Dr Gopee

The Single Most Important Priority in Life…

— Dr R Neerunjun Gopee

Health is our true wealth

– Anon

That’s right: it’s your health. Everyone’s health. The health of a country. The health of the world.

As another New Year rolls on, it is customary for many people to make resolutions. As with other such self-impositions by common mortals, some of these resolutions are fulfilled, several partially so, others not. Nevertheless, since ‘something is better than nothing,’ it is perhaps a good way to start the New Year, a simple method to discipline oneself for one’s own good. When we think a little more about this, however, we must surely realise that none of the resolutions will have any meaning if we are unable to carry them out because of any physical or mental problem – if, in other words, our health does not permit us to do so.

The fundamental condition for us to achieve anything whatsoever, from the simplest to the most complicated – is that first of all we must be in good health. And what is good health has been defined by the World Health Organisation (WHO): ‘Health is a state of complete physical, mental and social well-being and not merely the absence of disease.’ This was laid down at the inception of WHO in 1948, and has not changed since.

But perhaps, with the larger perspective that we now have about existence as a whole, we can slightly modify the definition to include a spiritual dimension. Thus ‘Health is a state of complete physical, mental, social and spiritual well-being and not merely the absence of disease.’(italics added). Here, ‘spiritual’ does not have a religious connotation: it is more about our ‘connectedness’ to all that exists, living and non-living, and with the help of new developments in science – physics in particular — in the understanding of nature (which includes us humans), it is quite possible for all of us to grasp the overarching and all-encompassing concept of spirituality which, however, we cannot elaborate upon in this article.

It is widely accepted nowadays that the finality of any development is man – let me clarify that this means man as a human being, that is including woman too, and this is the sense in which the term ‘man’ will be used here.

During her mandate as Director General of the World Health Organisation (WHO) Dr Mrs Harlem Gro Brundtland managed to bring up health to the centre of the world stage. In fact, she promoted the notion of the centrality of health in human development: without a healthy population there cannot be optimum economic productivity and growth, and therefore less than desirable human prosperity. Human health, development and prosperity therefore have interlocking links and must be considered together at all times.

Her thrust to give health such an important dimension should not surprise: after all, she was the one who coined the term ‘sustainable development’ that gained greater currency during the first conference on the environment in Rio de Janeiro in 1992, but which in fact first appeared in Our Common Future, also known as the Brundtland Report, which the UN released in 1987. The idea was that environmental, economic and social well-being for today and tomorrow are dependent upon one another, and require that we see the world as one system that connects space and time. All actions performed anywhere within that system impacts other parts of that system (e.g. air pollution spreads across space to affect quality of air all over the world), and the consequences are felt across generations (e.g. agricultural practice today will affect the ability of future generations to feed themselves).

It may sound too obvious, but it is worth reminding ourselves that the fundamental determinants of our health are the air we breathe (is it polluted with dangerous chemicals? Bad smells?), the water we drink (is it clean and potable? does it harbour harmful microbes/parasites?), the food we eat (How many additives – are they safe? does it contain pesticide residues? is it contaminated with bacteria?), and the soil in which we grow our food (too much of fertiliser?). Purity of air, water, food, and soil: this is in fact the essential pre-condition for our biological survival as human beings, as much as it is for our sound health.

In all countries, it is the role of the State to ensure the provision of potable water and clean air, ensure food security and food safety through appropriate laws and regulatory structures, and immunize people against infectious diseases through national vaccination programmes; this is largely the case in Mauritius. However, assuming that all is fine as regards these factors, what are we doing to keep ourselves fit, to avoid risky behaviours such as alcohol and substance abuse, to reduce our stress levels?

* * *

Doctors treat disease: health is mainly the individual’s responsibility

Whenever the issue of health comes up, people immediately think ‘doctor!’ It is assumed that the doctor is a magician who can keep us in good health by curing our diseases. In other words, we only take notice of our health and realise its true value when we fall ill and seek the doctor’s advice. Everybody wants to live as long as possible, and there is research under way to try and extend the average lifespan to well over 100 years. But would we want to live to such an advanced age if we are not in good health?

Everything starts with being in good health – education, work, building and enjoying a future with family and friends, contributing to society at large. Health is thus a most precious value, one that leads to all others, and we have every reason and obligation to put in the time and effort required to keep ourselves healthy from early on. Despite everything we do, we may still fall ill, because there can never be zero risk, and then there are so many factors that are beyond our control or are still unknown to science and medicine. But we certainly have enough knowledge and experience at our disposal to guide us towards health living if we really want to.

Let us start from WHO’s definition:

Physical refers to the body, built up from what we consume – ‘we are what we eat.’ Therefore we must eat, and drink, right so as to build and maintain a robust, disease free body.

Mental refers to the mind, which we may compare to the MS-DOS of the body which has its hardware (the structures, being tissues and organs) and software (the functioning systems powering the structures). ‘If you think well of yourself you are likely to remain well’ – the mechanism of this truism is described in an article in The Economist of 8 December 2012, which gives an account of research that has shown the intimate link between mental state and bodily health. Meditation has a positive effect on both the MS-DOS and the bodily software. Based on this research, the article proposes that the well-known saying ‘a healthy mind in a healthy body’ (mens sana in corpore sano) be now changed to ‘a healthy mind for a healthy body.’ Cool.

Social refers to our relationships with people in different settings – family, school, profession, community and society at large. Stable, happy relationships keep us on course. Elderly people who have good social networks, among other things, are less vulnerable to Alzheimer’s disease for example. When peace reigns, progress and prosperity follow, with positive impacts at both the individual and the collective levels.

Spiritual refers to the recognition that we are part of a greater whole which is the source of our being, and our power and strength, without which we cannot be, and unto which we must ‘return’ when the time comes. It is the origin of the Master MS-DOS. Understanding this strengthens us in the face of adversity, and makes us accept death when it comes as the natural process that it is, part of an ongoing universal cycle that is beyond time and space.

And so, what do we do to be in good health?

It’s very simple, and it’s neither mysterious nor rocket science:

1. Eat right 2. Do regular physical activity 3. Avoid risk factors.

If we go a bit into more details, it is equally simple:

1. Eat and drink everything: in moderation.

2. Eat amply of fruits and vegetables, plenty of greens (bredes and salads), nuts and pulses.

3. Eat less red meat.

4. Use less oil, less sugar, less salt.

5. Preferably use brown flour.

6. If you have never smoked: don’t! If you do: stop forthwith!

7. Any type of physical activity is OK, daily if possible, or at least 5 times a week. Walking – ‘an appointment with yourself ’ — is best at all ages.

8. Bond with family and friends to share joys and sorrows.

9. Don’t be a workaholic: be passionate about your work – but don’t let it become an obsession. Nobody will thank you for killing yourself.

10. Have your ‘space of silence’ daily. Call it meditation, or mindful meditation (Dalai Lama) if you wish – but spare the time for yourself.

Follow the advice given by the Ministry of Health and Quality of Life about undergoing screening tests, avoiding risk factors, and a pursuing healthy lifestyle. The advice is based on solid evidence. If you happen to have a disease, then comply with the recommendations of your doctor about the diet to follow, if any.

The best counsel I have read about health was from Ernst Mayr, Harvard biologist who was interviewed by Scientific American when he reached 100 and was writing his 25th book. To a question about his longevity, he replied: ‘However busy you are, walk one hour everyday.’ He died at the age of 103.

So, let’s get up and go! Happy New Year 2013.

RN Gopee

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