Sunday, November 11, 2007

The State of the World

This last week I attended the American Public Health Association (APHA) conference here in Washington D.C. This conference is the largest assembly for public health workers held every year. People from all over the states, and sometimes countries, come to attend the scientific seminars, poster sessions and expo. It's a great place to gather information, meet up with alumni, network and learn. This was my first time going and only went because I was reimbursed due to my fellowship. I got lots of information, tons of free stuff from the expo and learned loads. However, I came away with a profound sense of despair.

Why, you may, ask did I get this feeling? Why did I at one point think why did I go into the field of public health? What would make me question whether anything we do really makes a difference? Well, it's what I learned from the various sessions that gave me these thoughts.

I heard from people who worked in HIV/AIDS clinics, from people who worked with vulnerable populations and heard how the environment is causing the resurgance of vector and infectious diseases. I heard from experts how global warming is causing more than an increase in temperatures and how it takes more than medical supplies to truly help communities. I heard presidential bashing regarding public health, the environment and allocation of resources. Diabetes, obesity and lack of physical exercise were all discussed and analyzed. I attended sessions regarding women's health, and in particular reproductive health, and heard all about the history of abortion from a pro-choice lawyer. No matter what session I attended or who I talked to there was an underlying theme, no matter how subtle or insignificant it seemed... failure.

As public health workers we work to heal the entire community. This healing can come in all kinds of forms and usually requires helping multiple levels within that community, such as educating and empowering women. Creating a better infrastructure that includes roads and clinics and increasing the availablity of anti-retroviral drugs are other examples. What I kept hearing throughout the conference was how much more we needed to do and how we are significantly lacking in resources and money. No matter what session I attended there was always this theme. "We can't fully treat the women with HIV/AIDS until we better empower them. They can't be empowered until their government recognizes the need for education and their rights as citizens." Another common phrase, "Due to the World Bank and the International Monetary Fund, we no longer have the necessary funds to provide the proper services and until they are willing to be humans regarding money we never will."

Therefore, although public health endeavors have been beneficial in the past and still are I couldn't help but get the impression that for every one thing we did that was good ten more things would need to be fixed before it could be put into effect. I felt like it was a vicious cycle and really wondered if it would really matter what we did. The earth is getting warmer, forests are being destroyed, water is becoming more scarce and millions are dying of diseases. Can anything be done to stop this? Is it even worth the time and effort?

Yes, it is. People need help and although we may not see anything beneficial in the current future we never know what may happen in the long term. I looked back at the past of public health and realized good things had occurred that had worldwide effects. Global vaccines such as the smallpox eradication, fluoridation in water and smoking bans have all been beneficial and all took awhile to fully work. So as C. Everet Koop stated, "Health care matters to all of us some of the time. Public health matter to some of us all the time." We shall never give up.

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