Ritualized Medical Pluralism: Understanding the Social Legitimacy and Practice of Indigenous Knowledge and Spiritual Healing System Embedded in Pheri Culture of Phree Community in Nepal

The Pheri culture of the Phree community in eastern Nepal is an indigenous spiritual healing system used for both prevention and cure, grounded in animistic, shamanistic, and tantric cosmology. It addresses illness from spiritual affliction, cosmological imbalance, and social disruption. Households combine biomedicine with Pheri healing based on culturally specific explanations of illness, creating a pattern of ritualized medical pluralism. The study argues that Pheri is a complementary and essential therapeutic domain, and its marginalization threatens cultural continuity and community health resilience.

Study at a glance

Abstract

Background: Medical pluralism refers to the coexistence of multiple healing systems within a society. In Nepal, biomedicine exists alongside indigenous, spiritual, and ethnomedical practices, yet, research on preventive and ritual-based healing systems practiced by heterogeneous communities remains limited. This study examines the Pheri culture of the Phree (Pheriwala Jogi) community in eastern Nepal as an indigenous spiritual healing system that influences broader plural medical practices. Methods: The study employs a qualitative ethnographic research design integrating participant observation, in-depth interviews, focus group discussions, oral histories, and insider auto-ethnography methods. Fieldwork was conducted in Fedap of Tehrathum (January - April 2025) with data collected from Phree ritual practitioners, community members, and non-Phree users and analyzed thematically within a medical anthropological framework. Results: Findings show that Pheri culture constitutes a coherent indigenous medical system grounded in animistic, shamanistic, and tantric cosmology. Pheri ritual is used for both preventive and curative purposes, addressing illness attributed to spiritual affliction, cosmological imbalance, and social disruption. The widespread social legitimacy of Pheri healing has fostered a pattern of ritualized medical pluralism, whereby households combine biomedicine with indigenous and spiritual healing based on culturally specific explanatory models of illness. Conclusion: Pheri culture is a complementary and essential therapeutic domain in Nepal’s pluralistic medical landscape, addressing dimensions of suffering beyond biomedicine. Its marginalization threatens both cultural continuity and community health resilience. Novelty: The study introduces ritualized medical pluralism as a conceptual framework to foreground ritual healing as a central, preventive, and socially organizing medical practice rather than a peripheral alternative.