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Spiritual determinants of global health: Time to start the debate?

By Radhika Arora
on January 14, 2015

(Given the content of this article, it is mostly written from a personal perspective (hence the ‘I’ in many paragraphs), especially when talking about personal experiences; yet both authors share the key messages – hence the “we’ perspective in some parts.)


We’re living in a world full of turmoil. It’s perhaps always been like this; as the ancient Greek philosophers said, change is constant – nothing is permanent, except change. The Greek philosophers of this day, complexity theorists, will agree.

Perhaps we’re just more aware of the turmoil than before, via abundant media and social media. Having said that, seemingly frequent outbursts of violence and natural disasters, coupled with the spiraling world population and increasing pressure on our environment seem to add an additional layer of urgency.  When Ban Ki Moon himself starts writing alarming pieces like “We’re the last generation that can fight climate change” and you see Netanyahu – of all people – walking with other world leaders for “freedom of speech” in the streets of Paris, you have a feeling that ‘The Force’ is not exactly with humanity these days. Rather, the Force seems to be hell-bent on ripping apart humanity, and even destroying the habitat of the human species in the next century or so (Enter “Interstellar” if you believe in Hollywood solutions).

Given the odds that we won’t find solutions in time to change our destructive growth-oriented economic system to avoid catastrophic climate change, if we continue on the path we’re on, even if it’s one towards “sustainable development goals”  in the best scenario, one can’t help but wonder whether in addition to social, political and other determinants of health, we shouldn’t increasingly also talk about the importance of ‘spiritual determinants’ of global health – to  look beyond the spiritual determinants of (personal) health and well-being, that is.

Now, we are fully aware ‘spirituality’ is close to a swear word in the evidence and results-based world of many public health people. Spirituality is, at most, something to leave on your night desk in five star hotels where you’re staying to attend some High-Level Event To Save The World, or something to crack jokes about in relation to the real origins of a famous global health initiative  (see the notorious Bono & George W Bush PEPFAR “prayer room” legend). The more socialist public health people (the People’s Health Movement crowd naturally comes to mind) have even less patience with spirituality, based on their rather Marxist analysis of the ills of our economic system.  For other public health professionals, their faith is in fact an inspiration for their work, but they usually don’t talk about it that much, it’s something private. As for the “patients”, religion is often seen as a last resort for people in low resource settings providing some comfort, even if it sometimes hampers “evidence-based interventions”. Call it the “opium for the masses”, public health style.

But here we’re trying to go beyond the topic of ‘religion’ and discuss spirituality in a broader sense.



At the danger of now finally being revealed as some sort of ‘New Age/paranormal lunatic’ and/or part of the lunatic fringe of the health systems research community, we refer here to ‘spirituality’ in the Deepak Chopra sense, see for example his recent book ‘Spiritual solutions’:  as a path to inner growth and a ‘true self’, going from our typically rather narrow consciousness towards deeper layers of consciousness or even, ideally, a ‘pure consciousness’ or whatever you may call it. Instead of matter, apparent arbitrariness of events and a (very unjust) outside world, the focus is on consciousness, a higher purpose and unity between the outside and inside world. (disclaimer: I’m nowhere on this path – my co-author seems to have made a bit more progress)

Obviously, Deepak didn’t invent all this – he’s just building on ancient traditions here. And equally obvious, this is all just bullshit for the many people in this world with a materialist worldview – they probably reckon Deepak Chopra rhymes with Ophrah.

Anyway, sooner or later, in our opinion, an individual is likely to encounter a flash of this ‘spirituality’/ ‘bliss’ or – if you want – something which feels like ‘evidence’ of something you can’t “rationally” explain away. In some cases, it can even be a gut-wrenching event that shatters the world as you know it, opening up entirely new paths (no, not wormholes). Anyway, in my case (KDC), that happened some years ago, experiencing synchronicity  and a few other weird things which all happened around the same time. As I like to think of myself as an ‘evidence based’ New Ager (yes, Dawkins and many others don’t believe such a category exists), I explored the hypothesis of psychosis to “explain” these events  – but decided against the hypothesis, at least for the synchronicity stuff.

I haven’t done much with it since, and to be fair, these odd experiences haven’t really come back. Or perhaps I’m less aware of possible hints of a higher consciousness, and less in tune with my inner self. “The Gates to Nirvana seem to have closed again”, if you want. Yet, since then,  I do acknowledge the possibility of the existence of a another (larger) reality– and it’s a key reason why my agnosticism (of the time) has gone. Again, we are aware this sounds like a lot of crap for people with a scientific, evidence-based bent of mind – I just give my point of view here, for what it’s worth (being fully aware by the way that also in spiritual terms, I never got very far).


Spirituality at the humanity level

To make a long story short, looking at our world in chaos, we are increasingly wondering whether humanity as a whole shouldn’t (try to) go this path – or at least the ones among us with a first  name different from Richard.

Before you’re getting worried I’m going the nihilist “Kalashnikov & 72 virgins”- route here, I clarify: if we assume that there exist ‘spiritual solutions’ for personal problems – and I personally do, even if I routinely tend to ignore possible spiritual hints in my own life  – then why wouldn’t that be the case for the problems humanity as  a whole faces today? The whole world seems in need of a spiritual transformation, not just Islam – as is now commonly claimed by pundits (by which they usually mean that Islam should become “moderate” like most other mainstream religions and go through “Enlightenment” like Christianity did for example; become a rather harmless (even banal?) faith easily combined with our capitalist socio-economic system, if I may add…).

I don’t think this is the way forward. In fact, many of us should try to find our spiritual essence in a more radical way, by looking inside. Most religions and traditions have forms that actually lend themselves to this sort of inner transformation. So it’s not something exclusive to one tradition, Buddhism for example. I think it’s time we explore these paths.

Only if enough, or a critical mass of  people  (not a “vanguard” – that would sound too Leninist ) connect with their ‘true self’, we might have a fighting chance to change this world for the better, in time. In the 1970s Maharishi Mahesh Yogi – yes, the notorious Beatles Maharishi – put forward the idea which came to be known as the ‘Maharishi Effect’ which  hypothesized that the life of populations would improve, noticeably, if even one percent of the population practiced Transcendental Meditation. Even though the effect of TM has been the subject of many scientific studies, with promising results on the mental well-being of the individual, its impact on populations is yet to be substantiated.

Whether people make progress on this spiritual path through TM or other sorts of meditation, yoga, playing tantric games, long walks in nature, doing some odd new age stuff with their chakras or just by chanting ‘Modi’, ‘Netanyahu’ or ‘Putin’ while smoking pot is less important in our opinion. But it seems urgent and vital that (many) people go inside and try to find out what ancient sages have all been talking about.

Currently, in our work environments, including in global health, we do exactly the opposite. We have all kinds of benchmarks and outside ‘performance measures’ to see how we’re doing. That sort of accountability might be required too, but the most important accountability – that to our ‘inner self’ – seems to be MIA.  There is accountability to the ‘self’, yes, in global health – but that’s very much the competitive ego-game like in the rest of the world.

It is often said that a new, so called “cosmopolitan” citizenship, is urgently needed to tackle the challenges of the 21st century. I personally wonder whether such a broad minded citizenship is possible at all – at least at the levels required – if people don’t undergo a spiritual transformation. Do we really think a circular economy, divestment of fossil fuels, meaningful global justice, a comprehensive SDG agenda…  are possible – and in time ! – before this planet becomes uninhabitable for humans, if we don’t undergo a (21st century) spiritual transformation as well? Maybe glass-half full people might think so. The pessimists among us beg to differ. Something more will be needed.

That is anything but a new insight, others have done so far more eloquently and way more guru-style – they tend to have gray beards/hair as well as possessing real wisdom (instead of my very brief flashes of ‘something that might very well have been something extraordinary’’). I’m just putting it forward here, because  ‘trying to find your inner self’ before taking action, is not exactly seen as a ‘way forward’ in global health circles (These circles would probably advise a ‘quick win mental health intervention’ instead).

But that’s a mistake, we think. And it’s one we can’t afford, if we take ‘sustainable and inclusive development’ seriously. Global health might – like science in general – need a paradigm shift if we really want  a sufficient number of citizens to become cosmopolitan and collaborative in time.


Time to start discussing this ?

This post is just meant to kick-start some discussion. So feel free to comment below this post.

What does it “mean” that we see Boko Haram slaughtering innocent people, in mindless violence and horror, from a spiritual point of view? If you believe in some ‘higher purpose’ for human beings, what on earth does this mean, this very real horror inflicted on people, including using little girls as suicide bombs on markets? If you assume there is a higher consciousness, what is this “higher purpose” on earth trying to say to us? What does it “mean” that global inequality is so horrendous?   And questions like that. These questions aren’t new, in fact they are as old as this world – and some, for example people who experienced the holocaust, have in the past because of this decided against the existence of a higher reality. Yet, in the 21st century, these questions are coming back, and they seem even more inescapable than before. It reminds a bit of what some spiritual people “felt” – ominously – in the years before World War II, perhaps, anticipating the mayhem that was coming. (we don’t “feel” anything, by the way – we’re just trying to make sense of the world now)

If you take the personal level as some sort of indication, it is said that spiritual hints can help you to find the proper path for you, but that if you insist on ignoring them, you do so at your own peril – you can get bogged down in life, meeting endless and seemingly insurmountable obstacles (I’m well aware that the social determinants crowd might get really angry about this sort of statement). But, using the same logic, could there be some similarity at the global level? If humanity insists on ignoring the spiritual ‘writing on the wall’, will, eventually, this higher consciousness “decide” to stop our very survival on this planet? ( judging from my rather childish spirituality interpretation here, you can feel this could really be stuff for a Hollywood blockbuster )

If you believe this universe is amoral, you obviously don’t have to answer these questions. The same is true, by the way, if you believe there is evil and good in the universe. But if you do believe there exists some higher purpose/consciousness (or have experienced flashes of it, even if you didn’t fully understand them), you can’t shy away from these questions.

What is going on, in the 21st century, that humanity seems to be on the way to its own extinction?  And borrowing a leaf from development experts, do we have a ‘Theory of Change’ to get in time to the spiritual transformation needed – or is the opposite, more and more division between humans, far more likely? And where does spiritual transformation and exploring your inner truth end and the ‘occult’ begins –  or worse, serious mental health problems start?

We don’t have the answers, obviously. But it seems important to start reflecting on them if we want to make the quantum leap in terms of solidarity that this century seems to require. Even in the “secular” and competitive world that science is. And while being aware that our digital times are not exactly conducive to ‘going inside’…

(Nevertheless, we still hope you ‘like’ this articleJ. )