Medicine & Compassionate Care

Written by Kalei Hosaka //

Anand was the kind of person who could challenge the world’s darkest cynicism. Despite having lived with HIV for essentially his entire life, Anand found ways to joyfully inspire others—not least his peers also living with HIV. Anand found ways to bring hope into a community that had lost sight of it it. 

I met Anand for the first time in 2015 on a cool, October morning in Delhi, India, while I was an intern with Shalom [AIDS] Delhi (as part of Wheaton College, IL’s Human Needs and Global Resources program). Shalom is a community health clinic that serves neglected HIV patients from the Delhi slums; Anand was part of a support group for HIV-positive adolescents run by Shalom that I occasionally attended.

Anand died earlier this year (2017)— succumbing to AIDS at the age of seventeen.

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I first made the decision to study medicine after spending time with a family physician who told me that his greatest moment as a doctor was accompanying one of his patients with end-stage cancer to see her son graduate from high school before she passed.

From the beginning of my journey to the medical profession, my passion to work in health care has always been about helping people and communities in their most vulnerable situations, particularly those near death. Over the years, I have learned that being a physician comes with a kind of joy that cannot be found in any other profession. After all, the practice of medicine comes with the enormous privilege of (and power to effect change by) being both a healer and a teacher – providing pastoral care and alleviating physical suffering.

However, it does not take long for us to realize that the extent of physical suffering is largely unequal. A community’s health or illness is tied with historical legacies, socioeconomic position, citizenship status, and others—the so-called non-medical social determinants of health.

This point is epitomized best by the HIV/AIDS epidemic because social and economic inequalities have been central to the spread and treatment of HIV. HIV is a disease that concentrates itself among the most marginalized communities, including injection drug users (IDUs), sexual minorities, and poor migrant workers. Similarly, those who live in crowded areas (e.g. slums) and those who are malnourished are much more susceptible to Tuberculosis, a disease that causes millions of deaths per year globally (and not least within the HIV community).

Health (and disease) for many is the consequence of social, economic, and political inequalities. The disparities in prevalence of acute and chronic diseases are sobering, even in the United States. Native Hawaiians are nearly 3 times as likely to be diagnosed with diabetes than Caucasians in Hawaii (and are more likely to die of heart disease and cancer).  I presume the situation is not much different in other indigenous populations. Black males in the US are 21 times as likely to die of HIV/AIDS than their white counterparts. People who grow up in affluent countries are likely to have lifespans that are decades longer. Physical health simply cannot be separated from sociopolitical realities.

Yet, through Anand and the Shalom team that cared for him, I learned that not all hope is lost when it comes to sickness and disease. You see, a medical practice oriented by a vision of restoring peace and justice has the power to heal communities. A clinic like Shalom whose mission to compassionately care for whatever patients come through its doors gives people with HIV (who have suffered tremendously both physically and emotionally) the opportunity to experience healing and transformation.

Of course, as with any profession, the healing power that comes with the practice of medicine can be used for self-serving purposes; but it also can be a tool to the benefit of communities. Thus, on a personal level, addressing injustices in physical health is about solidarity. Future healthcare providers must decide where they will work and live, and which population they will work with. Where someone chooses to live has implications not only on the kind of family she wants to raise but also on the community’s health. Furthermore, praxis-oriented health service allows for opportunity to engage in political advocacy in order to create a society that better cares for people on its margins.

Regardless of the profession we are in, I believe that we are to be faithful to our call to work towards justice in the communities we live in. My decision to practice medicine and improve the physical health and wellbeing of underserved communities is ultimately about justice. Medical professionals have the privilege of crossing traditional barriers—both sociopolitical and personal—with the goal of alleviating suffering of individuals and communities. For me, that makes all the difference.

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Kalei Hosaka lives in his hometown of Kaneohe, Hawaii, (on the island of Oahu) and is a medical student at the University of Hawaii at Manoa’s John A. Burns School of Medicine. He is a member of the school’s certificate of distinction programs in both Native Hawaiian Health and Social Justice. He is an alumnus of Wheaton College’s (IL) Human Needs and Global Resources program, and studied Cultural Anthropology (BA) and pre-medical studies during his time at Wheaton.