“The right to protect the health and well-being of every person, of those we love, is a basic human right.”~ Elizabeth Holmes.
Country children in Jamaica (I don’t know if it happened in ‘Town’ – Kingston also) were subject to a particular tradition. At the end of every summer vacation, in order to be ready for school, they would be given a good dose of ‘salts’, or some kind of bush tea, a good strong purgative to give them a ‘wash-out’, a cleansing of the colon. Thankfully my mother was never a supporter of such practices. I am not sure what the intent of this practice was – did it cure worms? Did it remove toxins? Did it somehow clear the way for learning to take place? It was certainly a dramatic and explosive way to end the summer, an internal Spring cleaning!
Two of the concepts in medical ethics that help to guide the prescription of interventions are: Beneficence (do good) and Non-maleficence (do no harm). Of course there are many types of treatments that are uncomfortable, painful, and sometimes produce downright misery, but they should (if the intervention is ethical) produce more overall benefit to the person receiving it, than harm. We are living in an age where we have far more options, and can provide a person in need of healing with choices. We can show costs and benefits, advantages over one method of treatment to another, and hopefully have a dialogue where the final choice is up to the person who will live with the consequences.
I recently heard of a program that has been very effective in reducing the number of times people with chronic conditions (such as asthma, diabetes, hypertension – three very common chronic health disorders with many long-term complications if not managed well) visited the Emergency Room. One of the many benefits of the (formerly) Affordable Care Act, aka ‘Obamacare’ was the move towards community management of illness. The aim was for those with chronic conditions to be managed in their home, with support, rather than to be hospitalized with all of the inherent risks.
This innovative program in Chicago, was to address two problems at one time. A big inner-city hospital invested in low-cost housing for a number of their ‘frequent fliers’, homeless people with chronic health conditions that had no access to healthcare except through their local emergency room. The cost of housing them, of providing them with the access to preventive care and medicine, was less than the cost of the emergency room expenses. In fact, the cost of treating the homeless in the ER is 70 times higher than the costs for other patients! At the University of Illinois, half of the people visiting the ER were homeless. And one visit to the ER costs three times the monthly rent of one apartment. This was a ‘win-win’ proposition. Even if you look at this program from a purely economic perspective, it makes such good sense. For the homeless people, the fact that they had a roof over their heads, protection from the elements and access to medications, meant that their health improved dramatically. Housing as health.
Today is the anniversary of the founding of my high school in Jamaica, Clarendon College. The man upon whose dream and vision the school was created had his own experience with homelessness. He was a young minister at a country church up in the hills, and discovered that there was a man in the district who had no home. He slept outdoors, and begged for his sustenance. When Rev. Lester Davy knew of this situation, he suggested to his church members that they build a house for the man. It would have been a simple structure, nothing grand, but the church members felt they could not afford it. In response, Rev. Davy threatened to sleep outdoors himself until they provided the man shelter. If you are familiar with nights up in the higher climes of Jamaica, it can get very cool, and the dew soaks the ground at night, making it very unhealthy for a man with asthma. The home was built. Housing as health.
I have spent my adult life thinking about health and well-being. I have seen people with scary diagnoses who are happier and healthier than many who are without disease. I have heard from people who have been thankful for an encounter with a disease that gave them a new lease on life, a new appreciation for the simplest pleasures of life. This week I heard the story of a pop singer from the 80’s who had a stroke which affected his right side and his voice. His battle to recover led him to know that what makes being alive the most significant is giving to others. I have been humbled by the generosity of those who are dying. I have been touched by the gratitude of those in pain. I have been ashamed at the way I have taken my own health for granted, as I have been caring for someone unable to do the most basic of daily tasks.
On this Friday morning I wish to hear from my readers: How do you define well-being? This is a concept that is personal and unique to each individual. And what is it that contributes or improves your own well-being? Is it a practice, an item, a connection? And what threatens that well-being? It may be something simple that gives you that inner contentment, that sense that all is well with your world. It may be an activity that restores you, a meal that takes you back to childhood, a scent that brings a loved one back to your memory. How do you maintain or improve your well-being?
On this wonderful Founder’s Day morning, I am thinking of that most beautiful campus situated in the heart of Clarendon, where a man lit a flame 76 years ago, and it still burns brightly and fiercely, fed by the love of countless students who have passed through its gates. I can see the current students in their royal blue, white and khaki uniforms, streaming up the hill from the original Rose Bank cottage to the current Stuart Hall, ready to sing loudly and lustily, echoing through the ages. Walk good students! You stand on the shoulders of giants. Have a great weekend, Family!