11.16.2005
Irresponsible Dispassion
We read an amazing article for my Global Health Policy class yesterday. It was from Human Rights Quarterly (Volume 27, issue 3), but it was about maternal mortality, specifically deaths associated with pregnancy. Basically the argument was that if you look at the epidemiology of maternal mortality in the developing world, you can see that there are a lot of stupid deaths taking place because of lack of access to care. Even if you improve nutrition, education, water--all the usual suspects for disproportionate death in the developing world--you don't affect maternal mortality until you improve access to health facilities. The implication, of course is that governments have an obligation to prevent disproportionate deaths from pregnancy complications.
I loved the article and I think that every article about epidemiology in developing countries should convey the same sense of outrage and the same sense of obligation. I've been reading a lot of scholarly articles; most report horrific health statistics dispassionately. But I don't think scholarship and indignation have to trade off; as long as methods are sound and the truth as it's presented demands a response, I don't see why they should.
I loved the article and I think that every article about epidemiology in developing countries should convey the same sense of outrage and the same sense of obligation. I've been reading a lot of scholarly articles; most report horrific health statistics dispassionately. But I don't think scholarship and indignation have to trade off; as long as methods are sound and the truth as it's presented demands a response, I don't see why they should.
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In this country access to health care facilities is an especially pressing issue in rural areas. Kidney dialysis is a prime example. Many rural transit systems devote a large part of their resources to transporting individuals to remote dialysis centers. This is often a full day trip as it may take hours to get to the dialysis center, followed by hours on the machine, and a long ride home. Might it make more sense to take portable dialysis machines to the patients, instead of the other way around. Or fund more dialysis equipment in smaller local facilities to minimize the travel involved. The number of people on dialysis is increasing all the time. (But that's a whole nother public health issue - wellness education, nutrition, exercise, etc.)
There are access issues around birth control and abortion clinics too, especially for rural women. The nearest clinic may be hundreds of miles away. When politicians impose waiting periods, the ability of a woman from a rural area to obtain an abortion may be forclosed even when it is legal, because she can't afford the transportation and the overnight stay (or return trip) when there are no local facilities that offer the services she needs.
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There are access issues around birth control and abortion clinics too, especially for rural women. The nearest clinic may be hundreds of miles away. When politicians impose waiting periods, the ability of a woman from a rural area to obtain an abortion may be forclosed even when it is legal, because she can't afford the transportation and the overnight stay (or return trip) when there are no local facilities that offer the services she needs.
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