There are still many questions that need to be answered about the lives of the pre-Hispanic peoples of the southwest Ecuador. In particular, there are few archaeological studies that focus on the socio-cultural complexity and belief systems of the Guangala culture of the southern coast (100 BCE- 800 CE). This research uses paleopathological data collected from human skeletal remains from two funerary groups dated to the Very Early Guangala and Early Guangala phases of the ritual site of Salango. Changes in mortuary rituals can often be reflective of social change and therefore I situate my interpretations within the unique funerary setting in which these individuals were found. Analyses indicate that the Very Early Guangala individuals underwent significant physiological stress based on skeletal markers of chronic malnutrition and infection. Because of the ubiquity of these stress markers and the peculiarities of the associated mortuary setting, I suggest that the people buried at Salango during the Guangala period experienced a marked change in health and possibly altered the nature of ritual activity at the site in response.