When biomedicine appears not enough: local moral worlds and spiritual healing in Hunza valley of Pakistan
Asian Journal of Medical Humanities January 1, 2026 Peer reviewed DOI: 10.1515/ajmedh-2025-0018 via OpenAlex
Summary
In Hunza, Gilgit-Baltistan, Bitans (shamans) treat illnesses that biomedicine struggles to address, such as recurrent miscarriage and mental conditions attributed to supernatural beliefs. Ethnographic fieldwork indicates that local people continue to consult Bitans alongside biomedical services due to their unique role in addressing morally and existentially attributed illnesses. Their practices incorporate rituals, amulets, and herbal remedies, reflecting the influence of gender and generational expectations in a context where spiritual healing is vital for coping with complex health issues.
Study at a glance
| Design | ethnographic study |
|---|---|
| Population | local people in Hunza valley who consult Bitans for health issues |
| Key finding | Bitans provide essential spiritual healing for illnesses that biomedicine cannot resolve, emphasizing the importance of moral and existential dimensions in health care. |
Abstract
Abstract In Hunza, Gilgit-Baltistan, Bitans (shamans) continue to treat illnesses that biomedicine may diagnose yet appealingly leaves experientially unresolved: recurrent miscarriage, spirit possession, infant mortality, and mental condition often attributed to nazar (evil eye), jinn (supernatural beings), or pari (fairies). Drawing on ethnographic fieldwork in Karimabad and surrounding villages of Hunza valley, we focus on lay perceptions of Bitans and the underlying reasons local people still consult them alongside biomedical hospital services. The findings reveal a hierarchical medical pluralism in which these spiritual healers occupy an indispensable niche for morally and metaphysically attributed illnesses. Through embodied rituals, amulets, herbal remedies, and verbal healing, Bitans reconfigure domestic spaces into sites of healing and restore coherence to disrupted life stories. Their practice is also shaped by gender, generational expectations, and the local moral economy of spiritual work. These results suggest that spiritual healing and intuition play a vital role in the Hunza valley to address various dimensions of illnesses – moral, relational, and existential – that biomedicine alone cannot resolve.