Dr Javed Jamil | Clarion India
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 when unhygienic sexual practices (promiscuity, prostitution, homosexuality, etc) were creating havoc all over the world. No concept like “sexual distancing” similar to the current “social distancing” was proposed then. This is despite the fact that more than 38 million people died of AIDS in the last 25 years.
If we think of the infectious diseases in general and viral epidemics in particular, we will conclude that hygiene has a much larger scope than what is generally 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 convey through my book, “Economics First or Health First?” (published in 2019). It argued for implementing a Dynamic Paradigm of Health globally.
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, sterilisation of equipment, hand hygiene, water, sanitation and safe disposal of medical waste.”
It is clear that the WHO definition mainly refers to external physical hygiene and can hardly be regarded a comprehensive definition hygiene. If we want to have a 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. Market forces lay at most importance to External Physical Hygiene because it suits them. Internal Physical Hygiene, mental hygiene, sexual hygiene and social hygiene have no meaning for them, as these can pose serious threat to their vested interests.
If internal hygiene is promoted, tobacco and alcohol industries will have no relevance; 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.
Hence, for the forces of economics, it is the health of industries, not human beings, matters. 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 Vs Artificial Prevention
Normally, prevention is classified as primary and secondary. Primary involves the prevention taken before the emergence of diseases and secondary denotes prevention taken 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. The Natural Prevention has, therefore, been able to grab much less attention than Artificial Prevention and management because it is perilous for commercial interests. The latter has received greater attention simply because it is beneficial to the industries.
While the oral hygiene and body hygiene are emphasised 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, sexually 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, garment 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 arising from 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 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 alcoholism, unhealthy sexual behaviour, smoking, gambling, etc. has no takers as it would imperil the interests of the market. The Dynamic Paradigm of Health, however, proposed by me presents a holistic regime of hygiene.
The 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 & 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 on treatment of a problem rather than preventing it. It is, therefore, more expedient, in their calculation, 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.”