We here at GlobeMed adore Paul Farmer and his work as a medical anthropologist and a physician. When Dr. Farmer talks, we listen. And recently, as GlobeMed alum Neal Emery writes, he’s been pushing Rwanda’s dramatic healthcare overhaul as one of the brightest global health stories to come out of Sub-Saharan Africa in recent years. This is an article we shared with you on Wednesday in celebration of World Day of Social Justice, but I just wanted to highlight two things I took away from reading it.
I love the fact that Emery highlights the importance of primary care and preventative procedures. Emery writes, “All the while, Rwanda increased from 870 people on HIV treatment in 2002 to more than 100,000 in 2012 while retaining 92 percent of patients in care – compared to 50 percent in the United States – not in spite of but because of the investments in primary care.”
Many experts now say one of the biggest problems with the US healthcare system is the lack of focus on preventative medicine and primary care. The lack of interaction with doctors on a regular basis makes it hard to establish a relationship with physicians, makes catching deadly diseases such as cancer, diabetes, and hypertension less likely, and increases the cost of having to treat a patient with such illnesses down the road. The US seems to have good (or at least well-funded) “sick care”, but not anything near proper “health care”, especially considering how much money is spent annually. Rwanda, however, spends next to nothing on its healthcare system compared to the US, and has had incredible success, all things considered.
Finally, I wanted to point out a fantastic quote that Emery includes about the interdisciplinary nature of global health. HIV/AIDS is still a major problem in Rwanda, but the attitude of the government on the best way to treat and prevent the disease gives me great optimism that if they keep this up, the disease will be eliminated or made insignificant in the near future. The Minister of Health, Dr. Agnes Bingawaho, said, “HIV does not exist in a vacuum — if an HIV program does not address the associated problems such as tuberculosis and malnutrition, it will fail.”
Global health issues don’t exist in a vacuum, and yet too often we see well-meaning but misguided groups of Americans and Europeans coming to third world countries and handing out medicines and vaccines, and returning home after only a week and thinking they did a great thing. While these trips can prove to be incredibly powerful experiences for the people that go on them, they really do not address or help the situation of the people they were trying to serve. They fundamentally miss the point when it comes to such service trips: global health is complex and involves many different facets; if only one facet is addressed, the problem will not be solved.
Feel free to comment and add your own opinions on what this article means to you and what you take away from it.
Also, check out our photos from World Day of Social Justice on our Smug Mug!