One thing I've noticed since relocating to Nepal is the absolute pervasiveness of preventable deaths. Left and right I hear friends and family members say, "My Mother died when I was a child," "I have two mothers, because my biological Mom died when I was a small child," "My son drowned," "My friend drowned" and on and on. It's absolutely shocking and I find myself surrounded by death, in a way. What always surprises me is that it is so accepted. People die.
Does this change how people view life and relationships? Do people feel compelled to seek out information on health maintenance, disease prevention, and the like? I've had educated people ask me such strange questions, such as "Is it OK to eat pomegranate seeds? I hear they stay in your belly." And, "You should brush your hair because it stimulates the blood flow in your head. It's not good if you don't brush your hair."
So then I wonder, do people not stop to think about such matters and seek out quality information from experts or from reputable sources online? It's scary to think about the blatant gap in people's socio-economic status and their corresponding health knowledge.
In the U.S., and I imagine in many nations throughout the world, death is such a scary, tragic, and greatly feared fact of life. I imagine it is in Nepal as well, but I cannot help but wonder how the pervasiveness of it must change one's sense of place and permanency in the world. It's unnerving and unfortunate and preventable. Of course preventable deaths won't stop with education alone, but it can certainly help.
Saturday, October 18, 2008
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3 comments:
Great post. I've thought a lot about this as well in my work in countries with low life expectancy. There are so many different ways to think about it--from an economics perspective of how this impacts health prevention as an investment of time and money, from a behavior change perspective where there may be certain points at the sort of fatalism has taken over and made any health education campaign really difficult to be successful, etc., etc. No profound solutions in mind at the moment, but I think it's something worth more attention.
Great job with the blog, Jenara! I got really excited to see your guest post on nextbillion.net, which I also read. Keep up the good work!
I've often been struck by the same thought in visits to India. People's casual attitude towards death is not only evident in their words, but in their actions. The complete disregard for traffic safety in India, and in particular in a large metropolis like Delhi, is a constant reminder. But is this attitude towards death a cause or a symptom? I feel that it is a pervasive cultural issue that manifests itself in thought, action, and religious belief. I believe that it is a societal protective mechanism. As death is a more likely everyday occurance, people have to avoid dwelling on it. Perhaps someone with more knowledge than me can chime in, but I suspect that this is a phase that all societies go through as they transition from 'third world' to 'first world'.
I think there is also a feeling of helplessness that is apparent. I don't get the feeling that people feel empowered to seek out answers. It seems all too accepted; traffic is bad, people drown, hospital care is poor...the list goes on. It's sad. I don't know if it's a natural stage on the path to development, because that might assume that all societies have to go through it. More could be done, and that is of course the focus of all development work. But as Ben said, no profound solutions come to mind (within the current dominant aid/charity framework) and so I think the answer is business at the base of the pyramid (BBOP). BBOP has a lot of potential to help countries develop at a faster pace so that they do not have to endure for long periods the stages that Carson alluded to, but the challenge is to scale BoP initiatives so that they help accelerate the speed at which national economies grow. Then will come access to education, information, and capital and preventable deaths will decline. As a result, I think attitudes and expectations about death will also change. It's going to take a policy shift and a radical re-thinking in political, business, and public health institutions before real change is made; the structural change has to happen first in order for individual attitudes to change.
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