In chapter 9, Paul Farmer discusses the importance of addressing human rights in the process of addressing health care-considering that health care IS a human right. In order to battle the inequalities that exist in international public health, it is essential to promote human rights and health care as a fundamentally important right. Paul Farmer discusses the role AIDs has played in medicinal and public health, in that (quoting Jonathan Mann) “promoting and protecting health and promoting and protecting human rights are inextricably connected.”
This concept should be considered in public health advocates’ battle of diarrheal disease. Without addressing access to water and access to health care, the battle of diarrheal disease is a losing cause. Access to medicine is a fundamental right of humans. Access to water is a fundamental right of humans. To die of a disease that is cheaply curable and easily avoidable is a violation of a human’s natural rights. Governments have a responsibility to battle diarrheal disease because according to the declaration of human rights, people are have the right of “freedom from fear and want”. People contract diseases because they have a want- clean water. In order to battle diarrheal disease, one must battle the root of the issue, which is that people have a right to adequate, clean water and adequate nutrition. Provides these fundamental rights and we will see the positive repercussions in the decrease of diarrheal disease.
Absolutely True Diary of a Part-Time Indian by Alexie Sherman is a children’s novel that portrays the life of an American- Indian boy called Junior, and reveals the structural and social problems of an American Indian reservation. Although Alexie’s humor softens the harsh realities, the truth of the situation rings true to the reader. The poverty and social prejudice against the Indians is undeniable and leads to a cycle that the Indians cannot escape. Junior transfers schools because he is alcohol is the only route that the kids at his school are going down. He is the only one who is seeking to leave the reservation and faces prejudice from both his own people and the white world. He is putting himself in the white world because he understands the reality that if he want to be successful this is the only way for him to do it.
Throughout the book, cartoons that Junior draws reveal profound realities of his situation. One depicts how he imagines his parents to be if they had had the opportunity to pursue their dreams. It reveals the truth that because they were Indians they would never have access to the opportunities that white people have. It shows his mom as a school teacher and his father as a jazz musician. This is contrasted to the description of how his father actually is… an alcoholic.
This book is a prime example of the 1/3 World View in which every country has a third world aspect to it. While it is easy to understand how people are dying of diarrheal disease in Third World Countries, it is easy to neglect the realities of poverty and disease and oppression in our country. According to Kilgore’s research that, “Infant mortality due to diarrhea (per 100 000 live births) averaged 12.8 and was found to be high for blacks (33.1) and for residents of the southern United States (18.5).” While the rate of infant mortality is far lower in America than in developing countries, examination of where death by diarrhea disease occurs reveals where the structural and social defections lie in America.
Would you expect this home to be located in Arizona, USA in an American Indian reservation??
The article “All I Eat is ARVS” by I.A. Kalofonos reveals a tragic structural problem in Mozambique. Kalofonos analyzes the recent prevalence of ARVs- a medication that combats and cures HIV patients. From a quick glance, this medication is thriving- it is curing people and is free to the public! However, a deeper onlook reveals some disturbing realities. While there is no denying the drug is making AIDS patients healthier, many have tragically died of hunger afterwards. Furthermore, the prevention care center provides food aid to the patients, which -other members of the population argue- is taking the food aid away from them. ARVs are creating tensions in the community. It would be unfair to argue that ARVs are the sole reason for these tensions. Rather, the issue lies with the structure of the society where different social classes are receiving food aid and other are receiving none at all. The issue is that people are starving and while it is great that the government is caring for the HIV victims, in many ways they are neglecting the most fundamental health rights- including nutrition.
Food distribution is a careful, political ordeal in this small town of Mozambiqu- there never seems to be enough. – Sarah Salesa
Lack of nutrition has weighty consequences in spuring on other diseases, such as diarrheal disease. Malnutrition weakens the immune system and leads to the contraction of many other diseases. Without food, the body cannot fight against diseases. According to E. Schlaudecker “underlying malnutrition is a major risk factor for diarrheal disease.” It would seem silly to find an expensive cure for diarrheal disease and make it free to the public, but do nothing to provide for the population’s daily food intake. It would be pointless because the root of the problem must be addressed. Likewise, it is somewhat silly to combat HIV with ARVs and neglect providing adequate nutrition for those that are healthy. Long term change occurs only when the root of the problem is adequately addressed.
This week’s reading Can the Mosquito Speak examines the incident where the Aswan Dam was built in order to navigate the flow of the Nile to more areas and thus expand Egypt’s agricultural and food production. However the construction of this dam contributed to the spread of malaria by creating a pathway for the malaria carrying mosquitoes. To combat the malaria, DDT was used to kill the mosquitoes. Although the DDT was found to be harmless, it was continued to be used. This example epitomizes the cycle of man battling nature and the way that man attempts to manipulate nature fixing one problem but causing new natural problems to arise. Then man again seeks to solve the problem with technology which then creates new problems. Thus the cycle continues.
This resonates with the ongoing cycle where formula milk companies attempted to fix the problem of malnutrition by pushing formula milk products on women in third world countries. This manmade solution to lack of nutrition created new problems because of the bacteria carried in the water used in the formula milk products. Trying to use technology to solve baby malnutrition actually increased the problem of baby deaths in third world countries because more babies contracted diarrhea disease. The most natural solution- breast milk from the babies’ own mother is actually the safest form of nutrients that a mother can give her child.
AS we have discussed before, the root of the problem with Diarrheal Disease is the lack of access to nutritiona and water. Malnurioushed people have weakened immune systems that lack the ability to combate diarrheal virusues. It seems that the giving food aid would be the primary solution in combating diarrheal disease. Yet, providing food is much more complicated than just handing a loaf of bread over to the hungry.
Kristin D. Phillips discusses the politics of involved in giving aid in “Hunger, Healing, and Citizenship in Central Tanzania” and the problems that arise when giving aid to the poor. Essentially she claims that politicians gain people’s allegiances by giving them food, and even if the people don’t agree with their policies they are under those politicians power and authority. When people are starving, and people are willing to go to any extreme to get a bite to eat, politicians that give aid are viewed with an unearthly awe. This devotion gives them power. And when are politicians ever absent of corruption? In countries where people dwell in desperation, governments are especially corrupt. The aid-givers can easily keep a portion for themselves, sell the aid at whatever rate they determine to be appropriate, and manipulate/ deceive donators. So while, nutrition may greatly reduce diarrheal disease, we must be aware o fthhe politics that go into providing aid. It can quickly become “A Dirty Mess”.
According to the Dr. Rashid Haider, scientific fraud and falsification have increased dramatically in recent years. One area in particular is vaccine trials tested in distant, developing countries where infectious diseases run ramped and government/ scientific infrastructure is weak. Mandatory tests are often not performed according to False Reports on Vaccine Trials by Dr. Haider.
One such scandal occurred in February, 2011, when The International Centre for Diarrhoeal Disease Research, Bangladesh launched a large scale testing of a cholera vaccine in a suburb of Dhaka, India. The vaccine was proved to only offer 10% protection against cholera and thus almost useless as a diarrhoeal tool. The researchers had offered false information about the making, effectiveness and cost of the vaccine. They had treated 90,000 impoverished, rural women and children as experimental animals. While the intent of the testing was to create a cholera vaccine for the poor of India, the trial became unethical when the results were exploited for profit by European vaccine companies. Public Health advocates of the area demonstrated how the ICDDR,B raised false alarm, exaggerating the need for their vaccine in order to make a product on unknowing residents of Dhaka. The outcome- hundreds of residents had bought the vaccine, believing themselves to be cured, when most of them did not need it, and those that did were in no way protected. ICDDR,B never bothered to tell the participants that the vaccine was discovered to be useless.
This scandal is epitomozied with a quote from Paul Farmers book, where Marcio Fabri dos Anjos: “To what level of quality can medical ethics aspire, if it ignores callous discrimination in medical practice against large populations of the innocent poor?”.
Westerners testing on rural Cholera patients.
For one week a brutal heat wave hit Chicago in 1995, and killed over five hundred Chicagoans directly from the heat, and caused thousands of hospital visits for heat strokes (Klienenberg 1999). It was a disaster of nature, according to journalists. While it is true that the excess heat was uncontrollable, the number of deaths that resulted was not solely the work of the sun. This disaster revealed numerous problems in the social and political condition of Chicago. Nonetheless, the majority of news reporters failed to attribute the heat wave deaths to the underlying social issues, instead choosing to naturalize the disaster and deter the true cause of the high number of deaths. Klienenberg theorizes that this is because the majority of journalists are writing for the mass American audience who they believe are more interested in the power of the weather than in political affairs. Most of the news journalists are a-political and are not interested in activating change, but rather telling a story that readers will be interested in.
Likewise, according to Bristol and Donnelly, global health journalism struggles to report the social and political issues of the world because of a lack of interest in readers. While the mass population may watch a report on the tragedies of global issues, they often turn the TV off once the reporters attempt to explain the underlying causes. There is a lack of interest in the intricate political issues and thus journalists tend to naturalize disasters. They often discuss world health issues on a purely surface level in order to please readers. For example, a news reporter may discuss the statistics and tragedy of diarrheal disease, but never address the underlying governmental and social causes for the prevalence of the disease in a specific region. Perhaps if journalists told the whole truth, the public would be more aware and therefore more powerful against the social injustices that enslave the globe.
“Imagination and the will to carry it out are core features of survival” (Nordstrom 1998). Since the beginning of humanity, imagination has been the secret ingredient to human survival. When humans were attacked by wild beasts, they imagined tools to fight back. When they were cold, they imagined a way to create warmth. When they were faced with storms they imagined a way to build shelter. They imagined cities, social interaction, writing, ways of interacting. Creativity and innovation sets human kind apart from other animals. People create their vision of self, and grow into it. They create habits, culture, and ways of living. People author their own place in society. With out imagination, humans are left to the direction of someone else.
What terror war attacks is people’s ability to imagine and to create. Separated from imagination, people cannot create and thus are subject to someone else’s imagination- be they good or evil. Imagination empowers man because he can create a method to fight back. Terrorists thus seek to destroy this imagination. Because the people in Mozambican are able to imagine a different situation, they are able to fight the terrorist war.
The problem is that imagination is spurred on by examples. When people see an example of the way they want to live, and to be, they can imagine themselves in that life. In a barren, scattered, diseased, shattered world- as terror violence seeks to create- there is no vision of change.
Just as imagination is monumental in fighting terrorism, so is imagination key to fighting diarrheal disease in developing countries. If people can imagine a new lifestyle, they can create a new lifestyle. If they can imagine solutions to their situation, they can actualize those imaginations. For example in the South African slums, if people were able to imagine a new lifestyle- one that is clean, where hygiene takes priority, and rehydration pills were taken and used, long term elimination of diarrheal would occur. The problem is that people are often hopeless and can’t imagine nothing better for themselves. They settle into the lifestyle that was taught to them, with no hope for change. Inspiration and teaching communities to imagine and create new lifestyles could be huge in dismantling poverty and diseases.
A study by UNICEF 2009 shows that significant disparities exist in Jamaica regarding child protection, nutrition, education and health. This is largely due to a lack of governmental policies. In light of the weakened fiscal capability of the Jamaican government, new projects need to be implemented to improve how Jamaican programs address the issue of poverty in Jamaica. The study found that Jamaican children significantly benefit from basic services given from the government. Their programs are successful, increasing health and decreasing diseases such as diarrheal disease by significant percentages. However the overall quality of the services needs to be improved and the inequalities of access to these services need to be removed. The study shows that good nutrition is the foundation of good health. Lack there of results in an inability for children to function properly and to fight diseases. Understanding this, the government has implemented meal plans and feeding programs to improve the nutritional status of the schools. The survey shows the success of these programs, however there are also large discrepancies in where these programs are focused. The consequences can be seen in factors such as the frequency of diarrheal disease. The survey indicated that Jamaican children in big households in rural areas are far more vulnerable to diarrhea, and yet far less likely to receive appropriate medication. Thus the percentage of children in rural, crowded communities have much higher rates of deaths by diarrheal diseases. While the Jamaican government is on the right tract towards improving the health of children, their programs need to focus more on the areas where child health is the worst. As the video, Life and Debt (2004) points out, there is a lot issues that need to be addressed that lie behind what the touristic Jamaica portray.
“Often the poorest people are those who receive the worst public services and pay the most for water” (Whiteford 2005). Because of the failure of the Mexico state government, the residents have inadequate water and the power goes to the private vendors. This creates a delicate balance of power between private and public water companies, with the residents are at the mercy of both. In addition to not having enough water, the poorest communities are often given the worst quality water. To reduce costs, wells without filters are installed and the water that flows into peoples houses are often full of mud. Cleaning water is time-consuming task that usually falls to the women. A rag is attached to the faucet and then the water sits in a bucket to allow the mud to sink to the bottom. The effort, time and money it takes to obtain clean water adds an additional burden to residents who are already struggling to stay alive. The scarcity of available water increases the gap between the rich and the poor in these countries, putting the control of the water in the hands of a few priveledged.
Water scarcity has detrimental effects on health, especially children’s. Contaminated water is the root of diarrheal disease which is the second highest causes of death in Mexico. Disease spreads like wildfire in communities that do not have access to adequate, clean water.