Well healed

 

 

A young father comforts his son, who is receiving a blood transfusion to treat anemia at St. Luke's Hospital in Uyo, Nigeria.

What are the chief barriers to equity in health and well-being? They vary from site to site, of course, but are often strikingly similar if you're a doctor in Haiti, Rwanda, or serving the poor of the United States. The chief barriers are not poor individual choices, but rather a lack of access to effective prevention and care. We can analyze different methods of prevention and treatment, but it is really quite simple: poor health outcomes are associated with poverty and inequality, but they can be addressed in small ways and large.

Rotary's wonderful efforts on behalf of universal access to vaccines offers an example of an effective, focused approach, and has saved millions of young lives. The next steps will involve improving the circumstances of those saved from vaccine-preventable illness or malaria, because lessening health disparities depends ultimately on addressing fundamental social ills.

We can and must address the lack of basic tools, from diagnostics to therapeutics; the dearth of healthcare workers; and the absence of community-based models of care in locations without laboratories, doctors, or nurses (indeed, we need community health workers even where there are plenty of doctors and nurses, especially as chronic diseases replace polio, measles, and AIDS as the greatest threats to the world's most vulnerable). But we must also tackle broader obstacles to health, such as an absence of clean water, of primary and secondary education, of safe shelter, and simple lack of food. In so doing, we help to alleviate the greatest cause of health disparities—poverty. Every doctor working in these places knows that it's impossible to focus solely on clinical medicine when what ails your patients is not only disease, but also poverty and hunger and lack of jobs.   

We often draw on a rights-based framework in our work.  We believe in the right to health, and also in a right to clean water, a right to decent housing and employment, and a right to safe motherhood (500,000 women die each year in childbirth—almost all of them in the poorest parts of the world).  In order to provide adequate treatment for and prevention of disease, we have argued that these "social and economic rights" must be at the forefront of health delivery in resource-poor settings around the world. But even those who do not share this framework must come to agree that those caught in "the poverty trap" cannot spring themselves from this trap without basic medical and social services.

In Rwanda, where the country's stated vision is to leave poverty (and foreign assistance) behind by 2020, a country that may well be among the few on that continent to reach the Millennium Development Goals, investments in health care and education as a public good, for all citizens, are growing. Citizens of wealthy countries like mine, and members of organizations like Rotary, must continue to make and indeed grow our commitment to making poverty, and the diseases of poverty, history. We can and we must.

Read more about the other areas of focus that will be funded by The Rotary Foundation's new global grants, which are part of the Foundation's Future Vision Plan .