GLOBAL-HEALTH
Pre-Departure Research Critique
Holistic Health Integration and Women Empowerment
While in Mysore, India I am interested in researching about the integration of holistic health techniques like yoga, Ayurveda, meditation and religion incorporated in the health care system of the country. Going into a new culture, and a different system will give a lifetime opportunity to broaden my perspective on global health, illnesses, and healing methods with the wider view of how mental health, physical health, emotional health, and spiritual health are directly related to one another and therefore help me expand my global view on health. Holistic health is about the interconnection of the entire being, which incorporates different rituals, and plants in order to gain a profound healing not only in the physical body. In the United States we go to doctors when we need physical healing, and generally, they will prescribe a drug in order to suppress the symptoms, but they are not looking at the whole picture. I envision that in India doctors will typically look at the entire lifestyle of a person, and prescribe herbs, as well as physical exercise or meditation in order to first heal the emotional or mental bodies to, therefore, see results of healing on the physical level. In 1926 a South African statesman named Smuts created the word or concept of what is called “holism.” He proposed that the whole of our being is not only the physical body but rather also includes emotions and thoughts, spiritual beliefs and practices, cultural identity and community gatherings or practices, and environmental influences and acknowledged that these parts cannot be separated into a sum, but must be seen as a whole. (Dossey & Keegan, 2013)
I would also like to conduct research on women's health in relation to their socio-economic "class". Women in the United States have access to health care, and preventative measures such as yearly pap-smears, check-ups by the gynecologist and a wide range of obstetric care. It also gives access to health-care for birthing and the many different routes that can be taken for the journey of birth such as having a midwife, a doula, or even having a natural home birth. This key element in the United States allows proper care for any mental health problems a woman faces after birth such as post-traumatic stress, or depression. This also allows proper care for the newborn child. In contrast, in India, there are a variety of routes taken as preventative measures and that is differentiated within each economic status, or "class." India is known as one of the most populous countries in the world, and I imagine there is a lack of quality care for a woman. Inadequate access to quality obstetric care can develop physical and mental disabilities for women (Ray, 2014).
The integration of holistic health and quality care for a woman can really impact the culture of an entire society by empowering its people. Since a woman is the caregivers of a family, the outcome of their health and health-care access will, in turn, affect the entire family unit. In the study I want to be able to integrate both health care systems, comparing and contrasting the practices in the US from those of India. What type of access does woman have for birth care, mental-health care, and holistic care, also in regards to their socio-economic class? I would like to see the possibilities of how to make health-care, and preventative measures more accessible to a woman in need, and also learn about the holistic views of what health care even is all about in India. There is a shift currently happening in the international understanding of reproductive-rights, and furthermore broadening the concept of women’s empowerment. This is not only an intrinsic value for women, but this is crucial for the overall development of a population (Ray, 2014).
While in Mysore I hope to be immersed in the culture of India in all ways: spiritually, religiously, and medically in order to begin the process of uniting the holistic health systems such as Ayurveda, chanting, meditation, and yoga in with the western-medicine systems.
References
Dossey, B. M., & Keegan, L. (2013). Holistic nursing: A handbook for practice. Burlington,
MA: Jones & Bartlett Learning.
Ray, S. (2014). An index of maternal and child healthcare status in india: Measuring inter- and intra-state variations from capability perspectives. Social Indicators Research, 117(1), 195-207. doi: 10.1007/s11205-013-0340-9
Health In India
Holistic Meicine, Allopathic Medicine, and Women's health
Lecture Critique
Research Critique
India is known for being one of the world's most populous countries, with a wide range of culture it is an emerging-superpower. India is known for its medical-tourism and is one of the most sought-after "health" destinations in the world. But there is a difference between “medical” tourism and “health” tourism. Health tourism would be focusing a voyage around preventative medicine when medical tourism would actually be focused on an actual procedure or allopathic medicine. Health tourism can also be viewed as tourism to improve one’s health. People come to India specifically for their medical problems because of the low-cost, the availability of medical experts, advanced equipment, and specialty treatments. In India, there is a blend of Allopathic medicine, Ayurveda, Unami, and yoga. In every hospital, whether in the private sector or in the public sector there are two doctors, one is an allopathic doctor and one is an Ayurvedic doctor. Even when applying for your degree program in college you can receive a Bachelors’s Degree in allopathic medicine or a Bachelor’s in Ayurveda and Surgery.
Dr.Praveen Kulkarni is a professor in Public Health, prominent researcher, and medical professional here in India. During both of his lectures at PHRII (Public Health Research Institute of India,) he went over the history of medical tourism, the triple burden of health problems, the private-sector versus public sector in the health systems of India, and the socio-economic class differences between the health-care provided to India’s citizens. He claims that health should be provided by the state as written in India’s constitution, but the problem is that the government of India does not want to invest money in the people’s health. The budget for health in India is only 1.6% of the GDP. Therefore causing a rift, and creation of the private-sector.
The history of medical tourism in India actually dates back to about 5000 years ago to the Indus Valley civilization. Susruta was the first ancient surgeon of India, and he practiced Ayurvedic surgeries with his patients even before anesthesia. There are many healing modalities that were actually original to India, and have long contributed to India’s “medical tourism.” Foreigners are especially attracted to the Indigenous systems of Medicine. Interesting enough the people of India turned their backs on their own indigenous ways of medicine after the British colonization when allopathic drugs came into the picture. They started leaning towards a quick fix, rather than preventative medicine. After the establishment of International Yoga day about three years ago, more and more people have flocked to India for its indigenous systems of medicines. Now even Pancha Karma, which is a traditional Ayurvedic health therapy, is offered in all primary care hospitals. The main point of view in the United States towards health has generally been associated with allopathic medicine or curative medicine. We take a pill only once we have a symptom. Yoga, Ayurveda, and Unami are all traditional systems deep-rooted in the Indian culture. They are also known as the indigenous systems of India. These systems can be seen as preventative care. Both India and the United States have seen a rise in the popularity of Yoga, meditation, Ayurveda, Unami and different sorts of preventative medicines since the establishment of International Yoga Day. The challenges faced in the field of preventative medicines are specifically that there is not enough research that has been done in order to prove its effects on “health.” There is limited funding, limited time, and limited resources in this field, but it can be noted that there has been a surge in the publications on yoga, and Ayurveda in order to mitigate disease-related symptoms. (Jeter et. al 2015)
With the integration of all cultural aspects in India especially, health can be seen from many points of view. Politically, socioeconomically, religiously, emotionally, spiritually, and physically. To understand this you must understand the caste systems of India. In Dr.Shanti’s lecture, we extensively went over the caste systems that exist in the Hindu culture and she explained why the health care system is lacking in the public-sectors because of the caste system. Hindi is the main religion practiced in India, and all other religions are heavily influenced by the Hindu culture. Amongst the Hindus there are various subgroups but four major castes, and at the very bottom of the pyramid lies the “untouchables,” which are not even included in the four major castes. The Untouchables went through an identity crisis because they no longer wanted to be at the bottom of the Hindi caste system, and formed “neo-Buddhism” which then caused Buddhism to be cast out of India. Jainism was able to survive because the principles were very similar to Hindu. Islam was also considered of the lower classes. This caste system was represented as a pyramid by Dr. Shanti, and just like a pyramid the lower in the pyramid, the more the population grows. Bringing most Indians to the lowest socio-economic class possible, many beneath poverty level and unable to access any health-care providers. The untouchable kept a social distance and would not go to the doctors because they are “unclean.”
Since this is the reality that faces India, there are diseases which are more prevalent in the different socio-economic classes, or the societies specific castes. A “rich persons” disease would be hypertension, obesity, and any sugar problems. Low-income or “poor” persons disease would be malnutrition, lack of preventative care such as doctor visits, and vaccines. The public doctors might even split up the prescriptions for two different people, and the bug going around could then become immune to antibiotics. This then raises the question of integrity against the Indian Medical Council.
As Dr.Praveen would call it, “The triple burden of health problems” include the communicable diseases which are transferred from human to human, bug to human, or animal to human and includes but is not limited to HIV, Malaria, Rabies, flu, STD’s, etc. The non-communicable diseases include cancer, heart disease, hypertension, and diabetes, etc. Maternal & child health problems constitute for 1/3 of all the health problems of India. In this day and age, most of us living in the United States would assume that woman are treated as equals to men at least in most public settings like the health-care systems. We grew up in a culture that has fought for the rights of women and continues to fight for equality. Many of us mistakenly assume that women around the world receive that same type of respect and equality. In fact, in most of the other countries around the world, we can still see the gender roles being played out, and societies being predominantly male-dominated or patriarchal. India is a gender discriminatory state where male children are preferred and female fetuses are being eliminated. Young women are married off before they are 18, and are not given much value in society. About 27 million women give birth annually in India, but only about 6 million of those women are tested, or even get a checkup with a medical professional during their pregnancy. Anemia, or iron-deficiency accounts for nearly 60% of all pregnant women in India. (Vora, 2009) More than 45,000 women die a year from pregnancy complications.
The Indian government and many outside sources are now putting a spotlight on this gender discrimination. There are many incentives being made in order to help women, and the children being born like the Mother and Child Kit, The offering of money to deliver in a public hospital, and free public check-ups. The problem is that there is not enough education around childbirth, or the woman in general, and the lack of health care facilities in rural areas. There is a cultural stigma around the subject of women. So if a woman is having a severe problem she will live her life working for her family, not ever mentioning her pain or discomfort which could be cervical cancer or HIV. This stigma needs to be addressed through awareness, and empowerment in society. The expansion of the Indian health-care is much needed, and the differences in the socio-economic classes must become more balanced in order for the societies health to thrive as a whole. The integration of quality health care for women both through holistic practices and allopathic medicine can really help the families of all people globally. The health of the entire family is at the hands of the mother, and when a mother empowers her children and her husband, it will then impact the entire evolution of society.
References
Jeter, P. E., Slutsky, J., Singh, N., & Khalsa, S. B. S. (2015). Yoga as a therapeutic intervention: a bibliometric analysis of published research studies from 1967 to 2013. The Journal of Alternative and Complementary Medicine, 21(10), 586-592.
Vora, K. S., Mavalankar, D. V., Ramani, K. V., Upadhyaya, M., Sharma, B., Iyengar, S., . . . Iyengar, K. (2009). Maternal health situation in india: A case study. Journal of Health, Population and Nutrition, 27(2), 184-201. Retrieved from http://ezproxy.fiu.edu/login?url=https://search-proquest-com.ezproxy.fiu.edu/docview/202994072?accountid=10901
Personal Communication
Research Critique
I had the pleasure to meet Dr.Noor Fatima at the JSS Ayurvedic Medical Hospital, and College in Mysore. During the tour of the hospital, many things there fascinated me. Especially Dr.Noor’s perspectives on Medicine, healing, integration, and research. She was a dermatologist before deciding to change her career path and getting into her Ayurvedic practice. She chose this career path because of her love for Ayurveda’s integrative outlook on humanity’s well being as a whole, and individuals.
Ayurveda comes from the Vedas which are Indian scriptures which consist of four different books. The Vedas are the foundation of the Hindu culture, which is the reigning religion of India. Ayurveda is translated into “the science of life,” and it is an individualized, holistic medicine practice that incorporates the elements within the body so it is very particular to each person. The JSS hospital has a whole analysis process in order to diagnose a patient. The diagnostic takes about 30 minutes and is divided into a questionnaire, and a physical check-up in order to determine what Dosha a person is, and what is going on in their bodies. The Dosha’s are the elements, there are three Dosha’s which correspond to all five elements.
Since my pre-departure critique was based on Ayurveda and women empowerment through the cultural lenses of India, I automatically felt that Dr, Noor was the perfect person for me to interview because of my interests, and I knew that it would be a great opportunity to meet all of these powerful women in the medical field, whether that be allopathic medicine or holistic medicine. They are stepping out of the way society labels them, and making names for themselves, and helping all of the other women around them rise up with them.
Ayurveda is globally recognized as a system of preventative and historical medicine. It has also been recognized by the World Health Organization (WHO) as a complete system of natural medicine. Though it may not be widely known or spoken about too often, there has been a study called “The efficacy of Ayurvedic treatment for rheumatoid arthritis: Cross-sectional experiential profile of a longitudinal study,” which incorporated both allopathic medicine and Ayurvedic medicine and solely focused on the Ayurvedic treatments as the cure. This longitudinal study was conducted at the Ayurvedic Trust Hospital in Coimbatore, India over a 7-year period and followed 290 patients from 1977 to 1984. The conclusion of the research showed improvement of RA in all of the patients who participated in the Study. (Krishna. 2011)
Considering the main problem I encountered around holistic health is due to the fact that there is not enough evidence-based research that has been conducted in order to prove its effects on individuals “healing.” Especially its effects on chronic illnesses or mental health problems. Dr. Noor has been focusing her practice on the documentation, and research in order to broaden the horizons of Ayurveda. Her research involves specific therapy’s for Parkinson's disease in the brain. She has documentation on the effects of specific herbs used in an enema or taken through the anus, also the differences of taking the medicines orally. She found that through the anus, it is a much quicker result on the patients' outer symptoms such as shaking.
Dr.Noor’s perspective on the key challenges facing humanity and the global health conditions that we are facing as a whole has to do with how we are raising our children. What goes on at home, and what goes on at school will be the most important factors contributing to how somebody will exert their behaviors as adults. The parenting styles and teaching styles in India specifically are based on a lot of societal pressures like what type of job you will have in your future, what caste you will belong too, and what you will be able to accomplish in life. If you go to a school that doesn’t teach English, then you might never get the opportunity to step out of the country.
Dr.Noor also felt that a big part of the challenges humanity is facing on a global level has to do with the masculine and feminine being out of balance. In the Indian Culture, it is still normal to perceive a woman as lesser than, or for a woman to have to always answer to her husband in order for a woman to have a job, or go anywhere, first her husband must agree. The woman also takes care of the entire household, waking up before all the members in order to cook and clean for the day. In order for this challenge to be overcome as a society, we need to start raising up our women because they are the ones who are the glue to the family. The woman spends her time raising the children, and if she has not nurtured herself, how can she nurture a child. If there is not the proper care and nurture to begin our development at home this will affect how we exert our behaviors later on.
A big theme on this trip has been the youth, and their mental health in India and around the world. Dr.Noor got into the topic of children and their developing habits, and how they have been changing with society and the chemicals that we put into our bodies. Children should have a close relationship with their parents, and parents should listen to the children instead of pressuring them to be a part of society. Children are in need of love, and support in order to develop in the most positive way. “All diseases are psychosomatic, which means they stem from the brain or mind,” Dr.Noor Emphasized her belief that the mind and mental health will rule over our physical well-being.
References
Krishna, K. P. (2011). The efficacy of Ayurvedic treatment for rheumatoid arthritis: Cross-sectional experiential profile of a longitudinal study. International journal of Ayurveda research, 2(1), 8.
Field Experience: Cervical Cancer Camp
Research Critique
MOBILE CLINIC
Field Experience
One of the hardest days I spent in India was the field experience of the Mobile clinic. It might have been hard but it was rewarding, and empowering. Since my interests in India were learning about women’s health through awareness, and empowerment the mobile clinic PHRII, which also stands for Perana, provides to rural communities is exactly the experience i needed in order to understand the health disparities that faces not only the females of the rural villages, but all over India. In India health need to be looked at in a “gender” specific perspective.
PHRII stands for the Public health research institute of India, and the mission that the staff at PHRII maintain is to promote excellence in both basic and applied health research. They do this by getting funding through their projects. One of the most important aspects of this institute is the empowerment of woman through their education process, and all the counseling done in order to teach woman about cervical cancer, and HPV. This is a charitable service free to the woman in the surrounding
Mobile clinics are created for people who cannot reach Mysore city, there is 144 small rural villages in the Mysore district.
There are many health disparities in India, or in other words there is an unequal distribution of health-care.
The United States also has its own wide range of health-disparities, depending on your income of course, which makes it socio-economical. there are certain treatments insurance companies will not cover.
In India most woman who deliver at home cannot afford a hospital birth. It can depend on her socio-economic status, or even where she lives. For example if a pregnant woman lives 40 kilometers away from the hospital, but has no car, or there is no paved road to the hospital, there she encounters a problem.
Male children are preferred over the female children. In fact, it was a large issue that India faces in abortion because of sex.
Health is not only freedom from disease, but health is a state of well-being.