The Power of the Observer
You cannot solve a problem if you are not exposed to its reality. This idea is so simple, but digging down to the root of a concern has become a thorny dilemma for developing countries, especially when it comes to healthcare. Huge non-governmental organizations and corporations are pouring money toward medical relief, but why are people in developing countries suffering from highly preventable diseases? The leading causes of death in developed countries, like the United States, are heart disease and cancer. In contrast, in many areas of the developing world, easily preventable diseases like respiratory infections, diarrhea, tuberculosis, malaria and malnutrition are the leading medical problems. If we have the money and the medicine, what's going on? This is an extreme threat not only to poor populations but to our global society. The repercussions are endless. A poor health system anywhere becomes an ominous risk, both socially and economically, to everyone.
More often than not, developing regions suffer from corrupted politics or have decentralized governments that make a simple project an impossible endeavor. The administrative power is so removed from those who are informed and concerned that they have little means of conducting a pertinent project. The native educated youth of society, any developing region's largest asset, are often disenfranchised and at the mercy of complicated bureaucracy and poor infrastructure. The working conditions can be so frustrating that many either leave or lose their incentive and motivation to make significant progress. Thus, the original issues get lost amidst a tangled web of squabbling, squandering and politics.
NGO's and large corporations are highly visible enterprises that need to work through the government of a developing country. They cannot penetrate the deepest layers of a healthcare issue, which is often embedded within the infrastructure of the system. Because of the lack of exposure, there is a lack of follow-up to the proper allocation of funds. This is the main issue. No one can be held responsible, so the money is not directed to the source of the problem. What's the point in putting tons of money in medicine, where overuse may decrease its potency anyway? Improving the sanitation system, drainage and water sources will solve the problem in the long-term. Healthcare is about infrastructure and lifestyle just as much as about medicine, yet not many tend to look at it that way.
So who can change the system? Students can. Tomorrow's journalists, civil engineers, policy makers and healthcare workers are today's students. Students and interns are in a unique position to observe anonymously the reality of a societal concern. They can slip into crevices that visible organizations cannot, and their unassuming appearances can bring forth the truth in all of its forms.
A new organization here on campus called the Dartmouth Coalition for Global Health, comprised of students, faculty and alumni, realizes the importance of looking at health as a total social entity, and encourages Dartmouth students to develop a global perspective. (For more information about DCGH, you can blitz Dr. Lee Witters.) Medical philosophy cannot be isolated in scope; it is affected by everything outside of it. Public health is beyond the realm of medical sciences; it concerns us all. We are a part of a complete system of cause and effect and when we become the observers, we can begin to treat any issue at its root.