Stones, demons, medicinal herbs, and the market: Ethnic medicine and industrial aspirations among the Qiang of Western Sichuan

In global health it is commonly assumed that governments orchestrate a benevolent integration of “traditional medicine” into health systems and markets, through national policies and regulation, as in WHO’s “Traditional Medicine Strategy”. In China, rather than state orchestration, it is a healthcare market of products and services, operating within a nation-building framework, that shape “traditional medicine”. Furthermore, it is the country’s interests in developing materia medica for its domestic and export markets that are behind their long-lasting steering of the WHO’s strategy. In this thesis, I draw on my multi-sited ethnographic fieldwork to document how this development is unfolding among people of the Qiang (Ch’iang) minority in China. I show the attempts of city and town dwelling Qiang practitioners, academics, government officials and members of the pharmaceutical industry to standardise medicinal herbs and compound medicines, as well as to systematise disputed medical theories and practices. I argue that they do this, in order to articulate “Qiang medicine” as a discipline and “Qiang medicines” as products. I then contrast these efforts with the afflictions and choices of care among Qiang villagers, for whom “Qiang medicine” emerges as a foreign concept. What becomes evident is that differences in the desire and legitimacy to articulate “Qiang medicine” relate to diverging personal aspirations, professional connections and living milieus. Thus, I argue that the WHO “Traditional Medicine Strategy” and China’s “Chinese Medicine Law” predominantly favour the agendas of urban dwelling actors. These attempt to articulate “traditional” ethnic medicine and medicines by mirroring a scientised and state-sponsored contemporary Chinese medicine, for markets that are ultimately destined to cater for an ethnic Han majority. Ethnicity and medicine thus converge to serve a particular market dynamic. Such healthcare marketisation is embedded in a socio-political context that is specific to China, but relevant worldwide.