In Nepal, spirit possession is a common phenomenon occurring both in individuals and in groups. To identify the cultural contexts and psychosocial correlates of spirit possession, we conducted a mixed-method study in a village in central Nepal experiencing a cluster of spirit possession events. The study was carried out in three stages: (1) a pilot study consisting of informal interviews with possessed individuals, observations of the possession spells, and video recording of possession events; (2) a case-control study comparing the prevalence of symptoms of common mental disorders in women who had and had not experienced possession; and (3) a follow-up study with focus group discussions and in-depth interviews with possessed and non-possessed men and women, and key informants. Quantitative results indicated that possessed women reported higher rates of traumatic events and higher levels of symptoms of mental disorder compared to non-possessed women (Anxiety 68 vs. 18 %, Depression 41 vs. 19 %, and PTSD 27 vs. 0 %). However, qualitative interviews with possessed individuals, family members, and traditional healers indicated that they did not associate possession states with mental illness. Spirit possession was viewed as an affliction that provided a unique mode of communication between humans and spirits. As such, it functioned as an idiom of distress that allowed individuals to express suffering related to mental illness, socio-political violence, traumatic events, and the oppression of women. The study results clearly indicate that spirit possession is a multi-dimensional phenomenon that cannot be mapped onto any single psychiatric or psychological diagnostic category or construct. Clinical and public health efforts to address spirit possession must take the socio-cultural context and systemic dynamics into account to avoid creating iatrogenic illness, undermining coping strategies, and exacerbating underlying social problems.
This study has assessed livelihood diversification occurred in Kovalam, which is a coastal village in Tamil Nadu state in India. Livelihood diversification is a strategy which enables people to surmount the vulnerability of conventional income-generating activities by diversifying and expanding the number of activities for an improvement in their standard of living. Participatory Rural Appraisal tools, which are focus group discussion, key-informant interview and semi-structured questionnaires, have been used to collect primary data. The result suggested that fishing and fishing allied activities are the major livelihood in Kovalam village, whereas nowadays, small business, services, day laborer, vendors and other different activities are also practiced as livelihood options on a smaller scale. The emerging issue of freshwater insecurity interlinks with the gender division of labor corresponding to livelihood strategies. Gender can be integrated in a better way to ensure sustainable livelihood which will safeguard the wellbeing of coastal communities.
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