Infections and Inequalities

To really understand the injustice that our society continues to allow to happen, one needs to read Paul Farmer, yes the great humanitarian doctor, who provides a ethnographic review of the lives and the challenges of Haiti being ravished by AIDS.  The book, Infections and Inequalities, begins by discussing the modern plaques, AIDS and the re-emergence of TB.  He quotes Richard Wilkinson in 1996 stating, “the health effects of inequality have shown us how deeply people are affected by these structural features of our society… great equity would add to the average length of life … Not only is the cost of inequality a cost we incur for no economic benefit, but all the indications are that it imposes a substantial economic burden which reduces the competitiveness of the whole society.”  Farmer describes his foray into helping those in rural parts of Haiti and the challenges faced in attempting to make a difference there where medicines, tools for screening, and human support were almost non-existent.  Each chapter provides another view into the deadly diseases of AIDS, and TB.  The belief that woman were immune from HIV and that gay men were the only ones at risk proved even more deadly as the disease spread rapidly, especially in places that had little to no education and prevention.  Farmer provides an overview of the spread of AIDS from its earliest detection in the late 1970s through the books date of publication, 1999. (In many ways, I wished that he would provide a further update on the progress and challenges the disease continues to face.)  The personal stories of native Haitians from birth to death further indicated the depth to which Farmer himself has connected with people who had limited understanding of their own medical condition.  There are a few stories of success, though for the most part, as is with HIV, no long term success, especially at the time of the publication.  Farmer talks about the need for our society to intervene and not make this issue a “poor person’s” reality alone.  He speaks as a role model through his regular trips from Cambridge to Haiti to attempt to make a difference.  His data is compelling, comparing various female/male, monogamous/multiple partners, gay/bisexual/heterosexual, type of work environment, poor/affluent, and urban/rural villages.  The question we need to answer: what will make one act and be conscious of the disease and strife that face the poor?  I made my small contribution to Doctors without Borders today, how about you?  http://www.doctorswithoutborders.org/donate/overview.cfm?ref=main-menu  A compelling read for those who have a heart, but more important for those who need to grow one!