An article from Newsweek emphasizes this theme in public health: http://www.newsweek.com/2010/12/13/how-to-stop-cholera-in-haiti.html
The article begins by pointing out the potential health threat this outbreak is to us Americans. Proximity and trade agreements throughout Central America as a result of NAFTA make disease spread through North America a realistic and potentially rapid threat. The health threats of our neighboring countries should be considered a threat to our country, especially as viral disease have the capacity to evolve and develop into new strains. As witnessed from the swine flu epidemic last year, the US has the resources to respond to a spread of disease throughout this country. But, if the purpose of public health is to prevent the spread of disease, shouldn't we as a society seek to prevent the spread of disease to our shores by attacking the problem at its core: lack of infrastructure, sanitation, and medical treatment in Haiti.
While it's easy to dismiss the cholera outbreak as a problem for Haiti, the article cites the ability of such diseases to spread around the world as a reason not to discriminate diseases and countries by economic welfare - as exemplified by the success of HIV programs in diminishing the prevalence of HIV in Haiti. The same should be applied to this recent epidemic. The article cites the need for cholera vaccine to be exported to the country, but poses the barrier of cost to treating cholera. But does the cost outweigh the benefits? Would the price of letting this cholera epidemic outweigh the cost of aid given in preventing the spread of disease? I personally believe from a political and economic standpoint it makes sense to ensure the health of the country. Politically, a cholera outbreak that has already led to 2,000 deaths in the past month threatens to ruin the stability of the region. Economically, treating the country's 10 million is more sensible than potentially treating 300 million plus people in the US and throughout North America.
I suppose the real question is what is the role of those who have in dealing with the plight of the have-nots. The issue thus becomes one of social justice. The treatments all exist. We know the importance of sanitation and infrastructure and the helpful role of antibiotics and vaccinations. Yet the system is willing to deny access to these life-saving procedures. Personally, I think access to these treatments should be granted to those who want them, and while economically it may not be cost-effective, the cost of tackling a global outbreak of cholera could prove much more costly.
Haiti has historically been shunned by the world in terms of aid--whether in response to natural disasters or less-pressing concerns as simply developing the government. It seems odd that a nation who has such a compelling history of independence, and what we might consider "American" spirit is neglected by the US--we share so many different variables.
ReplyDeleteWith the wealth of organizations in Haiti, especially right after the earthquake, one would assume that things are under control. But this is becoming increasingly obvious that this is not the case. Haiti suffers from a collapse of infrastructure (roads, buildings, etc.), sanitation, order, disease, and other damage both caused by the earthquake and other occurrences. What people I think neglect to think about is the difficulty that accompanies any attempt at mobility around the nation--roadways are still in disrepair, buildings are still full of rubble, and the amputees are common. How do you create a program to immunize and treat those people who are afflicted when they can't even get to you? Before any real progress is made, simple changes have to be accomplished. Sanitation and infrastructure repair being the primary goals in my mind.
I think you are right to point out the very real threat that this outbreak constitutes. But, where has news of this outbreak been in the media? Haiti was all over the news right after the earthquake, but has now virtually disappeared from coverage. People so quickly lose interest and while short-term fix-its like a donation are great, we need to take sustained interest in these issues to many any real difference.