The map above, obtained from Worldmapper.org (a site I recommend), shows the proportion of carbon dioxide, methane, and nitrous oxide (commonly referred to as "greenhouse gases") emitted from each country in 2000. The map below shows the proportion of childhood deaths from diarrhea in 2002.
What's the connection between climate and health? More on that in an upcoming post, but it is widely acknowledged that the increasing release of carbon dioxide, methane, and nitrous oxide into the atmosphere is having a noticeable and negative affect on health, especially malnutrition and diarrhea.
April 7 is World Health Day and the theme is "Protecting Health from Climate Change." For now, suffice it to say that this theme certainly bring together issues of health, rights, and faith. And the maps above are a thought-provoking contrast.
I'm at a conference this week and today heard a particularly interesting talk about the efforts to reduce malaria in Africa, especially among those in extreme poverty.
The promotion and use of bednets has had a significant and truly impressive impact on malaria reduction. But, the speaker mentioned that in the early days of these bednet campaigns, it was found that only approximately 60% of those who received bednets used them. The various international partners in these efforts spent much time thinking about the reasons that nearly 40% of those receiving bednets did not sleep under them, and various proposals were put forward to study the causes and possible solutions. After much time spent thinking about how to develop an effective study that would help quantify the problems and solutions to the use of bednets, one local person said, "why don't you just help the people hang up their bednets." After all the complex discussions that had taken place, that one simple solution, to hang bednets for those who received them, was ultimately what raised bednet use rates from 60% to over 90%. Helping families hang their bednets is now standard protocol in malaria bednet campaigns throughout Africa.
This story, when we heard it, raised chuckles through the audience, because it was such a perfect example of over analysis by the "experts" and simple, real, effective solution-finding by the local people. The story reminded me of an article I read several years ago, and have always appreciated, that was published in the British Medical Journal (link below). The article effectively raises an important and serious point through humorous means by pointing out that experimental trials are not always possible, nor are they always necessary, before promoting certain health strategies.
Granted, too often, our strategies are not well evaluated. But, we need not go to the other extreme and think that all our solutions need to be tested through rigorousexperimentation before we can implement them. Indeed, in the real world of health and rights, sometimes, as the bednet story well illustrates, what is most needed is careful, culturally-informed thinking.
I don't want to loose the inspiring story here about how a simple solution (bednets) and a simple strategy (hanging them up for people), is truly having a life-saving affect on millions of people in Africa, but I think you'll find the linked article similarly thought-provoking.
I am continually impressed with the Public Library of Science and their free-access journal (see PLoS Medicine link in side bar). Don’t be fooled by the title, because they publish on issues much wider in perspective than simply “medicine.” Much of what they do could truly be called public health and human rights related.
If you have never spent much time at their site, I want to point out a few places that offer a lot of valuable reading.
The journal has a special collections here http://collections.plos.org/plosmedicine/index.php where they highlight special topics including: Global Poverty, Grand Challenges in Health, Disease Mongering (interesting phrasing and worth a read), Pediatrics, Social Medicine (including an article by Paul Farmer), and others.
These are all very interesting and worth-your-while collections to browse. To highlight one of them, the Disease Mongering papers open with, “Disease mongering turns healthy people into patients, wastes precious resources, and causes iatrogenic harm. Like the marketing strategies that drive it, disease mongering poses a global challenge to those interested in public health, demanding in turn a global response. This theme issue of PLoS Medicine is explicitly designed to help provoke and inform that response.”
Also, the Poverty collection includes compelling articles about, child rights, "moral imagination" as a missing component in global health (a particularly interesting read), and others.
The papers in all of these collections are well written, well researched, and are certain to make you think. Happy reading.