Pathogens and Poor

For class we recently read a chapter in Paul Farmer’s Pathologies of Power that I feel fits into my topic of health care in globalization very well. I especially liked this chapter as well because it brought in some of the information that I am learning in my Microbiology classes.

Farmer made a point that all over the world the poor are sicker than the nonpoor. He brought up the fact that this is because they have more contact with pathogens and because they do not have the means to obtain the help that they need to stay healthy. As presented in my previous post on Nicaragua this is very true, but I believe that there are some other factors that play in as well, based on information I have obtained from other classes. I learned in my Microbiology class that there are various reasons why we get and stay sick. One is poor nutrition. If we are not receiving the right fuel for our bodies or enough of it the body starts to shut down certain systems. When you are malnourished your immune system is the first to go. Your body has to make the choice of running the organs you need to stay alive or the immune system, and that is why we need to eat a good balanced diet. For poor who do not have access to the types of food that your body needs to run effectively or even to food at all you can see the problem. They essentially have no immune system to keep them from getting sick and when they do get sick they aren’t receiving the nourishment they need to fight off the illness. Now some may say that all this may be true, but look at the United States. Many nonpoor eat poorly and you don’t see them dying prematurely to diseases. To them I say yes many nonpoor eat poorly but, these people have access to healthcare, which the poor do not, as Farmer points out. In addition to that many nonpoor are dying prematurely of diseases due to poor nutrition, but that is another topic.

Farmer states that poor come in contact with more disease. This I believe is very true. In my trips to South and Central America I have witnessed large families and sometimes more than one family sharing a single small living space. This is a perfect way for disease to spread. Many viruses and bacteria can be spread when a person coughs or sneezes releasing minute droplets of saliva that are carrying thousands of pathogens and are then inhaled by another individual. How are many people going to avoid getting sick when they are all sharing a single space? Nonpoor may be crowded into a single space and come into contact with pathogens, but again they also have the access to the care and nutrients they need to fight off disease.

Now as Farmer has pointed out in his book some doctors and nurses try and help solve the problem of access to healthcare for the poor by offering their services. One problem is that these endeavors are poorly funded and thus cannot reach as many people. In addition to this, as was the case in the look at Nicaragua, there are not enough of these people in the areas they are needed. Also, just giving poor medicine or a check up and sending them on their way is not going to be enough. Some diseases require months of treatment and you may feel better after a short time, but you are not. If someone is working just to survive and they start feeling better, why should they continue to take the measures they need to fully fight off the disease when they need to work to provide food and other necessities? I like what Farmer has to say for this. He sees health care as a work of social justice. That we need to help people in the situations they are in and work to help make theses situations better. If this means working with a small population at a time instead of solving the problem in one big sweep I think that it is worth it.

Works Cited:

Farmer, Paul. Pathologies of Power: Health, Human Rights, and the New War on the Poor : with a New Preface by the Author. Berkeley: University of California, 2005. Print.

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Nicaragua, a health care conundrum

Having visited Nicaragua and spent some time with the locals of the poor class, Nicaragua’s health care system is of interest to me. Looking back I wish I would have asked more questions as to the state of healthcare, especially now that I know a little more about the country.

Nicaragua, as well as most of the world’s poorest countries, went to the World Bank and IMF for assistance. They were advised to strengthen privet sectors by lowering spending in non profit areas. This resulted in a cut to healthcare funding. I understand where the World Bank and IMF were coming from in a way. It makes since, if you want to increase your economy, put money into areas that will produce the goods and encourage the growth of economy. However I don’t think that you should be forced to cut health care funding in order to adhere to the conditions set out by the World Bank and IMF. Adding this cut of healthcare to the already unequal health care system and many people will have to go with out the basic care they need to survive.

Inequality is very prevalent in the Nicaraguan health care system, which has three tiers. The upper class of Nicaragua receives their healthcare privately, and what care they cannot receive in their own country, they will receive in others. The working class, comprising about eight percent of the population and only includes those working for the government and industries, receives their health care through The Nicaraguan Social Security Institute, which they and their employers pay into, and is similar to insurance. This “insurance” is mainly government funded and the majority of the government health care budget. The Nicaraguan Social Security Institute provides for basic medical care including medications and care for the spouse and young children of the family.

The rest of the Nicaraguan population, about ninety percent, the poorest receive public healthcare that is poor and mismanaged at best. There are public clinics for these people to go to, but many of these clinics lack the resources need to be helpful. In addition to the poor quality of these clinics, many of these services are only offered in the larger cities, and the majority in the capital city of Managua. This is leaving the majority of the country without health care services at all, simply because there aren’t any around. If the poor are fortunate enough to receive care, they may not be able to afford it or the medicine. One medical visit could cost several days wages, if they have a job, and several days without food. Is it better to receive medical care than eat?

I have witnessed the dilemma these people are in. While I was in Nicaragua I saw a family whose father was ill but in order for him to receive care he would have to travel to the city, the cost of traveling alone would cost several days pay and they needed that money for food. I also spent a good deal of time with a three year old girl. She had a stomach ailment and her family had taken her to a local clinic, but the resources at this clinic were poor and they could not figure out what was wrong. Her family wanted her to get better but they could afford neither the care nor the cost of traveling it would take to maybe make this little girl better. And so she suffered, this little girl who should have been smiling and happy toddler was sullen and sad.

I see the health care problem in Nicaragua as one with multiple causes. One being that the government cannot fund the care needed for the entire country. Another is that the resources needed for healthcare are not available, this includes the number of doctors and nurses available to serve. Even if these two causes were fixed and there was enough funding and resources I see the last cause as the one that will continue the problem. The people can barely afford food and as long as they are in a state of struggling to nourish themselves, day by day, they will not be able to have the health care they need.

Works Cited:

http://www.jhc-cdca.org/health.html

http://www.access2insulin.org/html/nicaragua_s_health_system.html

http://www.tortillaconsal.com/health_nicaragua.html

http://www.mapsofworld.com/nicaragua/healthcare/

http://countrystudies.us/nicaragua/27.htm

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History of Health Care

Health care today is expensive and insurance is helpful, but may not cover all medical expenses and may itself not be affordable. How did healthcare get to where it is today, both in terms of medicine and insurance?

Medicine has been practiced as far back as Ancient Egypt and farther. However, this medicine we would not recognize as medicine today. The first practices of healing where religious in nature. Priests, medicine men, other religious leaders would perform rituals in order to heal an ailment. At the same time herbal remedies where also used as the first medicines. As time went on people began to understand more about the human body. Egyptians removed growths on skin and learned about the body through dissection during mummification. Greeks introduce the ideas of exercise and healthy eating and the theory that health was related to bodily fluids and these ideas continued well into the Middle Ages. In the beginning of the Renascence science began to take over medicine when dissection of human corpse was no longer illegal. Next came the discovery of bacteria through the work of scientist like Louis Pasture in the nineteenth century, proving that bacteria was the cause of ailments, not bad air (Slonczewski and Foster, p.16). Studies where also being done to pin point causes of disease epidemics, such as the one by John Snow who pinpointed that one well that was contaminated was the cause of the cholera outbreak in London (Slonczewski and Foster, p. 994). In the 20^th century antibiotics such as penicillin where discovered, transplants and blood transfusions where safely completed and new medicines are developed based on ongoing scientific research. Unfortunately advances in medicine also cause more expenses. It takes money to fund research as well as the production of medical equipment and drugs. Some of these costs are carried on the consumer in their medical bills others through taxes.

Health insurance is a relatively new concept; in fact medical insurance in the United States did not come about until around the 1920’s. Before this time medical expenses were low because medical technology had not fully begun to develop and people where treated in their homes. Cost of medical care was not a chief worry at the time as much as missing work because of sickness, and the loss of pay that went with it, was. So around 1915 a type of insurance called “sickness funds” was put in place to compensate for any lost wages due to illness. About this time railroad, lumber, and mining companies were setting up medical services for their employees or they had contracts with medical groups to provide care for workers. By the 1930’s many employers provided prepaid contracts with health groups for their employees. In the mean time medical cost were raising, and the demand for medical care was increasing. In the 1930’s the depression hit and money was short everywhere. It was then that the first structured insurance was formed by hospitals, Blue Cross and then Blue Shield. After these two companies paved the way, commercial insurance companies began to offer health insurance in the 1940’s. By the 1960’s 75% of Americans had health insurance. In the 1960’s insurance for the elderly and low income through Medicare and Medicaid came about, funded through the government. This was the start of insurance how we know it today.

Today we are facing high costs of medical care and insurance, both of which are expensive. For those who cannot afford the cost one option is to go without. Should those who can afford medicine and doctors be the only ones to receive care? I know that receiving care involves payment to help keep clinics and hospitals running, but healthcare has evolved to fit the consumer society, if you cannot pay or conform to their requirements you do not receive the care. Insurance was created to help now it has become a hindrance to many, some companies refuse to offer coverage because of your medical history and most is expensive. I feel a change needs to take place so that all, not just the young, healthy and those who can afford it, receive health care, however I am not sure what that change should be.

Works Cited:

Slonczewski, Joan L., and John W. Foster. Microbiology An Evolving Science. New York: W.W. Norton, 2009. Print.

http://encyclopedia.farlex.com/doctors,+history+of

http://eh.net/encyclopedia/article/thomasson.insurance.health.us

http://www.lwv.org/Content/ContentGroups/StudyTaskforces/HealthCare/HCET_BP_EvolutionHealthCareUS.pdf

http://www.bmj.com/cgi/content/full/314/7097/1823

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Health Care

This blog will be dedicated to the topic of health care in relation to inequality and globalization. As a student looking into going into the medical field and maybe some day working overseas as well as in the United States, I am interested in my future career in light of globalization and inequality. Health care is a problem world wide as well and in the United States. From the information I have acquired in the past few years from watching the news I know that in the US many people who need health care are going without because they cannot afford insurance and certainly can not afford the medical bills they will be charged. These people are the elderly and the poor in our society. My globalization class talked about the “invisible poor” and how they are living in the worst part of cities and striving to live, some panhandling because they can make more money there than with an “acceptable” job. We discussed how in the world today our society is a consumer society and we strive to earn money to buy more things or the ideas that companies are presenting to us in their ads and that the poor today are “failed consumers.” I think that in much the same way the poor and elderly are “failed consumers” of the medical field. Hospitals are businesses and what they are selling could make lives better but because the poor and elderly can not afforded health care they do without. If these people choose to purchase medicines they need they could be spending money that they need for food or housing. Much is being discussed in the new today and for the past few years about healthcare and the state it is in, in the United States, in fact this is not new as an article from the Washington Post in 2006 demonstrates( http://www.washingtonpost.com/wp-dyn/content/article/2006/12/12/AR2006121201436.html). Through my blogging on this topic I would like to learn more about the health care in the United States and how it relates in the inequality and globalization in relation to the country where I live and also in the state of Washington. I am interested in the relationship of inequality in health care in relation to life expectance as was presented in this blog http://www.willwilkinson.net/flybottle/2009/10/20/inequalities-in-health-care/. I would also like to find out what the state of health care is like in other countries including first and third world countries. How is health care related to globalization in these areas? I would like to come out of this with a clearer picture of the career path I have chosen outside of the world of science. This may even help me be better at what ever job I choose.