The changing meaning of health

It is a good thing that Nagas are increasingly becoming aware of their health. Some of the people are very well informed, now that a lot of health information is just a click away and many newspapers reserve certain space everyday for health news and tips. Diagnostic and treatment facilities are getting more sophisticated each year. Disease patterns are also changing over the years. Tuberculosis is not the dreaded killer disease anymore, Small Pox is wiped out from the world and even Nagaland has achieved and maintained the elimination rate of Leprosy. These infectious diseases are giving way to non-communicable diseases like cardio-vascular diseases and cancers. With the antibiotics revolution, many of the infectious diseases have become treatable while non-communicable are on the rise, largely because of change of lifestyle, diet, and change in the physical and social environment.

However, this disease changing trend is not clearly demarcated, not least in Nagaland. The world has vitnessed the emergence/resurgence of infectious diseases like HIV/AIDS, Hepatitis B, and the fear of influenza (H1N1, SARS) pandemic is looming. Malaria has made a comeback after optimism of its eradication in the late 1960s and 70s. These infectious diseases are much harder to treat, coupled with the antibiotic resistant strains of bacteria now abounding. In Nagaland, two different scenarios emerge. At one end, we have people who suffer and die from easily treatable or preventable diseases (usually poor people in the villages) while at the other, we see increasing non-communicable diseases which are usually associated with affluence. Also, the scenarios are complicated by the fact that infectious disease like HIV/AIDS is spreading fast in the rural areas where awareness level is low, and non-communicable diseases like peptic ulcer and neck cancers are increasing in the villages.

There is also an emerging phenomenon in Nagaland and it will only increase in the future. As Nagas love to imitate others, especially the west, in dressing, food habits, etc. so also, Nagas are becoming obsessed about health like the people especially of the west. As mentioned in the beginning that mountains of health information are available in the internet and newspapers, people have become obsessed about their health. A very simple example is: when anyone gets a cold, he/she will simply eat a cold tablet as though it is a sweet, without medical prescription and unnecessarily. Over the counter drugs are the most abused drugs because they are freely available and are seemingly harmless in the short run. Actually, they are not. Misuse of antibiotics has resulted in multi-drug resistance where a person does not respond anymore to a host of antibiotics.

In the wider aspect, this obsession is reflected in the churches’ teachings about health and wellbeing, often heard in the ‘prosperity gospel’. The promise of complete physical and spiritual wellbeing is being preached which in reality is elusive in this world of Sin and death. People long for these things and unrealistic expectations in turn probably do more harm than good to one’s health. This is not a blanket cover criticizing the entire ministry of spiritual healing, as physical healings do occur occasionally to the surprise of medical experts.

In a time when physical beauty is being prized above all, cosmetic surgery is an extremely profitable business. People shell out any amount of money for creams that make one look younger than one’s age. Men also resort to all measures and regimes to keep their body in enviable condition. Though not wrong to keep one’s body healthy and beautiful, this health obsession has a philosophical basis which is sickening. It is also unhealthy for one’s mental health as it causes mental stress and anxiety. A lot of cardio-vascular diseases are due to the stressful lives that competitive modern people live. Many fall victims to false miracle therapies that claim to cure all illnesses. This whole concept of obsession for one’s health is known as ‘medicalization of health’.

Now, these all calls into question, ‘What is Health’? The definition of health is muddled by the fact that diseases are now defined from the molecular level to the societal level. Defining health as ‘absence of disease’ is not correct anymore as a so called ‘healthy’ person may have genetic defects which are not expressed externally. In other words, would you call someone ‘unhealthy’ who suffers no bodily discomfort but simply has a defective gene, or would you call someone ‘healthy’ when all medical investigations detect no disease but the person doesn’t feel well? Health therefore is also a very subjective matter. Whatever may be the medical condition, a person or a society may be feeling just fine and accept certain conditions be it sickness or death as a part of life while in some other, a single case of the same condition may be a cause for alarm. In medieval Europe when Tuberculosis was so rampant and there was no medicine for its cure, the disease even became a symbol of fashion. Those who cough blood and have thin physique as a result of Consumption (former name of TB) were considered ‘sexy’.

To date, the most widely used definition of Health is the one given by the WHO. WHO defines Health as ‘a state of complete physical, mental, and social wellbeing; and not mere an absence of disease or infirmity’. Its criticism is that Health cannot be defined as a ‘state’. No person by this definition can be qualified to be labeled ‘healthy’ as no one can achieve that ‘state’ where she/he has complete physical, mental and social wellbeing. This definition however, sets a standard (an ideal state) that each strives to achieve. Rather than being a ‘state’, K Park says that health is a dynamic concept where a person continually adjust to the ‘changing demands of living and of the changing meanings we give to life. It helps people live well, work well and enjoy themselves’.

The WHO health definition captures well the different dimensions of health. When we talk of health, we commonly mean physical wellbeing. Mental wellbeing is not properly understood and social dimension is neglected. WHO definition teaches that health is not just absence of disease, and treatment not simply tablets, injections or going under the surgical knife. All the three are equally important and are inter-related and interdependent. A classic example of this is the dictum, ‘poverty causes ill health; ill health causes poverty’.

With Dr. Keneinguzo Zumu, for Touphema Students' Union magazine