Abstract: This article draws on fieldwork among patients pursuing healing using macrobiotic diets at a Buddhist temple clinic not far from Ho Chi Minh City, Vietnam. It examines the (re-)emergence of macrobiotic diets as a movement for “nurturing life” (dưỡng sinh) in modern Vietnam. By examining the use of macrobiotic diets among this temple’s patients and followers, the article unravels popular discourses of food and health, and their intertwining relationships with conceptions of chronic diseases in contemporary Vietnamese society. The popularity of this temple as an alternative therapeutic centre for people with chronic conditions also sheds light on notions of illness, healing processes, and religious beliefs. The rise of macrobiotics as an alternative diet and lifestyle reveals people’s uncertainties and mistrust amid many prevalent problems in contemporary Vietnam, such as food safety concerns. Altogether, “nurturing life” activities offer strategies for individuals to adapt to a rapidly changing social context.
Key Words: Buddhism, Health, Macrobiotics, Diet, Healing, Food Safety, Vietnam
Introduction
Back in 2016, I was visiting a patient in the University Medical Center in Ho Chi Minh City, where patients with liver cancer were treated with the latest technologies available at the time. In a shared in-patient room, where a few patients stayed to recover after their surgery, I was listening to a conversation between roommates, who all had liver cancer. A lady was encouraging her fellow patients:
“Just don’t worry and stay happy. We should stay happy even with our cancer. After this treatment finishes, we should go to the Brown Rice Temple. There is a monk there who heals patients with ‘brown rice and sesame salt.’ Just go there, no matter what disease you have, you will be cured (bệnh gì cũng hết)!”
This paper draws from fieldwork conducted in this Buddhist temple, which I will call Brown Rice Temple, located approximately one hour from Ho Chi Minh City by bus. The temple has been well-known in Vietnam, particularly among people suffering from chronic conditions including cancer. The abbot monk is said to be able to heal people with serious illness using a macrobiotic diet method. As such this place also has been nicknamed “Brown Rice” temple in local vernacular.
The Brown Rice Temple abbot’s teachings on macrobiotics have been widely disseminated through Buddhist networks. Therefore, I have also travelled to multiple locations in Ho Chi Minh City and neighboring provinces to meet with the abbot’s followers and people treated by him. Those locations include macrobiotics shops and restaurants in the busy central districts of Ho Chi Minh City opened by his disciples. These sites are meeting points for people who follow this diet, as well as a small community of people pursuing the diet for health reasons in a neighboring province.
Macrobiotics is summarized by many of my research informants, whose experiences are presented in this paper, as an endeavor to nurture life (dưỡng sinh). They often stated that “macrobiotic food is for the nurturance of life” (thực dưỡng là dưỡng sinh). Macrobiotics is lived and described as a process of self-cultivation that enforces individual choices and agency in a social milieu of uncertainties and mistrust. Inundated public healthcare institutions offer insufficient care and support for cancer patients in the public system. This is a pervasive issue (Lincoln 2014), compounded by Vietnam’s struggles to respond to food safety and environmental problems (e.g., Ehlert & Faltmann 2019; Faltmann 2019; Figuié et al. 2019; Swenson 2020: 45–9). Choices of macrobiotics as an alternative diet and lifestyle constitutes an individual response to a rapidly changing social context that comes with many problems.
This choice of macrobiotics to cope with the constraints of the country’s food industry and medical system resonates well with Farquhar and Zhang’s (2012) research on “life nurturing” in China (“yang sheng” in Chinese). Yang sheng has a long history which dates back to Daoist and Confucian works, and the term is rooted in an ancient Chinese belief that life is a process of “active forming and crafting” (2012,13). It is practiced by contemporary Beijingers less as a philosophical and scholarly movement, and more as a daily practice to keep them healthy. Yang sheng thus includes a wide array of activities from taichi and qigong to calisthenics, jogging, swimming, walking backward, water calligraphy, dancing, singing, and keeping birds. It also includes cultural practices, such as appreciation of tea, wine, medical cuisine, meditation or learning a new language (2012, 17).
Importantly, as the authors point out, yang sheng is widely practiced by many Chinese citizens as their “tactics of everyday life” in coping with an uncertain social and political order, including the Chinese state’s withdrawal from provisioning of healthcare. This sociopolitical trigger for the growing popularity of yang sheng in China echoes with the concerns about rising medical care costs in Vietnam. The overcrowding of public healthcare institutions is often cited as one of the main reasons that brought followers to this diet. Since the transition to a market economy in 1986, Vietnam’s government has significantly cut down its funding for several public welfare services, including healthcare (Sidel 1997; Salemink 2006; London 2014, 98; Luong 2005, 127). This retrenchment has led to the booming of a private healthcare system which caters to the needs of higher- and steady-income groups, while lower-income groups, especially those with severe illnesses, face extreme challenges in paying for their medical care, even when they utilize public hospitals and the state’s public health insurance.
In their book, Farquhar and Zhang ask an important question: to what extent is the history of the state embodied in the everyday tactics of citizens (2012, 13–14)? They point to the violent biopower that Chinese states impose on its citizens, such as the example found in China’s population policies. However, yang sheng emerges as a way for Beijing citizens to cope with the neoliberal state and its significantly reduced governmental support for hospitals, medical schools, and clinics, as well as its advocacy for fee-for-service models since the 1980s. Thus, yang sheng practices—many of which are designed to boost one’s physical health—reflect this shift in biopower of the Chinese state in contemporary times. As the authors point out, although yang sheng is not an “overt political power” of Chinese citizens, it nevertheless enables them to “escape without leaving” the uncertainties caused by the withdrawal of state support by taking care of their own health (2012, 20).
Drawing on Farquhar and Zhang’s discussion of Beijing people’s practice of yang sheng as a “tactic of everyday life” against the changing sociopolitical landscape in China, I explore macrobiotics—a life-nurturing practice in Vietnam—as a strategy chosen to cope with the various issues in food systems, the environment, insufficient healthcare provisioning, and economic development. As I will show, the pressing problems of contemporary Vietnamese society have given rise to new waves of self-care strategies and life-nurturing movements among its population.
Research on the sociocultural significance of macrobiotics in Vietnam, as well as in other countries, is rare. Many publications on macrobiotics are books introducing this diet written by George Ohsawa (who spread this diet to Vietnam in the 1960s) and translated by his Vietnamese disciples in the 1960s and 1970s1. Academic analysis of the sociocultural significance of this diet among Vietnamese people, especially those living with diseases, is largely absent2. Stalker’s (2009) study on the histories of macrobiotics in the United States and Japan is among the few studies that shed light on the cultural meanings that macrobiotics has to its consumers. Contrary to Vietnam, where macrobiotics is perceived as a life-nurturing practice, when it was promoted in the US by George Ohsawa in late 1950s, the diet appealed to American youngsters as a form of “culinary rebellion” or “culinary tourism”. American consumers eagerly experienced “exotic, ascetic, ‘natural’” and “Orient” Japanese diet through macrobiotics (Stalker 2009, 3-4). Nevertheless, in Japan, Ohsawa’s homeland, macrobiotics did not at first gain popularity. However, after its success overseas, it was embraced by the Japanese as a triumphant representation of Japanese traditional cuisine in the West. The diet also appealed to Japanese people as a form of “culinary nostalgia,” as it links with Japanese folk wisdom of the body and health and emphasizes women’s traditional role as professional housewives who are tasked with preparing wholesome meals for their families (Stalker 2009, 8-12).
In Vietnam, the (re-)emergence of macrobiotics as an alternative diet reveals rising awareness among the local population about food and health, the environment and food safety, and the potential effects (both positive and negative) of food on health and well-being. This is the result of multiple rising problems related to the environment, food, healthcare, and chronic illness in modern Vietnamese society.
To demonstrate the above observations, I first provide a brief description of macrobiotics and a short history of its introduction and development in Vietnam. Since there has been no published historical account of macrobiotics movement in Vietnam, I rely on oral histories I collected among staff members of “Ohsawa House,” a historic macrobiotic food store opened by the first students of George Ohsawa in Vietnam and long-term followers of this diet who lived through the pre-1975 period, when macrobiotics first became popular. This is followed by an ethnography of healing activities in a temple well-known for its macrobiotics advocacy, not far from Ho Chi Minh City. I then analyze the rising awareness as well as spiritual beliefs surrounding food and diet in health promotion and life-nurturing movements in today’s Vietnam. The paper concludes with reflections about macrobiotics and life-nurturing practices vis-a-vis the larger landscape of contemporary Vietnamese society.
Macrobiotics in Vietnam today
The macrobiotic diet (or macrobiotics) is a diet based on ideas about types of food drawn from Zen Buddhism. The diet focuses on the balance of yin and yang elements of food, as well as emphasizes consumption of whole grains, plants, seasonal, and local products.
Macrobiotics is translated into Vietnamese as “thực dưỡng,” which means “nurturing food.” For most people who follow macrobiotics in Vietnam today, it is a way of eating that is mainly based on ingredients of brown rice, sesame, soy, beans, nuts, and seaweed. A macrobiotic diet might also include a small amount of fish and shrimp.
Macrobiotics is widely known in Vietnam to be founded by George Ohsawa (1893–1966) and introduced in the then Republic of Vietnam (South Vietnam) by Ohsawa himself during his trip to Hue in the 1960s. Subsequently, the diet was actively promoted by his Vietnamese students and became popular in South Vietnam in the 1960s and 1970s. However, it almost fell into oblivion after 1975 when the country was reunited at the end of the Vietnam War and during the subsequent years of extreme food shortage.
Macrobiotics has once again gained popularity in Vietnam in recent years due to work by a number of macrobiotics advocates, including a few Vietnamese celebrities; the abbot of Brown Rice Temple, who also runs a clinic to treat diseases using macrobiotics; and his followers, many of whom became owners of macrobiotic food production companies, macrobiotic food stores, and restaurants. Those strong promoters of macrobiotic movements are long-term practitioners who self-report to have successfully improved their health and cured diseases using macrobiotics.
Macrobiotics was first introduced and promoted in Vietnam by foreign teachers. However, through the process of dissemination and popularization in Vietnam by many local “gurus,” macrobiotics in Vietnam have been vernacularized and thus are different in many ways from the macrobiotic diet practiced in other countries like America and Japan.
One significant difference can be observed from the fact that today it is also well-known locally as the “brown rice, sesame salt” diet (gạo lứt muối mè). The reason behind this name is that under the guidance of a few Vietnamese macrobiotics teachers, a large number of followers in Vietnam mainly consume brown rice with sesame salt exclusively as the main food of their diet for at least a short period of time. Therefore, many have mistakenly conceived macrobiotic diet as a diet comprising of brown rice and sesame salt only.
Many people in Vietnam follow macrobiotics as a healthy plant-based diet to maintain good health and prevent diseases. Nevertheless, macrobiotics, or “brown rice sesame salt” as it is usually known locally, is particularly popular among Vietnamese people living with health problems as a method to fight diseases and to enhance one’s health. It is also noteworthy that a few “gurus” have controversially promoted macrobiotics as a remedy to cure cancer or other dangerous illness, even though there is no high-quality clinical evidence that a macrobiotic diet is helpful for people with cancer or other diseases.
The most influential person playing a vital role in advocating for the benefits of macrobiotics in improving health and fighting diseases in recent years is the abbot of the Brown Rice Temple where I conducted fieldwork for this research. It is said that after curing his own disease with macrobiotics, he has pledged to use this method to save people who suffer from various diseases.3 Macrobiotics in Vietnam today is heavily influenced by his teachings. His lectures on the benefits of macrobiotics have reached far and wide through social media sharing and YouTube videos, as well as via Buddhist networks.
However, the abbot’s advocacy of macrobiotics as effective cure for various diseases and his temple clinic are not without controversy. There is a widespread, mistaken belief among Vietnamese people, and among cancer patients and their families in particular, that biomedical treatment, especially surgery, will only worsen the condition and make sufferers die sooner (Thuỳ An 2019, Thư Anh 2020). Some patients and their families therefore choose to place their trust in alternative treatment instead, such as in the macrobiotics diet method advocated by the Brown Rice Temple abbot. A few patients who could otherwise have been saved by biomedical treatment have unfortunately died from cancer because of their rejection of biomedicine in order to follow macrobiotics as a cancer treatment method. This has led to heated controversy surrounding macrobiotics as a cure for dangerous diseases, as medical authorities voiced their concerns and warned patients of the possible consequence if one stops biomedical treatment (Mai Ngọc 2019, Thiên Lam 2019, Hồng Hải 2021).
The sections below provide a description of the Brown Rice Temple clinic and how patients living with different conditions are treated by macrobiotics diet.
Photo credit: Le Hoang Ngoc Yen
The Temple Clinic
Brown Rice Temple is a beautiful Vietnamese Zen temple located approximately 25 kilometers from Ho Chi Minh City. During weekends, the temple becomes very busy with hundreds of patients who travel here to seek a cure. Among them, many travel from afar such as from Hanoi and Vietnam’s northern provinces, as well as from overseas, hoping to be seen by the abbot.
Saturday morning is a time when the pagoda gets very busy. On that day of the week, besides functioning as a religious worship site, the pagoda also becomes a clinic. There is a room near the main hall, where the abbot monk sees his patients, with the signboard “Traditional medicine clinic” (Phòng chẩn trị y học cổ truyền) installed above its door. The signboard also shows the abbot monk’s name and his role as the traditional medicine doctor (lương y) in charge of the clinic.
The main hall where the Buddha’s statue is seated is fairly empty, while most visitors concentrate around the clinic. On Saturdays in particular, the place feels more like a clinic than a temple. Many seemed to have travelled a long way, with their family members, carrying bags and luggage for an overnight stay. Some others arrived in cars, vans, or mini-buses. Sticking out from their bags are folders containing medical test results and prescriptions from hospitals and medical clinics. Because the number of patients is large, many patients who wanted to be seen by the abbot monk had to arrive one day earlier, on Friday, to get a numbered ticket. Only the first 50 patients or patients with the most severe illness will be seen by the monk. Many among them have cancer.
Outside the clinic, many patients and their families patiently wait for their turn to see the monk, some who are tired lie down on one side of the pagoda main hall. Many others are keen to chat with other patients about their conditions, what the abbot monk told them to do, and how to follow the macrobiotic diet prescribed to them.
Here, patients are seen free of charge. However, they will have to purchase items listed in their “prescriptions” by themselves. Instead of listing medicine items, “prescriptions” issued by this temple clinic contains different types of macrobiotic food and nuts and “natural” supplements. There is a shop inside the pagoda selling macrobiotic products and fresh organic produce at this pagoda. After getting their prescription from the monk, many patients go to this shop to purchase their supplies.
The pagoda’s kitchen prepares and serves macrobiotic food free of charge to all visitors, including patients and their families staying in guesthouses around the pagoda, who have formed a small community of temporary lodgers around the pagoda. Free macrobiotic food is also given to poor people in that area. I was offered free macrobiotic meals every time I visited the temple for fieldwork. Every day at lunch and dinner, day visitors and the temporary residential community of patients and their family staying around the temple would gather at the dining hall to have meals. Everyone would sit around round tables in the hall and eat from their own plates. In addition to brown rice and sesame salt, there were different dishes such as tofu and vegetables.
Hà, a young lady staying in a temporary accommodation adjacent to the temple, told me that because all the meals they got while staying here were free of charge, she tried to reciprocate by helping clean up the tables and washing up after the meals. Hà is a student who travelled to the south from Hanoi, the capital city in the north. Here she joined the small patients’ community who stayed in temporary accommodations around the temple and took part in the daily routine of this therapeutic community. At 4:00 AM, she and others in the guesthouses wake up to join in chanting and meditation sessions at the temple. They then have free time in the morning, and some volunteer to help with preparing macrobiotic food at the temple kitchen. At around 11:00 AM, after the gong sounds, everyone gathers to have lunch, and then rest after lunch, while some others volunteer to do the dishes or clean up in the kitchen and dining hall. In the evening, they gather again in the temple main hall for evening chanting. Weekend routines are a bit different, as Saturdays are the only days when the temple clinic is open and the abbot monk sees his patients. Sundays are also special because they would attend the weekly public sermon given by the abbot monk. Many patients who travelled from afar to attend the Saturday clinic stay overnight around the temple to attend the Sunday lecture.
Hà actually travelled to the Brown Rice Temple to find a cure for her depression. For her, being a part of this community helped her reflect on her illness and find hope for the future. Seeing many people who live with life-threatening conditions such as cancer, but still strive to fight their illness, Hà felt inspired and thought she was still lucky because her illness is not terminal even though she has suffered so much from it. Besides, being a member of a community where she and her neighbors could share with each other their experiences with illness and healing journeys, be molded into a regular regime of consuming macrobiotic foods (as medicine), practice chanting and listening to Buddhist sermons, and work voluntarily for reciprocation and for merit (làm công quả) at the temple helped to shift her mental focus and thoughts away from her problems.
In the following section, I give a more detailed account of the patients who come to the temple to seek treatment for their conditions using the abbot monk’s macrobiotics method.
Food as Medicine
Many patients come to the Brown Rice temple clinic as a last resort, since they have been “rejected” by medical doctors (which is “bị bác sĩ chê” in Vietnamese). This term also implies a death sentence for patients who are rejected by biomedicine. Meanwhile, many others come because they do not want biomedical treatment. In particular, some want to avoid surgeries that would be required for their treatment.
In the hallway during the day, dozens of patients can be found slowly chewing brown rice in a small bowl. It is there I met Lan, an elderly woman from Phú Thọ province in the north who moved to the south to live with her daughter. She was diagnosed with colon cancer two months after she moved. For years before that, she already had digestive problems, evidenced by the changing color and shape of her stool, but she had kept ignoring the problems. She simply thought certain types of foods were not suitable for her and stopped eating those foods.
Her doctor told her that her cancer was because of this chronic bowel problem. However, she said this was because the vegetables and plants in the south are polluted, not as clean and fresh as produce in her hometown. That is why, during the first two months she came here, she felt okay, but from the third month onwards, she started feeling sick. First, she had the flu, and then a series of other problems.
Lan seemed to be accepting of her illness. She was nearly 70 and felt it was okay to die—but she wanted to die “lightly” (nhẹ nhàng) and without pain. The doctors said they must perform an operation immediately to save her, but she said no. She only wanted things to be light. Surgery would be too much for her.
One reason why she rejected the surgery is that she knew two patients of the same disease who had their colons taken out. All the stools and gas then led into an external bag hung to one side of their belly. It was too weird for her. She was concerned, wondering how that would that be when she went out and met people, or when she went to the temple. How could she go around with a bag hung to one side of her body?
One of the two patients she knew never had his bowels surgically replaced into his body. After three years, they should have been repaired, but by then the doctors refused to do another surgery for him, because of the risks involved. She did not want to be like that. She asked herself: “How could I die without my colon inside my body?” (Chẳng lẽ mình chết mà không có ruột chèn vào à?)
She wanted to die with an intact body. She burst into laughter telling me about the man she knew who passed away with his colons divided into two parts – one inside his body and one outside. She believed if one’s karma is over, then one will go. She will die if it is her time, with or without surgery. Biomedical treatment for cancer is too much for her. Instead, she determined that “brown rice sesame salt” is much lighter (nhẹ nhàng). Therefore, she decided not to follow biomedical treatment and go straight into this diet.
At the lunch table, I also met with Phương, who had systemic lupus erythematosus (SLE) that led to kidney problems. She was living and working in Germany when her work and life was disrupted by her illness. At a hospital in Germany where she received medical care, her doctor told her that her condition has nearly led to renal failure, and she would be put on dialysis in a couple of months.
Phương strongly rejected the idea of being stuck with a machine for the rest of her life. She therefore travelled back to Vietnam to find a cure. She searched for well-known traditional medicine doctors and one month later, she found her way to the Brown Rice Temple.
The abbot monk put her on a strict macrobiotic diet, which mainly consisted of brown rice, sesame salt, and nuts. During the lunch she said she was craving for sugar-cane juice and coconut water under the heat of southern Vietnam, but she was trying to control her own appetite: “Thầy (which means “teacher” or “master,” a pronoun used to address or refer to monks in Vietnam) explained to me that I am sick because I am too yin, so I have to eat only yang foods. Both sugar-cane juice and coconut water are yin so I have to avoid them.” She repeated, time and again, that she did not want to be on a machine for the rest of her life. Therefore, she wanted alternative treatment.
On the one hand, a correct diet (ăn đúng) of macrobiotic food—consumed as instructed by the abbot monk—is revered in this community as a supposed remedy for their illnesses. On the other, wrong food and a wrong diet (ăn sai) are usually cited by informants who follow macrobiotics as the main reason for their illnesses. In the next section, I further discuss widespread perceptions in Vietnam today on food safety and wrong diets as a potential threat to one’s health and well-being.
Food as Threat: Illness and Modern Life
“Bệnh từ miệng mà vào” (Illness comes in from the mouth). Many of the people who follow macrobiotics that I met during fieldwork, like Lan, whose narratives are presented above, cite this popular Vietnamese saying while attributing diseases, particularly cancer, to a “wrong diet” (ăn sai). Lan believed her cancer was caused by contaminated vegetables she had consumed when she moved to the South, and because “they put too much sugar into food here in the South. Everything tastes really sweet here,” she said. Many other patients and their families I met had the same idea about unsafe food as the main cause of their illness. For instance, one patient commented: “Food everywhere is polluted. They use a terrible amount of chemicals in agricultural produces. And those imported foods from China are toxic. We eat but we do not know what we eat into our body.” Such statements reflect anxieties over Vietnam’s food safety problems (Lincoln 2014; Judith & Faltman 2019), the public’s general concern with imported produce from China (Figuié et al. 2019, 152–3, Swenson 2020, 45) and rising interest in locally produced, organic products (Faltmann 2019).
Moreover, chronic diseases such as diabetes, cardiovascular disease, and even cancer are seen as a direct consequence of gluttony, materialistic abundance and indulgent lifestyles. Phú, a man who calls himself a loyal disciple of the Brown Rice Temple’s abbot, told me a story about the most severe case he had known:
There was a boy who was the only son in an extremely rich family. Both his maternal and paternal families loved him so much, he lived an extravagant life like a little king. They fed him every day with the most lavish foods. Then he fell seriously ill and was brought to the hospital. But it was too late. The doctor just shook her head. That was the case with the most cancer that oncologist had ever seen in her career. The cancer had spread to most organs in his body.
Then he turned back to ask me:
You see, our grandparents lived in the countryside. They ate simply, with what they found in the nature, like water spinach and sweet potatoes. But they were healthy. Now we have so much food. But how come we also have so many sick people with cancer?
Humphrey and Mandel (2020) write, “The post-socialist societies still struggle to come to terms with the clash between deeply ingrained moralities and the daily pressures, opportunities and inequalities posed by market penetration” (2020, 1). In the last century, Vietnam has shifted from a centrally planned economy to a rapidly growing and globalizing market economy. Following severe shortages of food and daily essentials during the subsidy period of the 1970s and 1980s (see McLean 2008, Le 2018), the majority of Vietnamese people now have adequate access to food, particularly in urban centers such as Hanoi and Ho Chi Minh City (Ehlert & Faltmann 2019, 11). From a country that focused on basic needs in everyday life, Vietnamese contemporary society has shifted into a culture that aspires toward the sensory experiences of a good life (Nguyen & Thomas 2004). Together, with a rise of the middle class and middle-class culture, particularly in urban areas (Hansen 2017) now “having adequate food and warm clothes” (ăn no mặc ấm), the essentialism of the past has been upgraded into a rhetoric of indulgence and satisfying the senses. As the popular idiom goes, people aspire to “having tasty food and beautiful clothes” (ăn ngon mặc đẹp).
For macrobiotics followers however, overeating and a wrong diet account for the surge in numbers of people suffering from chronic disease in contemporary Vietnam. Their narratives of illness, treatment, and recovery are morally charged with critiques of human greed and the modern, materialistic lifestyles that are believed to result from modernization, industrialization, urbanization, and even wealth and materialistic abundance, as reflected in Phú’s comments above. A society where so many people are sick is believed to be an unavoidable consequence of environmental, social, and moral impurities, such as greed.
Accusations of greed do not only indict consumers’ greed and over-consumption, but also include producers’ greed. For example, most people that I met who follow macrobiotics expressed concern about farmers’ and food producers’ ethics and honesty, after repeated food scams have been revealed in public media. This reflects the Vietnamese population’s profound concern about food safety and food producers’ ethics, not only with domestic products, but particularly with Chinese food produce.
Several people following this diet I met often contrasted their macrobiotic food with the ordinary foodstuff sold everywhere in the market, and food products imported from China. During a trip to a village in Bình Dương, 30 kilometers from Ho Chi Minh City, I met a small group of elderly farmer women who first learned about macrobiotics from the abbot of Brown Rice Temple, and since then, had committed to using only brown rice and macrobiotic food and drink. I heard them comparing the tamari soy sauce that they made from the local beans which took many months to ferment, and the soy sauce sold on the market. They also compared the vegetables they grew in their gardens, the water from their wells, and the brown noodles they made, with those sold on the market which, in their opinion, were all soaked with chemicals. A woman said that the growers of these unsafe vegetables and food on the market are “as evil as the Chinese,” as there had been multiple scandals of unsafe food imported from China reported on the news at that time of my fieldwork.
The rise of macrobiotics as a supposed path to recovery from illness therefore sheds light on multiple aspects of mistrust in such a rapidly changing society as contemporary Vietnam. It lays bare people’s mistrust toward the foods on their tables, the farmers who produce them, and imported Chinese products. It also demonstrates people’s misgivings about the public healthcare system and biomedicine’s capability to cure chronic illness.
The following section describes patients’ notions of efficacy and conditions for successful treatment, as well as their perception of trust as a prerequisite for treatment processes in this temple clinic, a special setting where the line is blurred between healing and religious beliefs.
Healing and Religion at the Temple Clinic
One late afternoon, a middle-aged woman arrived at the temple with her husband. As a newcomer, she quickly approached our chatting group sitting in the airy hall behind the main hall. She looked a bit tired after a long flight from Hanoi, but promptly joined in the group’s conversation and told us about her condition: she had been diagnosed with breast cancer. Another woman in the group responded as soon as she heard the word “cancer”:
Oh, don’t worry about anything! Here you will be cured no matter what illness you have. Just have peace of mind (an tâm) and focus on treatment here. Do exactly as instructed by Thầy. You will be healthy soon!
The lady from Hanoi asked again, doubtfully, not yet convinced: “But my doctor said it is already late-stage cancer.” She later took off her wig, exposing the bald head and tired, sickly face of a patient with a serious condition.
The other woman just smiled kindly and said affirmatively:
Oh, no worries at all, even cancer is not a problem here. You just have to absolutely trust. Believe in the Thầy’s method. You will be cured as long as you believe.
Most sick people who stayed around the temple expressed strong hope in the therapeutic properties of macrobiotic foods and in the abbot monk’s guidance. They repeatedly assured each other of the effectiveness of the macrobiotics method. It is notable that patients strongly emphasized the importance of belief in their healing journey. Another one added: “If (someone) wants to be cured, it is a must that (s)he believes absolutely in the brown rice sesame salt diet and in our teacher’s guidance.” Others agreed, “Yes, just do whatever our teacher tells you to do, and you’ll be fine.”
It is sometimes suggested in the patients’ discussion that in addition to belief and compliance, one would also need “duyên” (predestined fate) to be cured, particularly for miracles to happen in case of terminal cases such as late-stage cancer, for which biomedical doctors already “shake their heads”—meaning there is supposed to be no cure. Stories about such miracles popped up frequently in patients’ chats in the temple, but they also agreed that such rare cases need a combination of absolute belief, a strong will to live, and on top of that, fate, as they often commented “Ai có duyên thì được chữa khỏi” (which literally means “who has the destiny [to be cured] will be cured”).
The discussion then went on to stories told by group members about how the diet can be correctly followed:
To treat illness, patients must follow a very strict dietary regime, and absolutely comply with the teacher’s instructions. Many people must eat only brown rice and sesame salt for weeks. Thầy will tell you when to stop and when you can eat other things. Also, when they chew, the rice should be chewed extremely carefully until it becomes a sort of soggy liquid inside the mouth. Only then should one swallow the food. So just a small bowl of brown rice will take several hours to finish.
What the gurus impart to the practitioners is therefore not merely the techniques of cooking and eating for desirable health effects, but a cult-like diet and discipline regime. Many people whom I met during fieldwork at the temple strongly emphasized that one must follow macrobiotics rigidly and exactly as they are instructed by the teacher, which at times created conflicts between themselves and their families, who had different opinions about healthy diets, illnesses, and medical treatment.
Although it is the patients’ self-discipline that is crucial in pursuing the strict diet regime, they often attribute the positive outcomes that macrobiotics diet has on their and others’ health to the efficacy and religious power of Thầy. Macrobiotics is therefore practiced by many people I met like a daily religious ritual, in which there are rules to follow and gurus whose teachings and words are like sacred texts that need to be strictly observed.
While eating is believed to be a way to cure diseases, many people whom I met attached spiritual values to the food they ate, the method of eating they followed, and the gurus who taught them about this diet. According to their beliefs, food can contain good and bad merit. By eating certain foods and avoiding others, diners transformed their karmic status and, in turn, their health conditions and lives. Macrobiotic food in Vietnam is believed to be healing food not merely because of its emphasis on using locally grown, seasonal, and “clean” ingredients and whole grain starch, but also because it is imbued with spiritual values. It is a meritorious food that does not entail killing animals and does not pass on the animal’s karma to consumers.
When I first visited the Brown Rice Temple, one of the things that quickly attracted my attention was a table near the entrance on which there were many handbooks on macrobiotics and CDs containing the abbot monk’s teachings and sermons for free distribution. A lady in a brown lay Buddhist suit was standing at the table. She enthusiastically greeted me and handed me one book titled “the macrobiotics handbook” written by the abbot monk and a few CDs of his public sermons. Knowing I was new to macrobiotics, she told me to read the handbook and listen to the CDs carefully when I got home. She then explained to me that we got ill when we ran out of good merit.
Everyone has good merit, but if we depend on the good merit to enjoy a blessed and lucky life without creating new good merit, one day our good luck will run out and we will become ill. Good merit is like money. We can see our money, so we know when we are running out of money. But we cannot see our reserve of good merit, and never know when our good merit is used up and we are about to suffer. Therefore, we should read what the abbot monk wrote in his book to know what to eat to gain good merit, and what to eat to lose merit.
She also opened one book on the table and pointed out to me a page with the text of a sutra, and instructed me to chant it before I eat a macrobiotic meal. That way, I could make more merit while eating.
Macrobiotic food is meritorious not merely because it is vegetarian, but also because it requires enormous amounts of preparation and is not always readily available on the market. Macrobiotic meals and ingredients served and sold at the Brown Rice Temple and its shops, as well as at macrobiotics restaurants, shops, or cooking groups in Ho Chi Minh City, advertised their food as “clean” food that was home-made and locally grown without using any chemicals, pesticides, fertilizers, or colorants.
It is not only eating the right food that is believed to be a merit-making practice. During my fieldwork among macrobiotics followers, I also encountered the perception of illness as a manifestation of bad karma. I met Phan, who described himself a loyal disciple of the abbot of Brown Rice Temple, at his macrobiotics restaurant on one busy street in one of Ho Chi Minh City’s central districts. Before opening this restaurant business, he worked as a construction engineer and owned a construction business. While working on a construction project near the Brown Rice Temple, he decided to drop by to listen to a public sermon by the abbot monk, just out of curiosity. He was immediately convinced and switched to a macrobiotics diet soon after. One month later he started his own macrobiotics restaurant business.
Similar to many informants I have met, Phan perceived illness as a consequence of bad karma in the past and also linked the therapeutic effect of this diet to the patient’s karma. In Vietnam, macrobiotics food is also mostly vegetarian food (although it is not necessarily the case in other countries like Japan). In Phan’s restaurants, dinners are served with vegetarian meals featuring whole grain rice and noodles, as well as other vegetarian dishes cooked with macrobiotic techniques. Not only are vegetarian dishes in macrobiotics good for health, according to Phan, but by avoiding meat, eaters can avoid consuming the animals’ karma, and avoid making further bad karma by killing animals.
However, in Phan’s opinion, merit-making dishes in macrobiotics can only heal someone whose bad karma is not too “heavy.” If a person’s bad karma is already too heavy, the diet and the monk’s treatment would not be sufficient to offset it and macrobiotic intervention would be too late to procure any positive effect. Therefore, there are many people with serious illness who follow macrobiotics diet in hope of a cure, but eventually succumbed to the disease despite having strictly followed this regime.
Phan is an avid and loyal follower of the abbot monk of Brown Rice Temple, but he also admitted that the regime prescribed by the monk is not a miraculous cure of cancer or serious illnesses for every patient, as rumored. Only a very small number of people with fatal diseases, such as cancer, had been cured, Phan said, and their success was a combination of many factors. Most importantly, they must have the fate (duyên), and enough good karma from past merit to save them. Regarding those people who did not make it, Phan believes it was not due to the inefficacy of the diet nor the abbot monk, but the overwhelmingly bad karma that those patients had from their pasts. He explained:
If two little kids in the neighborhood fight each other, you can come in between them and stop the fight. But if two notorious gang leaders are fighting with swords and guns, would anyone dare to come in between and stop them? Likewise, if you have heavy karma from the past that makes you sick, the abbot monk would know he cannot intervene in the cause-and-effect circle (vòng nhân quả) and so he is unable to do anything for you.
In addition, the spiritual components involved in the healing process also take forms of inner purification. For example, Lan (whose story of illness is presented above) told me about her friend whom she met when she came to the temple for consultation with the abbot monk. This lady had late-stage breast cancer and had followed the therapeutic regime determined by the abbot monk for a few months. She did everything as advised by the monk such as eating only brown rice and sesame salt for an extended period of time, and used home-made plasters from natural ingredients exactly as instructed. She later told Lan she felt better and believed the poison of cancer was coming out of her body, as she saw the used plasters turned black after being removed. However, after a few months, this friend passed away from cancer.
Lan explained to me that although the monk’s method is very good, it also requires the patients to maintain a positive and purified spiritual state in order for the method to work. Lan believed her friend could not make it because she could not let go of the profane ties with her husband and money problems. Lan’s friend had been very angry since she found out her husband had an extramarital affair. She stressed out worrying that her husband and her mistress would get together and live a happy life after she died because of cancer. She had intended to make arrangements for her property to be inherited by her husband, but she was anxious that if the estate was to be inherited by her husband, after her death, his mistress would actually become the owner and benefit from what she had worked very hard for with all her life.
It is noteworthy that her death from cancer was not attributed by her fellow patients to the abbot’s advice or to the inefficiency of the macrobiotics diet, which has not been proved to be effective in treatment of any diseases. Instead, her death was interpreted by the woman’s fellow patients to be the spiritual and moral failure of that individual. According to Lan, the poor lady was unable to let go and purify her heart. She was still trapped in profane worries, her desire to control and her jealousy, so her spirit was full of “tham sân si” (greed, anger and delusions). In other words, this was a failure in “tu tâm dưỡng tính,” the cultivation of one’s soul and nurturance of one’s personality, which is perceived as one essential part of the healing process.
It is significant that the re-emergence of macrobiotics diet in Southern Vietnam in recent years has been led by Buddhist networks; beliefs about macrobiotics and its effects among contemporary followers are therefore significantly influenced by Buddhist beliefs and religiosity. Whether or not one can be cured by macrobiotics, particularly in cases of severe, life-threatening illness, is believed to depend on different factors such as patients’ fate (duyên), karma, state of mind, or strong will and strict adherence to the monk’s instructions. Strong religiosity among patients seeking a cure in the Brown Rice Temple clinic can also be observed in the fact that few would challenge the abbot monk’s authority or teachings. When treatment fails, it is always regarded as the patient’s fault, failure of compliance, heavy weight of bad karma, or to do with other factors.
Many who are following this diet to protect their health define macrobiotics as a “life nurturing” (dưỡng sinh) endeavor. While macrobiotics food nurtures physical body, “life nurturance” also encompasses a spiritual process. It requires patients’ trustful attitude, strong will, strict self-discipline, and moral effort to get rid of greed, hatred and anger. For many followers, the experiences with macrobiotics therefore are also characterized by spiritual transformation and efforts at self-cultivation (see also Le & Le 2021).
Concluding Reflections
This article has shed light on the shift to a macrobiotic diet among people living with illnesses in Vietnam, focusing on patients who seek treatment in a temple clinic run by a Buddhist monk well known as a prominent figure among the macrobiotics followers’ community in Vietnam in recent years. Research data collected from informants reveals and resonates well with previous research on the pluralism in concepts of health, healing, and diversity in health-related practices in Vietnam (Craig 2022; Wahlberg 2006; Monnais, Thompson & Wahlberg 2011; Wahlberg 2014). Pursuit of macrobiotics on a long-term basis in hope of a cure for different illnesses, as well as perceptions surrounding food and well-being, are remarkable examples of alternative treatment that co-exists with and even rivals the dominant healthcare system, and an intricate web of notions that support it. This article also traces the intersection between perceptions of illness and religious beliefs. It sheds light on how religious authority and religious beliefs such as karma and karmic qualities of food affect notions of illness and recovery.
Many informants in this research define their attempts at a supposed path to recovery in hope for a cure as an effort to nurture life. The diet nurtures not only the body but also the soul, or, in their own words, “macrobiotics is nurturing life” (thực dưỡng là dưỡng sinh). As I have shown in this article, we can draw a connecting line between nurturing life as a social phenomenal in modern Vietnam and yang sheng, nurturing life in contemporary Beijing, China, as convincingly demonstrated by Farquhar and Zhang (2012). Nurturing life in both studies can be seen as tactics of ordinary citizens to care for the self, to maintain physical and spiritual well-being and keep their lives balanced in a changing social context where the state’s subsidized medical care is shrinking, healthcare is increasingly commodified, and individuals have to take more responsibility for their own health and well-being. In Vietnam, similarly, “dưỡng sinh,” or nurturing life, can be observed as a strategy for ordinary individuals to hope for obtaining more control of their own health and well-being in an uncertain time that is marked with changes in the economy, healthcare systems, environment, and food-safety problems, rising numbers of cancer cases, and people living with chronic illnesses, such as diabetes and high blood pressure.
The popularity of an alternative diet that supposedly has effects on health in Vietnamese society at large also reveals heightened concerns and awareness among the Vietnamese population about food and health, as well as the important challenges of today’s modern society, such as the rise of cancer cases, deficiencies in the public healthcare system, and pollution in the environment and in food production. In addition, discussions with research informants demonstrate how notions of a healthy and clean living environment are believed to have health-promoting effects, as most people contrast the material abundance and comfort of modern life with its myriad of problems related to food, the environment, and healthcare. They are nostalgic for a past with pre-modernized and pre-industrialized, simpler lifestyles that are (arguably) believed to have produced healthy Vietnamese bodies in the past.
Moreover, this study has demonstrated the fluidity of the notion of nurturing life in today’s Vietnam. “Dưỡng sinh,” nurturing life, does not include only improvements of physical health and recovery from illness, but also entails spiritual cultivation of a purified mental state and positive, trustful attitude. As a well-nurtured life encompasses both realms of body and mind, so does the process of healing and overcoming ailments. For many research informants, shifting into the macrobiotics diet inherently entails undertaking a moral project. One learns to control greed and gluttony, let go of desires, consume everything in moderation, and limit needs. In particular, one learns to be responsible for their own health—being aware that whatever is taken into the body will have certain effects on the body and health—rather than depending on others’ care. It is indeed a self-cultivation journey (tu tâm dưỡng tính).
As such, the macrobiotic diet movement, or other alternative diet movements for the purpose of promoting health in Vietnam in general, demonstrate a social phenomenon that is not only related to food and health. Rather, it reveals individual choices and efforts to fill the gap left behind by a rapidly developing market-oriented economy in which healthcare is commercialized and privatized. It shows some anti-industrialization sentiments among certain groups and lays bare common critiques of modern lifestyles and of rapid shifts in the society and economy. This research into a specific alternative diet movement in Vietnam therefore offers a window into a larger social landscape of contemporary Vietnam through which the macrobiotics movement represents one among multiple strategies taken by local people to navigate the risks of modern life, and to mitigate the uncertainties of a changing society.
Finally, the macrobiotic diet movement in Vietnam epitomizes a contemporary Vietnamese social landscape of a dynamic and diverse society moving forward quickly, but not without its own conflicts between the new and old; between modernity and nostalgia; between industrialized, consumerist lifestyles and past ways of living; between globalized, modern values and traditional ones; between a pluralism of local healing practices and beliefs and dominant medical science—conflicts that have been simmering in Vietnam since the 20th century (see, for example, Jamieson 1995; Bradley 2004). The popularity, as well as the controversiality, of macrobiotics in Vietnam today, constitute one of the multifaceted expressions of these conflicts in modern Vietnam.
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Notes
- See, for example, “The Order of the Universe”, “Essential Ohsawa: From Food to Health, Happiness to Freedom” by George Ohsawa.
- A recent survey conducted in urban Vietnam by Phan & Nguyen (2009), however, does not draw a distinction between vegetarianism and macrobiotics.
- There has been no scientific evidence that macrobiotics can cure any diseases. For more information on the diet, see, for example, Roger (2022), Lienard (2022), West (2022).
