Geography and Health Inequality: what can be done about it?

One of the universal human rights is the right to health.  By right to health, I am not just referring to access to basic health services and building of hospitals but a wide range of factors that are essential for a healthy life.  These include amongst others:

  • Safe drinking water and adequate sanitation;
  • Safe food;
  • Adequate nutrition and housing;
  • Healthy working and environmental conditions
  • The provision of health-related education and information;
  • Maternal, child and reproductive health.

Being raised in Malta, we have been privileged from birth with a system of health protection that provides equal opportunity to everyone to enjoy the highest attainable level of health incorporating all of the above factors.  Since these factors have always been present all throughout our upbringing, I can afford to say that we have started taking them for granted.  For us, these things are expected rather than appreciated.

However, taking some minutes to reflect and observe the world around us, it wouldn’t take us much to realise that the things we take for granted someone else is praying for.  Let’s take Kenya for example.

DID YOU KNOW that in Kenya…

… only 60% of the whole population have access to clean water?

… only 30% of the population have access to improved sanitation?

… 1.6 million people are living with HIV?

… only 20% of Kenyans have access to some sort of medical coverage? (i.e. with a population of 44 million and rising, as many as 35 million Kenyans are deprived of quality health care coverage)

This summer I had the opportunity to do a voluntary work experience in Kenya with the organisation Right 2 Smile.  This experience has helped me realise how the above facts are not just things we read about on the internet or listen to on the radio but it is the reality facing millions of people around the world.  It is a reality where if you need water, you don’t just open the tap and find what seems to be a never-ending supply but you have to spend four hours of your day to get the water for your family.  It is a reality where the families barely manage to pull together the money needed to pay for the basic necessities like food or clothes let alone to buy medicines if need be.

And if that is hard to believe in the seemingly well-advanced world of today, you have not read everything just yet!  This is because earlier this year all government hospitals in Kenya have been paralyzed as the doctors went on strike demanding the government for higher wages and improved working conditions.  This left the Kenyans with no choice except for visiting a private hospital in case of need.  By the time I went to Kenya, the industrial action had been going on for months so one can imagine what an impact this would have on the lower social class families.  Coming with a medical background whilst pursuing a degree in medicine, this situation intrigued me to engage in long conversations with the locals hearing their own first-hand experience of the situation and how they are affected.  One particular conversation, which will remain imprinted in my mind, was with a woman who is currently pregnant and was overburdened by the situation because she did not know what she was going to do when the time for delivery of the baby arrives.  Should she go to a private hospital a few days before the due date and pay thousands of money to be able to be cared for there until the baby arrives?  Or shall she risk delivering at home with all the possible complications that could be associated with such as the transmission of HIV to her child?  The situation is not as clear-cut as it might seem whilst reading this article as many families do not afford the former option.

Throughout my voluntary work experience, I was given the opportunity to visit a private hospital in Ngong with some children who needed follow-ups there.  As discussed with the doctor, children with chronic conditions will need follow-ups all throughout their lives and what would happen if their families cannot afford to go to private clinics?  Or if these children do not live with their families?  Is it sustainable for the organisation to provide the money for their care?

Another memorable experience I had whilst in Kenya was the day when I had the opportunity to work with a local doctor to provide medical check-ups to all the students at Olasiti primary school.  Personally, I was initially amazed because since we were there on the first week of school after recess, we were not expecting a lot of children to attend school (in-keeping also with the calm pace of the Kenyan culture).  But on that day the attendance rate was inspiring!  Many parents eagerly sent their children to school to be reviewed by the doctor because God knows when they had had their last medical check-up.  This also shows how much they care and that if they the opportunity for a healthcare free at the point of care just like we have in Malta, the situation of their health would be so much different.  It was baffling to see so many students with illnesses like tonsillitis or skin infections that could easily be treated by appropriate medications but their families could not afford taking them for a medical check-up and to buy the medicines.  Therefore, they were trying to ignore the symptoms hoping they will settle in a short time and they won’t suffer repercussions.  There were other conditions which with more education could be prevented or at least prevent their transmission from one person to another (by for example absence from school for a few days).  Here, I would also like to praise the idea of the coordinator to create a medical register so as to know the overall health status of the children at the school and make it easier for the children to be followed up later on.  On a more positive note, I was also encouraged when the headmaster called me into his office and discussed with me how he is going to contact the parents and ensure get the required treatment.  Such an action was so uplifting because I felt that the work we were doing was making a difference and what we had started was going to continue.

All these rewarding experiences have set me thinking:  Don’t these people also have a right to health?  If yes, why is it clearly not being respected?  Why don’t we stop romanticising poverty and reducing human beings to objects of pity but instead start focusing our minds on what can be done from our side to improve the situation?  Suggestion: What if we can invest more in improving the health facilities in the Maasai community and offering more health education in the school?  What if more medical volunteers offer their time and energy to work there for a period of time?  Yes, I believe money is important but clearly it is not everything – it’s the human recourses that can make a project sustainable.