Diabetes management - diabetes prevention - India - Mahatma Gandhi - obesity
Introduction
Mahatma Gandhi, also known as Father of the Nation, is one of the most influential
Indians of all times. His thoughts and philosophies continue to shape modern Indian
polity, and his achievements are remembered with respect even today, 66 years after
his death. A multifaceted personality, his thoughts, words and actions provide much
needed motivation to millions of people in India and beyond.
The word ′satyagraha′ was used to describe a way of life meant to achieve social transformation.
Defined by him as ′pursuit of truth by non-violent means, including voluntarily imposed
self suffering′,[1] satyagraha was said to have universal applicability in time, situations and populations.
The term satyagraha is used to refer to popular, mass-based movements against evil,
which seek to achieve social justice or other beneficial outcomes.
Would satyagraha be applicable to the modern diabetes pandemic? Would Mahatma have
used the techniques of satyagraha to prevent, and fight, diabetes? Would he have given
priority to diabetes care, keeping in mind the multiple responsibilities and activities
fighting for his attention? What else would he have done to limit the spread of diabetes?
This article hypothesizes answers to these questions, based upon the writings of Mahatma
Gandhi, and his biographies.[2]
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[4]
[5]
Importance of Diabetes
Some of the problems that the world faces today are similar to those of Mahatma Gandhi′s
time. Poverty, malnutrition, and health issues are as relevant today as they were
half a century ago. The character of health issues, however, has changed markedly
during this time.
Diseases such as the plague and polio, which Gandhi was familiar with, have been controlled.
In their place have emerged chronic lifestyle conditions such as diabetes. The global
impact of diabetes, which has emerged as a major public health, as well as economic,
problem cannot be underestimated. The Mahatma would therefore certainly have focused
his attention on fighting the diabetes epidemic.
Mahatma Gandhi believed in the concept of trusteeship. He felt that man is a trustee
of his body, with a pre-ordained duty to care for it.[2] Without a healthy body, one could not have a healthy mind, or serve the nation properly.
Mahatma Gandhi was an ardent advocate for health. He studied both theoretical and
practical aspects of health and nutrition, and penned a book entitled. The Key to
Health.[3] Amongst the eleven wows (Mangal Prabhat)[4] that he requested inmates of his Ashram to take was ′control over palate.′ He was
a firm believer in the maxim ′eat to live, do not live to eat.′ Had he been alive
today, he would certainly have taken the diabetes epidemic head-on, experimenting
upon himself, and practicing dietary control, before advising others.
Gandhian Lifestyle
Gandhi would have launched a satyagraha against diabetes - a search for the truth,
and for solutions which are acceptable to all. He would have studied the issue in
detail, and prepared a comprehensive character of demands to achieve holistic health.
This would have been concordant with his definition of health: A state characterized
by physical fitness, along with harmony of mind and senses.
Gandhi exhorted satyagrahis (soldiers of satyagraha) to fight evil, not the evil-
doer. In diabetes, he would have asked the community to tackle diabetes, without discriminating
against people with diabetes.
Gandhi would certainly have led a movement in favor of healthy lifestyle. His idea
of healthy food is well documented: He proposed a balanced vegetarian diet with limited
free sugars and cooking oil, sourced from local farms which use organic methods of
growing crops.
He would probably have spoken out against the consumption of calorie-dense processed
foods, and requested students and other followers to take oaths promising not to take
′foreign-made′ or unhealthy foods. This would have been a perfect corollary to his
other injunction: Control over the palate, and avoidance of intoxicants. Gandhi would
also have taken this opportunity to propound the virtues of vegetarianism. In his
writings, he had listed nutritional, scientific, moral, hygienic and economical reasons
in favor of a vegetarian diet: These would have been highlighted.[5]
Mahatma Gandhi also supported the concept of bread-labor, i.e., earning one′s keep
through labor. Though not a strong supporter of organized sports, he would have suggested
daily physical activity in the form of spinning (Khadi) or involvement on other village
industries, to maintain metabolic health. This would have been similar to the evidence-supported
concept of community exercise.[6]
Gandhian Diabetes Counselling
Gandhian Diabetes Counselling
The rules listed by him for the conduct of satyagraha[1] are particularly appropriate for a person-centered style of diabetes counseling.
Just as taught by Mahatma Gandhi, one should study the issue (diabetes, in this case),
and ensure self-reliance before starting satyagraha (the war against diabetes). The
expectations from diabetes care should be rational, while explaining all possible
courses of action to people with diabetes. The counselor should trust people with
diabetes in their care (and vice versa), and aim to achieve consensus building (shared
decision making) by non-violent, pure means (without using intimidation or creating
fear). Diabetes counselors should utilize open, straightforward techniques in order
to find a position acceptable to all. Since there is no predetermined end to a ′satyagrahic′
diabetes counseling, e.g., the use of a particular investigation or management strategy,
there is no question of defeat for any participant. A satyagrahi diabetes care professional
never assumes that he knows everything, or is ′always right′: He strives to understand
the whole truth. This is true of every diabetes care provider- our professional journey
is one of continuous search for excellence.
It is also true of diabetology as a science: Our knowledge is constantly evolving
(for the better), and so is our practice. Our understanding of the fact that we still
have many facets of diabetes to discover and unravel has also grown in recent years.
The diabetes researcher′s philosophy, in this way, therefore, is similar to that of
a satyagrahi.
Gandhian Social Transformation
Gandhian Social Transformation
The diabetes satyagraha, as visualized by the Mahatma, would extend far beyond the
confines of clinics and hospitals. He would have involved the entire community or
society, asking them to consume healthy foods, in moderate quantities, and avoid diabetes-unfriendly
calorie rich foods, in solidarity with people with diabetes. He would also have requested
food manufacturers to voluntarily refrain from producing and selling unhealthy foods,
or reduce the content of free sugars, fats oils, salt and condiments.
Physical activity would be encouraged by participation in village industries and farming.
The satyagraha against diabetes would also provide for stress management, perhaps
through yoga, or meditation, or recreation booths.
Gandhian Diabetes Management
Gandhian Diabetes Management
Mahatma Gandhi repeatedly mentioned the need for nonviolence to his satyagrahis: Non-violence
in word, thought, and deed; by choice, not by compulsion.[7] This should be remembered by all diabetes care professionals: A few words of empathy(diabetes
therapy by the ear),[8] simple actions to create diabetes-friendly society, and choice of safe drugs with
minimal chances of hypoglycemia and weight gain are what Mahatma Gandhi would have
expected from us.
Purity of means was a concept promoted by Gandhi. He felt that means determined the
end. Though one did not have control over the final end, one could control the means
that one utilized to achieve a particular goal. From a diabetes perspective, reaching
a particular HbA1c is less important than ensuring that safe, well-tolerated drug
is utilized in diabetes management to do so. Gandhi propagated the use of appropriate
technology, in a manner which would not dehumanize people. The use of appropriate
technology, including modern drugs, insulins and delivery devices, to manage diabetes,
would have been welcomed by him. However, he would certainly have emphasized lifestyle
modification as the treatment of choice, and would perhaps have criticized current
trends towards drug therapy in place of non-pharmacological action.
Conclusion
Gandhian thought provides an interesting, and hopefully effective counterfoil to the
diabetes pandemic. Perhaps the information contained in this editorial can serve as
inspiration for a worldwide comprehensive, concerned fight against diabetes. Gandhi′s
philosophy can also be used as a motivating factor for people with diabetes, family
members, and health care professionals, who believe in his ideals.
The last century saw Mahatma Gandhi lead many satyagrahas or movements against socio-political
evils. Perhaps we can honor his memory by successfully executing a satyagraha against
diabetes creating a way of life which aims to achieve optimal, holistic, health.
How to cite this article: Kalra S, Baruah MP, Saboo B. The Satyagraha against diabetes. J Soc Health Diabetes
2015;3:1-3.
Source of Support: Nil.
