Putting the Spirit into Culturally Responsive Public Health: Explaining Mass Fainting in Cambodia.

The study explores the cultural and religious meaning behind episodes of mass fainting sweeping through garment factories in Cambodia. An ethnographic study was conducted at 20 garment factories in Kandal, Preah Sihanouk, Kampong Cham, Kampong Speu, Takeo, and Kampong Chhnang provinces. Informants were 50 women who fainted or possessed and their families, factory and clinic staff, and monks. Informants described their views on the causes of the mass fainting. Based on the informants' views, the seeds were sown when factories were built on former Khmer Rouge killing fields, when local guardian spirits were disrespected and when the factories were not inaugurated with the proper rituals. We found that an inauspicious death, a conflict leading to violation of a vow, or culturally inappropriate interventions by management explained what triggered the episodes. The results show that people believe that mass faintings occur in parallel with tensions between the workers and the foreign owners of the factories and tensions between the human and spiritual owners of the land. The study has implications for the development of culturally responsive public health interventions in mass group phenomena.