St. John’s Medical College in Bangalore, India, is on the verge of celebrating 50 years of its establishment as one of the premier Medical Institutions of India. As one celebrates the successes, one must also take time to introspect, in the true spirit of re-evaluation and re-affirmation, the core values of an Institution that is so dear to our hearts.
India is a complex land. Our lives are touched by economic, social, religious, political and cultural dimensions. An effort at understanding this complexity would necessarily be inadequate. There is therefore an even greater need to look inwards at one’s own place as a religious minority, in this diverse and often divided society. This need is crucial if one wants to preserve one’s core philosophy and values.
The Mission of St. John’s is stated as “to train health care professionals who are ready to reach out to the medically un-reached of the nation by harmonizing dedication to excellence with a commitment to social justice in health care”
This mission of St. John’s is entrenched in the teachings of Jesus Christ – the man and God, who preached in simple words, the very essence of our existence. His words were not incomprehensible even to the uneducated. The simplicity of his teaching belies the depth of his understanding of humanity and of his expectation from his followers. The words of Jesus Christ extol one to constantly strive to share his mission of love and faith.
In the Indian context, there is a growing trend among Christian organizations to become ‘secular’. Becoming secular is now beginning to mean that one stops talking about Jesus Christ, stop mentioning him at public forums, excuse him from exhortations for moral values and keep mum about him at the vote of thanks. The name of Jesus Christ has been taken out from Catholic schools, colleges and hospitals and politically right words inserted instead.
Can St. Johns then truly train ‘professionals who are ready to reach out with a commitment to social justice??
The Indian Context
In an article ‘Caste and inequalities in health’ in the Hindu dated August 22nd 2009, Prof. KS Jacob categorically dissects the influence of caste in every aspect of health care delivery and states in no uncertain terms that ‘the system, generally identified with Hinduism, is also prevalent among Christians, Sikhs and Muslims.”
Practices that are being classified as human rights violation are being practiced within the Christian community. Is this not a serious breakdown in our basic value system? Does this not require urgent action and change?
We live in a deep rooted unequal society. As persons who must practice Christ-like values, Catholics are horrifyingly tolerant of inhuman and non Christ like practices against fellow human beings. Every part of the Christian value system should reject and resist these practices. However in an effort to be a minority that is not dissenting and troublesome, Catholics close their eyes with indifference, shut their ears to the screaming voices and remain mute against atrocities. Catholics want to be a non-threatening and consequently non-threatened part of the Indian society. They accept discrimination and even worse practice it and in the process have failed to reach “the least of the brethren”.
Indian society is a caste based society. 15% of the upper caste population holds 75% of the assets. Power and elitism belong to the upper caste, as a hereditary right. The dalits have borne the brunt of generations of abuse and exist under the derogatory terminology called ‘untouchable’, although, legally, the practice of the caste system has been abolished under the Indian Constitution.
The combination of western ideas of class and the Indian concept of caste, have evolved within the Indian Catholic system, a quasi -upper caste power centre– a group that professes Christianity but aligns itself with ‘upper caste’ practices.
Historically, this quasi- upper caste group belongs to geographic or cultural backgrounds that had practiced discriminatory caste and class behavior prior to their conversion to the Christian faith. These groups counter the principle of equality that is intrinsic to the Christian faith. They draw clear lines between ‘them’ and ‘us’ – ‘us’ belonging to the ‘superior’ caste or class and ‘them’ belonging to those from dalit or tribal origin.
This discrimination and continued oppression manifests itself in most aspects of governance and management of Catholic institutions. Because the Indian Church is administered by this ‘quasi upper caste group’ and the voice of the ‘inferior group’ is mute, discrimination occurs through a collective pledge of silence and pretension.
In the Indian Catholic Church, the practices are seen in vocations to and power structure of the clergy, selection of decision makers, representatives in critical social and development areas, admissions and employment opportunities, practices of marriage, education and social networking. Admissions to St John’s Medical College for the medical and para-medical courses are glaringly discriminatory.
People who hold key positions in St. Johns are generally people from the Non Catholic ‘upper castes’ or their pseudo – counterparts from within the Catholic faith . These persons communicate a wrong message about the ideology of St. John’s – the message being transmitted under the guise of caring and advancement. They profess to put St. John’s on the ‘international’ playing scene. Catholics cannot pretend to be gullible victims of this trap. We cannot call ourselves an organization with Christ-like values and yet allow ourselves to be led into sinful practices of superiority and inferiority. All of us profess to be equal, but in an intrinsically casteist and racist society, we have to be forever watchful of being bitten by the very same bug that we profess to hate.
The non- Catholic upper castes, in collaboration with the quasi upper caste Catholics, block the essence of Christ’s faith and service. This practice of oppression is obvious but we don’t want to see. The people from the ‘lower castes and class’ who are selected into St. John’s live a life of shame and pretension. They are ashamed of their roots and adopt a complex behavior combination of insecurity coupled with false bravado.
We as an establishment and as followers of Jesus Christ cannot sit back and pretend that we do not see this mockery of Christ’s values on a daily basis. These selection processes give rise to a vicious cycle. People in decision making positions skew organizational goals in favor of material and social well being and power. Having no Christ like core values, they communicate the same to medical students.
The stated mission of St. John’s to train health care professionals who are ready to reach out to the medically un-reached of the nation lies in shambles One does not have to look too far below the surface to see that hardly any of St. John’s expressions of value based medical education are being practiced in reality.
Unless we acknowledge that there is pathological mindset in our midst we will fail to understand and acknowledge why our selection processes are so skewed and why our mission of reaching the medically unreached cannot be reached.
Can we ever hope to have a better role model for physical, mental and social healing of the Samaritans and lepers of our society than the one whose name we refuse to utter??
Harmonizing excellence with a commitment to social justice ?
There is a conspiracy of silence in St. John’s about the social determinants of health and no student will be able to provide a meaningful dialogue on aspects of social justice that determine health of individuals, the community or the country. Medical students are linked with tertiary services provided by the St. John’s hospital and are shockingly ignorant about the existence of poverty, inequity, discrimination and psychological abuse faced by millions of people on a day to day basis. Textbook values are useless to sensitize medical students about their role as healers and change agents in society.
St. John’s cannot take recourse to saying that 25% of our alumni (the religious sisters) stay permanently in under-privileged areas. Why don’t we train just that 25%? Why are we bothering with the other 75%? We cannot pretend that this is a small number and ease our conscience. We must question the nature of our Medical education and the value system we are imparting to our young students. The Community Medicine department at St. Johns neither provides a vision nor leadership to inculcate values of justice and equity in medical students.
At no time during my Medical course or during my Post graduation, have I heard teachers mention the social dimensions of health. At no time have I been told about millions suffering from poverty and discrimination. I have never been made aware of my important role in a mission of healing. At no time have I been asked to grasp the nature of my responsibility to my fellow human beings.
How can I choose a path that has not even been offered to me?
Is there a way forward?
-Simply practicing the teaching of Christ makes us secular. We propagate our secular nature by practicing the teachings of Jesus Christ. Jesus accepted everyone with love– there was not a man or woman rejected by him because of religion, caste, social background or color. The socially ostracized were accepted with love by him. As an organization, we have one abiding set of guiding principles and that is set by Jesus Christ.
-Let us also examine whether we want an external accreditation or an internal validation of our core commitments. Can we question ourselves and humbly acknowledge that we have failed to address and eliminate practices of discrimination within our own system?
-Let us take a conscious stand to minimize in St. John’s, the role of oppressors from other faiths and quasi upper caste groups from our own faith. Their ‘intellectual’ acuity cannot be an excuse for their lack of moral grounding. Let people with Christ-like values lead our organization even if they are slightly ‘less intellectual’. It would be a small price to pay in return for a peaceful soul and for a value based organization.
-St. Johns should not be ashamed to give Jesus Christ the rightful place as the Head of the Institution. It should neither compromise core values nor compromise quality. Indeed it should have a core value of developing a spirit of compassionate competence among its Medical students.
-Can we accept criticism and trouble to hold on to our core values?
-Can we train our medical students to understand and address abhorrent practices that intrinsically and inevitably contribute to ill-health?
-Can our teachers incorporate core values in medical students to understand and address social evils that influence every aspect of health?
-Can we incorporate the true spirit of the Alma Ata declaration on health as ‘a state of complete, physical, mental and social well-being, and not merely the absence of disease or infirmity?’
Are we ready to train health care professionals who are ready to reach out to the medically un-reached of the nation by harmonizing dedication to excellence with a commitment to social justice in health care” in the true spirit of the Mission of St. John’s ?
-Can we work towards stating, both in spirit and in practice that we do indeed have Christ like values? As St. Camillus said, can we ‘put more heart into our hands, brothers and sisters?
Are we ready to reach out…………….to those who really need us??