Health, healing and humanities

The lack of medical humanities in Pakistan hinders interdisciplinary understanding and innovation in healthcare policy

Several years ago, in Beirut, I first got to fully appreciate the value of medical humanities. It was a small workshop at the American University of Beirut. About a dozen researchers were huddled together to discuss the dimensions of antimicrobial resistance in the region, and how recent conflicts had impacted the rise of superbugs in several countries in the Middle East. At that time, I was working on how poor quality medicines increased drug resistance and hence was invited to the meeting to discuss some of my own findings, and share any thoughts I had about broader societal trends on why counterfeit medicines continue to proliferate in many parts of the world and what it means for the rise of superbugs.

I was familiar with the broader discipline of conflict medicine and had read papers and books on the impact of conflict on health and healthcare access. But it was at this particular meeting, where I was surrounded by historians, ethicists and anthropologists, in addition to doctors, nurses and public health professionals, that I fully got to understand the necessity of medical humanities. The impact of the conversations I had, and benefitted from, was deeply personal and profound. It changed my own research and opened up a whole new world of research methods, approaches and exposure to existing debates on how power, privilege and politics shape health of communities. My association with humanists and social scientists has been instrumental in my own research and understanding, and has shaped a lot of my recent writing.

Last week, at a dinner, I got to meet a colleague who is now a senior administrator at a major university in the Middle East. He was telling me about how his university is expanding the medical humanities programme, focusing especially on history of science and medicine in the region, including the history of medical practices and policies in rural areas. Incidentally, this was just a few days after I had visited a history professor whose most recent book focuses on how public health became a contested space between the two sides during Algerian war of independence (1954-1962). Both colleagues - one a local, and the other one based in the Middle East - talked about how their students come not only from humanities but from medicine, biology, public health and other disciplines in science and engineering. I could only wish that similar programmes would be possible in Pakistan.

The idea of humanities or social sciences and medicine coming together - whether it is history, sociology, philosophy or anthropology - is not particularly new. Pakistani scholars in humanities and social sciences have done extraordinary work on gender based violence, malnutrition as well as HIV and other infectious and communicable diseases in the country. Yet, a structured and formal approach, with departments and programmes on medical humanities, are non-existent in the country. I know from my own experience that the attitude in ministries, national archives and hospitals towards historical records is deeply problematic. At the same time, the siloed structure of our education system means that many are unable to even imagine how medicine and humanities could come together.

The consequence of this impenetrable wall is that national conversations on individual and collective attitudes and ethical dimensions of healthcare provision are devoid of deeper understanding of the history of various policies. Discussion on bioethics goes no further than consent and inclusion. How local and national politics has shaped our healthcare access (for better or worse) and how state's role has evolved (again, for better or worse) in regulating health of individuals has not gotten due attention. All this results in policies being impulsive and ad hoc, and administrators having no recognition that their brand-new idea has been tried before and failed spectacularly. Perhaps the biggest loss here is the missed opportunity for our students - the opportunity to learn from multiple disciplines, to break the silos, and to imagine and work towards a different world.