The holistic concept of health is not only the body, but also the interrelated condition of human mind, society and culture. If we want to improve health, social justice, cultural sensitivity and emotional balance must all be addressed.

Therefore, an effective and equitable health system is only possible if all these dimensions are covered when creating health policy, service or educational curriculum 

The concept of humanitarian medicine or health has been expanding worldwide for the past few decades. Its main objective is to develop a more humane, sensitive and holistic approach to health education. This concept seems even more relevant in a culturally diverse country like Nepal, full of inequality and public health challenges.

Human health education refers to the practice of understanding and teaching the dimensions of health, patient experience, health systems, life and death through literature, art, philosophy, history, sociology, human behavior and culture. It adds human sensibilities, critical thinking, and moral conscience to the traditional biomedical approach focused on science and technology.

Its initial use in Nepal

Under the guidance and leadership of the then Vice-Chancellor Rajeshnath Gongal, Patan Institute of Health Sciences, this concept was implemented for undergraduate medical students from 2018, and since 2021, teaching and learning has been expanded according to this concept in undergraduate nursing of the institute.

Life, experience, old age, persons and families dealing with disabilities, expectations of health workers and patients and their families, and dreams of people facing the end of life and the responsibilities of health workers are the main themes of humanitarian health education. This category is equally important for all people, but it is very necessary for health workers. 

Its method of study is participatory. Where different situations of life and the world are exchanged, self-thinking or artificial situations are created and students learn how to speak and behave with patients, their relatives, how to see patients in society. The role that people should play in personal and social life is taught by discussing and debating about perspectives, social reality and dimensions related to human rights and individual's self-esteem.

During its learning, students are introduced to various literature, art, acting and interaction. The reaction they get from the society to the students who pretend to be disabled and go out on the busy street, they get life lessons. 

is an important part of this genre to make people aware of the social exclusion, financial problems, harsh words faced by people with disabilities and their families with their one-hour experience. Apart from that, the students are discussed about solving the inhumane activities in the society.

Our experience to date has shown that students who are limited to studies focused on medicine or disease treatment do not adequately understand the patient's emotions, background, or cultural sensitivities. But when they learn through poetry, stories, drama, art, or personal experiences, their perspectives broaden, and they become more responsible and empathetic health professionals. 

Reflections written by medicine and nursing students,  Group discussion, self-examination has further strengthened the importance of this subject   From the new academic session, we are also starting its practice at the post-graduate level of public health, because health care is not limited to medicine or hospitals only; It is a subject intertwined with community, faith, culture, and social behavior.

For example, what was the community's understanding of beliefs, communication styles, or social distancing during the pandemic? Answers to these questions may come from human health. Public health students have the opportunity to understand health disparities, gender disparities, or disparities through creative writing, real events, art, or drawing.

opportunities

In a socially diverse country like Nepal, a doctor or health worker needs to understand not only the treatment of physical diseases, but also the patient's life experience, economic situation, social status, and mental state. Through human health, students explore narrative writing, autobiographical studies, and art-based expressions of illness. E.g.: Through depictions or dramas of pain, they begin to experience the patient's feelings directly.

Such practices bring about positive changes in health workers' empathy, listening skills, and communication style. Influenced by this, healthcare workers practice seeing clients as empathetic people, not just numbers, which improves service quality.

In Nepal's various communities, health-related beliefs and practices are deeply intertwined with culture, religion, myth, and oral history. For example, understanding traditional practices during childbirth, popular beliefs about illness (eg, malnourishment), or traditional healing practices in different communities can be effective tools. Local arts like

, cultural expressions like songs, stories or folk dramas can also be powerful means of conveying the message of health education. The teaching process of this method is also done by the community itself. By being receptive, students develop respect for culture, communication skills, and trust-building skills.

Nepal's medical and other health-related educational institutions have been mainly science-centered until today. But a single topic is not enough to understand multifaceted health issues (eg: mental health, gender-based violence, geriatric health, acute trauma). The inclusion of human health in such contexts will equip future health workers with critical thinking, ethical decision-making skills, and a broader perspective, which will ultimately contribute to policy formulation and even behavioral interventions.

On the other hand, art is a means of deep expression of human feelings and thoughts. When the experiences of the sick, disabled, elderly, or mental health are presented through stories, poems, paintings, films, or theater, the message becomes more alive and effective.

In Nepal, there is still a tendency to view mental illness, disability or old age as sins of previous birth. But if such theme-focused art exhibitions or documentaries prepared by students develop sensitivity towards problems and a social justice approach in the local community. In this way, the relationship between art and medicine can serve to enhance public dialogue, remove stigma, and create new contexts for policymaking.

Challenges

Nepal's medical and other health education systems are still based on rote knowledge, fixed curriculum and exam-oriented assessment. It does not encourage the student to think creatively, question or understand a problem from a multi-dimensional perspective. Developing interdisciplinary skills or competencies such as human health that requires empathy, ethical thinking, and responsiveness to social contexts, which may be unsupported by current structures and colleagues, is always a challenge. Even

teachers are not enthusiastic about such a subject due to the syllabus burden, lack of time, and exam-oriented mindset of the students. For example, it is not a big deal to read about a drug or test method, but to know how to use that drug or test method. Rather, the ability to understand the patient's fear, pain or social situation is just as important. Junkura will be more important to complete the education .

The lack of sufficient human health teaching staff, teaching materials in Nepali language, and lack of related studies is also a challenge. Most of the content is based on a western context, which is not very compatible with the Nepali social structure or cultural sensibilities. For example, caste discrimination, gender-based violence, poverty, or entrenched social beliefs shape the Nepali patient experience.

A curriculum created without such specific social context gives students only a superficial understanding. Likewise, the practice of teaching through literature, visual arts, music or storytelling in Nepali educational institutions is also weak. To teach such a subject, one should collaborate with a writer, dramatist or anthropologist - but this trend has not yet developed.

On the other hand, there has been a strong opinion in the health education system - the serious thing is that subjects like anatomy, physiology, pharmacology, surgery should be studied, the rest is learned that way . That is why human health is still considered by many to be an emotional, non-technical, or unproductive topic.

It seems that some teachers are worried that such learning will waste the students' time and that students will fail in the internal or external exams because they cannot pay enough attention to the hard science subjects that should be studied. But the reality is that the health profession is also a social, ethical and cultural practice, in which the ability to 'empathize with the suffering of others' is very important.

For example, listening to a person's autobiography allows students to understand the depth of mental health, which may not be covered on the bookshelf. Such things or events have a profound effect on a person's behavior.

While discussing education, the core element of the education system is – assessment. Current health education examination systems measure student learning based on multiple-choice questions, practical tests using predetermined practice methods, or theory tests. But what human health teaches—listening skills, humanity, ethics, and maturity in perspective—can't be captured by any of these common measurement systems.

Therefore, an alternative evaluation method should be developed for this. Eg: reflective experience diary life narrative essay; art or visual presentation; Evaluation based on group or individual feedback should be considered. But unfortunately, if health-focused schools teach only easily measurable, subjects, future education will be incomplete where  A sensitive but abstract subject like human health cannot find space. In the

conclusion, 

Although the use of human health in Nepal is still in its early stages, its potential is wide, especially when we teach students how to deeply understand the multifaceted and human aspects of health. In addition to academic knowledge and skill development, this learning method can also change the humanization of the health system, access to services and acceptability.