Beholden

What does it mean, Susan Holman asks readers in this book’s title, to be beholden—that is, to be obliged or duty bound to others? How does the answer to this question change when these others are people of faith providing assistance around health in global contexts? As a historian whose work crosses the fields of religion and health, Holman addresses these questions through a series of cases in which religion contributes to what she calls ethical tensions in global health today.

The book opens as Holman finds materials by Benjamin Rush among family papers. A leading nineteenth-century physician, advocate on a range of social issues, and serious person of faith, Benjamin Rush was one of many early physicians who took special religious concern for caring for the poor. His approach and reasons for doing so were his own and lead nicely into the case studies that follow. Holman is primarily concerned in each subsequent chapter not just with the relationship between religion and health, but with ideas of charity, human rights, social justice, and moral obligation that underpin these relations.

The second chapter focuses on pilgrimage and global health through stories of people traveling in search of physical or spiritual healing. Holman takes readers from a contemporary Hindu pilgrimage festival in India, to broader meditations on the meanings of water, to global health questions about whether water is clean. All of these stories, she argues, show that global health and related questions of rights, entitlements, and faith-based actions are not primarily about international aid but are part of everyday life. Faith-based approaches to global health, Holman argues, call for broad frames and multiple stories.

Holman returns to  Rush and a second nineteenth-century American physician, Henry Trevitt, in chapter 3. Through detailed descriptions of each of their lives and work, Holman shows how difficult it is to disentangle the public from the private, and the role of religion in health-related spheres. These stories help illuminate how people in power  justify their health-related aid efforts, Holman argues, and how everyday experiences have global impacts.

The fourth and fifth chapters explore human rights—economic, social, and cultural rights as a formal concept—and assets-based approaches to community development. Everyone active in faith-based responses to poverty, Holman argues, needs to be knowledgeable about the rights framework and able to engage it across religious differences, despite the fact that formal documents say little about religion. This chapter lays out the history very well. Discussion of religious health assets in chapter 5 is also thorough and thoughtful. Holman shows how the concept developed out of the African Religious Health Assets Programme (ARHAP), and has since traveled to and developed in the American context, especially through Gary Gunderson’s work in Memphis. While questions about the model remain, Holman nicely uses it effectively to make a case for the challenges faced by public health professionals, which must be addressed in order for religion to be taken seriously.

I was most intrigued by the final chapter, in which Holman pulls together themes from earlier chapters to explore what is wrong with gift-based aid, and to ask what it means to help others in ways that promote individual and communal health through tangible assistance. She focuses on food and water—substances central to aid and to many religious rituals—to offer meditations on reciprocity, the moral value of gratitude, and the relationship between gifts and solidarity assets in community building. Through a kind of theology-in-practice she encourages those working for global health to include a broad range of perspectives, including the religious, and to pay attention to lessons learned about ethical approaches to wealth and poverty historically. Rather than offering prescriptive advice, Holman concludes by encouraging readers to learn and listen more, and recognize that all actions are contextual.

This book is beautifully written and individual chapters could be assigned in courses in religious studies, theology, and history. The guiding questions are thoughtfully articulated and Holman is clear, especially in the final chapter, about how her own experiences as a Christian shape, and ground her perspectives. Such reflections might be fruitfully put into conversation with those from other religious traditions in ways that continue to bring together scholars, people of faith, and healthcare professionals to continue this conversation in all of its religiously diverse forms.

Wendy Cadge is Professor of Sociology and Women's, Gender and Sexuality Studies at Brandeis University. 

Wendy Cadge

Date Of Review:

July 19, 2016