I have bee n reading and enjoying Alanna Shaikh’s blog Blood and Milk lately, and and today she has another pithy post up on  Why you can’t understand global health. I agree with her basic premise completely – even with years of nursing, overseas volunteer work and postgraduate study in development I still have no idea of how it is to live in the zero-sum game that is the life of the very poor.

But it got me to thinking about how we can start to learn about it.  I don’t know that experience, but my husband does.  He was born into a poor family in a small, third-world town.  I learn from his experience.  I refer to his expertise often in my work and writing.  And he is not alone.  The world is now so interconnected.  While there are still many living in poverty there are also the lucky ones who escaped.  How can we utilise their experience and expertise?

It also reinforces my belief in the value of the academic work of social scientists, particularly anthropologists.  Too often in health care and development we prioritise technical knowledge and skills. Long term and in depth ethnographic study of communities and their lifestyles, culture and values could add so much to the design of appropriate and effective interventions.  Yet it is rarely done… it doesn’t fit well in the project life-cycle.

So often the voice of the poor themselves is missing from health and development literature.  But itw ill take  time to stop and listen, and a change of mind-set to value the knowledge they have.

Advertisements

Missing

March 15, 2009

“Missing:” A message video by UNICEF about Maternal Mortality from Big Yellow Taxi on Vimeo.

‘The Poverty Diet’

January 8, 2009

‘The Poverty Diet’: a Comparison of the American Diet and Weight Loss Plans in Consideration of Global Food Shortages | EcoSalon – The Green Gathering.

The ‘diet’ described here is pretty typical for rural Central America. Vanessa Barrington’s discussion of her experience in Guatemala helps put the ‘economic crisis’ of developed nations into perspective.

Socialised medicine

June 12, 2008

I am tying this on my laptop, sitting in a hospital room while I wait for my husband to return from surgery. He has been limping around since injuring his knee in January and after a few months caught in the cycle of GPs, physios, specialists and ACC he is now finally getting the cartilage repaired.

I could complain about the waiting and the paperwork and the wasted time, but I’m not going to. Because last week we watched Michael Moore’s ‘Sicko’, and now all I feel is grateful.

ACC (the NZ government accident compensation corporation which replaces private insurance for accidents) may have taken 3 months to arrange the surgery but he is getting what he needs. Completely free. And in a nice comfortable private hospital.

We have also been through years of struggle with his head injury and subsequent migraines, and he is only just getting the care he needs, but that is more to do with unhelpful doctors than the system itself. As with the knee injury, all specialist appointments and any tests required are paid for by ACC. And presriptions for his expensive medicine are significantly subsidised.

When our little girl was born the midwife and hospital stay were free, as were 6 weeks of midwife visits at home and the all health care for the first 6 years of her life.

When my Dad had 2 heart attacks last year he got full emergency care immediately, cardiac catheterisation (twice) and all follow up rehabilitation care free.

I have posted on this subject before, and my opinion has not changed. Having have seen both ends of the system, as a nurse and as a patient (and obviously as a patients relative!) I simply cannot comprehend the American fear of “socialised medicine”. I remember having drawn out discussions about it with American friends, who mirrored the concerns shown in Sicko- worries about government control, higher taxes, rationing and waiting lists. There is of course some validity to it. Prioritisation and rationing are facts of life in this system. Private hospitals exist here because those who have the money prefer to have thier surgery as quickly as possible, and in hotel-like surrounds. But I’d much rather live in a country where everyone is able to access health services regardless of socio-economic status, and where I know we will get emergency care immediately than the alternative. And I’d rather pay for it with my taxes than through an insurance company. At least I know the government isn’t trying to make a profit out of me.

Women Deliver

January 20, 2008

I just ‘found’ this post in my drafts list and was struck again by the numbers. Although I’m sure the reason it hasn’t been posted is because I was going to add some thoughts based on my own experience as a mother, nurse and volunteer in the developing world- but I don’t think it really needs it. Just read and reflect on the implications for yourself (the italics are mine).

Every minute of every day, a woman still dies needlessly during pregnancy or childbirth, most in the developing world. Ten million women are still lost in every generation – our mothers and sisters, daughters and grandmothers, wives and partners, friends and neighbors. At the same time, 4 million newborn babies die every year, also from causes that are mainly preventable.

In this silent tragedy, huge disparities exist between rich and poor countries and between the rich and the poor in all countries. One in six Afghan women will die during pregnancy, compared to one in 2,500 in the United States and one in 29,800 in Sweden, according to 2000 figures from the World Health Organization – the greatest disparity in all the indicators WHO monitors.

 

Fully 42 percent of all pregnancies everywhere experience a complication during pregnancy and childbirth, and in 8 percent of all pregnancies, the complications are life-threatening. Survival rates depend upon the distance and time women must travel to get skilled medical care. Maternal mortality, defined as the death of a pregnant woman during her pregnancy or within 42 days of pregnancy termination, has dire consequences for the woman’s family, community and country.

 

Click here for more.

 

Original article by Joanne Omang
From The Global Health Council

The Story of Stuff

December 6, 2007

Please watch this teaser then go to the site to watch the whole thing- before you do your Christmas shopping!

A horribly complex issue

October 10, 2007

This morning I attended a workshop on FGM (Female Genital Mutilation or “female circumcision”). We care for a lot of refugees at the health centre where I work, including a significant number from Somalia and other African countries where FGM is practised, and so although it is uncommon and illegal here it is something we do see regularly and need to know about.

Female genital mutilation (FGM), often referred to as ‘female circumcision’, comprises all procedures involving partial or total removal of the external female genitalia or other injury to the female genital organs whether for cultural, religious or other non-therapeutic reasons. (WHO)

Girls usually undergo FGM prior to puberty- the average age is 6-8.  While it is increasingly done by health professionals under local anaesthetic, in rural areas it is still carried out without anaesthetic, with scissors, razor blades or knives while the girl is held down by female relatives.  In the short term the girl may experience excrutiating pain, shock infection, haemorhage, urinary retention and fractures.  But it doesn’t end there.  Long term issues caused by FGM include difficulty passing urine, pelvic infections, scars, cysts, fistulae, difficulties with menstruation, increased risk of HIV transmission, sexual complications, childbirth complications and negative psychosocial impacts.
While the physical trauma that girls go through is horrendous and quite harrowing to contemplate, what I found most disturbing was the psycho-social issues they face, the fact that even in New Zealand women see the pain and long term complications of FGM as preferable to the socially ostracised life they and thier daughters would lead without it.

FGM is a complex multifaceted practice deeply rooted in a strong cultural and social framework. It is endorsed by the community and supported by loving parents with what is believed to be the best interests of a young girl at heart. FGM can only be understood within its cultural context, for in the societies where it is practised — despite its harmful physical affects — FGM provides women with many social and cultural benefits…

Whether the practice is shrouded in rituals and celebrations, or whether it involves a visit to the local midwife, FGM is an integral part of a girl’s social development. The practice is deeply embedded in the social norms of the community and there is immense social pressure on all young girls to conform. A girl who does not undergo FGM is likely to be severely socially penalised, and is often despised, taunted, ostracised and made the target of ridicule. No one in her community may want to marry her, and what is clearly understood to be her life’s work — marriage and childbearing — will be denied her.

For a woman living in a patriarchal society with no access to land or education and no effective power base, marriage is her main means of survival and access to resources — and FGM is her pre-requisite for marriage. With the beliefs surrounding FGM deeply embedded from childhood, the social approval associated with FGM and the sanctions women face if they don’t undergo FGM — the benefits of FGM would seem to outweigh the physical difficulties. FGM is inevitably viewed in a very positive light and this can explain why women continue to cling to the tradition, colluding in their own daughters’ circumcision.  (fgm.co.nz)

It makes me incredibly sad and angry that women and girls are faced with these kinds of realities. I have the utmost of admiration both for the women who live daily with the impacts of FGM on thier physical and psychological health, and for those who have taken the huge step of refusing to have thier daughters circumcised.

Dreaming of the sea

June 14, 2007

 amatsea.jpg

A couple of days ago I received an email from a former ship-mate from Mercy Ships. It was the usual mass-mailout, what-are-we-up-to now and look what Mercy Ships is doing kind of email but for once it caught my attention. Mercy Ships newest and largest ship, the Africa Mercy, has just undertaken its maiden voyage and arrived in Africa, and this email contained photos, and links to a BBC report and photographic tour of this ship, and a new song released just for Mercy Ships.

As I browsed I started getting a bit nostalgic. I remember the things I loved about the ships. Sunsets at sea. The throb of the engine and gentle rocking of the ship as I settled to sleep in my cosy little bunk. The thrill of arrival in a new port, waking to a new view out my porthole, walking off the ship to explore a new city, a new country. The feeling of actually doing something positive for the world.

And then I realised why I have been so unsettled lately. I have spent 4 of the past6 years studying development. I have spent countless hours reading and thinking about poverty, social justice and religion. And far from being more prepared for work with the poor, I feel discouraged and somewhat stymied.  I have spent too long critiquing what is happening and the problems caused by  well-meaning volunteers and development professionals and don’t feel I can “do” anything much that would help.  I miss the innocent enthusiasm with which I set out to “save the world” years ago, and I miss the secure and easy answers that my Christianity gave me at that time.  It has all been replaced with cynicism and doubt.  Maybe our Pentecostal pastor was right 5 years ago when he cautioned my husband against university studies.  To much knowledge and thinking can be a dangerous thing, especially for religious belief and idealism!

I still believe the Mercy Ships ideals are good, and I definitely believe there is a place  for the ships in medical relief work, but given the changes in me I’m not sure I could ever fit back in there.  Add to that the negative memories and the aspects of ship life I would rather not remember I guess I’m going to have to stick to following their progress online, and dreaming about the sea.

Global Snippets

June 9, 2007

Women forced to give up their jobs, marriage: Another consequence of the war in Iraq. “Insurgents and militias want us out of the work environment for many reasons: Some because they believe that women were born to stay at home – cooking and cleaning – and others because they say it is against Islam to share the same space with men who are not close relatives”.

And the G8 Verdict Is – Failure: “Even this $60 billion smokescreen can’t cover up for the abject failure of the G8 to move forward on their AIDS promises. This is devastating news for the 40 million people living with HIV and AIDS… 24,000 people have died over the last three days while G8 leaders have been wrangling over text on how many lives to save”. And Oxfam has noted that only a fraction of the US$60 billion represented new aid since the figure was spread over an unspecified number of years and includes money already pledged.

Study finds child hunger costs Central America billions of dollars every year“This study is a wake up call to the international community that widespread child hunger is not only a moral and humanitarian issue, but it has economic consequences as well.” Maybe those leaders who don’t care about children’s lives will listen to the money.

Finally, some good news-for those of us that live in New Zealand: The Global Peace Index ranks NZ at no. 2.  The news is not so good if you live in the Sudan or Iraq. And it does make me wonder about the wisdom of our plan to move from NZ to Honduras.

Upside down world

June 1, 2007

I have just come across Upside down world,

an online magazine uncovering activism and politics in Latin America. Founded in 2003,  it is made up of work from writers, activists, artists and regular citizens from around the globe who are interested in flipping the world upside down…or right side up. Upside Down World provides concerned global citizens with independent reporting on Latin American social movements and governments that have refused to prostrate themselves to the interests of corporate globalization, and instead have focused their work on addressing the needs of the people.

There are some very interesting articles posted, from all corners of Latin America and on a variety of topics-

From Bolivia’s gas conflicts to worker-run factories in Argentina, from Guatemalan resistance to mining to the new political process in Venezuela .

They have just published an article on the Goldcorp mine in Honduras, something I have posted about before(here and here).  Here are some excerpts from the article:

The results of the latest water quality and health study, which was released on February 7th of this year (2007), show that water sources -including a domestic use well built by the company- have higher levels of copper and iron than even the generous amounts allowed by the World Bank guidelines for open pit mining areas… of the ten local people to have had their blood sampled, every single one has quantities of lead and arsenic in their blood at a level considered “very dangerous” by the World Health Organization (WHO).

Leslie Yaritza Perez hasn’t given up on waiting for the day when her baby, 18 month old Carla, will start walking. Carla still can’t support her body weight, and has little control over her legs… Carla’s father works at the mine, and their family home in Palo Ralo is a stone’s throw away from where the company built a well for the displaced community, which was later found to be contaminated with arsenic.

Honduran mining law stipulates that mining concessions can be cancelled if the mining activity “affects or damages water, air, flora, fauna, the community and the general ecosystem.” The government, led by President Manuel Zelaya, has shown little will to back the concerns of the communities and suspend Goldcorp’s concession in Honduras… For now, the battle lines have been drawn. Communities dealing with illness and water contamination, which is affecting their children more than anyone else, are on one side. Goldcorp, a major gold company waging an expensive public relations campaign is on the other.