Public Health is Public Wealth
January 18th, 2007 | Published in Africa, Environment, Governance, Health, Nigeria | 1 Comment
Some 160 years ago, the discovery of Dr. John Snow at one of London’s hand water pump ushered in the science behind public sanitation and health (improved sewage disposal and clean water supply systems), one of the several areas several African nations have yet to master, and have miserably and repeated flunked post-independence.
When Snow unraveled the connection between fecal matter, water and Cholera in London in 1845, little did he know he had set the foundation pillars for public health, and the stage for one of the most important medical milestone in the last 200 years: Sanitation and public health. According to a recent Reuters report: “Improved sewage disposal and clean water supply systems, which have reduced diseases such as cholera, was the overwhelming favorite of 11,341 people worldwide who voted in the survey conducted by the British Medical Journal.”
While cases of Cholera outbreaks and have fallen considerably over the years in Africa, sub-Saharan Africa (SSA) remains the hot spot for Cholera and other water-borne diseases. This can be partly explained by the preponderance of conditions that contribute to the breakdown of public health systems and the emergence of preventable diseases in general -political instability and disruptive events (conflicts, environmental disasters, massive dislocation of people) - conditions endemic to SSA. However, this argument doesn’t apply to the more stable regions, cities and townships in Africa, where public health infrastructure is severely compromised as well. Any major city in Africa qualifies as good examples.
Here are some questions that come to mind as I write:
- Why have Nigeria and several sub-Sahara African nations remained stagnant, and public health initiatives lackluster and non purpose-driven?
- Why has it been difficult to ‘leapfrog’, and assimilate the lessons others have learnt hundreds of years before us?
- How can we overcome ‘development-inertia’?
This excerpt from the New York Times (Nov 9, 2006) captures one of the counter-currents we need to overcome:
“Issues dealing with human excrement tend not to figure prominently in the programs of political parties contesting elections, or the agendas of governments…They’re the unwanted guests at the table.â€â€”New York Times.
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January 19th, 2007 at 11:27 am (#)
Imnakoya:
My comment is moreso directed at devlopment inertia in SSA in the genral context, as it relates to all types of infrastructure.
My friend, please forgive me for saying this, but I think that in SSA, we can’t rely on the governments to provide some of these infrastructural devlopments. Unfortunately, until some of the governments in SSA become more proactive, the burden to do this may continue to fall on the people most affected by these issues. But, yesterday, while watching a rather fascinating documentary entitled, “Africa Open for Business” there were several entrepreneurs who referenced this same opinion. They said that within their respective industry’s that they had formed an alliance as it pertained to providing infrastructure.
In many low income districts in the States, the groups that often step in when local government is moving too slowly are the community development corporations. They are normally chaired and committeed by the local residents of their respective areas.
To be honest with you, I am not sure that this can be applied to public health in SSA. However, it seems like it may not be very probable that one may be able force some of SSA’s governments into doing something, which they are not already doing. This is sometimes puzzling to me. Have you ever read George Ayittey? Well, as far as his in your face style, I am not sure if I agree with that. Where I do agree with him is that in lieu of strong government supportive structures, community centered and organized groups may be able to partially fill some gaps. If someone asks me how much of the gap these organizations could fill, my answer today would be that of uncertainity. It’s just that as you have said certain governments have not been able to keep up with their citizens needs. Especially like you have said in the public health areas, if the affected communities did not organize to raise funds, awareness, development, and etc. they might end up waiting indefinitly for the governments response.
Again though, that’s just my take on the issue, as it stands today. Hopefully, this doesn’t offend someone, but if it does, my apologies just trying to offer my help a little bit on this very complex and huge issue.
Also, my readings on the many viewpoints in this area tell me that what I have mentined above possibly oversimplifies these huge and complex issues. Maybe we can continue to study this issue and continue comparing notes.
Take care.