Medicine and systems of politics and development are so intricately intertwined that often times they seem like parallel systems to one another. The intermingling of the three especially occurs in the global health and development arena. Disease, for example, can be analyzed as a medical, political as well as a developmental problem which devastates a country. In summary, disease has three primary connotations in the context of
Apartheid, which led to the strict segregation among the races, was instated from 1948 to 1994. Apartheid led to empowering the minority European elite which controlled much of the socioeconomic and political power in the country. The segregation took away voting rights and citizenship of individuals who resided in
Apartheid can be perceived as a form of continuation of colonialism where a small European minority still controlled much of the resources. Because the labor reserve was still in
The segregation which was initially implemented to be “separate but equal” turned out to be systems which were very separate but far from equal. This segregation actually empowered the white elite as they were able to deny access to proper health care, education, and sanitation to the black majority. The black majority had a ratio of 1 doctor for every 44,000 individuals while the minority had 1 doctor for every 400 individuals. Annual expenditure on education was only $45 for a black pupil while $696 was allocated for each white pupil. [8] These figures clearly indicate that these two groups were segregated into a system which treated the black majority unfairly and unjustly. Apartheid and its devastating consequences during and after this terrible implementation can be classified as a disease which deeply struck
The disease in the political system lies in the very fact that a system is not able to adequate sufficient amount of care for individuals who are most in need. ‘Politics of the belly’ ruled the governance of the country as the minority European elite mistreated the black majority.[9] The symptoms of the diseased political state can be perceived thorough various ways in the case of
A disease in the more physiological system indicates weakness and suffering of the individual. This may range from the weakness of the immune system which leads to other infections due to the body’s state as well as the direct symptoms of the disease which may range from severe vomiting to fever. An epidemic leaves a population devastated as it affects a large population. An epidemic like AIDS leads to a great number of individuals in the older and younger brackets but eradicates the working class. This has created a huge crisis as individuals who are left are either too young or too old to work. [11]
HIV began to rein havoc in
Because a woman’s power in requesting a condom is not taken or even considered, women are highly subjected to HIV. For instance, males in South Africa sometimes practice “dry sex” in which the women is intentionally wiped dry in order to increase the sensational pleasure for the man. This practice makes the woman’s vaginal canal more prone to bleeding, further leading to the spread of HIV. [15] Women hold a subordinate role in society making them more susceptible to coercive or this type of unwanted sexual behavior. It is estimated that 80% of rural South African women are victims of domestic or sexual violence.[16] “One in every three women in SA is in an abusive relationship, a woman is killed by her partner every six days and there is a rape every 35 seconds.”[17]Often times women are also economically dependent on the male members in their life, and economic stability is sometimes conditional upon the consent to have sex. [18] For the reason that HIV/AIDS is looked upon highly negatively in society, women and men who know they are HIV positive are discouraged from speaking out to their partner. Additionally, if the sexual intimacy does lead to pregnancy, the child also contracts the disease in some circumstances if adequate treatment is not allocated. Women also have a higher likelihood of infection when exposed to HIV. Furthermore, even if women are monogamous there is no guarantee that the males in the relationship are the same way. Men who are promiscuous are often times considered more masculine and therefore having multiple sex partners is, in a way, encouraged from a cultural stand point. Therefore, the spread of HIV is also further spurred by various cultural influences. [19]
Some reports also indicate that Apartheid led to a huge loss of the notion of a family in the black South African culture. Men spent most of the year away from their wives and children which led to the loss of culture and tradition in the native black South African population. Because fathers were so far away from home, the family unit was utterly destroyed. Some scholars also argue that the location of labor reserve actually hindered the reproduction and growth of the black population in and around
Additionally, when couples do have an opportunity to see each other, they are more likely to engage in unprotected sex as the very notion of a “condom” is often seen as a means of promoting promiscuity and disrupting child bearing. A woman who proposes to use a condom can be construed as ‘lose’ by her very suggestion to use protection with her partner despite the fact that it is socially acceptable for her male partner to have multiple sexual partners. Condoms are also perceived as uncomfortable and unnatural in monogamous relationships. Because the development and disease intervention specialists may not take into cultural factors of this sort into, this leads to inadequate methods of support and help. This is one of the primary examples of why health intervention fails in implementation. For example, in this situation many lecture about condoms may be given, and the individuals in a certain population may be given the access to condoms, however, if an individuals sees the condom as a hindrance of reproduction, this contraceptive method may be hindered and not practiced. Furthermore, individuals do not see condoms as a sign of protection but rather view is as a method for promiscuity. Moreover, because men have more social power, they may feel further empowered by the notion of using no protection and somehow see a condom as a form of entrapment or rejection. [21]
In addition another reason of project failure may be due to the notion of westerm superiority. An organization which goes into these developing countries for a project or a clinic sometimes makes the assumption that locals have little or no knowledge and that in some way these individuals are inadequate. Until western health care system and development systems are able to recognize other individuals in these countries as different instead of inferior it may help further. Flipping through the World Bank pages of the “end poverty” year report is filled with glossy pictures of individuals from all parts of the world yet all of these pictures seem to have something in common. There is usually a westerner intervening and this foreign intervention is somehow portrayed as a godsend to these people. Nevertheless development and health projects are appreciated but this notion of superiority does not help the pursuit of development rather builds a greater divide between the haves and have nots. [22]
The greed of economic profit and prosperity can also be seen as a form of disease in all three systems of medicine, politics and development. In medicine, large pharmaceutical companies hold much of the power and seek markets which are most profiting to the company. These companies do not necessarily want to cure disease as a cure of any disease would lead to a decline in the sale of a particular drug. The companies are far more concerned with the profits it seeks. [23] Therefore their goal lies in the fact that they want a population who are infected by a disease dependent on the medication as this would provide a constant source of profit for their companies. Although medications which slow down the progression of HIV in an individual are in existence, a drug company does not see a profitable interest in providing medication for the numerous infected both in South Africa as well as other parts of sub-Saharan Africa. These individuals are not able to pay large amounts of money for the medications and therefore pharmaceutical countries would rather invest in countries where individuals have the financial capacity to overpay for medications. In political terms, the climate in
Both western medicine as well as western development always seems to yearn for hard facts and data sets which can be easily manipulated and redistributed. Medicine like development cannot necessarily be standardized in every way and form into each society or individual. Whether as a doctor or as an economist, an individual needs to realize the importance of cultural impact and cultural significance. The failures of these development projects and the failures of trying to eradicate disease is not because the intentions are not good or just, but perhaps that these intentions are not carried out in the proper cultural context in which these intentions ought to be carried out. When looking at medicine it is so much easier to systemize and categorize every symptom and every disease. Every condition is given its own name then why are individuals not? It is perhaps this discrepancy between treating a patient for an illness vs. understanding the patient with the illness which leads to the various failures in development as well as health interventions around the world. The large inadequacy of western medicine lies in the fact that often times finding the cure may not necessarily be the answer. As for in medical practices, the political systems of development face a similar situation. The disease of corruption, “politics of the belly” and red tape bureaucracy may never end, however some changes in infrastructure and policy among these political systems may allow for a positive future. Recognizing that finding a cure for all the diseases which exist today would be a nice solution, however, this would certainly not solve all the complexities of disease which will continue to exist despite of cures. There is likelihood that even though all the disease of today’s world may be cured, another disease or virus may very easily arise and devastate the population again. Although this “disease” can be one which weakens the individuals physically, politically, socially or economically, the diagnosis and treatment per say needs to be customized in the context of cultural and social factors of the location. Medicine should perhaps be more focused on disease preparedness and prevention rather than eradication. Although one does not have a way of knowing what diseases or how these diseases will come about, massively increasing public health interventions will definitely help.
[1] http://www.un.org/av/photo/subjects/apartheid.htm
[2] Post-Apartheid South Africa
[3] http://www.un.org/av/photo/subjects/apartheid.htm
[4] Post-Apartheid South Africa
[5] Post-Apartheid South Africa
[6] http://www.econlib.org/library/Enc/Apartheid.html
[7] http://www-cs-students.stanford.edu/~cale/cs201/apartheid.hist.html
[8] http://www-cs-students.stanford.edu/~cale/cs201/apartheid.hist.html
[9] Source Citation: Nevin, Tom. "Apartheid era crooks exposed: a damning new report exposes instances of deeply entrenched grand corruption involving high ranking politicians and businessmen during the apartheid era. The report gives the lie to perceptions that corruption in
[10] Source Citation: Nevin, Tom. "Apartheid era crooks exposed: a damning new report exposes instances of deeply entrenched grand corruption involving high ranking politicians and businessmen during the apartheid era. The report gives the lie to perceptions that corruption in
[11] http://www.avert.org/aidssouthafrica.htm
[12] http://www.avert.org/aidssouthafrica.htm
[13] Source Citation: Suich, Alexandra. "Women and AIDS in
[14] http://www.avert.org/aidssouthafrica.htm
[15] Source Citation: Tshabalala, Lerato, and Suzy Brokensha. "Would you put any of these into your vagina? Of course not. But hundreds of thousands of women in
[16] http://www.engenderhealth.org/news/newsreleases/040305.html
[17] http://www.africa.upenn.edu/Urgent_Action/apic_82299.html
[18] Source Citation: "In
[19] Source Citation: Suich, Alexandra. "Women and AIDS in
[20] [20] Post-Apartheid South Africa
[21] Source Citation: Maharaj, Pranitha, and John Cleland. "Condom use within marital and cohabiting partnerships in
[22] Seeing Like a State
[23] Source Citation: Silverman, Jennifer. "Where drug dollars go. (Policy & Practice).(Brief Article)." Family Practice News 32.16 (August 15, 2002): 34(1). InfoTrac OneFile. Thomson Gale.
[24] Andersen, Martin Edwin. "Oversight crisis at development banks: slashed wrists, blood-smeared offices and workers too terrified to complain: what can be done to root out alleged corruption at the world's development banks? (The world: multilateral finance)." Insight on the News 19.6 (March 4, 2003): 32(2). InfoTrac OneFile. Thomson Gale.
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