Being Part of the Change

This past week, ABC News launched its Be the Change: Save a Life initiative – “stories and solutions for a global health initiative”. The idea, the way I understand it, is to highlight and share real world solutions to the array of global health challenges. One of the components I find fascinating is how these solutions are coming from every sector, not just medicine and public health. There are portable and re-heatable (without electricity) baby incubators from a group of Stanford students; pumps to clean water from a former nightclub owner; and local solutions too, like horses to get HIV tests to labs in time in Lesotho.

Being local, which won’t be a surprise to my regular readers, is key. Nifty tech devises and creative fund-raising are important, we need both for innovative and sustainable solutions. However, to make innovations work a) the local needs, environment, and lives must not just be acknowledged, but understood and b) solutions need to be fostered from within communities and not just presented to them.

This year-long initiative will undoubtedly share with all of us some truly remarkable solutions…for determinants and disease. And hopefully, as with the piece on child nutrition in Guatemala (I know someone involved with this initiative!), medical anthropologists and other community thinkers will be engaged and highlighted. For when all of us are part of the change, practical, simple and human solutions become a reality and lives are saved.

Developing Poor Health

Youth in Qatar (NYTimes)

In most of our discussions around obesity and other diseases associated with “modern life”, we tend to only address the United States and other western industrialized nations. There is another area of the world, however, that is also facing many of these same conditions and ones unique to their settings. Qatar (and other nations of the Middle East) has one of the highest rates of obesity in the world! A nice piece in the NYTimes examines how the privileged lives of native Qataris (less than a quarter of the country’s current population), fed by their nation’s oil wealth over the last several decades – rocketing them to developed nation status decades faster than the general trend has been – are literally making themselves unhealthy. Youth especially, who drive everywhere, eat multiple fast-food, high fat meals a day, and still follow the traditional practice of marrying first cousins, are seeing the devastating effects of speedy development more than anyone.

A couple of interesting aspects of Qatar’s situation jump out. First off, there are obviously cultural differences between Qatar, the Middle East in general, and older industrialized nations that make their circumstances unique. Religious beliefs and practices, social and gender hierarchies, and an environment that can be harsh (and hot!) has perhaps given Qataris less flexibility in their epidemiological changes (or more structure?) One of these elements is the traditional practice of marrying within your family, often a first cousin  known as consanguineous marriage. As many of you may know, reproducing within a small gene pool, like a family, causes any number of genetic disorders and birth defects. (Check out March of Dimes’ recent report on global birth defect trends.) Additionally, Qatar’s fast economic rise has created not only a population of super wealthy but of relatively poor as well. Qatar could be facing a dual-disease burden much like India is currently – India’s economic rise has had a negative health impact on both the newly rich (i.e. rising rates of obesity) and the continually poor (i.e. children dying of malnutrition).

The global health community should take note of Qatar’s story. In the U.S., we can reflect on the health downsides to economic growth (obesity, diabetes, CVD, etc.) and note that some of our health concerns are not isolated within our borders – the US has a malnutrition problem too! For the international development community and international health organizations, seeing some of the side-effects of rapid economic development can perhaps teach the global community what side-effects to be leery of, how similar human populations can be, and how important a role our cultural practices and differences play in our health outcomes.

*Image originally appeared in NYTimes article highlighted in this post.

Another Perspective: How Easily We Forget

A colleague pointed out over the weekend, in her blog haba na haba, hujaza kibaba, that less than 40 days after the earthquake that rocked Haiti to the core, the public and media have already moved on. While its not surprising that the media and much of our attention is now focused on the Olympics and our own political messiness (remember the health care negotiations this coming Thursday!), this does not mean that the people of Haiti aren’t still suffering and facing daunting challenges. Not being an expert in disaster relief, transition, and development, I am overwhelmed by the thought of the sheer amount of coordination and continued dedication that will be needed. If you are interested in learning more, or being part of the solution, you should look at her blog and a post I had in January about health challenges Haitians are facing post-earthquake.