Speaking Through the Body: Leukorrhea as a Bodily Idiom of Communication in Garhwal, India

Abstract

<p>Among women in South Asia, the complaint of vaginal discharge (often called leukorrhea) is extraordinarily common. Genital secretions, according to Ayurvedic concepts of the body, are considered a highly purified form of"dhatu", or bodily substance, and loss of this precious substance is thought to result in progressive weakness or even death. Women suffering from "dhatu loss" complain of vaginal discharge as well as somatic symptoms such as dizziness, backache and weakness. The link between unexplained gynecological symptoms and mental health concerns has been explored by both psychiatrists and anthropologists in South Asia Cross-cultural psychiatrists have suggested that leukorrhea and its associated symptoms may represent a somatic idiom for depression. In this research report, I explore a more broad construction for leukorrhea as a "bodily idiom of communication", in which the woman's body serves as a template for the expression of deep emotion. I suggest that leukorrhea may represent a discourse of distress; of resistance to social oppression; a discourse about sexuality; a way of reflecting upon a rapidly changing society. Leukorrhea has entirely different meanings in the dominant biomedical discourse, where it has come to represent reproductive tract infection (RTI). Early biomedical studies suggested that RTI was prevalent in South Asia, although these studies were limited in scope and flawed in methodology. Women suffering from sexually transmitted infection are at higher risk for the transmission of human immunodeficiency virus, an issue ofincreasing concern in South Asia A public health program entitled "the syndromic approach to the management of STIs" has been launched in South Asia to treat women presumptively for STI based on the reported symptom of vaginal discharge. Despite evidence that the approach is resulting in significant over-treatment ofwomen with antibiotics, the program continues. I explore the way in which the polysemic symptom ofleukorrhea has been medicalized, and comment on the negative effects ofthis construction ofthe South Asian woman's body. I conclude with a discussion ofthe interface between ways ofknowing, and the role of the anthropologist who works at this interface, which is invariably fraught with political and ideological tensions.</p>