Convivial health

Many Filipinos are aware of what “congenial” is, thanks to our obsessions with beauty pageants and the selection of a Miss (or Ms.) and Mister Congeniality, for whoever has the friendliest and most pleasant disposition.

Convivial has related meanings. In Latin, a convivium is a banquet in the sense of eating and being merry. Extended further, it’s enjoying not just good food but good company. A related word, convivere, means to live together, happily.

In recent years “convivial” has been used in the social and environmental sciences to refer to the need to find ways to live together, not just humans but all living creatures, together with the environment. “One Health” is now taught in various universities dealing with human health sciences, as well as in veterinary and animal sciences, agriculture, and a wide range of environmental sciences.

The trigger for all these developments has been the climate emergency (also known by older terms like climate change). At medical and allied health professional schools and veterinary colleges, I’ve found myself revising earlier lectures on One Health toward more concrete and positive, lectures on “conviviality.”

Starting this year, I’ve been more directed toward the future, explaining how human and veterinary health care will need to deal with issues that haven’t even made it into textbooks yet but will be major problems in the next few years.

This year’s global heat wave—the worst in recent recorded history—caught many countries unprepared. I’ve been writing about this since March this year, noting how countries have been issuing health warnings that are measured not just by temperature but by combinations of temperature with humidity (so-called “wet bulb temperatures”). It’s actually residents of tropical countries who take the heat lightly thinking, “Oh, we’re used to hot weather, a few more degrees won’t make a difference.”

But the heat wave can make a drastic difference. In Arizona, for example, hospitals found themselves having to admit patients who suffered foot burns by simply walking on sidewalks that had become very hot.

The heat wave has increased the number of “mysterious” cases involving patients losing consciousness or dying, relatives, and even health professionals thinking it’s a stroke … which is sort of accurate except it’s heat stroke.

I’ve found myself warning friends of all ages (including my children), to make sure they have their water tumblers with them when they go out, and not to get dehydrated from the heat. One of my daughters discovered “pup cups” that you can order from Shopee or Lazada, cleverly designed low-cost contraptions that allow you to keep water and snacks in a container with two separate spaces, water easily poured into and out of a built-in cup. They’re not just for pups but for older dogs, and cats. Vets need to warn their clients that dogs and cats do die of dehydration, as many did during this year’s heat wave.

Climate change is also affecting the habitats of all kinds of insects and microorganisms that can cause disease. Dengue’s geographical spread is taking new patterns with climate change, with reports in new areas like Southern Europe and southern Brazil.

Ticks (garapata), long known to pass on diseases in warmer climates, are now creating problems in cooler climates. In China, scientists looked at four species of ticks and found their distribution has shifted from southern China toward the north because of a combination of changes in temperature and rainfall as well as a reduction in forests.

Since my family lives with so many dogs and cats, whenever someone comes down with a “mystery” disease, I have to look at the type of contact between humans and nonhuman animals, and plants, and the interactions with the climate for possible explanations.

I worry that the existing medical and veterinary curricula are already so packed, making it difficult to insert convivial health topics but neglecting these emerging trends in health and disease may mean more mysterious causes of illness and health in the years ahead, misdiagnosed or treated inappropriately.

Convivial health is learning to understand the complexities of living together with all creatures great and small, and in different types of environments, natural as well as human-made (also referred to as built environments). As I type this, I look at one of my dogs who I take with me most places, including school and office, where she provides endless comfort and solace to stressed staff. I know, too, I have to be responsible enough to make sure she doesn’t bring in fleas and ticks and knows where to pee and poo. That’s all part of conviviality, living happily … and healthily together.

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mtan@inquirer.com.ph