(5): 433–447.CrossRefGoogle Scholar
  12. Fernando, Suman 2012a Challenges for Mental Health Development in Low and Middle Income Countries. Paper Presented at the ‘Global Mental Health: Bridging the Perspectives of Cultural Psychiatry and Public Health’ Conference. 5–6th July, Montreal, Canada.Google Scholar
  13. Fernando, Gaithri A. 2012b The Roads Less Traveled: Mapping Some Pathways on the Global Mental Health Research Roadmap. Transcultural Psychiatry 49(3–4): 396–417.CrossRefGoogle Scholar
  14. Goddard, Michael 2011 Out of Place: Madness in the Highlands of Papua New Guinea. London: Berghahn.Google Scholar
  15. González Holguín, Diego 2007 [1608] Vocabvlario de la Lengva General de todo el Perv llamada Lengua Qquichua, o del Inca. Electronic document,, accessed September 16, 2012.
  16. Gose, Peter 1994 Deathly Waters and Hungry Mountains: Agrarian Ritual and Class Formation in an Andean Town. Toronto: University of Toronto Press.Google Scholar
  17. Greenway, Christine 1998 Hungry Earth and Vengeful Stars: Soul loss and Identity in the Peruvian Andes. Social Science and Medicine 47(8): 993–1004.CrossRefGoogle Scholar
  18. Harvey, Penelope 1998 Los “hechos naturales” de parentesco y género en un contexto andino. In Gente de Carne y Hueso: Las Tramas de Parentesco en los Andes. Denise Y. Arnold, ed., pp. 69–82. La Paz: ILCA/CIASE.Google Scholar
  19. Janowski, Monica and Fiona Kerlogue, eds. 2007 Kinship and Food in Southeast Asia. Copenhagen: Nordic Institute of Asian Studies Press.Google Scholar
  20. Kirmayer, Laurence J. 2012 Cultural Competence and Evidence-Based Practice in Mental Health: Epistemic Communities and the Politics of Pluralism. Social Science and Medicine 75(2): 249–256.CrossRefGoogle Scholar
  21. Krogel, Alison 2011 Food, Power, and Resistance in the Andes: Exploring Quechua verbal and visual narratives. Lanham: Lexington.Google Scholar
  22. Larrea, Carlos and Wilma Freire 2002 Social Inequality and Child Malnutrition in Four Andean countries. Revista Panamericana de Salud Pública 11(5–6): 356-364.CrossRefGoogle Scholar
  23. Meigs, Anna 1987 Food as a Cultural Construction. Food and Foodways: Explorations in the History and Culture of Human Nourishment 2(1): 341–357.CrossRefGoogle Scholar
  24. Myers, Neely Laurenzo 2010 Culture, Stress and Recovery from Schizophrenia: Lessons From the Field for Global Mental Health. Culture, Medicine, and Psychiatry 34(3): 500–528.CrossRefGoogle Scholar
  25. Orr, David M.R. 2012 Patterns of Persistence Amidst Medical Pluralism: Pathways Toward Cure in the Southern Peruvian Andes. Medical Anthropology 31(6): 514–530.CrossRefGoogle Scholar
  26. Pandolfo, Stefania 2008 The Knot of the Soul: Postcolonial Conundrums, Madness, and the Imagination. In Postcolonial Disorders. Mary-Jo DelVecchio Good, Sandra Teresa Hyde, Sarah Pinto and Byron J. Good, eds., pp. 329–358. Berkeley: University of California Press.Google Scholar
  27. Pedersen, Duncan, Hanna Kienzler and Jeffrey Gamarra 2010 Llaki and Ñakary: Idioms of Distress and Suffering Among the Highland Quechua in the Peruvian Andes. Culture, Medicine, and Psychiatry 34(2): 279–300.CrossRefGoogle Scholar
  28. Ramirez, Susan Elizabeth 2005 To Feed and be Fed: The Cosmological Bases of Authority and Identity in the Andes. Stanford: Stanford University Press.Google Scholar
  29. Read, Ursula 2012 “I want the one that will heal me completely so it won’t come back again”: The Limits of Antipsychotic Medication in Rural Ghana. Transcultural Psychiatry 49(3–4): 438–460.CrossRefGoogle Scholar
  30. Ricard Lanata, Xavier 2007 Ladrones de Sombra: El Universo Religioso de los Pastores del Ausangate. Cuzco: CBC/IFEA.Google Scholar
  31. Robin, Valerie 2005 Caminos a la Otra vida: Ritos Funerarios en los Andes Peruanos Meridionales. In Etnografías de Cuzco. A. Molinié, ed., pp. 47–68. Lima: IFEA/CBC.Google Scholar
  32. Saavedra, Javier, Mercedes Cubero, and Paul Crawford 2012 Everyday Life, Culture, and Recovery: Carer Experiences in Care Homes for Individuals with Severe Mental Illness. Culture, Medicine, and Psychiatry 36(3): 422–441.CrossRefGoogle Scholar
  33. Sánchez Garrafa, Ricardo and Rodolfo Sánchez Garrafa, eds. 2009 Medicina Tradicional Andina: Planteamientos y Aproximaciones. Cusco: CBC/Centro de Medicina Andina.Google Scholar
  34. Scheper-Hughes, Nancy 1988 The Madness of Hunger: Sickness, Delirium, and Human Needs. Culture, Medicine, and Psychiatry 12(4): 429–458.CrossRefGoogle Scholar
  35. Silverblatt, Irene 1987 Moon, Sun and Witches: Gender Ideologies and Class in Inca and Colonial Peru. Princeton: Princeton University Press.Google Scholar
  36. Skar, Sarah Lund 1994 Lives Together—Worlds Apart: Quechua Colonization in Jungle and City. Oslo: Scandinavian University Press.Google Scholar
  37. Sohrsdahl, Katherine, Natalie Slopen, Kristine Siefert, Soraya Seedat, Dan J. Stein, and David R. Williams 2011 Household Food Insufficiency and Mental Health in South Africa. Journal of Epidemiology and Community Health 65: 426–431.CrossRefGoogle Scholar
  38. Summerfield, Derek 2008 How Scientifically Valid is the Knowledge Base of Global Mental Health? British Medical Journal 336: 992–994.CrossRefGoogle Scholar
  39. Summerfield, Derek 2012 Against “global mental health”. Transcultural Psychiatry 49(3–4): 519–30.CrossRefGoogle Scholar
  40. Tapias, María 2006 Emotions and the Intergenerational Embodiment of Social Suffering in Rural Bolivia. Medical Anthropology Quarterly 20(3): 399–415.CrossRefGoogle Scholar
  41. Topor, A., M. Borg, S. di Girolamo, and L. Davidson 2011 Not Just an Individual Journey: Social Aspects of Recovery. International Journal of Social Psychiatry 57(1): 90–99.CrossRefGoogle Scholar
  42. Valdizán, Hermilio and Angel Maldonado 1922 La Medicina Popular Peruana. Lima: Torres Aguirre.Google Scholar
  43. van Vleet, Krista E. 2008 Performing Kinship: Narrative, Gender, and the Intimacies of Power in the Andes. Austin: University of Texas Press.Google Scholar
  44. Weaver, Lesley Jo and Craig Hadley 2009 Moving Beyond Hunger and Nutrition: A Systematic Review of the Evidence Linking Food Insecurity and Mental Health in Developing Countries. Ecology of Food and Nutrition 48(4): 263–284.CrossRefGoogle Scholar
  45. Weismantel, Mary 1988 Food, Gender, and Poverty in the Ecuadorian Andes. Philadelphia: University of Pennsylvania Press.Google Scholar
  46. Weismantel, Mary 1995 Making Kin: Kinship Theory and Zumbagua Adoptions. American Ethnologist 22(4): 685–704.CrossRefGoogle Scholar
  47. WHO 2008 Mental Health Gap Action Programme: Scaling up Care for Mental, Neurological and Substance Abuse Disorders. Geneva: WHO.Google Scholar
  48. Wilson, Caroline 2010 ‘Eating, eating is always there’: Food, Consumerism and Cardiovascular Disease. Some Evidence from Kerala, South India. Anthropology & Medicine 17(3): 261–275.Google Scholar
  49. Yates-Doerr, Emily 2012 The Weight of the Self: Care and Compassion in Guatemalan Dietary Choices. Medical Anthropology Quarterly 26(1): 136–158.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  1. 1.School of Education and Social WorkUniversity of SussexBrightonUK

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