Ch. 4 Journal

'Diseases of Poverty"

Summary:

According to the WHO, health is defined as "a state of complete physical, mental and social well-being and not just the absence of disease" (p. 75). The book cautions that disease analysis through numbers can be persuasive, misleading and often based on assumptions. Death rate, under-five mortality rate (U5MR), infant mortality rate and life expectancy are proxies for determining a population's risk of disease. There are many many variable of health: age, gender, urban vs. rural, education, poverty. Selective biomedical interventions include vaccinations for malaria, measles, tetanus, rehydration salts and vitamins, and treatment for diarrhea. Two challenges that arise from these interventions is that often the health sector is poor and cannot provide the resources, and also that embracing these interventions and changing behaviors is not sustainable.

"China's performance... teaches an important general lesson: large improvements in the health of the population can be achieved of there is a broad and lasting political commitment, with a consistent emphasis on preventive measures and basic curative care. In other words, social progress is not merely a by-product of economic development. Policies matter" (World Bank 1990 p. 89).

I completely agree that the health of a nation is shaped by policies. However people can choose to adapt a health lifestyle, therefore health goes two-ways. It is the responsibility of the individual and also the government.

AIDS is a disease of poverty. HIV/AIDS causes huge amounts of mortality, especially in Sub-Saharan Africa. The virus can be spread through sexual intercourse, needle sharing, blood transfusions, syringes by injecting drug users. Using a condom is one way to protect against the spread of disease. There is a picture on p.91 in the text that shows a grandmother with 2 grandchildren Thailand, since their parents died of AIDS. There is a huge generation gap between grand-parents and grandchildren because the parents are dying. This places increased pressure on the older generation to provide for an increasing amount of young. Also this affects how the younger generation is raised, because resources are limited and can affect their health, education and living conditions.

"The World Bank has recently estimated that 15-20% of all HIV infections in Africa now occur in infants that have been infected by their mothers" (p.91). This statistic is very unfortunate because the unborn child is at risk and has no choice in his/her fate. I believe if mothers go to clinics and the necessary precautions and medication to prevent transmission, rates will drop. This is more easily said and done and success relies upon increased government involvement through spending, education campaigns and response from the people. Prenatal counseling by maternity nurses can go a long way and this type of transmission can be prevented if the right steps are taken, mainly through policies that provide resources and education to expectant mothers.