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Yoga Therapy and the Health of Refugees

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Yoga Therapy and the Health of Refugees Faculty of Humanities Centre for Human Rights Education Yoga Therapy and the Health of Refugees Narayan Gopalkrishnan This Thesis is presented for the Degree of Doctor of Philosophy of Curtin University February 2012 1 Declaration To the best of my knowledge and belief this thesis contains no material previously published by any other person except where due acknowledgement has been made. This thesis contains no material which has been accepted for the award of any other degree or diploma in any university. Narayan Gopalkrishnan February 2012 2 Acknowledgments This thesis is the product of the support of many people whose generosity, compassion, time and assistance has sustained me in different ways to this point in my life. I offer my heartfelt thanks to each and every one of them. I would like to specially acknowledge the following people: My partner through this wonderful journey of life, Hurriyet Babacan. Thank you so much for the strength and wisdom that you have shared with me over the years and I look forward to sharing many more years together. My mother, Usha Gopalkrishnan. Thank you for nurturing me towards developing a strong sense of social justice and a desire to work towards a better world. You taught me that age is no barrier to learning and doing. Vinitha Nayer, for being a great influence in my life. Thank you for the care and love you have provided for me over the years. Hari Nayer, you have always been there to pick up the pieces. I especially thank you for putting up with me in my young and heedless days. Sushil and Jane Pillai. Thank you both for helping us to survive very troubled times. I really value your guidance and support. Tahsin and Fatma Babacan. I deeply appreciate the open hearts with which you accepted me into your family. You really helped me to make the transition into a new country and a new relationship. All of you did, Alperhan, Bilge, Davut, Yasemin, Nazim and all the younger generation. Thank you all. Nandita Nayer, for the wonderful human being you are and all the love and care that you have added to our lives. Ece and Justin, much of this thesis was written at the dining table in your house. Thank you for everything, especially over the last couple of years. Difficult times become much easier with the support of good people. Linda Briskman, a wonderful supervisor and a terrific human being. I am indebted to you for the ideas, encouragement, motivation, guidance and care that you gave me 3 through this thesis. I really appreciate the time and effort you put in, above and beyond the call of duty and I am grateful for the unwavering belief that you had in me and in my research passion. Karen Soldatic, for the intense effort you have put in to get me over the line. Your feedback was constructive, detailed and uplifting. I thank you for the rigor with which you went through the different incarnations of this thesis and am very appreciative of the fact that you were going through drafts of my thesis in the most unlikely places, even while you were on holiday! Mitra Khakbaz and Behice Bagdas, who have been the most loyal, loving and supportive friends that one could ask for. Thank you for being by my side all these years, through all the good times and the bad. Jenny Adams, thank you so much for all the help and encouragement you gave me. Your help was invaluable in completing this research. Judy Singer, for all the generous assistance you provided me, including all the wonderful people that you put me in touch with. Your thesis was a great benchmark for me and I look forward to working together in the near future. All my yoga teachers at Kaivalyadhama, Lonavala, Krishnamacharya Yoga Mandiram, Chennai, and at Yoga Vidya Dham, Nasik. Also a special acknowledgement to Simon Borg-Oliver, a great yogi and a caring teacher. Multicultural Development Association, a wonderful organization that it has been my privilege to work with over the years. And Kerrin Benson, thanks for all the help. Kelly Yip, Jose Zepeda, Uri Themal and all the other wonderful people I have worked with in Australia. Joe Madiath, one of the main pillars of community development in India and someone I consider my mentor. Thank you also to all of the Gram Vikas staff, I really enjoyed our years together. The Bhima Soara people of the Mahendragiri ranges, for teaching me how to live life all over again. 4 Nivedita Menon, for helping me to take the hard decision to leave the corporate sector to work in the community sector. All my colleagues at JCU, thank you for the wonderfully supportive environment and collegial encouragement and I look forward to some great times. Last, but not least, I sincerely thank all the participants who agreed to give of themselves, their time and their work. Without all your involvement this research would not have been possible. I would particularly like to acknowledge participants of refugee background for generously sharing your stories and opening your lives to me. 5 Abstract Refugees settling in Australia have many physical and mental health issues prior to arrival, issues that can be exacerbated by the settlement process. In Australia, the health needs of refugees are largely managed through a biomedical approach involving medication and/or psychotherapy and counseling. This approach stems from a clear separation between systems that deal with physical health issues and those dealing with mental health. The biomedical basis for working with refugee health issues has been useful up to an extent as the framework is very effective at disease control and prevention but is not so effective for chronic disease that is linked to multiple behavioral, socio-cultural as well as biological factors. Further, there are a number of other aspects of refugee health that biomedicine is unable to respond to effectively, such as cultural differences in understandings of health and illness, causality and healing, mind/body duality, as well issues of power relationships and structures. There is increasingly within Western medicine an awareness of the embodied interface between the spiritual, the social, the psychological and the biological being. Scholars argue that an integrated or holistic paradigm that incorporates the different aspects of health, including the biological, the psychological, the social and the cultural, would make for far better outcomes in terms of the health of refugees than the biomedical by itself. This thesis examines the role that yoga therapy, as a complementary therapy, can play in responding to the complex health issues of refugees settling in Australia. The research presented in this thesis utilized qualitative research methodology involving a literature review and document analysis, in-depth interviews and focus groups. The participants included people of refugee background who had taken part in yoga programs in Australia, as well as support workers, medical practitioners and complementary therapists. The thesis describes the perception of the health of refugees settled in Australia among service providers and refugees themselves, and the key factors impacting on this. It further looks at the existing mainstream responses in Australia to the health needs of refugees. It then critically analyses the role that complementary therapies like yoga therapy can play, and concludes that, particularly if they are incorporated within an integrative medicine framework, they have a significant contribution to make towards supporting the health needs of 6 refugees. The thesis argues that holistic systems that address different levels of being and incorporate biomedical systems as well as complementary and alternative medicine systems (CAMs), such as yoga, massage and tai chi, will support the health needs of refugees in a culturally appropriate and effective way. The thesis finally presents recommendations of strategies for future policy and practice. 7 Table of Contents Declaration ............................................................................................................................... 2 Acknowledgments .................................................................................................................... 3 Abstract .................................................................................................................................... 6 Table of Contents ..................................................................................................................... 8 Abbreviations ......................................................................................................................... 11 Introduction: Yoga Therapy and the Health of Refugees ...................................................... 14 The Path to Yoga Therapy and the Health of Refugees ..................................................... 18 The Aim of this Study ......................................................................................................... 21 Significance of this Study ................................................................................................... 22 Researching Refugees ........................................................................................................ 23 Thesis Map ......................................................................................................................... 25 Chapter 1: Methodological Considerations ........................................................................... 30 Philosophy of Research .....................................................................................................
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