Sometimes the only thing standing between clarity and
confusion is asking the right questions.
In the introduction to the book Dying
for Growth, Millen, Irwin, and Kim do just that in the context of
globalization and its impact on the world’s most marginalized populations. Challenging the notion that economic growth
trickles down to improve global health, they have profoundly asked the right
questions: what is growing, and who is dying?
The opening story of the young Guatemalan girl literally living off of
the trash of others all too clearly illustrates the problem with assuming that
growth will benefit all with any sense of equity. To this girl, it does not matter that
worldwide average life expectancy has gone up nearly 20 years since the 1950’s,
or that half as many children die before the age of five than did half a
century ago. Her daily life is still a
struggle through an unhygienic and dangerous environment.
In the Ted talk that we watched the first day
of class by Hans and Ola Rosling, they used the improvement of global health statistics to claim that, in general, things always improve. But what if we always judged global health
improvements from the perspective of the least common denominator, those who
see little benefit from the system of global health policies in place now? The statistics would tell a very different
story. When we learn basic statistical
measures such as mean, median, and mode in middle school algebra, we are taught
that no one measure can accurately describe a data set. So what is growing? Average life expectancy. The number of children that make it to age 5. But what about the low end of the spectrum?
How is that data changing in the face of globalization and economic “growth”? And the more important question: who is
dying? Who is still dying? And why? If economic growth isn’t the answer, what
will be?
Hi Sydney,
ReplyDeleteThank you so much for bringing such reflection in my day! Your post instantly grabbed me and your relationship as you described the connection between the individual and the larger picture we often see in a data set, reminded me of a child named Brian that I met in Kenya a few years ago. When he was among the masses in the program he was involved in he was just another, but it was when I had the opportunity to speak with him was when he was a shining star with an incredible spirit. You brought me back to that feeling I had.
With regards to your questions on who is still dying and why, those are such heavy questions but I think it got me thinking about the fact that some of the leading causes of death today are caused by diarrheal diseases and prematurity and low birthweight. Economic growth as Farmer et al., describe in chapter 6 does help in access to healthcare (roads, transportation etc.) but it is when we leverage it with the sociocultural factors that he describes as just as important is when it can make the difference to the individual. For example, that child may be surrounded by neighbors or people that he knows who care for each other just as family would and having the ability to advocate for that child and perhaps developing a transportation program with the local community members may get him what he needs. So I think the answer to your question is that no, Economic growth is not the only answer to this. It is part of the equation but it is when we include the others is when we may be close to one. We need to take advantage of the economic, technological resources that we have now than we did before. The key brings me back to what Sanjay said when she came to speak to our class, it is the people on the ground that have the answers and it is by listening to them that the individual mother or child can get the answers that they need. Does this make sense?
Thank you so much for bringing such reflection in my day!
Great reflection Sydney and perfect comment Amy!
ReplyDeleteI totally agree with Amy that economic growth is only a part of the equation and people on the ground usually have the secret clues.
In fact, I prefer to apply the SEM when analyizing & putting stratigies for such health problems. No doubt that policy and economy play a great role in proposing solutions but, in my opinion, these are the broad lines that can be applied to any population without taking into consideration the other crucial factors that varies individually. What about the individual and its itra and inter relations? What about variations in SES, income, cultural background and beliefs among different individuals? What about social norms, social stigma and social support in realtion to different health issues? What about the role of NGOs and community initiatives to save those who are suffering and dying while the economic growth is celebrating its success from more broader perspectives?
I remember the video that we watched in class "how safe we are" and that the doctor who belonged to those people was the one who had the secret keys to save suffering people from death.
In my opinion, collaboration is a MUST for saving those who are dying while being unnoticed for the higher authorities and the global economic growth!
The story of the young girl in the beginning of the article really grabbed my attention as well. It was very descriptive and eye opening about the conditions that some people still live in that is unheard for us. I think the claim of improvements in economic growth will "trickle down" is made by those that don't necessarily place emphasis on the importance of improving health in these impoverished nations. I too believe we should be measuring improvements in health from the least common denominator- if the worst off nations are not seeing improvements, we are not doing our job right. If this continues, it will only continue to widen the health gap in the world. It is an important but very difficult question as to how we work to lessen the gap. How do we get these people the resources they need to live a longer, healthier life?
ReplyDeleteExcellent post Sydney and equally good comments by you all. The questions are very valid and needs long term answers. We have ample proof that the "trickle down" theory does not work well in practice and resources are cornered by the traditionally powerful set in any society. The other question following on Hannah's comment is, "do we need to get the resources to the people who need them?" or " do we need to create pathways that will enable them to use their existing resources to the fullest extent?". And Sydney, data is a tool, an exact tool and at the same time a political tool. Measurement too!! We need to take the available evidence and our assumptions about the conditions and work informed by them. As we have already learnt, dependence on definitions and standards cannot blind us from observing people's conditions.
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