For the forces of economics, it is the health of industries, not that of human beings, that matters more. Let people suffer, but under no circumstances market can be allowed to suffer. Let the people be killed, families be disintegrated, tensions of all kinds plague society, but the interests of the corporate must never be allowed to be killed; slump must not disintegrate them and non-growth must not plague them.
The Covid-19 pandemic has forced the world to take some hygienic measures with extreme seriousness. What is extraordinary in these measures is that rather than leaving it to the individuals, the governments are enforcing them. Unfortunately though, similar concerns were not shown in the wake of HIV pandemic when unhygienic sexual practices (promiscuity, prostitution, homosexuality, ec) were creating havoc all over the world. No concept like “sexual distancing” similar to the currently in vogue “Social distancing” was proposed then. This is despite the fact that more than 38 million people have died of AIDS in the last 25 years. If we think over the infectious diseases in general and viral epidemics in particular, we will have no option but to conclude that hygiene has a much larger scope than what is normally believed and practiced as hygiene. And if we include other non-infectious major killers of the world (like alcohol), we will have to further expand it developing a holistic regime of hygiene. This is exactly what I tried to develop in my book, “Economics First or Health First?” (published in 2019), the work that argued for implementing Dynamic Paradigm of Health in the international system of affairs if life is to survive and become healthy and peaceful.
If we want total health, we need a purer world; if we want a purer world, we need total hygiene. Hygiene is currently being used in a very limited sense. According to the World Health Organization (WHO), “Hygiene refers to conditions and practices that help to maintain health and prevent the spread of diseases. Medical hygiene therefore includes a specific set of practices associated with this preservation of health, for example environmental cleaning, sterilization of equipment, hand hygiene, water and sanitation and safe disposal of medical waste.”1
It is clear that the WHO definition mainly refers to external physical hygiene and can hardly be described a definition of comprehensive hygiene. If we want to have comprehensive plan of hygiene, we will have to include the following:
- Internal Physical Hygiene:no exposure to alcohol, drugs, tobacco etc;
- External Physical Hygiene: regular washing of the exposed organs of the body, cleaning of the area after each passing of urine and defecation, cleaning of hands after touching any unclean things, maintenance of mouth hygiene through brushing of teeth, etc;
- Sexual Hygiene: sex only with spouses of opposite sex, no to promiscuity, homosexuality, sex with animals, incest, paedophilia, anal sex and sex during menses and immediate postnatal period, oral sex and washing of mouth and private parts soon after intercourse;
- Mental Hygiene:no to any such activities that can incite people to indulge in life-threatening activities, like pornography, watching sex and violence, reading materials that can lead to corrupting thoughts;
- Spiritual hygiene: preaching to others, meditation, services to the people, charity, etc;
- Environmental Hygiene: cleaning of clothes and surroundings and strictly maintain environmental equipoise;
- Social Hygiene: no to economic exploitation and corruption, commercialisation of unhealthy practices, murders, spreading mischief, rumours, etc.
But this holistic regime will have hardly any takers because of the interests of the forces of economics and politics. External Physical Hygiene is of utmost importance for the market forces because it suits them. Internal Physical hygiene, mental hygiene, sexual hygiene and social hygiene have no meaning for them, as these can pose serious threats to their vested interests. If internal hygiene is promoted, tobacco and alcohol industries will nosedive; if sexual hygiene is applied, many industries including film, pornography, prostitution and tourism will become defunct; and if a campaign for social hygiene ensues, gambling industries will perish. For the forces of economics, it is the health of industries, not that of human beings, that matters more. Let people suffer, but under no circumstances market can be allowed to suffer. Let the people be killed, families be disintegrated, tensions of all kinds plague society, but the interests of the corporate must never be allowed to be killed; slump must not disintegrate them and non-growth must not plague them.
Natural Primary versus Artificial Primary Prevention
Normally prevention is classified as Primary and Secondary, Primary involving prevention before he emergence of the diseases and Secondary involving further prevention after the disease has emerged. I have further classified Primary Prevention into Natural and Artificial. Natural Primary prevention can be defined as the avoidance of such activities and attempts to prevent such environmental conditions to emerge and grow as may be conducive to the development of diseases. Artificial Primary Prevention can be defined as the prevention of diseases through use of certain materials, medical products, vaccines, or equipment. Pharmaceuticals thrive on the spread of diseases, and so do the doctors, the owners of nursing homes and hospitals and paramedical personnel. Natural Prevention has therefore been able to grasp much less attention than Artificial Prevention and management; because Natural Primary Prevention is perilous for their commercial interests. The latter has received greater attention, because it is beneficial for the industries. While the mouth hygiene and body hygiene are emphasised upon as these propel the sales of thousands of varieties of tooth-brushes, tooth-pastes, lotions, soap, sanitary pads etc., a term like ‘sexual hygiene’ (except of course the use of condoms) has found no mention anywhere. The result is that, while all other infections in the US (and most other developed countries) have shown remarkable decrease in the last half century, Sex transmitted diseases are on the rise. Out of the top 10 infections in the US, five are STDs and about every fifth of adult has a STD. More than 15 million Americans contract STD annually. These are staggering figures for a superpower that has the biggest medical network in the world. If Sexual Hygiene were popularised, the sex-market could have crashed. Even the Hotel, Food, Garments and tourism industries would have suffered. Hence, only the artificial preventive methods that invariably advocate the use of condoms were chosen to allay the fears of the promiscuous and the pervert and those coming in their contact. The odour emanating from the mouth of a person not properly brushing his teeth gives sleepless nights to the industries, but the foul smell from the mouth of smokers and drinkers have never caused any alarm. The health of mouth and skin (that is to be kept healthy through creams, lotions and powders) has always kept them worried but not that of liver, heart, brain and lungs. The death and destruction on a much greater scale due to alcoholism have never bothered them. Similarly, the problems due to the steady increase in human population has been a matter of huge importance necessitating world-wide campaign, but the much greater and severer problems owing to the rapid increase in the population of vehicles have not even come to their notice. Such indeed has been the perfection with which the economic fundamentalists have been promoting their plans that their interests can easily be visualised in almost all the campaigns being pushed by the governments or international agencies.
To sum up, the modern approach towards health is to promote artificial prevention of diseases requiring the use of certain materials produced by the market, like toothpastes, creams, vaccines of different types, condoms, jellies, etc. Natural Primary prevention involving ban on harmful practices like alcohol, unhealthy sexual behaviours, prostitution, promiscuity, smoking, gambling, etc. has no takers, as such a strategy of prevention would imperil the interests of the market. The Dynamic Paradigm of Health however proposed by me presents a holistic regime of hygiene. This holistic approach has the following components:
Natural Primary Prevention
It will be involving active measures, involving Legal, Executive and Social measures to stop harmful practices like alcohol, unhealthy sexual behaviours, prostitution, promiscuity, smoking, gambling, etc. Items and practices that are unhealthy by their very nature or become natural habitat for infections cannot be allowed to be available to the people on the pretext of Freedom of Choice. Allow good choices not the dangerous choices!
Artificial Primary Prevention
It will support all the health-protective measures like vaccines, safe drinking water, condoms in special circumstances and use of pastes and creams. But these should not undermine the importance of Natural Primary Prevention and should only have an additional role.
Treatment and Management
Treatment and Management including all its dimensions will of course remain the mainstay of treating the diseases. However, again, as part of the follow-up, Natural Prevention is to be stressed wherever it can help in stopping the recurrence of the diseases.
It can be seen that most of the measures related to Natural Primary prevention are not going to be easily accepted or promoted by the forces of globalisation. Artificial preventive measures are aggressively promoted and Natural prevention is not given its due. The current international paradigm of health is therefore an incomplete programme, which makes serious compromises on health for the sake of the dominant forces.
This also explains why Pulse Polio Campaign has been run at an unprecedented level in the last three decades throughout the Third World while campaigns against diseases like Malaria and Tuberculosis have lagged far behind both in pace and intensity. This is despite the fact that while Polio hardly kills anybody and only paralyses a few thousands, Tuberculosis and Malaria kill millions of people every year. But as anti-tubercular and anti-malarial drugs are manufactured by the Pharmaceutical industry, they have no interest in pursuing campaigns that would reduce their incidence. If these diseases are controlled through preventive methods by the governmental agencies and other organisations, the sales of the medicines will suffer a huge loss. In contrast, polio has no treatment available in the market. It has only vaccines as a preventive measure. The industrialists know it very well that the masses are more inclined to spend money for treating a problem rather than preventing it. It is therefore more expedient, they calculate, to sell vaccines through the governmental and other agencies. Not only will this ensure greater sales of vaccines but will also ensure the utilisation of governmental funds in industry-friendly activities. In this way, the money they give as taxes will be used indirectly for their own benefits.
“Dynamic Paradigm of Health”
Holistic Hygiene is a part of “Dynamic Paradigm of Health” that I have proposed. It gives a Holistic Definition of Health, which is as follows:
“Health is a state of complete physical, mental, spiritual and social wellbeing, which must be safeguarded not only through the maintenance of a health preserving regime at the personal/individual level, but also through the establishment of a health-protective and health-promoting family system and a health-protective and health-promoting social system.”
Interestingly, in the wake of Covid-19 outbreak, for the first time the system appears to be functioning as an actively health-protective system. People are not being left with the option of living with their own freedom of choices but are being forced to follow a strict regime. The same health-protective philosophy has o be adopted if a long term plan on maintaining health has to be put in place. Individuals cannot be left with their own health-protective options. The system will have to be health-protective withholding those choices that are inherently dangerous for life.
This approach will also require a change in the philosophy of community medicine. The current international curriculum of medicine has Social and Preventive Medicine also known as Community Medicine as one its chief disciplines. This subject studies the statistics related to the various diseases, the factors associated with its spread, how to respond to widespread medical problems at a large scale like epidemics and endemics and how to prevent them. The public health programmes like Population Control/Reproductive & Child Health, vaccination programmes for diseases like Tetanus, Diphtheria, Pertussis, Meningitis, Hepatitis, Bird Flu, Chicken pox, Polio, etc, anti-mosquito drives, Tuberculosis and Leprosy control programmes and the Programme for control of HIV/AIDS come under the Community Medicine. This is also taught as one of the subjects in the medical degree courses all over the world as well as a postgraduate course. With the march of “globalisation”, community health too has gone “global”.
The basic problem with the Community Medicine is that it focuses only on finding medical solutions to the medical problems created by social reasons. There is hardly any talk of finding social solutions to medical problems caused by social practices of different kinds. When the forces of economic fundamentalism contemplated that the population should not be allowed to grow at the current speed if their model of “growth” has to succeed, the medical experts were approached, and they began to put all their energies in finding medical ways to control the population. When the market forces embarked upon the “sexual revolution” that required protection of men and women against pregnancies and sex transmitted diseases, the medical fraternity was quick to provide all kinds of solutions. The social transformation was being pushed through in accordance with the demands of the market, which more often than not brought new diseases to the epidemiological levels. While formulating the laws of the country, economics was given the chief consideration and health became an easy victim. There is now a need to change the whole concept of Community Medicine. The focus must now be shifted to finding social solutions to problems arising out of social practices or changes. Instead of being the only solution, the medical solutions should be an important supplement to the social solutions. I have named this approach as Therapeutic Sociology.
Therapeutic Sociology is not a passive concept like Community Medicine. It is an aggressive and dynamic concept that has an overriding and overpowering influence on all the other aspects of social life, both governmental and non-governmental. It will not be a mere spectator to what is happening or developing on the earth but would pose a challenge to the dangerous ideas and practices. The primary purpose of human living is to avoid death and disease and promote a healthy being, and this primary objective must never be lost sight of in the glitter of the market. Therapeutic Sociology would be a wall in the way of the forces that care little for the masses and exploit their weaknesses for their own ends. Therapeutic Sociology will conduct health impact studies of all the developments taking place, and will then suggest suitable remedial changes in legal, social and medical structure to stop the march of the diseases and deaths. It will also help in developing a “healthy morality” aimed at ensuring health and peace in society in place of “commercial morality”.
To sum up, the aims of Therapeutic Sociology will be:
- To ensure that the supremacy of health is never compromised with in the affairs at different levels: individual, family, social, national and international;
- To campaign for establishing and strengthening a health-protective and promoting family system;
- To campaign for establishing and strengthening a health-protective and promoting social system;
- To ensure that the national and international laws are rewritten to safeguard health;
- To ensure that substances and practices that are decidedly dangerous for human beings are not allowed to exist or at least prosper;
- To conduct health impact studies of different socio-economic developments and spread awareness about them;
- To aggressively campaign against the institutions that are involved in practices that increase dangers for the lives of human beings;
- To create atmospheric and environmental conditions suitable for promotion of health;
- To promote a model of family health that is conducive for the health of men, women and children;
- To focus on both the primary and secondary preventive methods;
- To unveil the designs of economic and political forces, so that they are not able to do anything that endangers health in any way;
- To promote such customs and rituals as are beneficial for individual’s health, family health and the health of the masses;
- To lay an equal stress on the survival and health of all the human beings in different stages of lives: foetus, paediatric, adolescent, youth, middle aged and geriatric;
- To lay an equal stress on the health of both the genders: men and women
Dynamic Paradigm of Health needs to be applied to:
* Make certain changes in the constitutions of the countries;
* Make certain important changes in the objectives and methodology of the international institutions;
* Introduce new concepts in medical education;
* Develop a dynamic attitude among the doctors to change the course of the socio-economic path;
* Develop new strategies to combat the health problems faced by the mankind.
The Covid-19 outbreak has provided the world an opportunity to follow a more aggressive path to ensure survival and high standards of life. Market forces and he political forces cannot be allowed to dictate the health programmes and the philosophies behind them. Life and health need to be seated and remain in the driver’s seat without any break.