Events

The biomedical ‘disease’ model that dominates much of public health theory and practice is missing the important connection people make between their bodies and their everyday life worlds. In many parts of the world, health is experienced and embodied in the emotional, mental, spiritual, physical and social, and political-economic worlds people inhabit. Chinthar roge (“worry illness”) as expressed by the impoverished living in Dhaka slum settlements, humanises the medical domain by paying attention to people, not just disease specific worlds to which human beings peripherally belong. For residents, life is one of exhausting and relentless uncertainty, dealing with endemic poverty, erratic jobs, insecurity and crime, precarious living conditions, unstable relationships and networks. Basic services, such as water, education and electricity services remain limited or inaccessible, or they pay high costs for access. Housing is insecure and evictions are routine in the lives of informal settlers. Their very existence is one of continual stress and fragility. Chinthar roge clearly highlights the limits of medicine as most residents’ lives are situated between hope, fear, anxiety and chronic deprivations. Chinthar roge is not an illness borne per say, but to them akin to a ‘way of life’ illness, it is their core being which embodies this everyday pain, worry and suffering and the body then becomes a form of truth telling, and the medicalisation of this illness speaks of the unspeakable of their existence. We need to recognise that health is as much mental, emotional, spiritual as it is physical, and directly impacted by the social, economic and political conditions that people inhabit. Unless we own up to the fundamental reality of the illness of poverty, we will continue to produce short-term band-aid solutions, with little improvement in the lives of the most disadvantaged.