Friday, March 26, 2010
A disease of poverty
One of the things that’s been on my mind over the past couple months came from our very first training session with Dr. Berggren. Wade had asked Dr. Berggren what scabies are and Dr. Berggren proceeded to describe the pathology of Sarcoptes sabei and how it is treated with promethrin. However the words she used to describe the disease really caught me off guard: “It’s really a disease of poverty.”
A disease of poverty. I don’t know if I’ve ever heard something described in this way. In microbiology, we’ve been learning about infectious diseases and the risks of giving birth in “unsanitary conditions” but not once have we talked about how sometimes – people have no other choice. In the classroom – we talk about how one should avoid “poor sanitation,” “bad hygiene,” and “stagnant water” nonchalantly like “it’s just common sense.” But never have we addressed the fact that there are places in the world that have very little access to something as simple as clean water. Diseases of poverty are diseases that are more prevalent among the poor than among wealthier people. In many cases poverty is the leading risk factor for such diseases, and in some cases disease can (or allegedly) cause poverty. Why is that?
A few years ago I watched a documentary about a couple who had decided to live incarnationally as Nike factory workers in China. They lived in the same living quarters, worked in the factory, and tried to live off the same wages as their co-workers. At one point, the wife had become extremely sick due to the poor living conditions. Not only was she unable to work, but her husband was forced to choose between using his day’s wages to purchase food for them, or to save up for medicine for his wife. Without food and/or water, she continued to become sicker. Diseases of poverty reflect the dynamic relationship between poverty and poor health; while such diseases result directly from poverty, they also perpetuate and deepen impoverishment by sapping personal and national health and financial resources.
214 out of 228. That’s where Ethiopia ranks in the world in terms of GDP. Definitely not good enough to be on the all-star team of life – at least not in terms of money. What does this mean? This means that the greater majority of Ethiopians are poor. A lack of physicians means that when the people of this nation contract preventable diseases like Scabies or Trachoma, they sometimes can’t find someone to treat them to rid them of these infections. Once they do, the issue of money comes back into play. The more and more I read and learn about Ethiopia, the more I see that the issues are not singular, but systemic. Ethiopia lacks the infrastructure necessary to maintain sanitary conditions for all of its people. What happens when people wash, bathe, and drink from the same water that is used to dump sewage? Or when space requires families to live in huts with their livestock? People become infected with (often preventable) diseases. What happens when there is disease but not enough health care workers? What happens when those health care workers cannot be paid?
While our hope and goal is to go to Ethiopia and bring about some good in the sector of healthcare, the deficit of healthcare is due to problems that run much deeper than they eye can see. And the need for healthcare comes from situations that seem far beyond our reach. Where does the cycle stop? And what is our role as medical students, as future physicians, as fellow citizens of a single planet in bringing this seemingly downward spiral to an end?