Field Notes: Reflections of an Educator in Resource-Limited Settings 

I have been involved in the field of health humanities for more than seventeen years. The field initially focused on medicine but later expanded to involve other health disciplines. I started teaching medical students but have also been involved with nursing and dental students. I have also facilitated sessions for faculty members. My perspective on and comprehension of the practice of medicine have expanded because of this interaction.  

My interest in the field dates to 2007, when I enrolled in the PSGFAIMER Institute’s health professions education fellowship program (https://apply.faimer.org/prog/psg/) in Coimbatore, India. This fellowship comprised creating and carrying out a curricular innovation project (CIP) at my home institution in addition to participating in on-site sessions at the Institute. Combining my passions for teaching, literature, and the arts, I chose to create a medical humanities (MH) module for my CIP. I began by providing undergraduate medical students at Pokhara, Nepal with a voluntary program on medical humanities, which quickly became an area of emphasis for me. My colleague and I also provided a program for all first-year students at a brand-new medical school in Lalitpur, Nepal. I also led workshops on the subject at several Indian universities in 2020, right before the COVID-19 pandemic. We exchanged knowledge, and I learned about the many projects being carried out in Indian colleges. Traditional teaching and learning methods were of course then upended by COVID-19, which also gave online education a boost.  

 In developing nations there are fewer interactions between the ‘traditional’ humanities and the health humanities. Health humanities (HH) is still a developing discipline in India, where most states/provinces have specialized health universities with which colleges offering health courses are affiliated and involvement of humanities faculty in teaching the health humanities is low. In India, the former Medical Council of India developed an attitude, ethics and communication module that has now been taken up by the National Medical Commission. This module has created interest in the humanities among faculty of medical colleges, and there is now greater awareness of the discipline. A retired English teacher, Dr Radha Ramaswamy, and her team created the Centre for Community Dialogue and Change in Bengaluru, India. This organization offers Theatre of the Oppressed workshops for breaking patterns and creating change. They have facilitated workshops at several institutions in India and even in other countries. Workshops have also been offered in medical colleges. The organization offers periodic training-the-trainers’ workshops. Some medical college faculty who have been trained in these training workshops also facilitate Theatre of the Oppressed workshops. Online webinars and conferences have become more common.  

In Aruba, in the Dutch Caribbean, I began teaching medical students through films, and for the past ten years, I have been concentrating on this. We have presented seminars on this topic at various health professions education conferences in collaboration with others. I have written a few articles on the topic, and I recently worked on a module that used films to help undergraduate dental students develop empathy. 

The last two decades have seen a steady growth in health humanities in South and Southeast Asia and in other regions of the continent. Modules and sessions are being offered to undergraduate and postgraduate students. A few institutions are also offering electives in this area for medical and other healthcare students. HH has several benefits in the education of future health professionals. Health is inherently psychological, social, and related to history and culture. Modern medicine is dominated by technology, and the health system is inherently complex. Methods from the humanities and the social sciences using an interdisciplinary approach are required to promote sustainable interventions that can address the complexity of health and disease that may have origins in social, economic and other factors. HH can develop students’ capacity for critical reading and reflection, and they can then examine health and medicine in society, practice and their own lives; it may also inoculate students against the hidden curriculum (a set of norms, values and beliefs that are not explicitly taught but are learned at the institution) and loss of empathy that may occur in medicine. Doctors and other health professionals engage in a social contract to serve society. Health humanities can help to introduce the contract to students, encourage its exploration, and also introduce ethical issues and dilemmas.  

I have gained a deeper understanding of HH and its connection both to medicine and to the general humanities. A year and a half ago I became a member of an online global network for the health humanities, and the group in addition to health professions educators also has individuals from the arts and the humanities. I have realized that like medicine and the health sciences, the humanities have their own terms and descriptors, theories and concepts, and these may be difficult for health professionals to comprehend. The opposite is also true, as humanities scholars struggle with medical jargon. An open mindset and greater effort are required to address the gaps. In the developing world, the humanities and the health sciences diverge right after ten years of schooling and are mostly in physically distinct locations, yet many health care professionals still have a personal interest in the art of medicine.  

A variety of factors must be considered to treat illnesses and maintain health. The physical and genetic makeup of the individual, the socioeconomic status, social determinants of health, access to good quality healthcare, rational use of medicines, cost of healthcare and preserving the power of antibiotics are among these. Through my research and teaching in the health humanities I believe I have gained a more holistic understanding of a human being and of health and illness situated in culture, society, family and moral values. Today we have wearables and other devices that provide a constant stream of data that must be interpreted and converted to actionable insights. However, we have a responsibility to make sure that the essential humanity of our patients does not get lost in a sea of data. The humanities and the sciences can, should, and must work together to improve health and well-being.   

Web image by Giuliano Gabella on Unsplash