The Economics of Health

The tragically and profoundly misgoverned country of Zimbabwe recently introduced a two hundred million dollar note to try and keep up with hyperinflation (now estimated in the hundreds of millions percent a year!). The breakdown of the economy and loss of political leadership has resulted in an implosion of the health system as well, marked by a deadly cholera outbreak and violent quashing of peaceful protests staged by health care providers. All this and much more calamity from the former bread basket of Africa.

Photo: A mere 10,000,000 Zimbabwean dollar. By the time you read this, it's worthless.

Home sweet, toxic home

I recently visited a new home care HIV/AIDS care initiative in an urban slum in Kampala, Uganda. While parts of Kampala can be green and pleasant, this area looked, felt, and smelt like shacks on a toxic waste site which is what in fact they were. These are truly the frontlines of providing care in the rapidly urbanizing developing world. And who leads this care? It certainly doesn’t appear to be the government, but rather the NGOs with their bursting, financially-strapped hearts. While platitudes are appropriately rained down on the game-changing activities of PEPFAR and the Global Fund, a few steps on the mountains of trash, a quick hop over a filthy, putrid stream and one can see the harsh reality of a situation not captured in yearly reports.

Photo: The streets of Mbuya, one of the nicer urban slums of Kampala.

Righteous Indignation

The tension between minority indigenous populations and the "ruling" majority is a constant and challenging reality of the modern world. For example, here in the USA we have a sad legacy in regards to our national treatment of the Native American. Across the way, in China, nationalistic fervor and authoritarianism result in the systematic oppression of the "aborigines". William Harlan and Ryan Wylie have made an excellent short documentary of the conflict between the Raramuri, an indigenous group in Mexico, and commercial loggers. It provides an instructive example of the elusiveness of providing justice to the indigenous and of obtaining an equipoise between societal morality, preservation, and modernity in the setting of many years of fault.

Photo: Opening screen shot of the documentary, "Running For Their Lives".

Good Governance

The Dominican Republic and Haiti are two fascinating countries of compare and contrast. They both occupy the same island in the Caribbean, yet their fates have been much different. The Dominican Republic is well governed, democratic, peaceful, and a tourist destination. Haiti is disastrous on all these fronts. A look at the environmental devastation of Haiti is instructive.

Photo: Satellite photo of the border between Haiti and the Dominican Republic demonstrating the clear cutting of Haitian forest.