“We are all human beings”

Some people believe that there is enough money and resources available to deliver basic health care effectively on a global scale, so the problem is how to do it. Earlier this year, Laurie Garret wrote about “The Challenge of Global Health” in Foreign Affairs. Her mains points are:

  1. success should be defined and measured in terms of (increasing) life expectancy and (reducing) maternal mortality rather than reducing specific disease rates.

  2. there is more govt/charity money than ever for health care in developing countries (several billions of $$s). spending is focused on political or donor-centric initiatives like AIDS, not on what’s needed to reduce mortality in patients in these countries

  3. this leads to contradictions like money being available to treat aids in HIV-positive mothers, but no money being available to address the most important causes of infant mortality and maternal mortality in terms of numbers of deaths.

This controversial article touched off a string of counterpoints by several leaders on global health advocates including Jeffery Sachs, Paul Farmer, Alex de Waal and a counter-counterpoint by Garret. They are all worth reading.

In particular, the untiring work of Dr. Paul Farmer (Harvard) on public health in Haiti is one of the most inspiring stories in service to the poor who don’t have access to the most basic health care made possible by modern science and technology. In addition to being a medical doctor, he is a Ph.D. in anthropology which he uses as a tool to be a more effective health care leader/provider in Haiti where belief in voodoo medicine can be a barrier. Self-described as “I’m an action kind of guy,” his life story is described in a book by Tracy Kidder called “Mountains Beyond Mountains: Healing the World: The quest of doctor Paul Farmer” that is guaranteed to break you down as it exposes you to the kind of public health conditions that exist in Haiti and what Farmer’s efforts have been able to do to change that. I’m about half way through it, and one of the most striking lines in this book is when a Hatian expecting mother and her baby die because she is refused access to blood for a transfusion and her sister remarks, “We are all human beings.”

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