I've ceased to expect much from the English Guardian on the subject of development now that their development section is "in partnership with the Bill and Melinda Gates Foundation". But a recent blog post from the section takes pretty much the opposite stance to that of the Gates Politbureau when it comes to the question of basic water, sanitation and hygiene over vaccination.
The Gates publicity machine tends to gush about vaccines, about how they are the future of health and development, about how they are investing $10 billion in them, advocating for a 'decade of vaccines', etc. This flies in the face of public health experience over many decades. For Gates, public health means giving people some drugs and letting them swallow them with contaminated water.
But according to the Guardian article, the World Health Organization estimates that 10% of global disease could be prevented through the provision of safe water, sanitation and hygiene facilities. That estimate sounds rather low, especially for infant and childhood diseases. But at least it is recongized that conditions such as cholera and guinea worm can not be eradicated without providing people with the basics.
Gates, on the other hand, wishes to sink much of his Foundation's money into a vaccine for cholera and polio, with only dribs and drabs going to WASH. And it's not just the Foundation's money that is involved here. It seems that when the Foundation makes a pronouncement about anything, regardless of its serious lack of understanding of the issues, global policy does likewise.
The massive cholera epidemic currently raging in Haiti is a result of a lack of water, sanitation and hygiene services in the country. This lack is not purely a result of some recent disasters, either. The country has been left dangerously underdeveloped as a result of numerous factors, many of them political. Even if a vaccine was available, people would be unlikely to have received it in Haiti and they would likely have been infected with many of the other water borne diseases that are as debilitating and deadly as cholera.
The author of the Guardian article, Yael Velleman, is a policy analyst at WaterAid. The article also calls for closer cooperation between government departments responsible for health, on the one hand, and water, sanitation and hygiene, on the other. This means that donors and those working in development need to connect these two development themes and recognize that they are interdependent.
So, yes to vaccines and other medical technologies. But without better living conditions, they will make little or no difference to people's lives. WASH must come first because without it vaccines will be useless. If you don't believe me, carry out this quick thought experiment: mix vaccine with water drawn from the nearest source of contaminated water and swallow.
These are excellent and sobering insights from WaterAid and Yael Velleman, in particular. There is more on the above issues on their website, including some clarification of the Gates Foundation's stance on immunization and how inimical it is to development (my words, not hers!). The issue is covered in pictures in another Guardian article.
Showing posts with label cholera. Show all posts
Showing posts with label cholera. Show all posts
Monday, May 23, 2011
Thursday, April 28, 2011
Literacy as a Source of Ignorance
A review of a film entitled 'Shame in the time of cholera' mentions, as so many articles do, the role of illiteracy in such epidemics and how high levels of illiteracy make it difficult to disseminate information on how to avoid cholera.
High levels of illiteracy are a disgrace in the 21st century and make efforts to improve health conditions very difficult. But it is worth comparing illiteracy in poor areas with the sort of priorities rich and powerful people make about the health of those in poor areas.
Telling people to wash their hands, keep their houses clean, be careful about sanitation and personal hygiene, etc, is like a sick joke when there is little or no access to clean water or basic sanitation facilities (I'm not criticizing the film maker or the reviewer here).
And there may well be all sorts of stories about cholera coming from the wind, witchcraft, miasmas, etc, but there is also the story about cholera epidemics being prevented by drugs and technology and other great human feats.
But are people supposed to take these drugs and use these technologies in the absence of improvements in water, hygiene and sanitation? If so, the exercise will fail. Cholera and other water borne conditions were eradicated in Western countries, not by drugs, but by clean water, modern water infrastructures and sanitation facilities.
Some people and insititutions seem to think that they can pick out a few diseases, such as cholera and polio, and produce vaccines for them. They think that distributing these drugs far and wide will reduce morbidity and mortality, but they are wrong.
People treated for a handful of diseases will simply suffer from, and some will die from, other water borne diseases unless the whole issue of water and sanitation is addressed (and, of course, nutrition, health in general, education, social services, etc).
A name (of a person and an institution) that springs to mind is Gates. Bill has put a small amount of money into water and sanitation projects, but the main thrust of his spending is on vaccines. He even boasts about this.
His wife has talked abut how much we can learn from Coca Cola, because they have a distribution system for their destructive product. I know Coca Cola like to wave their products about in famine and drought areas, but people don't need bottled water, which wastes far more water than it produces. They need a sustainable supply of clean water, unlike what those living in Kerala and other parts of India experienced when they happened to be close to a Coke factory.
Myths are not exclusive to poor, undereducated people suffering from bad health. The sort of myths emanating from Gates (the people and the foundation) are far more harmful, because the media, that great purveyor of myths, blasts them around the world, and so many powerful people seem anxious to repeat myths from the powerful Gateses.
Drugs, scientific breakthroughs, technology and things that the likes of Gates are interested in are not a priority; clean water and sanitation, along with basic health and education are priorities. This is not new, but the message doesn't seem to have reached the literate.
High levels of illiteracy are a disgrace in the 21st century and make efforts to improve health conditions very difficult. But it is worth comparing illiteracy in poor areas with the sort of priorities rich and powerful people make about the health of those in poor areas.
Telling people to wash their hands, keep their houses clean, be careful about sanitation and personal hygiene, etc, is like a sick joke when there is little or no access to clean water or basic sanitation facilities (I'm not criticizing the film maker or the reviewer here).
And there may well be all sorts of stories about cholera coming from the wind, witchcraft, miasmas, etc, but there is also the story about cholera epidemics being prevented by drugs and technology and other great human feats.
But are people supposed to take these drugs and use these technologies in the absence of improvements in water, hygiene and sanitation? If so, the exercise will fail. Cholera and other water borne conditions were eradicated in Western countries, not by drugs, but by clean water, modern water infrastructures and sanitation facilities.
Some people and insititutions seem to think that they can pick out a few diseases, such as cholera and polio, and produce vaccines for them. They think that distributing these drugs far and wide will reduce morbidity and mortality, but they are wrong.
People treated for a handful of diseases will simply suffer from, and some will die from, other water borne diseases unless the whole issue of water and sanitation is addressed (and, of course, nutrition, health in general, education, social services, etc).
A name (of a person and an institution) that springs to mind is Gates. Bill has put a small amount of money into water and sanitation projects, but the main thrust of his spending is on vaccines. He even boasts about this.
His wife has talked abut how much we can learn from Coca Cola, because they have a distribution system for their destructive product. I know Coca Cola like to wave their products about in famine and drought areas, but people don't need bottled water, which wastes far more water than it produces. They need a sustainable supply of clean water, unlike what those living in Kerala and other parts of India experienced when they happened to be close to a Coke factory.
Myths are not exclusive to poor, undereducated people suffering from bad health. The sort of myths emanating from Gates (the people and the foundation) are far more harmful, because the media, that great purveyor of myths, blasts them around the world, and so many powerful people seem anxious to repeat myths from the powerful Gateses.
Drugs, scientific breakthroughs, technology and things that the likes of Gates are interested in are not a priority; clean water and sanitation, along with basic health and education are priorities. This is not new, but the message doesn't seem to have reached the literate.
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