When religion and healthcare collide

Savita Halappanavar is a name which Ireland will not easily forget. Nor will India.

Six years ago, I remember writing about the 31-year-old dentist of Indian origin who had arrived at the University College Hospital in Galway with a back pain complaint. She was 17 weeks into her pregnancy and a miscarriage was suspected. For three long days, the young woman pleaded to have her pregnancy terminated. But doctors at the Irish hospital refused. In Catholic Ireland, the law did not allow termination of pregnancy as a standard procedure. A doctor was not permitted to terminate a pregnancy except in an emergency situation. There was a foetal heartbeat; the doctors didn’t want to take a chance. They waited, and then it was too late. Savita contracted an infection and died of blood poisoning.

Savita’s family, and activists in Ireland and around the world, have argued that her life could have been saved had the foetus been removed sooner. The medical staff had reportedly refused her desperate pleas because there was still a foetal heartbeat.

The tragedy was a defining moment. Outrage at the unnecessary death of an young woman mounted, sparking mass protests within Ireland and across the world about the interference of religion in medical science.

On Saturday, Savita Halappanavar was back in the news. There was finally something to celebrate. Pro-choice campaigners in Catholic Ireland had won overwhelmingly in the country’s abortion referendum. They voted for a change in the law. This will pave the way for the Irish government to relax its abortion laws.

Today, there is a mural bearing Savita’s image in Dublin’s Portobello district. There are flowers and tributes from people who flocked to pay their respects.

Savita died needlessly. But her death galvanished a movement that made sure others would not suffer her fate. Savita’s death has also sledge-hammered the stark reality of what can happen when religion is allowed to collide with medical science.

This isn’t just an Irish story. Countries around the world are grappling with tensions between religious traditions, culture and medical science. The friction affects the health of millions of people. In the United States, this has been a big issue for long. In 1989, two Christian Scientists were put on trial for murder as their seven-year-old daughter had succumbed to diabetes. The child’s parents had never taken her to a doctor. At stake were conflicting notions of the parents’ right to religious freedom versus the State’s duty to protect the lives of its citizens.

In another reported case in the United States, two Christian Scientists were convicted of manslaughter for depending on prayer rather than medical treatment to heal their two-and-a-half-year-old son. The child died of a bowel obstruction in 1986.

Astoundingly, more than 40 US states allow exemptions to vaccination for religious reasons. A US-based NGO called CHILD Inc actually tracks religion-based medical neglect.

This is the situation in the developed world where religious obscurantism continues to hold sway over vast numbers despite formal education and wealth.

What about India, where millions remain unlettered and mired in abysmal poverty and where the sickly poor are more likely to turn to neighbourhood quacks than science?

Indian laws are not typically incompatible with the dictates of public health but it is equally true that often religious and cultural taboos trump the law, affecting health adversely,

Once again, the issue is not about education or money. Many years ago, I remember a woman working in an international agency telling me about her ailing newborn child. It was the month of December. The family had gone to Hardwar for a holy dip in the Ganga. Along with the adults, the baby also took a dip. Anyone with common sense could have foreseen what would happen next. But not this family. The child almost died of pneumonia but the faith in the all-healing holy dip has remained.

Then there are food taboos. There is a 2012 academic study titled “Beliefs Regarding Diet During Childhood Illness” in the Indian Journal of Community Medicine. Authors Asha Benakappa and Poojita Shivamurthy point out that the vast majority of childhood diarrhoea and respiratory infections — between 50-70 per cent — is exacerbated by “food restrictions during illness due to false beliefs, leading to a vicious cycle of malnutrition and infection”.

“One’s belief in food is strongly dictated by one’s upbringing, superstition and religion,” the authors noted.

Distressingly, it does not matter if the caregivers are educated. In my travels through rural India, I have found that family elders and religious beliefs continue to be the main influencers when it comes to critical issues like breast-feeding and diet. Unscientific beliefs persist, causing death and sickness.

There are many reasons why this is so. One key factor is India’s social and educational system that doesn’t really encourage questioning. That there are some questioning minds is despite the system, not because of it.

Laws alone can’t eradicate religious and cultural beliefs which collide with medical science. Narendra Achyut Dabholkar, a medical doctor, rationalist and founder of the Maharashtra Andhashraddha Nirmoolan Samiti (MANS), the Committee to Eradicate Superstition in Maharashtra, was murdered in 2013 as he relentlessly campaigned against superstitions, dubious tantriks and assorted “holy men” who promised “miracle cures” for ailments, and preyed on the gullible.

His home state has enacted the Maharashtra Prevention and Eradication of Human Sacrifice and other Inhuman, Evil and Aghori Practices and Black Magic Act, which criminalises black magic, human sacrifices, use of magic remedies to cure ailments and other such acts which exploit people’s superstitions. But obscurantism continues to hold sway, endangering lives in the state and elsewhere in the country.

Ireland has paid a grand tribute to Savita Halappanavar. Now it’s our turn. Faith can be a positive influence. The problem is blind faith, which refuses to distinguish between harmful and harmless practices. India can pay homage to Savita by stepping up the fight against those regressive practices and beliefs which adversely impact the health of millions of men, women and children.