The Natural Connection

“Count your children after the measles has passed”—Arabic Proverb 

I recently had the misfortune to visit a discount store to shop for a birthday card on the day before Halloween. As I shuffled through the cards on the rack, trying to decide if my niece would prefer Garfield or Peanuts, a small ghost zipped about my feet. 

“Matthew!” the ghost’s mother shrieked, “you slow down or you’ll never get any candy tomorrow!” The Matthew-ghost carried a small plastic pumpkin that he was filling with Snickers and Jelly Bellies as he cruised aisles filled with grotesque rubber skulls that squealed when you pinched their noses along side of jolly Santas. Somewhat confused about the holiday at hand, he sang, “Jingle Bells, Jingle Bells, Jingle all the way…” Matthew’s mother stood nearby, fingering tea towels embroidered with eight tiny reindeer. 

After about the tenth refrain of that Christmas carol, Matthew’s mother turned to her sister and pleaded, “Mary Lou, put him in the buggy, or somebody is gonna steal him!” “Fat chance” I muttered, and then I noticed his feet. Under his Ghoul-In-The-Dark costume, Matthew wore designer sneakers.

 Some days it is easy to be a medical cynic. The national health care budget of our country now exceeds $2 trillion, 15% of the gross national product, the highest in the world. Still, the public and the politicians are unhappy. Things are not perfect. For $2 trillion you would think that the government would pay for Viagra, and it doesn’t. Neither will it pay for piercing your nose or coloring the gray in your hair. You don’t get too many frills for $2 trillion anymore. 

Our dueling presidential candidates both promise to fix the situation at hand with more funds and lucrative public benefits, should either win the election. Still, despite the inequities in our health care system, we live in a country that is the dream of countless immigrants who still strap themselves to little life rafts and head out into open waters, hoping to reach our shores. Listening to the political spin-doctors, we wonder what would ever possess them to want to leave the Third World behind. 

As a nation, we often forget to count our blessings when it comes to our health and our health care. We are among the fortunate nations classed as an “Established Market Economy” by the World Health Organization. The United States, along with other industrialized nations, spends 89% of the global health care budget. Developing nations, on the other hand, spend 11% of the global budget, but suffer from 90% of the global burden of disease. 

A lot happens on Thanksgiving Day, the somewhat orphaned holiday that lies wedged in between Halloween and Christmas. Much of America sits down with family and friends to a bountiful table laden with more calories than they can jog off in a month. 

On each Thanksgiving Day, over 10,000 of the world’s children die of infectious diseases caused by unsafe drinking water and improper sanitation. While in our community we moan when we are prohibited from watering our lawn during drought season, a child dies in a developing nation every eight seconds of a water-related disease. 

On each Thanksgiving Day, two thousand children die of measles, part of the 1 million that will die this year from this preventable infection. Deaths from measles are almost unknown in our country, thanks to strong public health vaccination efforts. Another 1,000 children will go blind that day from preventable causes such as Vitamin A deficiency and Trachoma, an infectious disease transmitted by a bacterium. Fortification of our food supply with Vitamin A, and treatment of our newborns with antibiotics to prevent Trachoma have virtually eliminated these causes of preventable blindness in the children of this country. 

On each Thanksgiving Day 1,6000 women in Third World countries die of complications related to pregnancy and childbirth. The lifetime risk of a woman dying in childbirth in some parts of Africa is 1:16. In North America it is 1:3,700. Maternal mortality has the largest discrepancy between developed and Third World nations of any health statistic. Due to the availability of medical care and trained birth attendants, it is safer to be born female in the United States than in the Sudan, Ecuador, or Pakistan. 

And on each Thanksgiving Day, the International Committee of the Red Cross tells us that 75 people, most of them children, will be killed by encountering one of the 120 million land mines that litter developing nations, a legacy from past and present political conflicts. Countless others will be maimed and suffer amputations of their hands and feet. Cambodia alone has two land mines per child yet to be detonated. U.S. trained orthopedists work tirelessly to care for these children, as well as those in our own country who are in need of rehabilitative services. 

Matthew’s two designer sneakers are a tribute to the fact that our nation’s children can walk safely on their own two feet, oblivious and without fear of stepping on explosives. He is free to play in the aisles of the discount store, innocently aggravating customers with his antics and off-key Christmas carols. As I hear him break out once again into “Jingle Bells! Jingle Bells!”, I smile. At least he doesn’t live in my neighborhood. 

Do we have a perfect society with a perfect health care system? No we do not. There is still much to do, and much we can do. With public and political will, changes will hopefully come. But do we have reason to give thanks? Yes, indeed we do. 

Happy Thanksgiving and blessings on you all.

©2000-2003 Pauline M. Bellecci, MD