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DR JAVED JAMIL examines the current definitions of health, analyses them and brings out how Islamic definition is most comprehensive. Then he explains how Islamic alternative system of health ensures complete physical, mental, spiritual and social well being of society.
Health is arguably the most important gift of nature to man. Without health, life becomes an unmeaning burden. But to maintain health requires exactly what the economic fundamentalists loathe: discipline in life with plenty of restrictions on activities. The worship of Hygeian is not tolerable for Mammon. "Restrictions" and "prohibitions" are words that do not exist in the lexicon of the bazaar.Health is also or must be perhaps the most easily recognisable criterion of right and wrong. In the simplest terms, right and wrong can be defined thus: what has a good overall impact on health is good, and what has a bad overall impact is bad. This definition can create some complications; but it holds good for most of the cases. Health itself is a comprehensive state of well being. Normally, it is defined in terms of physical, mental and social well being, with spiritual well being added as an essential constituent recently. Ideally this includes family health as well. This is essential for family is an organised unit of society comprising individuals. A person, male or female, child, young or old, is an individual, a member of the family and a member of society.
WEST'S CONTRIBUTION
West deserves ovation for the amazing advancement in sciences that the world has witnessed during last few centuries. It has undoubtedly helped man to overcome a large number of problems. Western scholars and scientists are worthy of encomium for their tireless, selfless and dedicated efforts to search and apply natural forces and resources for the benefit of mankind.They successfully imbued the 19th century with a scientific temper in human approach. But alas, this scientific spirit did not last long. The concourse of scientific development and economic fundamentalism, travelled some distance side by side, then the latter positioned itself in the driver's seat. The scientists were naive and guileless doves. They could not decipher their enormous potential as the ultimate guides for society. They could not muster courage, conviction, desire and wit required to thwart the onslaught of the economic fundamentalists who were full of intrigues, and used their money power to take control of almost all the departments of social existence.
While scientists toiled day and night at the expense of their comfort without receiving much in return, except mention of their names in books, their inventions and discoveries were hijacked by the merchants for their own benefit.If they had done so without disturbing the delicate environmental and social poise, it could not have been as devastating as it ultimately turned out to be. What the earth had to witness and bear was the most blatant misuse of scientific and technical information for the sake of money. The most amazing source of energy, the nuclear energy, was misused for manufacturing nuclear bombs capable of decimating the whole of mankind. Atomic bombs were hurled on the innocent citizens of two Japanese cities, Hiroshima and Nagasaki, murdering thousands of thousands of men, women and children, and crippling forever many more.
Other highly destructive weapons – combat aircraft, missiles, chemical bombs, etc. came into the hands of man. The objective behind their development was to impose the uncanny will of certain powers on the rest of the world so that they may be forced to acquiesce or cringe to their economic plans. Business houses started using the advanced equipment to boost their sales. Cameras are now used to take pictures of persons in the nude, and the electronic equipment is used to dispatch vulgarity and shamelessness in the houses of the common people. Technology is misused to loot and plunder in the name of fashion. Masses are made addicts of insalubrious and highly damaging items. They are made to drink what is unworthy of drinking and eat what is unworthy of eating. The precious time of men, women and children is killed with indecent, hazardous programmes.
Consequent on the blind race for money, what has suffered most is health – physical, mental, spiritual and social. While medical scientists have been perpetually engrossed in efforts to find out the aetiologies and remedies of various health problems, magnates have been relentlessly engaged in popularising whatever suits their interests, irrespective of their impact on human health. And the tragedy is that medical scientists too have lately become mere tools in the hands of industrialists. They sometimes resist. But, subdued as they are in disposition, at the most their viewpoint is published only in medical journals. If at all it becomes public, merchants find alternative ways to submerge it into oblivion. The medical world is not dynamic enough to aggressively push its concerns. The problem has further been compounded by the privatisation of medical institutions and research laboratories. The industries are now buying medical specialists for their own ends. They have the money power to lure experts who too seem to have found a heavenly haven in the garden of materialism.
DOCTORS SUBDUED BY CAPITALISTS
The callousness of medical experts and the passive nature of the medical educationhave strengthened the resolve of the economic fundamentalists to market everything the demand for which already exists or can be created through stage-managed propaganda. They are least bothered about the adverse effects of their actions on the individual, family and social health. The doctor has proved unequal to the dire challenges of the bazaar. The bazaar has continued to grow. Health has continued to suffer. Thus first tea and coffee hit the shops, and such was the "quality" of the campaign to popularise them that they rapidly assumed the status of household beverages.
The medical world was seized with the health problems related to these developments, and pointed out that these drinks had undesirable effects on heart, nervous and gastrointestinal systems. It is now well established that coffee is one of the significant etiological factors in the rising incidence of heart attacks and peptic ulcers. Yet, their social glorification continues. Tobacco and cigarettes of various tastes have seized the market. They have become symbols of high standard life with increasingly large numbers of people becoming addicted to smoking. To multiply their demands women who were previously disinclined to smoking were also encouraged. Equal as they are, if men can smoke why can't women?
Doctors have declared in unequivocal terms that smoking is not just harmful but is extremely hazardous to health. They have established that cigarettes can cause lung cancer that still remains almost incurable, bronchitis that leads to asthma causing severe distress in breathing, and are a highly significant factor in the development of coronary heart diseases. Each one of these diseases is either fatal or severely crippling.
Similarly, tobacco has been associated with mouth cancer and Buerger's disease, a disease of the veins of legs that may lead to the gangrene of foot. But all these caveats have failed to discourage smoking to any remarkable degree; for doctors are not assertive enough to pressurise parliaments to pass bills proscribing the production and sales of cigarettes, cigars and tobacco. Instead, doctors themselves have succumbed to the propaganda by the manufacturers and their henchmen. It is unfortunate but true that a sizeable percentage of doctors do also smoke. Smoking women are rapidly on the rise despite the accumulating evidence that smoking badly damages the health of their foetuses. But for a "forward-looking" woman, health of foetuses is not as important as the elan that she attaches to her smoking. After all a foetus is a foetus which can be sacrificed for a full grown society woman.
MOTHER OF EVILS GLORIFIED
Similarly, such has been the glorification of alcohol that any person trying to prove his credentials in society has no choice but to serve drinks to his visitors, especially on the occasions of celebrations. The medical sciences inform us in categorical terms that alcohol is damaging to the health whatever the amount imbibed. Yet, with the support of some partisan investigators, the campaign that it is harmless in small doses has gathered momentum. Some have gone to the extent of declaring it beneficial for the heart, capable of increasing a specific kind of cholesterol that seems to have a soothing effect on the cardiovascular system. It need not be emphasised that this sort of flagrant advocacy has chiefly been goaded by financial motives and has little to do with the medical truth.
At the most, they are truncated facts. What the medicine tells is that once a person starts taking alcohol, the level at which the desired euphoria is attained rapidly increases necessitating an increased intake. No person becomes an addict the day he or she smokes the first cigarette, or takes the first sip of bear, whisky, rum or wine. All the present addicts had small beginnings. Those who introduced it to them had argued that these were injurious only if taken in huge amounts and regularly. It is very well known that alcoholism may lead to fatal diseases like cirrhosis and Korsakoff"s psychosis, and has a damaging impact on almost all the organs of the body. It disturbs the power of reasoning thus leading to crimes, accidents and suicides. Ironically it can also lead to impotency; yet alcohol is presented as an essential adjunct to hot and wild sex.
Alcohol directly or indirectly kills millions of people every year, destroys innumerable families and leads to countless rapes. It causes severe financial losses to the well-established individuals who often get ruined on account of their intemperate drinking habits. Divorces are common outcome; and the wives and children of habitual drinkers have to pass their lives in an environment of extreme fear, insecurity and tension. Children too often start drinking in their teens. The party culture coupled with women's propinquity to try their hands at whatever men do as a manifestation of 'equality' and the encouragement by men for their own rejoicing have made alcohol popular among women too.
PROMOTION OF PROMISCUITY
The campaign for freedom of sex is a direct product of economic fundamentalism. The medical sciences have been mute spectators to the rise of sexual perversity despite the incontrovertible fact that it causes no less mortality and morbidity than smoking and drinking do.In many ways, its effects are much more dangerous. Time and again, epidemics or endemics caused by promiscuity or sexual perversions have devastated the mankind. Many of them have proved to be the decimating killers. Syphilis was the first sex-related disease that killed people in large numbers. The homosexuals and the promiscuous heterosexuals were the common victims. Syphilis is a bacterial infection that leads to severe cardiovascular and neurological complications. Before the discovery of penicillin, death was not an uncommon end. Up till 1940, it was a major disease in Europe and the US.
The incidence in 1943 in the US was about 4 per 1000 population. Despite the availability of highly efficacious antibiotics and tremendous fall in the number of cases in 1975, there were still more than 25,000 cases of primary and secondary Syphilis; 26,000 cases of early latent Syphilis were reported. The number of unreported cases was presumed to be several times greater. The gynaecologists and obstetricians in Indian subcontinent still regard Syphilis as one of the major causes of repeated miscarriages, and get VDRL test routinely done in all females with a past history of abortion. Chancroid, Gonorrhoea, Lymphogranuloma venereum, Herpes and Reiter's disease are other sexually transmitted diseases having varying severity and often producing crippling complications.
The emergence of social and preventive medicine (also called community medicine or public health) as one of the important disciplines of medical sciences has as much to do with economic fundamentalism as with the health of society. Here it is the medicine that is used to propel social and economic policies, and not vice versa. Major policies are formulated separately, or in tandem by the secretaries of the government and the tycoons of the industry. The bureaucrats in fact act largely as connoisseurs of the big business.
The population control, the AIDS control and the control of communicable diseases – all these programmes have been fine-tuned to suit or adjust to the market forces.If endeavours have been and are being made to eradicate small pox, chicken pox, polio, rabies and other such diseases for which vaccines are available, it is because no medical cures are available for them in the market. And vaccines can be sold on a much higher scale if the government and other agencies working in social fields are properly convinced of their importance. This has also been one of the ways to pull back the money, which the government might have exacted in the form of taxes or the agencies might have collected as donations from the rich. The ostensible human spirit behind these programmes would vanish in a few moments once alternative ways having bigger market potential are found.
CURRENT UNDERSTANDING OF HEALTH
According to Winpledia, "Health is the level of functional and/or metabolic efficiency of an organism at both the micro(cellular) and macro(social) level. In the medical field, health is commonly defined as an organism's ability to efficiently respond to challenges (stressors) and effectively restore and sustain a "state of balance," known as homostasis"
Another widely accepted definition of health is that of the World Health Organisation "WHO". It states that "health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity". This widely accepted definition was expanded in the 1970's and 1980's, as other components were included: intellectual, environmental, and spiritual health. The balance of all these components is based on the principle of self-responsibility.In more recent years, this statement has been modified to include the ability to lead a "socially and economically productive life." According to Winpledia, "the WHO definition is not without criticism, as some argue that health cannot be defined as a state at all, but must be seen as a process of continuous adjustment to the changing demands of living and of the changing meanings we give to life. The WHO definition is therefore considered by many as an idealistic goal rather than a realistic proposition."
The above definitions clearly demonstrate the impact of the economic fundamentalism, which have been stressing the inclusion of "socially and economically productive life" without insisting the adoption of a health protective socio-economic system. Economic fundamentalism relies on the promotion of individualism and the negation of family and society.In their view it is individuals that form society rather than that society comprises individuals. Market forces advocate the importance of absolute individual freedom, and strongly resent any suggestion that the demands of society in general and the demands of family in particular must guide individual choices. It is therefore necessary to restrict the definition of health to an individualistic notion. If "social well being" is talked of, it means how an individual acts within society and not how society protects the individual.
This definition is thus a passive proposition where the onus to maintain health falls on the shoulders of individuals themselves; family and society are not largely responsible to protect health. If society comes into action, it is invariablywhen a particular programme has the blessings of the market forces. If some hue and cry is raised by certain quarters to correct the ecology and environment, these are diplomatically tackled. Some of these demands have in fact the blessings of the big industries in order to fail the small-scale industries. And whatever the force behind these demands, environment to them just means air and water free of pollution; it has nothing to do with social practices and systems that are dangerous for the health, unless they have a scope for commercial use at a larger level. We will discuss later how and why only secondary preventive measures are advocated and primary preventive measures ignored.
QUR'ĀN'S POSITION
Islam on the other hand suggests a much more comprehensive definition of health. Let us examine the following verses of the Holy Quran, related to Health, Reproductive & Child Health and Family Health:
About Hygienic food
Say: Who hath forbidden the beautiful (gifts) of God, which He hath produced for His servants, and the things, clean and pure, (which He hath provided) for sustenance… (7: 32/A)
Unhealthy food prohibited
Forbidden to you (for food) are: dead meat, blood, the flesh of swine, and that on which hath been invoked the name of other than God. that which hath been killed by strangling, or by a violent blow, or by a headlong fall, or by being gored to death; that which hath been (partly) eaten by a wild animal; unless ye are able to slaughter it (in due form); that which is sacrificed on stone (altars); (forbidden) also is the division (of meat) by raffling with arrows…(5: 3/A)
About Environment
Why were there not, among the generations before you, persons possessed of balanced good sense, prohibiting (men) from mischief (and disorder) in the earth – except a few among them whom We saved (from harm)? (11: 116/A)
And the Firmament Has He
Raised high, and He has set up
The Balance of (Justice),
In order that ye may
Not transgress (due) balance.. (55: 7-8)
About Personal Hygiene
In Book well-guarded, which none shall touch but those who are clean (56: 78-79/A)
And thy garments keep free from stain! (74: 4/A)
Unhealthy social practices prohibited
They ask thee concerning wine and gambling. Say: "In them is great sin, and some profit, for men; but the sin is greater than the profit." (2: 219/A)
Mental and spiritual health
Then will he be of those who believe, and enjoin patience, (constancy, and self-restraint), and enjoin deeds of kindness and compassion. (90: 17/A)
O ye who believe! Persevere in patience and constancy; vie in such perseverance; strengthen each other; and fear God that ye may prosper. (3: 200/A)
(They are) those who persevere in patience, and put their trust on their Lord. (16: 42/A)
Sexual Hygiene
O ye who believe! Approach not prayers with a mind befogged, until ye can understand all that ye say,- nor in a state of ceremonial impurity (except when travelling on the road), until after washing your whole body. (4: 43/A)
They ask thee concerning women's courses. Say: They are a hurt and a pollution: So keep away from women in their courses, and do not approach them until they are clean. But when they have purified themselves, ye may approach them in any manner, time, or place ordained for you by God. For God loves those who turn to Him constantly and He loves those who keep themselves pure and clean. (2: 222/A)
Say: the things that my Lord hath indeed forbidden are: shameful deeds, whether open or secret; sins and trespasses against truth or reason… (7: 33/A)
Nor come nigh to adultery: for it is a shameful (deed) and an evil, opening the road (to other evils). (17: 32/A)
Homosexuality forbidden
The Holy Quran calls it indecency and lewdness and strictly prohibits it (7: 80-81)
Mother & Child Health
…for those who carry (life within their wombs), their period is until they deliver their burdens… (65: 4/A)
And if they carry (life in their wombs), then spend (your substance) on them until they deliver their burden… (65: 6/A)
The mothers shall give suck to their offspring for two whole years, if the father desires to complete the term. But he shall bear the cost of their food and clothing on equitable terms. No soul shall have a burden laid on it greater than it can bear. No mother shall be treated unfairly on account of her child; nor father on account of his child; an heir shall be chargeable in the same way. (2: 233/A)
If they both decide on weaning, by mutual consent, and after due consultation, there is no blame on them…(2: 233/A)
If ye decide on a foster-mother for your offspring, there is no blame on you, provided ye pay (the mother) what ye offered, on equitable terms. (2: 233/A)
Let the man of means spend according to his means: and the man whose resources are restricted, let him spend according to what God has given him. (65: 7/A)
On the basis of the above quoted verses, it is not difficult to conclude that:
First, in Islam, health is not a separate entity but one of the essential constituents of peace, which comprise peace at the individual, family and social level. (It in fact includes peace in this life and Hereafter.) In the current world on the other hand, peace means only an absence of wars and civil wars, and the international organisations define peace and health in a way that they seem to be totally different entities.
Second, in Islam, there are three tiers of society: individual, family and society. All three have equal importance and none can be sacrificed through the sword of the other. Health therefore too has to involve all the three. The three have a mutual relationship that makes them inseparable. Individuals have to establish a disciplined family and social system. In return, family and society have to protect individuals from all kinds of external threats. The current international system ignores family system and aims to cater only to the individual.
Third,Islam classifies acts into following categories:
(1) Halal (Permissible), without being obligatory or desirable;
(2) Fardh (obligatory);
(3) Mustahab (Desirable), without being obligatory;
(4) Haram (Prohibited):
(5) Makruh (undesirable) without being prohibited.
This categorisation is extremely important; this in fact makes Islam the most scientific system of the world. It also gives certain flexibility to the constitution that makes life easy for even those having weaker convictions.
The Quran itself declares that it allows what is good and forbids what is bad. Now, after studying various prohibitions and obligations in Islam on the basis of the till now available scientific knowledge, we find the categorisation of acts, where they are related with health, to be based on the following principles;
(1) Islam declaresprohibited all those things and practices that do not form parts of the normal requirements of the body and can directly lead to the development of a disease, which more often than not becomes fatal or causes physical handicaps like blindness, paralysis, etc. (Alcohol, pork, unhealthy sexual practices);
(2) Islam declares makruh or undesirable all those things and practices, which may harm the health but are neither usually fatal, nor lead to any physical handicap like blindness, paralysis etc.
(3) Islam declaresMustahab or desirable or obligatory all those things and practices that have beneficial effect on the health of the individual or society in general. (Circumcision, several foods, Ablution, Prayer, Istanja, etc.)
In the light of these observations, we can now give anIslamic definition of health,whichis 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 and individual level, but also through the establishment of a health-protective and promoting family system and a health-protective and promoting social system."
We shall see how this definition would give sleepless nights to all the proponents of globalisation and their stooges in the World Health Organisation and other health related bodies. The WHO has never insisted on identifying practices that are not suitable for humans and must therefore be totally prohibited, legally and socially, through effective measures at the national and international level. Whenever campaigns have emerged and intensified against certain practices like smoking, the suggestions have been not to impose total ban on these practices and the commercialisation of harmful substances and practices but only to create awareness among the people about the adverse effects of their actions. The same approach is visible when we study the LaLonde report. The report suggested that there are four general determinants of health, which he called "human biology", "environment", "lifestyle", and "healthcare organisation".
Thus, "health is maintained through the science and practice of medicine but can also be improved by individual effort. Physical fitness, weight loss, a healthy diet, stress management, training and stopping smoking and other substances are examples of steps to improve one's health. Workplace programmes are recognised by an increasingly large number of companies for their value in improving health and well-being of their employees, and increasing morale, loyalty and productivity at work. A company may provide a gym with exercise equipment, start smoking cessation programs, provide nutrition, weight or stress management training.
Other programmes may include health risk assessments, health screenings and body mass index monitoring." The report obviously stresses only the awareness and training programmes for individuals without even being lightly suggestive of any legal and executive measures to ensure a health protective family and society, where individuals are not exposed to dangerous substances and practices.
Another glaring weakness of the WHO definition is that it fails to properly explain the "spiritual"component of health. Some researchers tend to describe spiritual health as a feeling of happiness and contentment. Evidently, they are unable to differentiate between "mental health" and "spiritual health". Islam will help us to better understand the difference between the two. Mental health means the ability to respond normally to the situations, to possess a mental balance, a state of mental calm without anxiety or fear and not to have any palpable disorders of thinking. When we say a patient is "mentally ill", it means that the person is having problems of sleep, anxiety, fear, concentration, etc or his thinking process has become incongruous. In short, he has become either "crazy" (neurotic) or "mad"(Psychotic).
Merriam-Webster defines mental health as "a state of emotional and psychological well-being in which an individual is able to use his or her cognitive and emotional capabilities, function in society, and meet the ordinary demands of everyday life." Mental diseases can be intrinsic, caused by internal disorders of thinking, as well as extrinsic, caused by extrinsic factors like stress, fears and losses. Spiritual health, on the contrary, means an individual's ability to differentiate between right and wrong and resolve to lead a more righteous life, free of stratagems, deception, dishonesty and selfishness.
[Dr Javed Jamil is Chairman, International Centre for Applied Islamics and Chief Editor, "Islam, Muslims & the World". He has authored more than a dozen books including "Islam means Peace", "The Essence of the Divine Verses", "The Killer Sex" and "Rediscovering the Universe." He can be reached at [email protected].]
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