Conclusions

Just as Southeast Asia is not unique in terms of its geography, so are its diseases, as seen in biomedical terms, not unique to this part of the world. The distinctive profile of disease in the region is more the result of a complex interaction among the Southeast Asian environment, its inhabitants, and the world outside. In this essay this interaction was examined over two broad periods of time, the division of which was marked by the arrival of Europeans in the region.

How Southeast Asian peoples perceived and responded to disease prior to contact with the West reflects the processes of localization seen in other aspects of their culture. Perceptions of disease were dynamic, integrating features deriving from other regions of Southeast Asia, as well as from Chinese, Indie, and Islamic civilizations. These processes (which were evident in the naming of diseases), theories of causation, and therapy continued after contact with the West.

With the development of large, more concentrated, populations in the region, different types of disease became prevalent, most notably epidemics. The prominence of these diseases in accounts probably served to enhance the notoriety of the region for unhealthiness, among both Asians and Europeans (Schäfer 1967). However, underlying these diseases and the many others that were less dramatic in their effects and that did not figure prominently in accounts were widespread poverty and poor nutrition. These, rather than miasmas and steaming swamps, were the reasons for the prevalence of numerous diseases in the region. Thus, despite the introduction of public health measures, hospitals, vaccination, and eventually some of the other advances made by medical science, what could have the greatest effect on the prevalence of disease in the region was the relief of poverty. This is still the case.

Scott Bamber

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