Project Abstract

Transnationalism and Changing Medical Practice Paradigms in South Asian Sowa Rigpa (Tibetan medicine) and the West

Transnational medical practice is a common phenomenon in contemporary Sowa Rigpa, especially among exile practitioners in India and Nepal. Both in the form of medical tours abroad or local treatments of foreign patients and via telemedicine, doctors provide transnational medical care. However, as a result of the deterritorialization of practice and practitioners or new phenomena like telemedicine and innovations in medical treatment options, varying degrees of changes in contrast to national treatment paradigms occur that raise questions about efficacy of practice or benefit for patients. This research seeks to explore and analyse transnational Tibetan medical practice and asks to what extent this trend is transforming established principles, perceptions, and representations of Tibetan medicine. The aim is to determine and question tendencies towards a modern or global Tibetan medicine, following Wujastyk and Smith’s categories of modern and global Ayurveda. Using the methods of participant observation and semi-structured interviews with Tibetan medical doctors and patients, I will conduct 13 months of multi-sited ethnographic fieldwork in India, Nepal, and Europe. Ultimately, the research will help to understand the challenges to and possibilities for globalised medical practice, contributing to the growing anthropological interest in global health.

Why do I think it’s interesting to do research on transnational practices?

The very fact of a transnational medical practice makes major transformations – as compared to ideal treatment paradigms described in classical medical texts as well as a more common localized form of South Asian Sowa Rigpa practice – inevitable, and such transformations raise questions concerning a potential loss of efficacy and benefit for patients. Both the temporary presence of doctors abroad during medical tours and the often relatively higher costs of their treatments mean that the process of regular check-ups and follow-up appointments to correct treatment options is often dispensed with. Similar situations occur when patients from other countries seek Tibetan medical care in India or Nepal on a medical or tourist trip. In both these contexts, differing cultural backgrounds and language barriers can, moreover, pose challenges for effective and long-term treatment, as patients might experience difficulties in understanding the principles and epistemological rationale of Sowa Rigpa.

Further and more pronounced differences to national treatment contexts and processes arise in telemedicine settings. Telemedicine, initiated and maintained via social media and telecommunication applications, can provide access to Tibetan medical consultations, treatments, and advice to an extended clientele. Still, to what extent such telemedical practices offer effective medical diagnostics, treatments, and support needs to be clarified. The two-dimensional frameworks of virtual consultations change many preconditions of Tibetan medical practice, even if they offer doctors the opportunity to reach patients on a global scale more easily than ever before.

Finally, another aspect that complicates medical practice via telemedicine and abroad is the regulatory context that restricts or prohibits Tibetan medical practice, especially in western countries. In order to overcome such challenges in the long term, there are various efforts to find innovative ways of providing medical treatment. Efforts like these can likewise have considerable impact on how Sowa Rigpa is administered in transnational contexts.