Sunday 24 September 2017

What if ... malaria reaches America?


I wonder how many of you have caught the snippet of health news from Asia … the emergence of a lethal strain of malaria that is resistant to current treatments. 

I knew it was there in Cambodia, in a remote corner of the country on the border with Vietnam. Apparently it has now spread to Thailand and Vietnam - and so, potentially, into the ‘mainstream’ malarial areas. There has been a drive to eradicate malaria from the Mekong delta (using preventive measures such as bednets and sprays, plus experimenting with vaccines), but if this strain reaches the Mekong all those efforts will be undone.

The biggest worry is that it will spread to Africa - virulent strains already kill thousands every year, where treatment depends on proximity to a health centre and preventive measures are hit and miss.

I know that in Malawi everyone is given bednets in an effort to control the disease, but many find them unbearably hot to sleep under, and fishermen find the small mesh invaluable for trapping small fish. I visited a school and saw bednets full of holes. When I mentioned malaria people simply shrugged: it was just one more hazard of living in Africa.

But a lethal strain is more than one more hazard. It can easily spread far more widely than ebola or the Zika virus and kill more than thousands.

So, will there be panic in the western press? Not at the moment. After all, it is contained in areas that tourists and western businesspeople rarely visit. And our climate ensures that anyone returning from a malarial area cannot bring the virus home with them … so we've got nothing to worry about, have we?

But just suppose it reached, say, the industrialised parts of India which are building trade links with the west? What would we do then? How many businesspeople would happily wander around in an area knowing the local mosquitoes carried a strain of malaria that might kill them? What will happen to post- Brexit trade then? 

What if one stray mosquito found its way to the swamps of Florida? 

Oh the drug companies would swing into action then. Millions of dollars would be ploughed into research. More millions would be invested in education and preventive measures across the world.

Maybe malaria has to reach America before those deaths in Africa and Asia are taken seriously.

Sunday 17 September 2017

Anyone for hospital food?

One day, when I was in Malawi, we drove past a hospital. On the opposite side of the road, among the trees and mud banks, was a village of tents and shacks and makeshift food stalls.

‘For the relatives,’ Everlasting explained. (If you don't know who Everlasting is, click here!) ‘They know what people like to eat - so they can bring tasty food to the sick people in the hospital, good food that will help them get better.’

I don't know how many of you have sampled hospital food recently. But I've come across it twice in the past few months - and in two very different hospitals. Even so, the experience was similar.

Breakfast - cereal, and toast and tea - if you're lucky. You need to be awake when the nurse has five minutes to get it for you. Miss that window, and you have to wait till lunchtime. 

Most hospitals give you a lunch menu the day before. But there is no guarantee that they will have whatever is it you have asked for - or if it will be palatable. (Meals are cooked in a central factory, up to three months in advance.) Which is just tough for anyone with a special diet - or even a vegetarian (hardly a ‘special diet’ these days).

Tea - is a tired sandwich or soup that began life in a tin.

It's the cuts, of course - diets reduced to a bare minimum. No thought of offering something tasty and tempting to encourage sick people to eat. Which is why, if you should be visiting a hospital at lunchtime, you will see so many people arriving with plastic boxes full of something truly tasty. ‘They know what people like to eat - so they can bring tasty food to the sick people in the hospital, good food that will help them get better,’ as Everlasting said.

80% of the population of Malawi live in poverty. So it's not surprising that it's a challenge for hospitals to provide adequate nutrition to patients as well as treatments and medication. 


But in a wealthy economy like ours? There may be a conversation to be had about whether patients should make a contribution towards their food. But, as things are, patients with relatives nearby who have the time and energy to provide good nutrition will fare better than those with no one. Yet another division between those who have family to fight for them and those who are alone and abandoned.

Sunday 10 September 2017

Rationing the news.

I have to make myself watch the news at the moment. The political shenanigans in the UK and America are painful enough (the bungling might be comic if the potential consequences weren't so catastrophic) - but they pale into insignificance in the light of the recent onslaught of ‘natural disasters’. (The ‘..’ indicates a recognition that some of these may be the result of man-made climate change.) 

As one storm followed another - have we forgotten those who died in the mudslide in Sierra Leone? The floods in Asia that I wrote about last week, and those in China? Hot on their heels came the storms and hurricanes currently battering the Caribbean and America. A huge earthquake in Mexico has been relegated to the inside pages of the newspapers. 

Everywhere, or so it seems, people are homeless. Refugees from Africa and the Middle East brave the waves of the Mediterranean. Bangladesh - those areas not under water - are flooded with Rohingya Muslims from Myanmar.

It’s overwhelming - all this need and trauma. But we still have to deal with the realities of life. Domestic stuff has to go on - we need to decide what to have for supper and if we have enough milk. Lawns need mowing. Children need kisses before heading off to school.

I can only speak for myself here - I have to ration the news. If I catch every bulletin I risk being paralysed by the sheer extent of it all. But that way madness lies. And failure to look after the daily trivia helps no one. But there are times, when I musing over which book to choose in the library or picking over apples in the market, that I find myself reflecting on the insignificance of such choices. 


It's a dissonance that I find deeply uncomfortable. I don't have a solution - and maybe that's fine. We should not turn our backs - nor our feelings - on the millions of people in such terrible need. But there is no point on wallowing in their reflected misery - we have lives to lead. Few of us are able to  up sticks and do anything practical to help (though we can contribute to appeals). All we can do, it seems, is notice the enormity of it all and then keep the show on the road in our own small corners of the world.

Sunday 3 September 2017

Why are some floods more floody than others?


You can't have missed the pictures of floods in America. The impact of the storm in Texas and Louisiana has been truly shocking - and the heroism of those working to help those in need cannot be underestimated. Thousands have lost everything, and are now homeless. The water is now receding in places but the clear-up has yet to begin.

You might have missed the extent of the floods in India, Bangladesh, Nepal and now Pakistan. I've seen the occasional bulletin on the news programmes and passing pictures in the papers, but nothing like the coverage we've seen (here in the U.K.) from America.

So, just in case you think this is nothing more than a heavy monsoon, here are some figures. These floods have gone on for weeks - and there is more to come. Thousands have died. And (according to The Guardian) forty million people are affected. 

That's right - forty million people. 40,000,000 people - people just like you and me.

Now I don't wish to minimise the distress of those caught in the floods in America. Their trauma runs deep and their need for help is urgent. Already the relief effort is predicted to cost billions of dollars and Congress is being asked to help.

But I've no idea what it will cost to clean up the devastation in Asia. I know one of the most urgent needs is clean water (available in bottles in America) to forestall a cholera epidemic. I know they need mosquito nets to prevent malaria running wild. Local people are doing what they can. Friends of mine in Nepal have given blood and blankets. 

So where is the international relief effort? I am certain it's there. Volunteers will be working their socks off trying to provide shelter, food and health care. But who will pay?

Where is the disaster relief appeal? 

We've grown accustomed to disasters such as this prompting international appeals for money. It's the only way to raise the sums needed to scrape the surface of such huge need. So why not this time?

Or are we so focused on those wading through water in America that those in Asia somehow don't matter quite so much?


(When I raised this on Facebook I ruffled a few feathers. How dare I accuse anyone of racism, that sort of thing. But sometimes feathers need a bit of ruffling, don't they?)