Eghindi is an illness built around a set of pathological states experienced by Sahrawi in the desert environment of Western Sahara. Its core symptoms are caused by osmotic imbalances related to salt consumption. In 1975, many Sahrawi were exiled into refugee camps, and they have since experienced radical socio cultural changes, which are reflected in changing explanatory models of eghindi. Older and conservative refugees, attached to traditional Sahrawi culture, have expanded its conceptualization to include new pathogenic factors, while younger and progressive refugees, acculturated with Western culture, began challenging its existence. Eghindi became embodied within a broader process of negotiation of Sahrawi cultural identity. Our findings provide a framework for thinking about the evolution of illness in response to displacement, and highlight that when explanatory models evolve, intra-cultural tensions can arise within a population.