Towards an integral approach to health

What is your definition of integral health?

Jocelyn: Most allopaths tend to define health as an absence of disease, and that is also the dictionary definition. But ours is a positive definition which includes the whole being.

Ruslan: It’s a balance and harmony between the different planes and levels of the being. 

Why is there a need for a new integral healing centre in Auroville?

Ruslan: It was a response to a need. I worked at the Auroville Health Centre for six years. It served both the village and the Aurovilians and it was always very busy: sometimes I was seeing 40 patients in a morning. These are terrible conditions for a doctor to work in because you cannot give enough time and attention to each patient.

Some, of course, just wanted a quick fix to get back to their normal lives. But others were more conscious and wanted to know what was happening and to take responsibility for their healing, and these people needed much more time than the six or seven minutes I was able to give them. 

In addition, the Health Centre was largely allopathic and even though some alternative treatments were offered, there was no communication between the practitioners of the different modalities. We did not exchange files or anything like this. We were simply sitting in different rooms doing our consultations. 

Perhaps the main thing, though, was I came to work for Auroville, and in Santé we can focus on the Auroville population. In this new environment I can give 20 minutes rather than five minutes per person and we can eliminate the whole issue of queueing because, unlike at the Health Centre, here people can make appointments.

Jocelyn: Actually, the idea of an integral healing centre has been around since 1981 when Maggie, Ursula and myself sat together and dreamed of such a place. This was the original idea behind Quiet, but now this has turned into a spa.

I came back to Auroville in 1999, having worked in one of the first experiments in integral medicine in America. It had allopathic doctors, homeopaths, acupuncturists, chiropractors, psychotherapists, and three or four modalities of bodywork collaborating as a team. 

Unfortunately, that fell apart due to the American insurance system, under which some therapies were covered but others were not. But the idea remained in my head. So when I came back I wanted to immediately start to do something like that. Kailash Clinic, which opened in 2008, was the first big step because here there was an aspiration to go towards a more comprehensive approach to health and healing through using different approaches to address more than just one aspect of the being. 

Sumeet: Kailash was definitely a step towards integral healing because there we had a multidisciplinary set-up and we gave patients a choice of healing modalities. The practitioners working there talked together, there was cross-referencing, and patient records were accessible to everyone. This is very important from the point of view of integrating different approaches. 

Also, we wanted to bring quality and organization from the start, so patients were treated well, dressings were done professionally and we were very scrupulous about hygiene. 

However, space was limited in Kailash. Only one person could give a consultation at a time. And, as we had allopathic doctors working in the morning and other treatments in the afternoon, this again separated the healing modalities. 

In Santé we have far more space: now we have the potential to have five practitioners from different healing modalities working at the same time. To integrate the different modalities we have to meet regularly, so we have a common tea-room and a meeting room where we can meet and discuss common and chronic cases, and watch educational videos together.

But isn’t getting people from different healing approaches to work together a difficult challenge as many doctors and therapists have been trained to believe that their modality is the only ‘right’ one?

Sumeet: It is true that while we have always had many different health practitioners in Auroville, often they have not been able to work together. Partly this was because the space wasn’t there, partly because of other factors. But I feel that now there is a certain mass of people who are looking for a more integrated approach. 

Getting practitioners to widen their perspective can take time. I was trained as an allopath. The Western medical training is very restrictive. It says that the body is the only reality and the doctor is the one who does everything while the patient is basically passive. My faith in this system was shaken when I started reading Sri Aurobindo because what he wrote did not fit with what I was doing as a surgeon.

Actually, the boss of my surgical unit was a practising homeopath. He always used to say, ‘Let nature take its course’, and everyone used to laugh at him, but he also opened my mind to another approach. 

Ruslan: If there was one approach that was all-powerful, there would not be a need for different healing modalities to collaborate. It is because more and more of us in the healing sector understand that our different approaches have limitations as well as strengths, and that we need to complement each other to address healing in a wider and deeper way, that we want to sit together now and try to understand our different approaches. But this takes time and patience. 

Jocelyn: Everybody in the team has agreed to collaborate in this way. Otherwise they would not have joined the team.

Sumeet: On a practical level, this collaborative approach means that every practitioner working here has access to the same patient records. And we will have regular patient care conferences where the practitioners discuss complex cases, and hear about exceptional results or discoveries.

The next step will be to create individually-tailored plans for patients. One of the important things is that the patient must become part of the healing process. It’s no longer the doctor who is God and the patient merely the passive recipient. Fortunately, in Auroville we already have an environment where the person who is seeking health is ready to take responsibility for themselves, and cooperate, learn and change.

Jocelyn: In Santé, the patient will be able to choose which primary discipline they want because here we will have all the major primary disciplines – allopathy, homeopathy, ayurveda, acupuncture, bodywork – under one roof. 

But how can the patient make an informed choice?

Jocelyn: In the U.S. centre I worked in, the patient chose the primary caregiver, and this person referred them to whoever they felt was the most appropriate practitioner. In Santé we will have this approach, but we also want to develop a new concept of the ‘health navigator’.

Sumeet: To be a navigator you have to be able to evaluate the whole being in front of you, as well as know about the different therapies. This is a specialised job. However, it is important that everybody in the team, from the receptionist onwards, is able to provide some degree of navigation for the patient. 

Jocelyn: It’s the chronic cases, those who have not found the healing that they need, who are most in need of a specialised navigator. These are the patients who try one thing and then another; they go shopping around. We are not going to allow this because each practitioner needs to see the results of the treatment, and this takes time.

What is being done on the level of preventive health in Auroville?

Sumeet: There are two levels of preventive health: one is individual prevention and the other is public prevention. At the individual level, whenever somebody goes to see a practioner, the practitioner should not simply work on curing the immediate problem. He or she should also seek to prevent future problems by giving the patient advice about diet, lifestyle, exercise, yoga etc. 

Public prevention has to do with health policies as well as things like the quality of food being served in restaurants, the cleanliness of public places etc. Some work is being done in this area by the Auroville Health Services, but we are still very much at an embryonic stage in terms of having a public health programme for Auroville. 

Ruslan: The preventive approach is meant to be the first priority of medicine, but we practitioners are always caught up in addressing day-to-day issues, so we hardly ever have the time for this. We have to give much more importance to this element. 

But there are different approaches. One way is to view prevention as simply preventing disease in someone who is seen as a static entity. However, if we see the individual as somebody who is constantly changing throughout life including, perhaps, at the consciousness level, and we recognise that these changes can create disequilibrium and illness, the challenge is to help someone navigate their way through this. Maintaining the equilibrium of a dynamic being is a huge challenge. 

Some of the alternative therapists feel they are not getting sufficient support from Auroville. For example, they say that the Health Fund is prioritising allopathic treatment over alternative healing modalities. Do you agree?

Sumeet: The Health Fund is not against alternative therapists. It pays for treatment by the Tibetan doctor, by homeopaths, and for acupuncture and ayurvedic treatment. But the Health Fund pays only for those therapists who work within a known system with a therapeutic focus, and where the method of treatment and records are transparent. 

Ruslan: If a therapist doesn’t keep patient records, is not aware of certain medical risks and works totally in isolation, it is very hard for the Health Fund to decide whether or not they should pay for this treatment. So we have worked out certain guidelines for therapists to follow and work as a team and support each other.

Sumeet: But we do need to look at how the Health Fund functions. The Health Fund was set up primarily to pay people’s hospital and medical bills. It was not structured with deep thought to serve the health of Auroville. For example, the Health Fund doesn’t pay for prevention, an area where alternative treatments often work better than allopathy. So it is not biased towards allopathy, it is just that there is a distrust of the effectiveness of prevention. 

What do you think will be the healing modality of the future? 

Ruslan: Integral health is, of course, the goal. At this point in time, we have limited means and limited understanding of what this means. Today, we have to use the tools that have evolved over millennia. But as our consciousness grows, so will the way we use the existing tools, and new and better tools will evolve. As our understanding becomes subtler, so will the way we practise healing. 

Eventually, the ideal treatment one should provide would be like that practised by Mother and Sri Aurobindo. They thoroughly understood what was happening at the consciousness level so they were able to intervene in the most effective way. 

Sumeet: The whole point is to have humility. Who knows what integral health will look like? If you asked me in the context of Mother and Sri Aurobindo, I would say that only the new body will possess integral health. But what will the new body look like? 

This is why we do not call what we are doing ‘integral health’. We call it ‘integrative medicine’ because, while integral health is the goal, the approach at the moment is integrative. We do this in the hope of getting closer to delivering integral health, but we are not fooling ourselves that we are anywhere near reaching it yet.