Health & Disease

Permaculture and Healing — Part 1

Looking at Healthcare Through the Lens of Permaculture

Permaculture is a flexible tool and means many things to different people. Often those who put permaculture into practice in their daily lives, whether through land management or other means, are interested in finding not only a way to design our food and garden production but also to redesign other aspects of our lives, including many elements of mainstream society.

This is hardly surprising; permaculture is very practical and one of the things a trained practitioner can spot when looking through its lens is inefficiency and loss of energy or pollution. These are often present in the systems within which much of mainstream society is enmeshed.

Eating for health

The most common system which we aim to step away from by using permaculture is that of industrialised monoculture food production; by using permaculture we can design systems which provide a holistic, sustainable or ideally regenerative alternative to the wasteful, inefficient and destructive methods employed by those who produce food using large-scale chemical-intensive agriculture systems. But can we also utilise permaculture to help us provide alternatives to other aspects of the society so many of us have experienced so many problems within?

There are myriad ways in which we can obtain our food or change our diet in order to make it more holistic and ecologically sound and this can very often lead to enhanced physical health in our bodies. Nevertheless, the problem of illness remains, and what happens if we do get ill? This article will explore the use of permaculture as a tool for healing, one that can aid in the transcendence of so-called ‘mainstream’ medical thinking and which can be applied on a personal and community level.

Medical nemesis

Many have pointed out that there appears to be a correlation between the establishment of institutionalised agriculture and the rise of socio-economic problems among human communities (1). It seems that human food production as a part of the production of the ecosystem as a whole helped our ancestors to live in balance with the natural world.

On the other hand, once large-scale grain agriculture was established, and with it the seemingly paradoxical need to have many people all living in a small space where they can tend the grains, while at the same time having to clear all available land for the grains to grow to ensure that all those people have enough to eat, this balance became somewhat disturbed.

In the same way we can see, not healthcare itself, but the modern institution of healthcare, as being a dangerously unbalanced system from a holistic perspective. There are a number of critics of the modern healthcare institution. Perhaps one of the most enthusiastic and concise is Ivan Ilich, who stated in his 1975 work ‘Medical Nemesis’ (2), “The medical establishment has become a major threat to health.” (2)

In the book, Ilich used extensive data to argue that the modern medical healthcare system is inherently unhealthy, since it is geared toward profit rather than healing, and to the fixing of one problem rather than a holistic view of the human being (2). This is now such a commonplace criticism that it’s perhaps seen by many as common sense.

Social iatrogenesis

Ilich went further, however, in his explorations, into the cultural ‘norms’ which have built up around the modern healthcare system. It is the socio-cultural stories which are prevalent within modern healthcare which, he says, make it so dangerous to human health as they perpetuate our understanding of ourselves as dependent upon that very system. Ilich called this ‘iatrogenesis’ of society. ‘Iatrogenesis’ is any effect a medical professional or medicine has on a patient which does not support the patient’s goals or overall health, and causes further illness or injury (3).

Ilich stated that this social iatrogenesis: “obtains when medical bureaucracy creates ill-health by increasing stress, by multiplying disabling dependence, by generating new painful needs, by lowering the levels of tolerance for discomfort or pain, by reducing the leeway that people are

wont to concede to an individual when he suffers, and by abolishing even the right to self-care. Social iatrogenesis is at work when health care is turned into a standardized item, a staple; when all suffering is “hospitalized” and homes become inhospitable to birth, sickness, and death; when the language in which people could experience their bodies is turned into bureaucratic gobbledegook; or when suffering, mourning, and healing outside the patient role are labeled a form of deviance.” (2)

Medical myths…

One example of this is the idea of painkillers. Ilich questioned the logic of wanting to ‘kill’ pain; since it can be seen as a way in which our bodies communicate with our conscious minds, and if we shut it out we break this connection.

He also questioned the idea that pain can be objectively measured to the extent that doctors can prescribe medicine solely for pain, when it is a unique subjective experience for every person (2).

This can be directly applied to permaculture by looking at the first design principle of ‘Observe and Interact’. If we experience pain, we are the only ones who can observe it successfully, since we are the only ones who actually feel it. If we block the observation process then the interaction is also blocked, and we perhaps lose our ability to deal with the pain on a personal level.

This is not to say that pain is good, or that no one should ever take painkillers, but that if we are always told the story that pain is something negative which can be objectively got rid of, then this takes away our self-empowerment to deal with what is, of course, an inevitable part of human experience. Thus our ability to self-heal is taken away (or never cultivated in the first place), and so we need a doctor to help us when we are in pain. And so the cycle continues.

Ilich noted the same dependency cycle in other aspects of modern society, for example in the modern story of death as a negative thing, which disempowers individuals since we feel this natural consequence of living to be some kind of burden too heavy for us to deal with by ourselves. Or by treating childbirth not as a natural emergence but a medical emergency, so we do not have control over even this basic function of life (2).

We can always choose whether or not to give away our power, but many do not necessarily even see that there is a choice.

Stepping away

So now that we are aware of the socio-cultural traps laid for us by institutionalised healthcare, what can we do about it? From a permaculture perspective, we do not need to change or get rid of the system. Indeed, there are many benefits of modern healthcare which can be utilised even if everyone becomes fully self-empowered, self-healing individuals.

Permaculture founder Bill Mollison has been quoted as saying: “If you have a dysfunctional system, don’t try to change it. Rather, determine what the institution was supposed to deliver and design a better system to actually deliver that purpose or service.” (4)

There are many alternatives to the modern institutionalised healthcare system in place today all over the world. Some are ancient practices which have been passed down for thousands of years, such as Ayurveda and other traditional forms of medicine. Some involve individuals working by themselves.

In part two of this article, I will discuss some of the options available to us to start taking steps towards designing systems of healthcare which are holistic, self-empowering and ecological.

These could be broadly divided into the categories of:

  • Plant wisdom – learning about the plants that can help us to heal and communicating with the wider environment in which they grow
  • Human wisdom – gaining wisdom of our own mental and physical processes and the power to change these at will in order to heal
  • Community wisdom – learning how to interact in a community of self-healers or holistic healers.

This final section, ‘community wisdom’, can be seen as the most challenging, and perhaps the most in need of a redesigned system in order to help us be healthy not only in our own bodies, but as part of a healthy community, comprised of both humans and other living beings.


  1. Hemenway, T, 2010. ‘How Permaculture Can Save Humanity and the Earth, but not Civilization’. Talk given at Nicholas School of the Environment, Duke University, North Carolina, USA and uploaded 9/2/13 to Films For Action: – retrieved 31/5/19
  2. Ilich, I, 1974. Medical Nemesis: The Expropriation of Health. Pantheon: New York City, USA.
  3. Medical Dictionary, 2019. ‘Definition of Iatrogenesis’. – retrieved 31/5/19
  4. Mollison, B, ? Interview with Mother Earth News, reprinted in Activists Hub, 1/7/14. – retrieved 31/5/19

Charlotte Ashwanden

Charlotte Ashwanden (nee Haworth). Born in London, I am very interested in peace and community and have a degree in Peace Studies. I got my Permaculture Design Certificate in 2011, from Treeyo at Permaship in Bulgaria, and my Permaculture Teaching Certificate in 2018 at Aranya in India. For me, permaculture is about so much more than garden design; I am mainly interested in applying ‘human permaculture’ as a complement to peace practices. In particular, I like to look at how human permaculture can be applied through psychology, communication and education techniques. In 2015 I got married in a pagan ceremony in a field to David Ashwanden and changed my surname to Ashwanden. With my husband, I’ve travelled a lot in Europe and Asia and encountered many permaculture and community projects. I have lived in various situations, from squatted land to intentional communities, as well as more ‘normal’ places, in the UK, Spain, Italy, Thailand and Vietnam. A professional dancer, I do fire and hula dance and sometimes run dance meditation workshops. Currently, I live in the Andalucian mountains.


  1. Interesting article, thank you. I am surprised that no mention is made of whole foods plant-based diets, as more than 80% of chronic conditions, i.e. why we get sick and die (heart disease, hypertension, type 2 diabetes, various cancers, various autoimmune diseases, etc) are caused by lifestyle, with the foods we eat being the major contributor (ref: The primary use of plants to man is not to heal sickness after the fact, but to eat them as part of a complete diet in order to promote health to begin with.

    For reference, I recommend
    – The China Study by Dr. T. Colin Campbell (million seller) or its followup “Whole: Rethinking the science of nutrition”
    – How Not to Die by Dr. Michael Greger (million seller)
    – Eating You Alive documentary or Forks Over Knives
    – for a deep dive, the online “Plant-Based Nutrition Certificate” from the T. Colin Campbell Center for Nutrition Studies

    “Everyone in the field of nutrition science stands on the shoulders of Dr. Campbell, who is one of the giants in this field.” —Dr. Dean Ornish

    “There have been only two people in the world that I know of that have demonstrated that they can arrest and reverse coronary artery disease, and they are Dr. Dean Ornish of San Francisco and Dr. Esselstyn of the Cleveland Clinic, and they both did it on a low-fat vegan diet.” —Dr. Ellsworth Wareham

    “We send our children to the best schools we can afford, and try to equip them with moral values that will last a lifetime, but we give them food habits that, when they grow up, will cut short two lives out of every three.” —Neal Barnard, MD

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