Seeking Ideas on Poverty and Health

[Gavin Yamey]

Dear friends,

I am preparing an article entitled “Which single intervention would do the most to improve the health of those living on less than $1 per day?”

My aim is to ask 100 people around the world (including some living in poverty) to answer the above question in around 50 words.

PLoS Medicine, the open access global health journal at www.plosmedicine.org, is publishing a special issue on poverty, human development, and health on October 22nd. My piece will be in this special issue.

If you are a health/medical/science journalist in a low income country, would you like to contribute? If so, please send me your suggestion and I will include the best ones in the article (if I include your suggestion, it will be attributed to you by name, and I'd like to add your job title and city).

In addition, if you are able to ask those you know who are living under $1/day what they believe would do the most to improve their health, and you can confirm that they would be happy to be quoted, I would be very grateful indeed.

With thanks and best wishes,
Gavin
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Gavin Yamey, Senior Editor, www.plosmedicine.org

[Swati Bute]

For sometime i was working with tribals, that project was on health of tribal women, i think in my country people are living with so many superstitions and fears, reason, lack of education and awareness, instead of making so many policies and committees its good if we can focus on educating people and generating scientific attitude among them, they should atleast know biology of human body, and reasons of different diseases, awareness and scientific temper is must for changing the attitude, then only it will be possible to implement all the programmes and policies successfully.

[Krystyna Knypl]

Hi Gavin,
congrats on this theme! In era of high-cost medicine writing about interevention which cost less than 1 usd is very good idea. In my opinion the best intervention is frequent hands washing. Next is no smoking ( no cost!) and keeping weight.
Greetings from Warsaw, Poland
Krystyna

[Calestous Juma]

The African Union and its New Partnership for Africa’s Development have recently published the Report of the High-Level African Panel on Modern Biotechnology, Freedom to Innovate. The report is available for download at the website of the NEPAD Office of Science and Technology http://www.nepadst.org/doclibrary/pdfs/biotech_africarep_2007.pdf

[John Daly]

Be careful of the way you frame the question. There are nearly a billion people living on less than $1 per day and they don't all have the same health needs. The answer might depend on where the person is living. What are the communicable diseases to which they are exposed. I suspect that the answer might be different for a man than a woman, for a child than an adult.

Of course, the best single intervention could be construed to be: "increase the person's income to $100 per day". Of course that might cost more to do for a billion people than you had thought to spend. The Copenhagen Consensus gave some estimates of the most cost-effective means to reduce poverty.
http://www.copenhagenconsensus.com/Files/Filer/CC/Press/UK/copenhag...

I would guess that a very cost effective thing to do would be to add enough resources to the global effort financed by rich countries to prevent the next flu pandemic. That pandemic might kill a few million to tens of millions of people when it arrives as it surely will without an effective, global, public-health campaign. Rich countries are now supporting such a campaign to save their own people, but I would guess that they will leave out some very cost-effective methods to prevent or limit a pandemic in poor countries. I don't suppose any really poor people will identify such an intervention.

[Rosebell Kagumire]

Hi Gavin,

Rosebell here.This is what I believe can help improve people's health in poor countries.

In Uganda, only 19 percent of women between 19-49 have never been to school. and 53 percent are literate compared to 83 percent.

Health in many poor nations has more to do with personal income and levels of education.

When you analyze statics on whose health is more at risk in these countries, it is mostly women and children.

With illiterate mothers, the health of many more children is bound to be at risk.

Many times, diseases affecting the poor are preventable. For example diseases like Cholera, malaria -which is the leading killer in Africa, affect the poor more because of the poor sanitation issues.

Maternal mortality in Uganda is still high with about 500 mothers dying out of 100,000.
low education levels among women have more to do with the poor health.

An educated woman will know what her child need to eat for nutritional purposes. And her income level are mostly higher than that of illiterate mothers.

For example I recently covered a story on Burkitts lymphoma in Uganda. The disease was first discovered in Uganda and was the first cancer to be identified as a treatable cancer.

But when you visit the only cancer institute in Uganda, you will find mostly children from rural areas.

This is to show, educated poor move to towns and there they can easily access medical care and checkups. Therefore they will be able to have their children diagnosed early.

Those children who still die of the disease are mostly from the rural areas which have no hospitals.

There’s a saying that when you educate a woman you have educated a whole village.
This is true, once women are in positions of power they can plan better for the communities.

There are also other issues that accompany low education levels. Women with out education are more likely to suffer violence especially domestic violence.

In Uganda, the survival of infants depends strongly on mother’s age many mortality cases among children under the age of five happens with those children whose mothers are under 20 years.

With no education, many girls get married just above 15 or even before that. They have no knowledge of how to cater for a child’s needs.
Well with education in place, these children’s lives can be saved, but only education will not save them.

Lack of government health care policies and proper health institutions which cater for the poor is the problem.
Most governments in Africa and other developing countries have not developed health care policies and their systems don’t work for the poor in the country.
On top of education, government must construct health centers close to communities which are currently lacking.

For instance in Uganda, many times drugs have expired in the medical stores when people in the rural areas are dying

Rosebell, Kampala, UG

[Murugi Murekio]

Hi Gavin
Murekio here from Addis Ababa. My take on this is we need to guarantee those who earn less than a dollar a day is food. Good wholesome food, protein carbohydrates and vitamins.
These people barely eat and due to this they are more prone to succumb to opportunistic infections that greatly weaken their bodies.
For example in Ethiopia, ARVs are free, but mostly women can barely afford a meal a day and so this diminishes their capacity to live healthily positive because they have no food.
So i say feed them, feed them, feed them, or at least ensure food security.
Good food Good health.

Ciao
:-D

[shiare yvonne tianga]

Thank you a lot for coming up with the idea.Infact i know quite a number of people who live on less $1 per day.it would be a good idea if i go round and ask people for their suggestions and then get back to you.

[shiare yvonne tianga]

I also think that people should be educated more about their health and eating habits.In most cases you might find that,these people live in slums and the only thing they think about is making babies.So the women tend to give birth to many children and they find it difficult to feed the children.Some children end up getting many diseases and you might find the parents cannot afford to take them to hospitals.It would be good if the Government can build clinics in these slum areas so that people can get easy access.They should also send people to educate the people on HIV/AIDS and how to keep their environment clean

[Ms Gwanvalla]

Improving the health of those living on less than a dollar in Cameroon will be to ensure that health services in this country are transparent. Have you ever been sick and when you get to the hospital for consultation the doctor will prefer to attend to the bourgeois and to those whom he or she knows. If you are poor you will be the last. Furthermore, I think duty-conscious doctors and nurses should be employed. I have seen several doctors who sit in their offices waiting for patients to come and bribe them for consultations, doctors who would spend time laughing and chatting in their offices rather than engage in work. Doctors who will sign for a medical certificate without examining the patient, doctors who will ask for money before administering a surgical operation, doctors who will not work if they were not financially motivated. Their mission is to raise money and not to save lives. With all these, one is left with nothing than to distrust structure, I mean the health structure. Institutionalisation is failing us and will continue to fail us if nothing in this done to uphold the moral and value of those working within the health institutions in this country. You need to go through these experiences then, you will get to undertsand why people will prefer to queue up and be attended to by traditional practitioners who will serve you on the basis of first come; first served.