This is the essay and poster on Gandhian Philosophy in Neurorehabilitation prepared for the 10th World Congress in Neurorehabilitation, Mumbai, India.
Neurorehabilitation is a complex process that involves minimization of neural damage and compensation of limitation of functions arising from neural disorders. New insights on neurorehabilitation can be gathered when observed from a Gandhian point of view. The perspectives, ideals, and vision of Gandhi are relevant today that one can find many parallels of principles from his life that are now used in medical practice worldwide.
Simplicity is prominently reflected in Gandhi’s ideas and way of living. His affinity to simplicity was evident even during his early days in England, when he cut down all unwanted expenses and chose to live in a modest setting. Gandhi firmly believed that happiness and prosperity are not bound to materialistic things but are derived from internal peace and satisfaction. He was against over-consumption and affinity to material possessions. The Gandhian virtue of simplicity has an important role in neurorehabilitation where the focus is on patient’s personal satisfaction and fulfilment. Oftentimes, the simplest of all interventions might be the most therapeutic to the patient. Some of the most complex life decisions of the patient can be changed simply by offering new perspectives. In neurorehabilitation, some of the most effective interventions such as mirror therapy and physical exercise are cheap, simple and inexpensive.
Gandhi had a holistic approach to his development as a complete social being. He did not divide his personal and private life into watertight compartments and mixed social, political and religious work harmoniously. He also believed that all life goals should be defined in such a way that it should make progress not only to one’s lifestyle, but also to one’s family, nation and the world. This philosophy of holism is one of the pillars of modern neurorehabilitation. A neurorehabilitation professional not only caters for the physical and psychological aspects of the patient, but also for the social and cultural dimensions of his/her personality. Neurorehabilitation involves working with not only the patients, but also their families. It also draws no boundaries between personal needs and social needs. Neurorehabilitation deals with several aspects of the patient’s life including nutrition, mobility, cognition etc. Thus, quality rehabilitation can be administered only by considering the patient as a whole, and not as a sum of organs.
Inclusivity and diversity were Gandhi’s core values. The ‘Hind Swaraj’ of his vision was the one where people thrived and cooperated despite differences in caste, creed, gender or religion. The same vision is applicable to neurorehabilitation in which all medical practitioners, caregivers, the family, and community have to work together with the patient to bring him/her to the fullest possible potential. There cannot be any hierarchy in terms of work division and everyone’s role is crucial in rehabilitating the patient. Gandhi emphasized that one’s action should be directed at the well-being of the poorest and weakest man (woman). This principle is of great importance in neurorehabilitation where the healthcare professional has to deliver the most care to the neediest and weakest patient.
Gandhi warned his followers that ‘healing should be its own reward’. In the present day world, medical care is commercialized and monetary reward is the primary reason for those involved in the healthcare industry. Gandhi had foreseen this problem as early as in 1925 when medical science was in its infancy. In neurorehabilitation where often debilitated patients might need lifelong treatment, it is inhumane to be acutely business-minded. Gandhi had also noted that science without humanity is the root of violence. In neurorehabilitation, the focus of the researcher and practitioner is on being compassionate, empathetic and tolerant. These humane values are emphasized more in neurorehabilitation than in other branches of medicine.
Gandhi had a life-long commitment to his ideals. His lifelong dedication to ahimsa and satyagraha are well-known and are praised by scholars and disciples alike. Similarly, in neurorehabilitation, the patients often need life-long care. Hence, neurorehabilitation becomes an integral part of the lifestyle of the patient. The patient and the healthcare professionals should work hand-in-hand, often throughout the lifetime of the patient to meet the goals of the therapy. Gandhian value of satyagraha encompasses the same philosophy: being patient, working consistently, and not stopping until the goal is reached.
The ideal community as envisioned by Gandhi is a reformed one where each individual works harmoniously to produce a self-sustaining economy. This aspect of community involvement is well-established in neurorehabilitation. The ‘social safety net’ provided by the state, and the ‘social cushion’ provided by the community are very important for patients needing neurorehabilitation. Community support and social awareness regarding neurorehabilitation are essential for enforcing policy change for accessible public spaces, pension plans and return-to-work policies.
It is evident that Gandhian philosophy is closely in alignment with the core principles of rehabilitation. Gandhi’s ideas and practices should continue to inspire healthcare professionals to seek provisions for applying ahimsa in various facets of their work in neurorehabilitation. In current times of intense competition, we, the healthcare professionals, must embrace Gandhi’s integrity and avoid the temptation to forego morality and empathy.