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a person’s sense of their own well-being. In Theresa’s case, her suffering was made considerably worse by the fact that her whole family had disowned her when she admitted to having the so-called ‘stigma’ of AIDS. She had been left to the care of some voluntary nurses who worked at a Catholic centre on the compound where her small house was situated. They were able to call on her a few times a week, with a little food, and some oil to rub into her ulcerated skin. The obvious emotional distress of being abandoned by her family simply compounded the disease itself.

      Yet others think of health primarily in relation to what we may call ‘sicknesses’. We can understand this as a social definition. A person is sometimes said to be ‘sick’ if they do not fit in with society’s understanding of what is ‘normal’ and ‘healthy’. A few decades ago, behind the Iron Curtain, a person who did not comply with society’s political ideas was defined as ‘sick’, and treated in a psychiatric hospital. Others are defined as ‘sick’ if they do not conform to what society expects of them because of their sexual orientation, or the shape of their nose, or some mental handicap; sometimes it can even be the process of simply growing old. Of course, it may be that ‘society’ itself is ‘sick’ rather than the individual who does not fit in. Either way, someone’s social environment can be significant in relation both to disease and to illness.

      For Theresa, her situation was made even harder by anxiety concerning her two young children. They attended a school where 75 per cent of the pupils were affected by the HIV virus within the family, and many were already orphans. When I visited the school of 730 pupils, there was a staff of ten, only two of whom were trained teachers. The sad fact was that there were several thousand unemployed teachers who had been fully trained in Zambia, but they were unemployable through lack of finance. There were insufficient resources for proper care of the children – what would ultimately happen to Theresa’s? The ‘sick economic context’ of Theresa’s society was a major factor in her own health and that of those around her.

      To give a different example, down the middle of the street in Matopeni, one of the slums of Nairobi in Kenya, is an open sewer in which human waste and all other rubbish is thrown. There is a little bridge over the sewer, and people walk across this and children play and scavenge nearby. No clean water there, or toilets, or showers. The brute fact is that one in eight people on this planet has no access to clean water. Matopeni is a small settlement. Sixty per cent of the people of Nairobi live in slums. Matopeni means ‘in the mud’. There is little dignity there, and health is poor. HIV and typhoid are widespread. There is lack of education, bad housing, bad food, bad clothing. So morale diminishes, behaviour becomes antisocial; men drink too much; and the young girls go into the sex industry to try to scrape together enough money to feed the children.

      One local woman, Catherine Kithuku, caught a vision for change, and became determined to improve living standards. Catherine and her friend Veronica set up a community group, mostly made up of single mothers, concerned for the welfare of their children. With support from a local Christian Aid partner organization, Catherine Kithuku has been working for the Matopeni community to construct a water and sanitation block to improve health and generate a small income. This is her prayer:

      I pray for change. I pray to live a clean, comfortable life, with privacy. I pray to see my family move out of slum life. I would ask people to pray for better housing, for children to be educated, for jobs for the young people, and support for single parents and the elderly. But most of all I pray for clean water. Without clean water we get sick. We have a lack of money and cannot afford to buy water. It will help bring a change in attitude. People will clean themselves more; they will clean their houses more; it will lead to a clean environment in more ways than one.[3]

      ‘Health’, then, is a broad term. It covers viruses and bacteria, and deals with the body as a functioning biological whole. It affects the individual person at many levels, physical, biological, psychological, social, moral and spiritual. Health is related to families, the individual person in a network of relationships with other people. It reaches out into the neighbourhood. The social setting of our lives impinges on our health in many different ways. Another dimension of health is ecological: the wider environment of clean water, traffic noise, air pollution, climate change.

      The Christian ministry of healing must concern itself with all these aspects of health. From the management of disease, to nursing care; from learning through suffering to finding new ways of being strong and healthy. Christians will be interested in surgery and medication, concerned with emotional health, counselling and therapy. Christians will care about the social pressures that make for illness, and seek for justice, which is the expression of love in our social environments. Christian concern will extend to the wider environment of the planet, the air we breathe, the quality and sufficiency of food supplies, the need for clean water. Health will embrace the whole of our spiritual environment before God. We are concerned not only with removing what is wrong, but with promoting what is healthy: community care, public health, spiritual well-being.

      A whole person

      Underneath these Christian concerns is the conviction that a person is not to be split up into different parts, but thought of as one spiritual–psychosomatic whole.

      We recall the prayer in 3 John, where the author prays for ‘good health’, and then adds, ‘just as it is well with your soul’ (3 John 2). The impression is given that body and ‘soul’ are separate parts of the person. In fact, they are better understood as different perspectives on the whole person. Even the New Testament phrase ‘spirit and soul and body’ (1 Thess. 5.23), which looks as though it splits us up into three separate components, is used to refer to the whole person from different points of view. The nineteenth-century biblical scholar J. B. Lightfoot comments on this verse that ‘spirit is the ruling faculty in man . . . through which he holds communion with the unseen world’; the soul is ‘the seat of all his impulses and affections, the centre of his personality’; while the body ‘links him to the material world and is the instrument of all his outward deeds’.[4] In the history of the Church there have indeed been times when Christians have operated with a split view of matter versus spirit, body versus soul, but today many are returning to the view – much more characteristic of the Bible as a whole – that human beings are complex creatures, functioning at many different levels, and in whom body and emotions, relationships and environments are all part of what it is to be human, and all these aspects have their part to play in our understanding of health. One contemporary biologist cautions against a ‘reductionist’ view:

      If humans are to be understood essentially in terms of genes and their products, then illness is to be corrected by manipulating them. The result is drug-based medicine and genetic counseling or engineering. These can be extremely effective in certain circumstances, but medical care based on this approach focuses on illness rather than on health.[5]

      Shalom

      To explore a Christian understanding of health, we need to turn to the witness of the Old and the New Testaments. We begin with one significant Hebrew word: shalom.

      Most frequently translated ‘peace’, shalom means much more than the absence of conflict. It is also translated as good health, favour, completeness, prosperity, rest, welfare. Shalom carries the sense that all is well, peaceable and safe. Therefore shalom is much more than the absence of disease, broader even than the absence of feeling ill. Health is part of shalom, the wholeness of life whereby each dimension of our being – physical, relational, emotional and environmental – is open to God and God’s ways. The vision of peace in Isaiah 2.1–5, which could almost be a definition of shalom, is set in contrast to the sickness of the nation (1.5–6), its idolatry (2.6–22) and the social injustices (3.13–15) that bring the judgement that the Lord will not be a healer (3.7b).

      It is a longing for shalom that the psalmist expresses when he writes: ‘There is no soundness in my flesh because of your indignation; there is no health in my bones because of my sin’ (Ps. 38.3). It is shalom that the psalmist celebrates: ‘Let those who desire my vindication shout for joy and be glad, and say evermore, “Great is the Lord who delights in the welfare [shalom] of his servant”, (Ps. 35.27).

      The social dimension to shalom becomes very evident in Jeremiah’s plea that the exiles should pray for

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