Week 5: Nutrition, Food Security and Global Health

I remember in college I became extremely frustrated when I asked people why there had not yet been a solution to people starving in the world (individuals who I thought might have intelligent insight into the problem), and many of the responses I would get would be that it was not our problem. Complete apathy, which just baffled me. Many of them felt that the problem was too big and that it was too far displaced from America for it to really be something that we as a country should be focused on solving. I feel that one quote given in this lecture really articulated my frustration with the fact that in a world that is as technologically rich as it is, there are still people dying of hunger. It stated: "When I give food to the poor, they call me a saint. When I ask why the poor have no food, they call me a communist (Dom Helder Camara, Archbishop of Recife, Brazil)." I think that Dr. Shahi made a good point when he asked "if undernutrition is an underlying cause of 53% of deaths among children under five years of age, why are we not focusing on this issue." We know which parts of the world are affected most by hunger, so we need to focus our resources on eliminating this problem. The fact that women's education and status can play such a huge role in reducing child malnutrition is something that the WHO and other organizations need to focus more on. I think that perhaps these public health organizations should try to gain support from internationally famous people, such as Oprah, to help champion this cause (as someone in class pointed out, didn't Oprah just open schools for women in Africa recently?). One can look to the awareness of the global problem of AIDS that has been generated in the past decade and the fact that it has a lot to do with famous people taking an interest to convince the public of its importance. Hunger, like so many of the other issues we have discussed in class, is completely preventable. It is just an issue of coming up with an innovative solution and convincing the people who have the resources to do something about it that this issue is worth their time. I think one interesting solution Dr. Shahi proposed in class was to make it possible for farmers in developing countries to have web-based access to directly sell their produce to buyers, rather then losing most or all of the profit to the dealers in between. I also found the presentation about Ready-to-Use Therapeutic Food a really interesting, and in my opinion good, solution. I think that any step towards preventing hunger is a good one, regardless of whether it is only temporary or not.

"In parts of India, diabetes in a girl makes her virtually unmarriageable."

I just read Childhood Diabetes: A Global Perspective by Martin Silink and I think that it made some really good, tangible points. I remember when my step-father was diagnosed with diabetes, and not thinking it was a big deal because I didn't really understand how much the disease affects every aspect of someone's life. However, now that he faces the decision each month of where he should cut costs in his budget so that he can afford his necessary medications and insulin shots, I am constantly aware of how terrible it is to have diabetes. It's not just the fact that you have a disease with no cure, but that even if you try to make all the necessary lifestyle changes that you possibly can, you may simply not be able to afford the necessary treatment needed to keep the disease from getting worse. The above quote caught my eye, because I think the mere implications of that statement being true are profound. Imagine the quality of life someone in one of these developing countries faces just because they have diabetes. I can't fathom not being able to be married simply because I had a chronic disease like this. I completely agree with the WHO Report from 2006 that suggested that an emphasis on educating individuals about the benifits of exercise and diet are clearly not enough. There needs to be more awareness of governments and health organizations about how detrimental these non-communicable diseases are for societies and economies, and in order to achieve this I think there needs to be more funding of organizations dedicated to curbing this pandemic. I think that if governments get involved and work with these organizations to help spread the message of how to better prevent diabetes there can be vast improvement in the incidence rate of diabetes. Furthermore, I also think that individuals can make a huge difference. For example, look at the succes of the film "Super Size Me." Though it may not have revolutionized American's eating habits, I think that it did make people think about the health consequences of unhealthy lifestyle choices such as eating fast food.

Watch this:

AIDS orphans, World Vision

New WHO director

I just read a short article the professor posted called "New WHO Director Optimistic About Taming Global Health Threats" by Lisa Schlein. The director was quoted as saying: "When women are given a hand up in terms of household income, we see improvements in their own health and that of families and communities," she said. "When we think about the health in Africa, we must never forget the links between poverty and health. Poor health anchors large populations in poverty. Better health allows people to work their way out of poverty and spend household incomes on something other than illness." I think this sums up last weeks topic really well. The new director's great attitude and excitement at tackling many tough global health problems was refreshing to read about, and I hope she follows through on the initiatives she has promised to address.

Inequality and human development

I just got done reading the article from last week titled "Inequality and human development." I thought it was interesting, however some of the suggestions the article made had no logistical solutions as to how these ideas could actually be put into practice. It emphasized that one way to decrease inequalities is to close the gaps in educational opportunities, but how is this to be achieved until social change has been made to alleviate reasons the gaps exist in the first place? Furthermore, it also suggested that the poor need to be empowered in order to reduce poverty, but the article did not elaborate on any suggestions for how this might be achieved. Also, the discussion of the three "As" for reducing inequality left me a little puzzled. All three (access, affordability, and accountability) make sense, but who is going to pay for these to be acheived? Where is all this money going to come from? It just seemed to emphasize to me that so many of the reasons of why extreme poverty exists is because of all these reasons that feed into each other, and there doesn't seem to be a clear place to start in order to begin the process of breaking down this problem. The ideas it gave were great, and fairly intuitive if one thought about the reasons why one would be impoverished, but I didn't really get any sense of how any of these objectives might be achieved or where the money would come from to make these necessary changes.
I found the section of inequality and health in the United States quite startling. One quote that really caught my eye and helped put things in perspective was that 18,000 Americans die prematurely each year solely because they lack health insurance. I guess that is what happens when you live in the only wealthy country in the world that does not have a universal health insurance system, as the article points out.

My first entry--I'm a little overwhelmed...

After two classes of PM 565, I feel as though a whole new world of information and knowledge has been opened up and literally dumped on me. I never realized how many organizations for public health existed, how many acronyms are necessary to know in order to follow lectures, or how much more knowledgeable my fellow classmates are then I about the issues that have always been vague and undefined for me. I am extremely excited and honored to be a student among such accomplished and passionate people, and feel like for the first time in my college studies I can actually learn as much from my peers as I can from my professors. I have found myself wading through other's blogs, trying to catch up on the background of issues they are addressing, and am really enjoying the process of emerging myself in this program.
The reason I entered this field is fairly simple. For the latter part of my life, my family and I have lived without health insurance. This has greatly affected my family in more ways then one would imagine, and that is what initially sparked my interest. However, through friends who volunteered and worked abroad, I became increasingly aware of how little my problem was compared to those healthcare disparities people face in other countries. The second reason was that I want to make a difference (don't we all :)), and for some reason I have always been drawn to the field of health. I think it is because it integrates the two things I am good at: science and interacting with people.
Anyhow the lecture this week was great. I think the part that stuck with me most was the comment made by Dr. Shahi, when he said something like "the true test of development is when you can imagine a child from the poorest family you know and a child from the richest family you know, and if they would both be able to pay for their child to sit in the classroom that we are in right now, then that country has passed the test." And like he said, I don't think any country has truly achieved development. One can examine our own nation, the world's leader (for now) of development, and the gap that exists between the rich and the poor is unacceptable. There is absolutely no reason that people should not have access to basic health care needs. I am excited to see what the newly elected delegates in Congress will do in efforts to address these issues. And although I am new to California, I have already heard a lot of hype about certain initiatives the governor wants to implement in this state in terms of health care and it will be interesting to see what happens.