Healthcare in underdeveloped nations

In certain impoverished nations, unless you pay at the reception, you cannot see a medical professional–even if you are bleeding, there is nothing they can do other than give you a cloth to wrap and stop the bleeding and that’s if someone is kind enough. This means that you must pay out of pocket for healthcare services each time you see the doctor. In these countries, unemployment is very high, sanitation is very poor, and people are highly susceptible to illness not once or twice, but constantly, with no access to healthcare.  As a result of having to pay for these services out of their own pockets, the lack of financial security increases families’ financial strain.

“Without health care, how can children reach their full potential? And without a healthy, productive population, how can societies realize their aspirations?” said UNICEF Executive Director Anthony Lake. “Universal health coverage can help level the playing field for children today, in turn helping them break intergenerational cycles of poverty and poor health tomorrow.”

The most primary and infectious causes of death in developing nations are malaria, AIDS, and tuberculosis. In fact, these diseases can be prevented in the same manner as in industrialized nations. Tuberculosis? implying that both adults and children lack access to immunization. Immunization, seriously? Everyone should be vaccinated against these deadly diseases, which have claimed countless lives before our great-grandparents were born. In the 1700s, tuberculosis was not only referred to as the white plague due to the sufferers’ pallor, but also as the “Captain of all these men of death.” Now that it is possible to contain the disease, why not do so in every region of the world and not only in wealthy nations? 

If an outbreak occurs, it can affect people in both underdeveloped and developed countries. For example, Ebola emerged in 1976 in the DRC and South Sudan. After a period of few to no occurrences, an outbreak resurfaced between March 2014 and June 2016. This was the largest Ebola outbreak ever reported, with over 28,000 cases. This occurred not just in West Africa, but also in East Africa, Italy, Spain, the United Kingdom, and the United States. If these regions of Africa had proper healthcare, the disease may have been efficiently contained. National and international authorities collaborated to help terminate this outbreak by building prevention programs and messages, as well as implementing policies with care. Personnel from the CDC were dispatched to West Africa to aid in response activities, including surveillance, contact tracing, data management, laboratory testing, and health education. In addition, the CDC team assisted with logistics, staffing, communication, analytics, and management.

During the height of the response, the CDC trained 24,655 West African healthcare professionals in infection prevention and control methods. In addition, by the end of 2015, 24 laboratories in Guinea, Liberia, and Sierra Leone were equipped to do Ebola virus testing. If all these strategies were done not only during pandemics, we would be able to avert a great number of outbreaks. These nations and others would be able to contain an outbreak before it spreads internationally. However, we wait until a pandemic threatens our minds before implementing laboratories and educating more healthcare staff in developing nations. Why not do this in the absence of a potentially deadly disease? Why not be prepared for anything that could affect us in both developed and poor countries?

We’re not ready for the next epidemic, Bill Gates remarked during the ebola outbreak. Obviously, Covid happened, and what appeared to be a simple sentence made so much sense. He went on to explain that we require a response system with the capacity to mobilize tens of thousands of healthcare staff. During his TED talk, he mentioned that in order to combat an epidemic, we need robust health systems in developing nations– where mothers can safely give birth there, and children can receive all of their vaccinations there. However, this is also where the outbreak will appear first.

“Past experiences taught us that designing a robust health financing mechanism that protects each individual vulnerable person from financial hardship, as well as developing health care facilities and a workforce including doctors to provide necessary health services wherever people live, are critically important in achieving ‘health for all,’” said Mr. Katsunobu Kato, Minister of Health, Labour and Welfare, Japan. 

What are we waiting for to improve healthcare in developing nations? In other words, what affects individuals in developing nations is likely to impact developed nations. Why not collaborate to create not only a better national healthcare system but also a universal healthcare system? Universal health means that everyone has access to and is covered by a well-organized and well-funded health system that provides quality and comprehensive health care and protects individuals from financial ruin if they utilize these services.

Guaranteeing the right to health means eliminating all kinds of barriers to accessing services…

Dr. Carrissa F. Etienne– Director of the Pan American Health Organization

Some Key actions for Universal Health are:

  1. Expanding equitable access,- Initiating and gradually extending primary care models and comprehensive service delivery that are centered on people’s needs. Assuring the prudent utilization of medications and health technology.
  2. Increasing stewardship and governance by teaching and empowering people and communities about their health-related rights and duties and encouraging them to participate in the development of health-related policies.
  3. Increasing and enhancing finance through eliminating payments at the point of service entry, identifying sustainable means of increasing health financing, and financially protecting individuals. These are only a few examples; the list is far longer.

The enhancement of health care in developing nations will have a substantial effect on the mental health of an infinite number of individuals. Healthcare is a human right!

References

World Bank and WHO: Half the world lacks access to essential health services, 100 million still pushed into extreme poverty because of health expenses. (n.d.). World Bank; http://www.worldbank.org. Retrieved June 7, 2022, from https://www.worldbank.org/en/news/press-release/2017/12/13/world-bank-who-half-world-lacks-access-to-essential-health-services-100-million-still-pushed-into-extreme-poverty-because-of-health-expenses

CDC. (2022, January 14). World TB Day History. Centers for Disease Control and Prevention; http://www.cdc.gov. https://www.cdc.gov/tb/worldtbday/history.htm

Fact sheet about malaria. (2022, April 6). Malaria; http://www.who.int. https://www.who.int/news-room/fact-sheets/detail/malaria

2014-2016 Ebola Outbreak in West Africa | History | Ebola (Ebola Virus Disease) | CDC. (2019, March 8). 2014-2016 Ebola Outbreak in West Africa | History | Ebola (Ebola Virus Disease) | CDC; http://www.cdc.gov. https://www.cdc.gov/vhf/ebola/history/2014-2016-outbreak/index.html#:~:text=The%20patient%20recovered.,hospitals%20in%20the%20United%20States.

Universal health coverage (UHC). (2021, April 1). Universal Health Coverage (UHC); http://www.who.int. https://www.who.int/news-room/fact-sheets/detail/universal-health-coverage-(uhc)

Gates, B. (n.d.). Bill Gates: The next outbreak? We’re not ready | TED Talk. Bill Gates: The next Outbreak? We’re Not Ready | TED Talk; http://www.ted.com. Retrieved June 7, 2022, from https://www.ted.com/talks/bill_gates_the_next_outbreak_we_re_not_ready

Maternal mortality disparities in the United States

Despite being quite good with children, I have never desired or felt the urge to have children of my own. However, when the prospect of giving birth crosses my mind, I am terrified and helpless—not necessairly of giving birth, but of giving birth as a black woman in the United States. When someone close to me or anyone I know gets pregnant and that person is black, my mind wanders to a cruel world more like a wilderness. I ponder what their experience will be like—  Will the individual return from the hospital alive, will they survive their aftermath, and will they be able to raise their children? I contemplate the doctor’s character, perhaps he or she will be kind enough to do their job with integrity. Perhaps! Perhaps! This is a state of limbo,  a state of doubt and  complete uncertainty. This wilderness is a dark realm riddled with raw sores and agony. It is frightening and the absolute worst place to be. How does one ease their State of mind when this notion occurs?

What are the statistics on the maternity mortality rate?

Before childbirth, during labor, and after childbirth, black women are two to six times more likely to suffer and die from prenatal complications than white folks. According to the National Library of Medicine, which evaluated data from 1979 to 1992, the pregnancy-related mortality ratio for Black women was 25.1 per 100,000, for Hispanic women it was 10.3, and for non-Hispanic white women it was 6.0. According to the American Medical Association, these rates have not improved, and bleeding, pregnancy-induced hypertension, and embolism are the leading causes of maternal death. Black women are nearly three times as likely as white women to die from a hemorrhage.

This is a recent 2020 report on maternal death rates from the CDC. The maternal mortality rate for non-Hispanic Black women was 55.3 per 100,000 live births, which was 2.9 times higher than the rate for non-Hispanic White women. Significantly higher rates were observed among non-Hispanic Black women than among non-Hispanic White and Hispanic women. Significant increases occurred between 2019 and 2020 for non-Hispanic Black and Hispanic women. The increase recorded between 2019 and 2020 for non-Hispanic White women was not statistically significant. The following graph from the CDC illustrates the aforementioned information.

When you read something theoretically, it doesn’t hit you as hard as when you use numbers—that is to say statistics. Numbers hit different— it’s as though your mind recognizes the enormity of the problem in plain sight. I was browsing the CDC website when these statistics blew my mind. It’s like, what the f**k is going on in this country.  Numbers certainly don’t lie.  And, to make matters worse, these rates continue to rise. This is bad—and bad is a nice term at the moment. This is cruel. 

Although statistics on the maternal mortality rate in Black women existed, it wasn’t until recently that this topic received national attention. According to Dr. Neel Shah, an Assistant Professor of Obstetrics, Gynecology, and Reproductive Biology at Harvard Medical School, until recently, medical practitioners did not systematically track maternal death rates. There are several approaches to comprehending these large disparities. Racial disparities are to blame for the rising number of mothers dying in childbirth in the United States. Black women are three to four times more likely than white women to die during childbirth.

Being wealthy or famous makes no difference given your skin color. Take into account Beyonce, Serena Williams, and Olympian Allyson Felix, all of whom have come forward to share their experiences with pregnancy and childbirth.  Even if you are the world’s best athlete and have a deep grasp of your own body, advocating for yourself might be harder than anticipated. Serena Williams was diagnosed with a clotting condition. She had previously experienced a blood clot in her lungs, so she was familiar with what it felt like. After giving birth, she got a blood clot in her lungs, and she was compelled to push vehemently for care. Because the professionals did not initially believe her, treatment was delayed. Blood clots are potentially fatal. As a result, it appears that education and social standing do not shield Black women from racism in healthcare.

There are countless examples of black women who have suffered unnecessary injury, death, and suffering. When these women described their symptoms and showed concern about what was happening to them, particularly with regard to their pain, the medical professionals believed them less. Reserach shows that medical professionals are more slow to respond to and address the pain of black individuals. Aren’t medical professionals trained to profile people and determine who is sick and who isn’t? Perhaps they are explicitly instructed to treat people differently based on their skin color?—I’m eager to learn what happens educationally during med school.

“There are systemic traces of racism that are built into this practice, and the way doctors are trained and some of that has roots that go back to slavery.”

Dr. Neel Shah– Assistant Professor of Obstetrics, Gynecology and Reproductive Biology at Harvard Medical School

Among developed countries, the United States has the highest maternal mortality rate. In most other countries, midwives outnumber ob-gyns, and primary care is fundamental to the health care system. As can be seen, medical experts play an important part in every healthcare system. Despite the fact that our country has a scarcity of medical professionals, this does not excuse the reality that the system is flawed and biased. Furthermore, the United States is the only country among developed countries that does not guarantee access to postpartum provider home visits or paid parental leave.

I assume that some doctors are doing everything in their power to treat each patient with equality and integrity. Nonetheless, our system is so broken and defective that other doctors are oblivious of their inappropriate and especially brutal behavior resulting into a high number of premature mortality.

References

Flanders-Stepans M. B. (2000). Alarming racial differences in maternal mortality. The Journal of perinatal education9(2), 50–51. https://doi.org/10.1624/105812400X87653

Behind the Headlines about Maternal Mortality. (2019, March 14). Behind the Headlines about Maternal Mortality; http://www.ihi.org. http://www.ihi.org/communities/blogs/behind-the-headlines-about-maternal-mortality

Maternal Mortality Rates in the United States, 2020. (2022, February 23). Maternal Mortality Rates in the United States, 2020; http://www.cdc.gov. https://www.cdc.gov/nchs/data/hestat/maternal-mortality/2020/maternal-mortality-rates-2020.htm

CDC. (2016, January 1). CDC Newsroom. CDC; http://www.cdc.gov. https://www.cdc.gov/media/releases/2019/p0905-racial-ethnic-disparities-pregnancy-deaths.html

NATAL podcast series gives voice to Black birthing experiences. (2021, August 19). Every Child Thrives; everychildthrives.com. https://everychildthrives.com/natal-podcast-series-gives-voice-to-black-birthing-experiences/

Maternal Mortality Maternity Care US Compared 10 Other Countries | Commonwealth Fund. (2020, November 18). Maternal Mortality Maternity Care US Compared 10 Other Countries | Commonwealth Fund; http://www.commonwealthfund.org. https://www.commonwealthfund.org/publications/issue-briefs/2020/nov/maternal-mortality-maternity-care-us-compared-10-countries

Healthcare should be a human right

The United States has such significant health care disparity that it is the only developed country that relies on private health insurance. Prior to the Affordable Care Act, approximately 20% of Americans had little or no health insurance. As a result, about 45,000 of those people died each year due to the expensive cost of health care.

No one should become ill and die simply because they are poor or lack access to health care. How inhumane!

The United States is one of the wealthiest countries in the world, yet its healthcare system is a disgrace. How can such a wealthy country be at the bottom of healthcare statistics given how much money it spends—research shows that the United States spends more on healthcare than any other country. In 2020, annual health expenditures were expected to exceed $4 trillion USD, with personal health care spending totaling $10,202 USD.

I’m curious where all that money goes. Our system prioritizes disease, specialty treatment, and technology over preventive care. Inpatient treatment, intensive care units, and subspecialties such as cardiology and gastroenterology are prioritized over nutrition, exercise, mental health, and primary care education. Doctors in high-tech specialties (such as anesthesiology, cardiology, or surgery) often earn far more than those in primary care.

You visit the doctor for a sunburn rush and receive a bill for approximately nine hundred dollars. Keep in mind that the time you spent with the doctor was about 2 minutes. For individuals who have health insurance, the bill will be lower or even covered. In fact, even insured Americans spend more money out of pocket for healthcare than residents in most other wealthy countries. Some people resort to buying drugs from other nations where the prices are much lower. Even though the power structure may be agreeable to healthcare insurers, pharmaceutical firms, and those healthcare professionals who benefit financially from it, our existing healthcare system is not financially sustainable. So, how much do you think individuals without insurance suffer from the consequences? This is completely ridiculous!

The most outrageous thing is that if you don’t have health insurance for a certain length of time in a year, you have to pay a fine/penalty to the IRS. In any case, health insurance is required. Even folks in the middle class who have health insurance risk devastation due to health care disparities. The rising expense of healthcare services can push people into poverty. According to a 2018 research, medical bills drove Seven million people below the federal poverty level. Medical bills have become the most profitable line of business for collection agencies. When it came to medical bankruptcy, the insured were 6% more likely than the uninsured to have declared bankruptcy in the past. They had not budgeted for unanticipated deductible and coinsurance fees. Almost two-thirds were unaware that their hospital was not included in their plan. Approximately 25% had their insurance claims dismissed. Every year, around 530,000 people file for medical bankruptcy. Health insurance providers have been raising patients’ medical expenditures by raising deductibles, which more than doubled between 2007 and 2017. At the same time, employers’ share has decreased. The average deductible in employer-sponsored health plans increased by 255 % between 2006 and 2018. Even those on Medicare are at risk. During retirement, the average 65-year-old couple anticipates $295,000 in medical expenditures. Most of them haven’t saved enough to cover these expenses without jeopardizing their retirement plans.

Is the purpose of our healthcare system to serve the public or to generate profit? A woman in labor was turned away from a private hospital in Alameda County because the hospital’s computer indicated that she did not have insurance. In a county hospital hours later, she gave birth to a stillborn infant. A hospital surgeon in San Bernardino sent a patient who had been attacked and stabbed in the heart to a county medical center after determining that his condition was stable. The patient arrived at the county medical facility in a comatose state, suffered a heart arrest, and subsequently died. These two hospitals transferred these patients to county facilities for economic, not medical, reasons — the receiving hospitals feared they would not be reimbursed for treating the patient. These patients were simply “bad business.”

“The enjoyment of the highest attainable standard of health is one of the fundamental rights of every human being without distinction of race, religion, political belief, economic or social condition”.

Dr Tedros Adhanom Ghebreyesus
Director-General, World Health Organization
WHO

Everyone should have access to the health treatments they require, when and where they need them, without experiencing financial hardship. When individuals experience marginalization, stigma, or prejudice, their physical and mental health deteriorates. Given the complex and confounding variables that accompany health care in the United States, even contemplating it is a source of stress. But when individuals are given the opportunity to be active participants in their own treatment, rather than passive recipients, and their human rights are respected, the outcomes improve and health systems become more efficient.

We must all work together to eliminate disparities and discriminatory actions so that everyone, regardless of age, gender, ethnicity, religion, health status, disability, sexual orientation, gender identity, or migration status, can experience the benefits of good health.

Healthcare should be a human right!

References

Topic: Health expenditures in the U.S. (n.d.). Statista; http://www.statista.com. Retrieved May 11, 2022, from https://www.statista.com/topics/6701/health-expenditures-in-the-us/#topicHeader__wrapper

Health is a fundamental human right. (2017, December 10). Health Is a Fundamental Human Right; http://www.who.int. https://www.who.int/news-room/commentaries/detail/health-is-a-fundamental-human-right

Is our healthcare system broken? – Harvard Health. (2021, July 13). Harvard Health; http://www.health.harvard.edu. https://www.health.harvard.edu/blog/is-our-healthcare-system-broken-202107132542

How to plan for rising health care costs | Fidelity. (2021, August 31). How to Plan for Rising Health Care Costs | Fidelity; http://www.fidelity.com. https://www.fidelity.com/viewpoints/personal-finance/plan-for-rising-health-care-costs

Health Costs | KFF. (2019, September 25). KFF; http://www.kff.org. https://www.kff.org/health-costs/

2021 Employer Health Benefits Survey. (2021, November 10). KFF; http://www.kff.org. https://www.kff.org/health-costs/report/2021-employer-health-benefits-survey/

The Effects of Household Medical Expenditures on Income Inequality in the United States | AJPH | Vol. 108 Issue 3. (2017, October 24). American Journal of Public Health; ajph.aphapublications.org. https://ajph.aphapublications.org/doi/10.2105/AJPH.2017.304213

Health Care for Profit or People? (n.d.). Health Care for Profit or People?; http://www.scu.edu. Retrieved May 11, 2022, from https://www.scu.edu/mcae/publications/iie/v1n4/healthy.html