Full transcript
0:01[music]
0:06[music]
0:17>> Hello everyone. I welcome you to the
0:19course introduction to medical
0:21humanities and today we are going to
0:23talk about why and how do medical
0:26humanities matter in India.
0:29Before I begin with this particular
0:32topic, I want to emphasize on what we
0:35have done till now.
0:38Broadly speaking, we have taken up
0:40keywords that are important to be
0:42understood in the context of reading
0:45medical humanities.
0:47Additionally, we have taken up three
0:49major theorists who are foundational to
0:52the understanding of medical humanities.
0:55We began with Susan Sontag, followed it
0:58up with Arthur Kleinman, and finally
1:00took up Rita Charon's work.
1:03Now, with this kind of a theoretical
1:05background, I want to now
1:08get into the most favorite part of
1:11what I call
1:13of this course and otherwise,
1:15which is why do we want to study medical
1:18humanities in India?
1:20Now,
1:21the core philosophy of medical
1:23humanities where it merges humanities
1:26with the medical, I think it is very
1:29essential and becomes extremely relevant
1:32in the context of India.
1:34India as such, we know, has immense
1:37amount of diversity, whether it is
1:40culinary, geographical, social,
1:43cultural, linguistic, so many we can
1:45quote in one go.
1:48In that capacity,
1:50how medicine is understood in different
1:54context, I think it plays a vital role.
1:58And that's why when we discuss medical
2:01humanities in the context of India, it
2:04becomes
2:05not only a matter of study, but also a
2:08matter of national interest.
2:12Uh quickly I will give you an overview
2:14what I will be doing. Uh very, very
2:16briefly I will touch upon the definition
2:18of medical humanities all over again.
2:20And then go on to talk about impact of
2:24uh medical humanities in Indian
2:25healthcare, follow it up with government
2:28policies and other related campaigns
2:31that help us understand the core of
2:35medical humanities.
2:37Like I said earlier, medical humanities
2:40together takes into consideration
2:43medicine, health, and humanities to
2:45better understand what health illness
2:48mean to people and communities.
2:51Now, when we think about healthcare
2:54policies and systems, these affect
2:57communities' well-being, encouraging
2:59more humane, reflective, and socially
3:03responsive approach to medicine.
3:08Why then medical humanities matters in
3:11India?
3:12Like I said earlier, the quotient of
3:14diversity is extremely pertinent.
3:18But
3:19the understanding of medicine because of
3:24diversity of India as well, cannot be
3:27just treated as biomedical.
3:30It must be socially responsive.
3:33India's diverse healthcare landscape,
3:36characterized by linguistic, cultural,
3:39and regional differences, further
3:41highlights the need for such
3:43perspectives.
3:44Progressive institutional initiatives in
3:47medical education increasingly
3:49acknowledge the importance of
3:51integrating humanistic approaches
3:54alongside biomedical training.
3:57These aspects help future healthcare
4:00professionals to develop a more holistic
4:03and socially responsive understanding of
4:05patient care.
4:08Every person experiences illness
4:10differently and these experiences are
4:13influenced by culture, language,
4:15identity and social context.
4:18By paying attention to such narratives,
4:20medical humanities scholars can identify
4:24needs, concerns and barriers that may
4:26remain invisible in purely biomedical
4:29data.
4:30These perspectives help healthcare
4:32providers understand the emotional and
4:34social dimensions of illness. As a
4:37result, many healthcare institutions
4:40increasingly recognize the value of
4:42narrative methods in medical training
4:45and practice.
4:46Listening to patient stories strengthens
4:49communication, builds empathy and
4:52ultimately supports more
4:54patient-centered and compassionate
4:56healthcare. Let us take a few examples
4:59because I think to illustrate it
5:01further, some of the examples are good
5:04idea. Most of the examples that I take
5:06are from Hindi because that is the
5:09language I am familiar with, but I am
5:12sure you can take this context into your
5:15own
5:17I mean language and you will find
5:19narratives. And therefore I'm using
5:21Hindi language examples. So
5:23please bear with me, but I'm also
5:25translating it in English for your
5:28reference.
5:29However, I would request you to look
5:32into your own examples at the same time
5:34and you will find that what I am saying
5:37with my own examples actually can
5:39reflect on what you have also come
5:42across in your readings.
5:46So a patient say for example in rural
5:48area might only say "Dhadkan badh rahi
5:51hai."
5:52Which loosely translates as "My
5:54heartbeat is increasing."
5:57Or "Dil bhari lag raha hai."
6:00Which is "Heart is heavy."
6:02to express their bodily symptoms.
6:05It is now up to the medical practitioner
6:08to deduce through further inquiry
6:10whether it is anxiety, stress, or any
6:14other cardiovascular disease.
6:17Miscommunication can lead to
6:19misdiagnosis.
6:21Now, when you integrate medical
6:23humanities into medical curriculum,
6:26this gap
6:28of
6:30how language can lead to
6:32a different kind of
6:35diagnosis
6:37is fostered.
6:38Because when you bring in the element of
6:41narratives into the curriculum, it
6:44fosters emotional understanding,
6:47cultivating empathy through attention,
6:50representation, and affiliation. The one
6:53that I'm discussing Rita Sharon, I mean,
6:55the model that she talks about, where
6:57she mentions three important elements
6:59within the scope of medical humanities,
7:02attention, representation, and
7:03affiliation, we can see that in the
7:06Indian context as well. To better
7:08understand this, I will take one more
7:11example that I have seen recently. So,
7:14there was a web series called Perfect
7:17Family that I came across, and it is
7:21created by Palak Bambri,
7:23and we find that the child, Dhani
7:26Karkaria,
7:28complains about constant stomach ache.
7:32Her family classifies it as a ruse to
7:36escape school.
7:37But,
7:38further up in the series, we realize
7:41that the stomach ache was a
7:42manifestation of her mental stress
7:45caused due to the stressful environment
7:48at home.
7:49Thus, not just the communication, but
7:51effective communication helps in proper
7:54diagnosis of underlying causes.
7:57Medical humanities helps medical
7:59practitioners bridge this gap.
8:04Let us uh
8:06take another uh example of India's
8:09diversity where we essentialize
8:13how and why narrative competence is
8:16important.
8:17If we look at India,
8:201.4 billion people, approximately,
8:2422 languages,
8:272,000 ethnic groups, different caste,
8:31religion
8:32shape the health scenario.
8:35To certain extent,
8:37many kinds of food habits, too.
8:40A tribal patient cannot explain the the
8:43symptoms
8:45in Hindi or English.
8:48To understand their symptoms properly
8:50and to do proper diagnosis, one needs
8:53interpreters and cultural understanding.
8:57Medical humanities provides training for
9:00both.
9:02To interpret the language and to also
9:05follow up the cultural understanding.
9:08And that is why you will see that when
9:10medical practitioners
9:12in all or maybe I should rephrase, the
9:14health professionals across the country,
9:17India, whenever they are posted in that
9:20particular region, the first thing
9:22perhaps they learn after their uh
9:25you know, service, is the language in
9:29the region in which they are posted.
9:33Similarly, many of the women feel
9:35hesitant to reach out to doctors for
9:37their gynecological health issues due to
9:40the prevalent stigmas around them.
9:43Here, the community health workers like
9:45Asha and Anganwadi workers may act as
9:49vital connections between them and
9:51health care systems.
9:53They often use storytelling, personal
9:56narratives, and visual aids like flip
9:59books to communicate health information,
10:02build trust, and combat myths serving as
10:05trusted community confidants.
10:08Despite the advanced medical
10:10infrastructure, many patients fail to
10:13complete their medicine course as
10:16prescribed by the physicians.
10:18The non-adherence to medicine
10:21leads to treatment failure, drug
10:23resistance, and other issues. Medical
10:26humanities helps in reducing this
10:29through better communication about
10:31dosage, building empathy and trust among
10:34the patients, aligning treatment
10:36according to cultural beliefs of
10:38patients.
10:40Now,
10:41in
10:42the Indian healthcare,
10:44medical humanities has
10:47increasingly
10:49impacted.
10:50And I will say this because I have
10:52analyzed quite a few policies, though I
10:54bring in very few here,
10:56but because this is an introductory
10:57course. But if you
10:59just quickly search on Google, you will
11:02find different healthcare policies
11:05across different states of India and
11:08also central government policies, which
11:10will indicate that there is definitely a
11:14humanities quotient
11:16that has shaped them
11:19for what they are.
11:21Institutional and governmental efforts
11:24have increasingly recognized the
11:26importance of integrating humanistic
11:28perspective into healthcare systems.
11:32Universities and research institutions
11:34worldwide have also contributed by
11:36establishing medical humanities program
11:39that prepare healthcare professionals to
11:42engage with the social, ethical, and
11:45cultural dimensions of illness.
11:47At the national level, many health
11:49services and policy frameworks have
11:51begun incorporating patient-centered
11:54care and narrative-based approaches into
11:57medical training and hospital practices.
12:00The introduction of competency-based
12:03medical education,
12:05which is called CBME in 2019, guided by
12:09the National Medical Commission, is one
12:11such example.
12:13In this, the curriculum aims to
12:16integrate aspects of attitude, ethics,
12:19and communication into medical training.
12:23It will help doctors become not only
12:25clinically competent, but also
12:28empathetic and socially aware.
12:32In addition, community health
12:34initiatives supported by government
12:37often rely on insights from social
12:39sciences and anthropology to better
12:42understand local health needs. Such
12:44efforts help design
12:47culturally responsive healthcare
12:49interventions and strengthen
12:51communication between medical
12:52professional and communities. Some
12:55community health initiatives that
12:57integrate medical humanities are
12:59discussed in the next slide.
13:02Let us take it from here.
13:04I must emphasize that these are just
13:06some of the examples that I am showing.
13:10You can come across many policies that
13:13you can use as example, and you will
13:15find that they do reflect the element of
13:18medical humanities penetrated into it.
13:21The first one that I begin with is
13:23called the National Health Policy NHP
13:262017, which aims to achieve universal
13:29health coverage and improve quality of
13:32life through preventive and promotive
13:35health care.
13:36It emphasizes ethics, professional
13:39standards, and equity.
13:41One of the major goals of this policy is
13:44the attainment of the highest possible
13:46level of health and well-being for all
13:49the ages.
13:50It moves beyond the purely biomedical
13:53model and integrates the idea of equity,
13:56dignity, and experiences of patients in
13:59its framework. The very famous the
14:02Ayushman Bharat Pradhan Mantri Jan
14:04Arogya Yojana,
14:06AB-PMJAY,
14:08is India's public health insurance
14:10scheme providing 5 lakh
14:13coverage per family annually for
14:16secondary
14:18or tertiary care to over 10.74 crore
14:21people and vulnerable families.
14:25It has recently expanded to include all
14:28residents aged 70 plus, regardless of
14:32income, in its scheme.
14:34It provides cashless treatment to
14:36low-income families, tackling the
14:38economic realities of India, and
14:41addresses the vulnerability of the
14:43elderly by providing them an opportunity
14:46to live a dignified life.
14:49The final program that I discuss in this
14:52particular context is National Program
14:54for Palliative Care, NPPC, which aims to
14:58provide rational pain relief, and
15:01palliative care is the care required by
15:03the terminal cases of cancer,
15:06AIDS, etc. It requires alignment with
15:10the patient, family, and community, and
15:12their support. Thus, a very good example
15:15of how medical humanities gets
15:18integrated in the Indian health care
15:20policies.
15:21India always, uh you will find that
15:24cultural narratives have
15:26dominated the
15:29understanding of
15:31national interest. And in this case,
15:34this merges with the health.
15:36And therefore, several slogans and
15:39advertisements
15:41become important not only from the
15:43government side, but also otherwise in
15:46day-to-day life, we come across many
15:49slogans and advertisements that are
15:51popular because they prioritize
15:55health.
15:56And when I say health, it's not just
15:58clinical. It It is also about the change
16:01in public attitude.
16:04Some of it, again, like I said, you can
16:06take your own examples. I take some of
16:09that I know.
16:11We see that
16:13the s-
16:14medical humanities ensures empathetic
16:17and culturally relevant message. What is
16:20important? You might have seen that some
16:22people say that I am not going to
16:25endorse anything that is harmful to
16:27health. All these are part of awareness
16:30campaign. The very fact that these cases
16:33come up in in the media is also a kind
16:38of an acknowledgement that it's an
16:40awareness regarding something that you
16:43could could not take up and on health.
16:45If you just quickly search on Google or
16:47maybe YouTube, you will find so many uh
16:50recipes around
16:52good food habits, so many uh channels
16:55around uh maintaining a healthy
16:58lifestyle in terms of exercise, walking,
17:01you know? So, all these are part of
17:04this whole idea where humanities should
17:08meet the medical.
17:09Let us take for example the slogan Do
17:12Boondh Zindagi Ki.
17:14That became the the
17:15of the nationwide campaign for pulse
17:18polio immunization program.
17:20The simplicity of the phrase combined
17:23with
17:24Amitabh Bachchan's
17:27you know, became
17:28the reason for the popularity of this
17:31campaign.
17:32So, you see how
17:34a social cause with a national kind of a
17:38cultural icon blended to create an
17:41awareness.
17:43The slogan Do Gaj Doori Mask Hai
17:45Zaroori. So, it is important to wear
17:47mask and maintain social distancing
17:49during the COVID-19 times. We had heard
17:53of this slogan. We have followed this
17:55slogan. And in fact, we have followed
17:57this slogan like uh it was most
18:00important thing at that point of time.
18:02It conveyed the message for social
18:03distancing in brief. And it was so easy
18:07to understand the language. I mean,
18:09somebody who was also not knowing the
18:12language would know what this means. It
18:14was crisp and easily understood by the
18:17public and suitable for multiple
18:19repetitions, reinforcing the idea of
18:22safety during COVID.
18:25Uh there is another, I mean, a slogan.
18:27You can see it here. It says TB Harega
18:30Desh Jeetega. Tuberculosis, uh
18:33if you look at the history of this
18:37particular disease in India, it I mean,
18:39India has
18:40fought this disease with
18:43a lot of
18:44you know, campaigns. Of course,
18:46resources too, but also there has there
18:48has been lot of campaigns around what
18:51what is to be done, what is not to be
18:53done. In this context, you will find
18:55that the slogan TB Harega Desh Jeetega.
19:00So, the very element of bringing Desh
19:04into the forefront, if TB loses. So, the
19:08idea of TB tuberculosis is personified.
19:13And it is pitched against the nation.
19:16So, as as citizens of this country, it
19:20the onus came to us.
19:22It was not just about uh
19:25health care professionals. The onus was
19:27led to the citizens of India. So, what
19:29it did was it encouraged the TB patients
19:32to get checked, take medicine, and
19:35complete the medicine
19:37course of the disease. These slogans
19:40came from the intersecting domain of
19:42medicine and humanities.
19:45In
19:46medical humanities, there are other ways
19:49also the issues related to health has
19:52have been dis-stigmatized.
19:54You can find that advertisement have
19:57also become a very mass awareness
20:00campaigns
20:02for the public.
20:04In 2018 particularly, the Union Ministry
20:07of Health and Family Welfare came up
20:09with anti-smoking ad featuring Akshay
20:13Kumar. I'm sure all of you know about
20:15Akshay Kumar.
20:16In this ad, Akshay Kumar questions the
20:19husband for smoking and suggests him to
20:23buy sanitary pads instead of cigarette.
20:25Now, this is one advertisement all of
20:28you must have seen. All those who are
20:30watching must have gone to cinema halls,
20:32I'm assuming, maybe. But, I think even
20:36if you watch it on any other platform,
20:39you will always come across this
20:40particular ad. It's a very familiar
20:42image, and that's why I'm using it. So,
20:45it was a very good idea, in fact, from
20:48uh
20:49the government side to use a campaign
20:51like this. And this ad focused on two
20:55health issues, if you can notice.
20:58One was indeed smoking, which was very
21:01visible. But, there was another aspect
21:03also, which was around the menstrual
21:06hygiene.
21:07By bringing it up so publicly, the
21:10advertisement attempted to criticize
21:12smoking as well as counter the stigma
21:15associated with menstruation.
21:17This demonstrates how medical humanities
21:20uses media and advertisement to
21:23challenge stigma and promote health care
21:27beneficial attitudes.
21:29By encouraging open conversation around
21:32sensitive issues, it makes health care
21:34awareness more inclusive, more
21:37accessible, and socially impactful.
21:41Finally, uh to uh sum up, I can say that
21:45medical humanities provides an important
21:47framework for understanding health care
21:50beyond medical
21:52perspectives.
21:54As this lecture highlights,
21:57health and illness are deeply shaped by
21:59social structures, cultural beliefs,
22:02historical contexts, and lived
22:04experiences.
22:06In the Indian context, where diversity
22:09of language, culture, and health care
22:12practices is significant, such
22:14perspectives become particularly
22:16valuable.
22:18By emphasizing illness narratives,
22:21ethics, communication, and empathy,
22:23medical humanities in the Indian context
22:27emphasizes on more patient-centered
22:30approach
22:32and complements scientific medical
22:34training by fostering interdisciplinary
22:37thinking and deeper engagement with that
22:41of human dimension of care. Ultimately,
22:44the study of medical humanities
22:46contributes to developing health care
22:48professional who are not only clinically
22:51competent,
22:53but also socially aware. They are aware
22:56of what India needs from them, not only
23:01clinically, but also how other aspects
23:05of being can influence the clinical
23:09dimension.
23:11At this note, I will stop and take it up
23:14further in the next unit. We have now
23:18completed the five lectures of week one
23:23and led
23:25the foundation of how we are going to
23:28take up medical humanities course
23:31in the context of India. Like I had said
23:34in my introduction itself, that there
23:36are two aspects that are foundational to
23:40this particular course. One, that at all
23:42point of time, it is going to be
23:44interdisciplinary and multi-disciplinary
23:46in nature. Therefore, it is not uh
23:50towards just one subject. It takes up
23:53many disciplines into one pitch. And
23:57second and most important, rather, I
23:59take up most of my examples from India
24:02because the quotient of familiarity with
24:05the context is something I do not want
24:07to compromise on in this particular
24:10course. That is the intent and that is
24:12the content. Thank you so much.