The Bioarchaeology of Care: A Case Study From Neolithic Vietnam

By David Mennear

A recent article in the International Journal of Palaeopathology, ‘Survival against the odds: modelling the social implications of care provision to seriously disabled individuals’ by Tilley & Oxenham (2011), proposed a new methodology called the ‘bioarchaeology of care’ to investigate the nature of support required to sustain life for disabled individuals in the archaeological record.

The focus of the investigation is the individual called Man Bac burial 9 (M9), from a Neolithic cemetery site (1700-2000BC) located in Ninh Binh province of northern Vietnam, 100 km north of Hanoi. Excavations between 1999 & 2007 uncovered 95 individuals from the site occupying a mouth of an estuary of the Red River Delta.

Care in society

M9 was a male between 20-30 years old, buried in a north-south flexed position on his right side, in contrast to the normal mortuary practice of extended supine east-west orientation. The skeleton of M9 exhibited extreme disuse atrophy of the lower and upper limbs, but he survived for approximately 10 years with either paraplegia or even quadriplegia – disabilities that were so severe that he would have relied on assistance for nearly ever aspect of his life.
This new methodology identified the context of care for M9, including reviewing the socio-cultural context, general health, and the physical environment of Man Bac.

Tilley & Oxenham then reviewed current clinical literature and split the care needed by M9 into a) basic and b) advanced care. Basic care consists of the daily necessities of life – dressing, food, water & transport, whilst advanced care includes maintenance of personal hygiene, managing long term environmental and physical concerns, general health maintenance, dedicated nursing, medical intervention as needed and continued well-being.
The methodology is still under development, but highlights the treatment and examination of people with disabilities within cultural context, something that has as much relevance for our own present cultural values
 http://www.pasthorizonspr.com/index.php/archives/06/2012/the-bioarchaeology-of-care-a-case-study-from-neolithic-vietnam