Getting to Health through Integrative Practices

Traditional medical practitioners far outnumber practitioners of allopathic medicine in most parts of the South World. They are thus, de facto, the world’s most popular form of primary care. This article discusses the re-emergence of traditional/integrative1 healthcare around the world. Within ‘post’-colonial societies, traditional health knowledge has re-emerged in the context of nationalist struggles for independence and a growing interest in natural health care. As people of the South World2 and indigenous communities become more self-reliant, interest in indigenous health practices develops. Concomitantly, as critiques of allopathic medicine’s side-effects develop, interest in natural and spiritual forms of healthcare grows. Those who can access allopathic care, however, almost always choose to blend it with traditional medicine. This article critically explores the fundamental concept of and the increasing popularity of integrative healthcare practices particularly within South World societies. We touch on the reintegration of traditional and modern health knowledge and how this trend is simultaneously occurring all over the planet. While colonialism negatively impacted the work of traditional medical practitioners (Shroff) [1], in contemporary times, many people are finding answers to modern problems in ancestral practices. It is challenging to piece together bits of verbal knowledge handed from one generation to the next so gaps in knowledge inevitably exist. Regardless, knowledge evolves, and changes are made to virtually all practices as a result. As new diseases and problems arise, wholistic health care is trying to adapt to these challenges. Blending the evolved practices of integrated healthcare with modern day conceptualizations of body and mind, today’s wholistic health practitioners have a much better toolkit than they had in the past. This bodes well for health promotion, disease prevention, treatment, rehabilitation and palliation of societies around the world. In blending ancient and modern healthcare knowledge forms, population health status may benefit from the transformative potential of healing properties of plants, particular foods, water, spinal manipulation, acupuncture, the deep connection between mind, body and spirit, massage therapy techniques, and the salubrious effect of a true healer. This article will explore the international, interdisciplinary, historical and contemporary manifestations of wholistic thought forms. The concept of wholism is defined in various ways. This article offers foundational understandings of this term from various parts of the world, illustrating the virtually universal, historical as well as contemporary nature of ideas such as interconnectedness, unity and oneness. Throughout human history, wholistic worldviews were dominant until the past 400 years or so when reductionist worldviews became prevalent. Currently, a revival of wholistic thought forms is taking place in many parts of the world. The purpose of this article is to sketch the landscape of wholistic philosophical foundations, discuss systems science in this context and apply these underpinnings to wholistic health. In addition, we discuss the importance of wholism and social justice for developing community health. Additionally, although we do not have space in this article to discuss it, we support efforts to regulate integrative health care for the purpose of protecting patients. We hope that this article will increase understandings of both the conceptual foundations of wholism as well as its South World applications to health. The article concludes with the recommendation that wholistic health-care practitioners take social inequities into account, so that integrative health care can become a means for individuals to take action for wellness as well as a means to create structural changes toward equitable resource distribution. 1The words integrative, natural, and traditional are used interchangeably in this article. 2South World is used here to encompass Latin America, Afrika, Asia, and the Middle East. We choose to spell Afrika with a K because we wish to acknowledge and embrace the spelling used by Afro-centric scholars. Open Acc J Comp & Alt Med Citation: Farah MC Shroff. Getting to Health through Integrative Practices. Open Acc J Comp & Alt Med 1(3)2018. OAJCAM.MS.ID.000112. Copyrights@ Farah MC Shroff.


Introduction
Thousands of years old, traditional systems of health care blend mind, body and spirit. Healers who worked with plants, those who set bones, spiritual healers, birth attendants and others, were sought out by local people partly because of shared cultural worldviews.
Despite European colonial invaders' attempts to destroy traditional medicine, its practitioners survived, and some are thriving today: serving 80% of the people of Afrika, 40% of China, 71% of Chile, and 70 % in India [2,3]

org) and FAPEG (Traditional Healers' Self-Proficiency Training)
promote Afrikan traditional systems of medicine through cultural and scientific research and training. These organizations aim to train healers. They work towards effective wholistic treatments for headaches, chronic pain, depression, and other conditions.

Charlatanism in the Practice of Traditional Medicine
We would be remiss were we to ignore the fear-driven and lucrative business of pseudo-traditional healers. Confusing authentic traditional healers with those who profiteer from the vulnerability and illness of people is a big mistake. While we rebuke the unscrupulous practices of those charlatans, the rest of this article will not focus on them. Our interest is in finding ways to regain health through wholism and traditional knowledge for the benefit of people in the South World and beyond.

Authors' Social Location
I am a Parsi who was born in Nairobi, Kenya. Swahili and Kikuyu were two of my first languages and I also spoke English, Gujarati, and some Hindi as a child. I believe that one of the most powerful roads of liberation is via indigenous knowledge systems which teach us about our worldviews, various practices, and ourselves. It is through these ancient knowledge forms that we help to build peace and justice and we also can see the commonalities between our worldviews. My work has largely been on South Asian indigenous knowledge and the linkages that all forms of indigenous knowledge have with each other. I have a genuine desire to see wholistic health practices re-emerge in the modern world, blending old and new in a practical and powerful way to heal this planet. Wholistic health systems, in concert with allopathic systems, have the potential to effectively treat many illnesses. Besides working as a researcher and an educator, I am a teacher of yoga, meditation, dance, singing, martial arts and other creative wholistic expressions. In writing this article, my hope is to contribute, even in a small way, to health for all people. As a diasporic Parsi, I strive to be an ally to people of the South World who are working towards better community health and social justice. I believe that Indigenous knowledge systems are interconnected and related to spiritual forms that will help the world to be healthier and more just. My interest in wholistic health has many roots. Wholistic health has tremendous healing potential and this has been proven in a myriad of peer-reviewed articles in medical journals, including systematic reviews (Mujahid et al.) [4]. I have personal interests for my own health and that of our family. In the early 1990s when I was preparing my PhD thesis From them, we learn about the importance of self-determination and freedom. Validating indigenous knowledge is part of the project for liberation. Amalgamating old and new knowledge forms has the potential to improve community health. This includes ancient knowledge emanating from traditional Afrikan societies, such as the importance of the ancestors, elders, language, greetings, heartto-heart communication and innumerable scientific advancements.
These scholars and social actors have taken action to help people regain self-knowledge, self-love and power in the world. Americans, Chinese, local elite imperialists, and I stand in solidarity with people around the world who are struggling for self-reliance, social justice, and peace, which are bedrocks for better health. This approach to traditional medicine acknowledges the tremendous healing potential of the spirit and the sagacious work done by those who are authentically connected to it. Those whose spiritual practices lead them to that profound sense of connection to all life are leaders in the creation of sustainable changes towards community health, human rights and peace.

Principles of Wholism
The English words health and wholistic are semantically related. They both stem from the same root word: The Anglo-Saxon words whole, hale, and holy (Pretorius) [5]. Despite the linguistic connection, the word wholistic is used in incongruent ways and has become an umbrella term that is used to encompass anything that is non-reductionist or dualist. We spell it as wholism, to accentuate the semantic connections of this word to the word "whole". In this article, the concept of wholistic health care will be used interchangeably with integrative medicine, traditional healthcare, alternative or complementary medicine and will be defined as approaches to well-being and treatment of illness that focus on the mind and body. Additionally, the term wholistic health care is used in this article to encompass self-care, practitioner-based care, and wholistic products. Wholistic self-care encompasses practices such as yoga, meditation, Tai Chi and Chi Gung. Wholistic care provided by professionals encompasses Traditional Chinese medicine, Ayurveda, Afrikan bone-setters, spiritual healers, traditional birth attendants, homeopathy, botanical medicine, therapeutic massage, and others. Products include herbs, potions, powders, tablets, pills and so forth. Wholistic schools of thought vary from region to region and throughout time, but ultimately, have more similarities than differences. A number of principles unite them. One principle they have in common is that entities and systems in the universe, including humans, are considered part of a unified whole that cannot be understood by the isolated examination of its separate parts (Dusek) [6]. These parts are actively interrelated, interlinked, interconnected, and dynamic. Wholistic worldviews do not focus exclusively upon the body or organism, but on the larger world and are often associated with spiritual or religious thought-forms.
At the heart of wholism, there is an awareness of the unity and mutual interrelation of all things and events. All things are seen as interdependent and inseparable. This ultimate and indivisible reality is called Ubuntu in southern Afrika, Brahman in Hinduism,

Dharmakaya in Buddhism, and Tao in Taoism. Shamans in Latin
America also embrace parallel philosophical concepts. Since this reality transcends all concepts and categories, Buddhists also call it Tathata-Suchness (Deshmukh) [7], that Which Is, or Is-ness, the sum of all forms. According to Afrikan wholistic worldviews, for example, the cosmos is one spiritual totality. Spirit is not separate from matter, as everything is connected. In Afrikan wholistic thought, all things are considered to be related through one divine force (Asante et al.) [8]. They are alive, giving and receiving energy, with all life and matter created for a specific purpose. The concept of Ubuntu, for example has been translated as "I am what I am because of who we all are" (Gbowee L) [9] illustrating a collectivist cultural value which acknowledges the primacy of relationship.
This also refers to kindness and other humanitarian values. Ubuntu is found in many Afrikan languages: Shona, Tswana, Rwanda-Rundi, Kitara, Luganda, and others. In the Yoruba tradition, the Creator, Oludumare, is considered to be transcendent, exhibiting the quality of "atérerekáyé (that which spreads all over the world or who covers the whole world or makes the whole world feel its presence)" (Omosade) [10]. 43 studying patterns-from crabs to lobsters and orchids to humansand in seeing the interrelatedness of life forms. For hundreds of years, much of western science concentrated on isolating the world's basic building blocks. Now that this has been achieved to some extent, the systems approach emphasizes principles of organization creating a more ample understanding of matter from macro and micro-perspectives. Systemic properties are lost when a system is dissected, either physically or theoretically, into isolated elements. Although it is possible to discern individual parts in any system, the nature of the whole is different from the mere sum of its parts (Kineman JJ et al.) [13]. This understanding ties in very well with principles of wholism and wholistic health.

The New Physics
Connected to systems science, some physicists also make connections between their work and wholistic thought forms.  [14]. The new physics thus emphasizes interrelation and the indeterminate, and probabilistic qualities of matter and energy. It also challenges components of the scientific method related to Newtonian mechanics, such as determinism and linear causality.

Evolution in Allopathic Medicine
Like systems scientists and the new physicists, some allopathic physicians are moving beyond these 'old' scientific paradigms in conceptualizing health issues (McQuaide M) [15]. While there are thousands of allopathic physicians whose work incorporates wholistic health, Deepak Chopra, MD, Andrew Weil, MD, and Paul Waako, MD, have gained great popularity. Their work has successfully bridged a gap between reductionism and wholism anddrawing from quantum mechanics theory-has conceptualized the importance of quantum or wholistic paradigms for health. These allopathic physicians with wholistic inclinations predict that sooner or later, allopathic medical science will catch up with the theoretical revolution in physics. As the interdependence of mind and matter is

Wholistic Health-Applying these concepts
Concepts of wholism find concrete application in systems of wholistic health promotion, disease prevention, treatment of illness and/or palliative care. What connects the diversity of these wholistic traditions is that without exception, they take into account mind, body, environment, and the interconnection between them. They recognize the interrelationship between human health and the social and physical environment. Wholistic health theory is posited on the notion that life force connects all that is alive in the universe, and that this energy is responsible for the life of all beings. There is no English word for this concept but in almost Wholistic healthcare theory understands malfunctions (illness) in the context of the social, cultural, and spiritual environment.
Treatment of both body and mind are considered integral (Barnes) [16]. The body is understood in a unified manner within wholistic health perspectives. Injury to one part of the body may thus damage another, seemingly unrelated, part. Kidney malfunctioning, for example, may result from a damaged heart. If one part of the kidney is injured, such as one medullary pyramid, another medullary pyramid may take over its functions. Wholistic principles maintain that the body has an innate capacity to heal itself, and the role of the physician is to first, do no harm and secondly, to assist the body in its natural tendency toward balance. As mentioned above, however, allopathic doctors are increasingly using alternative medicine in their practices, and some allopathic doctors work with alternative practitioners or frequently refer patients to them. Functional medicine, a relatively new creation, applies a systems approach that engages both patients and practitioners in understanding genetics, environment and lifestyle factors in healthcare. Increasingly, nurses, midwives, physiotherapists and other healthcare practitioners also incorporate wholistic practices into their clinics. So wholistic practices are growing in various healthcare systems.

Wholistic Health Care: A Growing Trend
While allopathic medicine is useful for the treatment of acute emergency care needs, wholistic health care appears to be promising for chronic conditions and mental health care. These medical conditions constitute a majority of health problems; chronic diseases are leading causes of death and disability around the world (Palmer) [17]. Thus there is a critical need for multiparadigmatic, evidenced-based prevention, and medication for chronic diseases and mental illness. Moreover, the WHO estimates that by 2030 mental health disorders, topped by depression and anxiety, will be a leading cause of disability (WHO) [18]. This is partly why awareness for wholistic care in North America is growing among health professionals and the general public. In the United States  [19]. In Canada, that number is similar, with one study finding that 73% of Canadians have used some form of wholistic health care in their lifetime (Esmail) [20]. While studies measure different definitions of wholistic health and varying time periods, Canadians are increasingly using wholistic health care. The interest is in part due to the increasing dissent with the present system of medical care delivery. Some people, particularly women, prefer wholistic practitioners partly because of practitioner friendliness and interpersonal sensitivity [8,21]. This relatively egalitarian relationship is valued for many clients who have sought out wholistic practitioners. Fewer side effects, the perceived lack of harm from wholistic health care and the possibility of improved health are other reasons why Canadians are turning to wholistic healthcare practices (Quan) [22]. However, wholistic practices are virtually always accessed in conjunction with allopathic practices.
In North America; very few people and practitioners, even those who are active proponents of wholistic care, use no allopathic medicine.

Wholistic Health Care Critically Examined
It is precisely because of their growth and interest that wholistic models also need to be considered critically. Most systems of wholistic health are overly concerned with the individual and her/his mind, body, and spirit, but rarely examine the health connections to the larger social world. This is probably the most astute criticism of wholistic health care. Most systems of health care, including wholistic ones, do not include social determination of health as a major component. This lack of attention to public health and the social determinants of health is a serious gap in wholistic healthcare practices. Furthermore, within many systems of wholistic medicine, patriarchal and classist overtones are apparent.
In Chinese medicine, for instance, Yin traditionally means the shady side of a mountain, but is also related with femaleness sometimes, and is interpreted under a patriarchal lens. Thus, within this lens (and not all lenses), Yin and women are considered more negatively than Yang. For Taoists, there is no such thing as absolute moral judgments, with neither Yin nor Yang representing good or bad [5].  [23,24]. Furthermore, wholism has been embraced by several groups, including those who serve non-wholistic ends.
Amongst them are "new age" entrepreneurs who are profiting from the commodification of wholistic health, including shamanic healing, hypnosis, trance work and so forth. These practitioners, who claim to be wholistic, profit from the work of others and from the teachings they have gained from South World knowledge forms, without crediting the original sources. They may claim to 'westernize' wholistic practices in order to lure customers who know very little about the origins of wholism. They may also excuse sexist, heterosexist, classist behaviour in the social organization of their work, on the grounds that the culture from which it comes is based on oppressive practices. This kind of racist appropriation and misrepresentation of wholism is dangerous, as are the claims made by practitioners masquerading as wholistic healers. They state that they can miraculously cure diseases in order to lure vulnerable and ill people into paying large sums of money for unproven therapies. Some aspects of these therapies are problematic when they fail to take into account power differences and their grafted relationship with race, class, gender, sexual orientation, ability, age and so forth. Some, such as Louise Hay, go as far as to suggest that people are 100% responsible for creating their experiences (1984: xiii). This completely negates the existence of hierarchies such as imperialism, racism, patriarchy, heterosexual dominance and so forth. While it is pleasant to entertain the thought that individuals who create peace and harmony in their lives will have no (health) problems, it defies the experiences of many of us. There is always the danger of simplifying health and healing to a point where power relations are not taken into account. Unfortunately, this simplistic type of analysis pervades the new age movement's rhetoric, which results in various forms of "victim blaming" (Crawford) [25]. While it is true that the new age movement emphasizes fitness, wellness, prevention and risk reduction, all while downplaying the vast and ambiguous external forces that influence health, we must be cautious not to confuse new age entrepreneurs with wholistic health practitioners.
The critique that wholistic health provides an individualistic solution to problems of health by changing the individual rather than the social causes of illness rings true. Plus, the victim-blaming ideology promoted by some wholistic health care providers shifts the burden of blame to the individual rather than the social context (Crawford) [25]. Yet this critique applies to allopathic medicine as well. Allopathic medicine does not encompass a social and political view of the determinants of health either. Public health, the humanitarian branch of allopathic medicine, is poorly funded and often neglected. Neglecting public health practices in most wholistic health systems is not a solid enough argument to dismiss wholism. It is, however, combined with the above arguments of appropriation and class privilege, a solid basis for dismissing the new age movement as opportunistic. Supporting well developed public health practice in all systems of medicine is a worthy goal.
Complementary public health approaches to improving health for all will make significant impacts on all systems of health care.

Closing Reflections
The concept of wholism is international and ancient, stemming, as does all knowledge, from the Mother continent--Afrika. Crossing countries and historical periods, wholistic concepts and health practices based on these thought forms flourished for centuries but have declined over the past 500 years or so under European colonialism. European domination of the planet brought with it reductionism, dualism and their off-shoot, allopathic medicine.
Currently there is a global re-emergence of wholistic thinking and wholistic practices, rarely framed within a libratory lens and embodied by concepts such Kawaidaa. This article analyzed the historical as well as contemporary basis of wholism as interconnectedness, unity and oneness, and its application to wholistic health care. Neither the allopathic nor the wholistic model of care attend to social inequities, yet wholistic practices generally take into account the many facets of the individual-emotional, social, mental, and spiritual. It is partly for its attention to emotional and spiritual aspect of health that wholistic care is popular. However, wholistic health care can be improved, and serve the needs of more people if race, class, and gender analyses were taken into account. The peoples of the South World still rely quite heavily on traditional systems of medicine and in many cases, this is because of its accessibility, financial and culturally. Deepening our understanding of the impact of social inequities on an individual's health will contribute to more efficient and just (wholistic) healthcare systems. When wholistic practices are joined with social justice approaches to working with communities, population health status promises to improve. This has been demonstrated in Thailand, Kerala, India, Brazil, Cuba and elsewhere. Moreover, when people's health care reflects their worldview, communities deepen their understanding of who they are-improving self-knowledge and pride. Major institutions are currently studying wholistic practices and products, including herbal remedies, bodywork, meditation, dietary changes and many others. Various studies, and some systemic reviews, are available on almost every type of wholistic practice, and some show promising results [26,27].
Working together, there is great potential for wholistic health care and allopathic medicine to improve population health [28][29][30][31][32][33][34]. Allopathic medicine has made great advances in population health, particularly in emergency and acute care. Combining all the world's systems of medicine and scientifically choosing those which have the best health outcomes-the world has the potential to truly heal. If practitioners were to also take social inequities into account, this integrative health care could truly become a means for individuals to take action for wellness as well as a means to create structural changes toward equitable resource distribution. I have written elsewhere (Shroff, 1996) about a health care system that incorporates public health approaches and integrates best practices from multiparadigmatic medical systems. This article also reviewed the interdisciplinary nature of the concept of wholism, illustrating the philosophical and scholarly unity in the notions of unity and oneness, interconnection and inseparability of mind and body.
Modern physics, particularly quantum mechanics, is at the forefront of the scientific frontier that has arrived at the same conclusions as philosophical ideas from Afrikan, Asian and other Indigenous cosmologies. Systems science, an interdisciplinary enterprise, is also part of this movement away from a reliance on reductionist thinking [35][36][37][38][39]. Given that the basis of wholistic philosophy is unity and oneness, a health care system that incorporates the most effective aspects of various systems of medicine would have powerful potential to improve population health on many levelsprofoundly embracing the concept of Ubuntu, which has often been summarized in the expression "umuntu ngumuntu ngabantu", meaning that a person is a person through persons (Ogude) [40].