The Bahá'í Community and Health Promotion:
dialogue, 1:2, pages 30-33
|The contribution of medical measures (both chemotherapeutic and Prophylactic) to the fall in|
the age and sex–adjusted death rates (S.D.R.) of ten common infectious diseases, and to the
overall decline in the S.D.R., for the United States, 1900-1973
and year became available
|Fall in S.D.R.|
|Fall in S.D.R.|
as % total fall
for the disease
|Scarlet fever||Penicillin, 1946||0.10||1.75|
|Whooping cough||Vaccine, 1930||0.12||51.06|
|Poliomyelitis||Vaccine, Salk/Sabin, 1955||0/03||25.87|
Modern medicine itself is not recognized as a risk factor. Dr. Jonathan Fielding, a professor of medicine at UCLA, notes: “Many hospital admissions are due to an undesirable secondary effect of medical care. For example, a 1979 study of 815 new admissions to a medical service of a university hospital found that 290 patients (36 percent) had one or more iatrogenic (medicine-caused) illnesses, with 76 (9 percent of all admissions) sufferings from major complications. A significant portion of iatrogenic illness is due to drug reactions, but complications of medical and surgical procedures also make important contributions to this largely avoidable problem.”
Does this mean that our system of medical care is without value? Hardly. Modern scientific medicine has made enormous advances in understanding, treating and often controlling a great number of diseases from which millions of people have or would have suffered. Yet, in the divorce of soul from body, a crippling imbalance has occurred. This imbalance has led to the inability to recognize the nonmedical factors that determine health, an inattention to the cultural, familial and emotional sources of disease and an absorption with the increasingly expensive technology of medicine which threatens to make care unaffordable to all but a few. Change must begin with a fundamental reappraisal of the system’s basic assumptions about out physical being.
Health Care and the Bahá'í Faith
Does the Bahá'í Faith begin its approach to Health Care with other or divergent assumptions? I believe it does and, further, that these assumptions suggest and mandate a fundamentally different health care system. Speaking of the purpose of health, ‘Abdu’l-Bahá says:
“If the health and well-being of the body be expended in the path of the Kingdom, this is very acceptable and praiseworthy; if it is expended for the benefit of the human world in general—even though it be for their material benefit and be a means of doing good—that is also acceptable. But if the health and welfare of man be spent in sensual desires, in a life on the animal plane and in devilish pursuits—then disease is better than such health; nay, death itself is preferable to such a life. If thou art desirous of health, wish thou health for serving the Kingdom. I hope that thou mayest attain a perfect insight, an inflexible resolution, complete health and spiritual and physical strength in order that thou mayest drink from the fountain of eternal life and be assisted by the spirit of divine confirmation.” (Tablets of ‘Abdu’l-Bahá p. 207)And in making clear the connection between body and soul, he further states:
“Between material things and spiritual things there is a connection. The more healthful his body the greater will be the power of the spirit of man; the power of the intellect, the power of the memory, the power of reflection will then be greater.” (Divine Art of Living, p. 163)Bahá'u'lláh also gave guidelines for health:
“O people, do not eat except when you are hungry. Do not drink after you have retired to sleep....
Do not neglect medical treatment, when it is necessary, but leave it off when the body is in good condition....
Treat disease first of all through diet, and refrain from medicine. If you can find what you need for healing in a single herb do not use a compound medicine. Leave off medicine when the health is good and use it in case of necessity....
A light meal in the morning is as a light to the body.
Avoid all harmful habits: they cause unhappiness in the world.
Search for the causes of disease. This saying is the conclusion of this utterance.” (Star of the West, Vol. 13, no, 9, p 252)
|Estimated percentage contribution of the four elements of the health field to premature mortality|
|Cause of death||Health system||Life-style||Environment||Human biology|
|All other accidents||14||51||31||4|
|Influenza and Pneumonia||18||23||20||39|
|Motor vehicle accidents||12||69||18||0.6|
|Cirrhosis of the liver||3||36||9||18|
|Average for ten causes||10.8||48.5||15.8||26.3|
|Source: Center for Disease Control, Public Health Service, 1979.|
The above statements clearly suggest that the promotion of health rather than the treatment of disease would be the first priority of and the foundation on which Bahá'í individuals, institutions and communities would build the health care system of a new world order. Such a foundation would support activities and programs that would make Bahá'ís leaders and agents of much needed change in a vital area of human service.
It is important to note that the recognition of the need for a fundamental change in our health care system and the assumptions about human life that underlie it is already well advanced among a growing number of practitioners outside the Bahá'í community. In 1977 the U.S. National Institute of Mental Health completed an analysis of American medicine with this paragraph:
“During the last two decades many physicians have begun to discover the limitations in the paradigms of western allopathic medicine....The focus on pathology rather than prevention, the destructiveness of so many pharmaceutical and surgical remedies, the too rigid separation of physical and emotional problems, the assumption of an asymmetrical relationship between an all-powerful physician and a submissive patient have promoted clinicians to look for answers in other traditions and techniques.Implications for Bahá'í Involvement in Health Promotion
“This search has led many to seek out traditions in which body and mind are regarded as one, in which therapeutics are directed at aiding the natural healing processes. Turning to acupuncture, homeopathy, herbalism, meditation, psychic healing, guided imagery, biofeedback....”
Such stirrings in the larger society along with the statements in the Bahá'í Writings have important implications for Bahá'ís. Let us briefly explore some of these implications.
Given the focus on behavior change in successful health promotion programs, and with the knowledge of the organic interrelatedness of soul and body, large scale health promotion programs offer either directly or by analogy useful models for Bahá'í mass teaching and development projects.
A useful example would be the work of the Stanford Heart Disease Prevention Program in Monterey County, California. This is a long term field trial of the effects of community-directed health education on cardiovascular disease. The core behavior change programs are nutrition, smoking cessation, exercise, blood pressure, stress education and weight loss—these having been determined to be the critical risk factors for cardiovascular disease. The program uses a variety of theoretical frameworks, interestingly enough all from the social and behavioral sciences and none from medicine, to guide its educational interventions. The results of the Stanford project have been encouraging. The program directors state: “Much of the success of the community education program can be attributed to the quality of the media campaign, to the synergistic interaction of multiple educational inputs, and to the interpersonal communication stimulated by application of these inputs in a community setting. A media-based program can be successful if it integrates goals, social support, and social controls and uses existing interpersonal networks as channels for the diffusion of health information. Such a strategy does not use mass communication exclusively; however, media are central to the plan. Although it is possible that in the future the entire effort might be accomplished by way of media, the current prudent choice of the “best” strategy for optimum efficiency of community-based risk reduction is a plan that blends a minimal focused amount of face-to-face instruction with an extensive media campaign that is strong enough to create the desired outcomes, in part, by itself.”
The metaphor here, in my opinion, is that with the considerable media exposure already afforded the Bahá'í Faith in many localities, Bahá'í communities can look to successful health promotion projects for ideas on how to effectively follow-up and exploit this coverage. Such projects would enable Bahá'ís to translate public awareness into knowledge of the Faith, motivation to join its ranks and the learning of the skills and characteristics necessary to adopt and maintain its beliefs. These stages of 1) awareness; 2) information; 3) motivation; 4) adoption and; 5) maintenance are the project planning stages utilized by the Stanford program. Such a systematic approach, field proven in projects designed to improve and enhance human health may well be useful to accomplish the large scale behavior change necessary to have mass conversion.
If health promotion community education projects provide a metaphor for mass teaching, then the message of enhanced health is a valuable ally for the Message of Bahá'u'lláh. The reasoning goes like this. Those people who are most effective in adopting new behaviors or beliefs are those who judge that they are capable of dealing successfully with different realities. This concept of self-efficacy is most prominently identified with the work of Stanford psychologist Albert Bandura. Individuals willing and able to change their health behaviors are those whose sense of self-efficacy makes them open to the further dimensions of spiritual health offered by the Bahá'í Faith. In addition, the Bahá'í Writings show that positive steps taken to improve physical health stimulate one’s spiritual being and open the individual to spiritual influences. This suggests that:
Robert Phillips is founder and co-owner of Consultant Services of Santa Cruz, California, which provides health care project management and research, organization development, education and training to hospitals and health care groups.
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