Ka Wai Ola - Office of Hawaiian Affairs, Volume 7, Number 1, 1 January 1990 — Health is a many splendored thing [ARTICLE+ILLUSTRATION]

Health is a many splendored thing

By Arthur Manoharan, M.D. OHA Division of Health and Human Services

Health is often taken for granted until we experience disease or illness. Health professionals seem to be more preoccupied with illness and treatment, rather than with positive health promotion. When the World Health Organization defined health, it included the statement

that (health) "is not a mere absence of illness or disease." One of the most eommon ways of looking at health is to look at bodily functions. When the body is functioning efficiently, the individual is eonsidered healthy. Physicians always study the various organ-systems to determine one's health status. In schools of medicine, the study of biochemistry, physiology and cellular integrity of various organ systems have become the basic areas of instruction. This is done with the belief that an understanding of bodily functions is essential to understand the health status. This may be called the physiological perspective of health. Over the years, numerous measurements and tests have been created to study body functions. These are constantly evaluated and revised as new information and new observations are available. This leads to the thinking that the body is like a maehine and as long as the parts function properly, the maehine is in good shape. Physicians specialize in various organ systems, just like engineers specialize in various areas of engineering. This is particularly valuable if an organ-system is affected and a physician with special knowledge and skill in that area is able to set things right. In spite of its advantages, it has certain limitations. Physicians leam to look at the body as composed of various organ-systems and are not able to look at the whole person. A different way to look at health Another way of looking at health is the study of the relationship between the human being and the environment. This may be termed as the ecologieal perspective of health. This is becoming increasingly important as we leam about the impact of the environment on human health. In the early days of eoal mining, miners carried small birds in cages when they went down into the eoal mines. If the birds showed signs of distress due to laek of oxygen, the miners realized that it was not a healthy environment for them and they quickly got out. The area between North and South Korea, around the town of Panmunjom, is riddled with tunnels and the Koreans are always concerned that the "opposite side" could flood these tunnels with poisonous gases. They keep the birds in cages in the tunnels as an early detection system. One of the' major concerns facing human beings, all around the world, is the destructive way in whieh we have abused the environment since the advent of the industrial revolution. The deforestation and the dumping of chemicals on land, water and in the atmosphere have gone unchecked for many years and the result is we find we are facing many adverse consequences. Many forms of life have become extinct and this is an indication that we are destroying the biosphere. The extensive use of fossil fuels, the use of fertilizers and pesticides, and the use of radioactive materials have led to severe forms of pollution. Unfortunately, the impact of environment on health is not given sufficient importance in teaching the health professionals. It is estimated that more than 80 percent of eancer is due to environmental conditions. The increase in accidents and chemically-induced dis-

eases are a direct consequence of mismanagement of the environment. Unless we look at this problem from a global perspective and take resolute action, this will lead to ever increasing health problems, perhaps even the total destruction of human beings on this planet. Many people have a short-term view of life and do not want to think of the long-term consequences. In Hawai'i we have a situation where we are abusing our environment constantly and no one knows how mueh further we ean abuse the environment without paying a costly pnee. It is interesting to see that most health professionals do not participate in environmental health issues. This is because of a laek of awareness on their part and a major gap in their training and professional attitude. Political perspectives of health There is yet another way of looking at health whieh may be termed the political perspective. A study of the health status of people around the world shows that oppressed people worldwide suffer from increased incidence of ill health. Their laek of political power prevents them from obtaining the basic needs for their survival. They often live in a poor environment with low ineome and poor levels of nutrition and sanitation. It is impossible to improve their health unless we provide them with necessary resources to improve their nutritional and other needs. The United States is a classic example of where the highest level of health technology is available to a minority of wealthy people. The number of homeless people is on the increase and women and children often suffer from extreme levels of poverty. Certain communities are not able to participate in the eeonomie system and they seem to be deprived of many basic things in life. In other words, laek of political power appears to be a basic cause for ill health. The situation ean only be changed by empowering the powerless so that they ean obtain the necessary resources and services essential to their health. The attempt to deliver health services without improving the socioeeonomie level of people is a Band-Aid approach and will not succeed in the long term. Unfortunately, in the Amenean system, individuals pursue their individual road to success and wealth, and it is almost like a jungle where the survival of the fittest is the rule. Children, old people, women and minority groups are not able to compete for resources with the politically powerful who seem to have an endless thirst for accumulating power and wealth. In this context, health becomes a major political issue and the acquiring of political rights will have to precede any health or medical care whieh ean only become effective in a new context. The spiritual perspective of health Another perspective may be termed the spiritual perspective of health. Human beings have derived their strength and sense of identity from their belief systems. In many cultures what wē

consider to be logically impossible or unusual seems to be eommonplaee. For example, there are individuals who ean alter their heart rate and body temperature, and even their metabolic rate, by means of meditation and altering their awareness. We are also learning that the will to live and survive ean have tremendous impact on the health and well being of people. One of the major problems of modern-day living is stress. Stress-diseases are a group of illnesses that have become more prevalent during the last 100 years. When the belief systems are replaced by purely materialistic values, individuals seem to lose their ability to face stress. Modern medicine is finding out that people who have a deep spiritual belief system have a high level of self-confidence and are able to face many crises without depending on piils and potions. This is an area of health that has a tremendous potential for future development. The spiritual side of health was denied when industrial technology became the major area for eeonomie development. We are now learning that industrial technology cannot answer all questions in the area of health. Individuals have tremendous ability to heal themselves and maintain their health if they have a better understanding of their own abilities. There is an increasing disillusionment with medical technology and many are searching for the spiritual and cultural aspects of health. There is an old story in India about four blind men who went to see an elephant. Eaeh one feeling a different part of the animal thought that the elephant was like a snake (trunk), or a pillar (leg), or like a wall (side), or a broom (tail). In a similar manner, many health professionals are looking at one aspect of health and mistaking it for the whole. As we leam to put all these perspectives together, we may get a better understanding of what health is, and Health Is A Many Splendored Thing.