Infections and inequalities
Program in Infectious Disease and Social Change Department of Social Medicine Harvard Medical School 641 Huntington Avenue Boston, MA 02115, USA A Corresponding author e-mail PIHPaul@aol.com
Paul Farmer(A), David Walton, Laura Tarter
"In the United States, this conclusion might have provoked little short of calling up the National Guard. But in Haiti we had not triggered much in the way of government response in announcing previous epidemics of communicable disease. Just five months previously, we’d seen several cases of meningococcal meningitis, first diagnosed when a baby presented with purpura fulminans— his skin was covered with distinctive patches of purple hemorrhage. He was in shock. Although he received antibiotics within minutes of reaching the clinic, the infant died while a doctor was attempting get intravenous fluids into a vein, any vein, as his mother stood by wailing."
Why did you not try intraosseous infusion
a standard method developed in 1940 ?
"INFUSIONS OF BLOOD AND OTHER FLUIDS VIA THE BONE MARROW IN TRAUMATIC SHOCK AND OTHER FORMS OF PERIPHERAL CIRCULATORY FAILURE * LEANDRO M. TOCANTINS, M.D., DIVISION OF HEMATOLOGY, DEPARTMENT OF MEDICINE JEFFERSON MEDICAL COLLEGE AND HOSPITAL, PHILADELPHIA JAMES F. O'NEILL, M.D., DEPARTMENT OF SURGERY, BOWMAN GRAY SCHOOL OF MEDICINE AND BAPTIST HOSPITAL, WINSTON-SALEM, N. C. AND ALISON H. PRICE, M.D. DEPARTMENT OF MEDICINE, JEFFERSON MEDICAL COLLEGE, PHILADELPHIA, PA. PHILADELPHIA, PA."
*http://download.springer.com.ezp-prod1.hul.harvard.edu/static/pdf/300/art%253A10.1023%252FA%253A1010088804348.pdf?originUrl=http%3A%2F%2Flink.springer.com%2Farticle%2F10.1023%2FA%3A1010088804348&token2=exp=1487435971~acl=%2Fstatic%2Fpdf%2F300%2Fart%25253A10.1023%25252FA%25253A1010088804348.pdf%3ForiginUrl%3Dhttp%253A%252F%252Flink.springer.com%252Farticle%252F10.1023%252FA%253A1010088804348*~hmac=2aedc016920e1bab65576c7e7b23c3b2c3e1017f81c5bcacfc8f64cd88f8be9a
"beleaguered public-health offi cer was recently asked why he did not come to investigate, he responded that, although he did have access to a jeep, he did not have money for gasoline. Meanwhile, in the United States, even the theoretical possibility of bioterrorism has moved hundreds of millions of dollars into research and conferences on a subject of dubious public-health signifi cance.[2]"
something I have seen happening in a number of developing countries.specially in India 2 decades ago when I was still there.I do not know if things have improved any in the interior rural areas.
"In his almost incomprehensible remarks announcing the initiative, Clinton allowed that “There is no market for the kind of things we need to develop; and if we are successful there will never be a market for them. But we have got to do our best to develop them.”3 In contrast to these hypothetical epidemics, very real epidemics are being ignored."
How about the purchase of jet fighters by India, Pakistan and Bangladesh? Which were one country just two generations ago?
" in a wealthy country, the spectre of biological warfare, for which there is exceedingly slender evidence, triggers a sort of officially blessed paranoia."
Meanwhile, a 23.5% jump in health spending includes an 11.54% rise for research that will help ambitious plans to eradicate four diseases from India: kala azar, a fatal form of leishmaniasis, slated for elimination by the end of this year; leprosy in 2018; measles in 2020; and tuberculosis in 2025.
At best, those of us working in places like Haiti can hope for trickle-down funds if the plagues of the poor are classed as “U.S. security interests.”[5]
Meanwhile ample evidence of MDR-TB’s epidemic spread within slums and hospitals and prisons, reviewed elsewhere,[11] is discounted because so many of its victims were coinfected with HIV— as if the virus added wings to the bacterium. Such exercises would be merely wishful thinking if they did not lull us into complacency and lead to ill-conceived policies.
Again, sub-standard care— endorsed by international authorities— led to the use of the wrong drugs for the substantial fraction of patients with drug-resistant disease. ( who are theses arseholes ?)
HUBRIS NOT HUMILITY
When the irrationality of improper recommendations was brought to public attention, it engendered mostly irritation, even anger. Humility has been in short supply among the experts.
s. But perhaps the most compelling justifi cation is to be found in considering the impact of differential standards of care for the poor. While the global era makes it increasingly diffi cult to live in ignorance of the suffering of others, it has not led to a more just partition of the fruits of science and technology.
During my 4th year in Medical school Me and 3 of my classmates attended a 2 week course at SCHIEFFELIN INSTITUTE OF HEALTH – RESEARCH & LEPROSY CENTRE, KARIGIRI
when we were talking to Earnest Fritchi a surgeon whose father started this mission and who was taking care of theses deformed leprosy patients told me this .
You really need not do great research in cancer. Just try and cure the thousands of children suffering from hookworm and roundworm infections and give them clean water and you will save more lives.
Program in Infectious Disease and Social Change Department of Social Medicine Harvard Medical School 641 Huntington Avenue Boston, MA 02115, USA A Corresponding author e-mail PIHPaul@aol.com
Paul Farmer(A), David Walton, Laura Tarter
"In the United States, this conclusion might have provoked little short of calling up the National Guard. But in Haiti we had not triggered much in the way of government response in announcing previous epidemics of communicable disease. Just five months previously, we’d seen several cases of meningococcal meningitis, first diagnosed when a baby presented with purpura fulminans— his skin was covered with distinctive patches of purple hemorrhage. He was in shock. Although he received antibiotics within minutes of reaching the clinic, the infant died while a doctor was attempting get intravenous fluids into a vein, any vein, as his mother stood by wailing."
Why did you not try intraosseous infusion
a standard method developed in 1940 ?
"INFUSIONS OF BLOOD AND OTHER FLUIDS VIA THE BONE MARROW IN TRAUMATIC SHOCK AND OTHER FORMS OF PERIPHERAL CIRCULATORY FAILURE * LEANDRO M. TOCANTINS, M.D., DIVISION OF HEMATOLOGY, DEPARTMENT OF MEDICINE JEFFERSON MEDICAL COLLEGE AND HOSPITAL, PHILADELPHIA JAMES F. O'NEILL, M.D., DEPARTMENT OF SURGERY, BOWMAN GRAY SCHOOL OF MEDICINE AND BAPTIST HOSPITAL, WINSTON-SALEM, N. C. AND ALISON H. PRICE, M.D. DEPARTMENT OF MEDICINE, JEFFERSON MEDICAL COLLEGE, PHILADELPHIA, PA. PHILADELPHIA, PA."
*http://download.springer.com.ezp-prod1.hul.harvard.edu/static/pdf/300/art%253A10.1023%252FA%253A1010088804348.pdf?originUrl=http%3A%2F%2Flink.springer.com%2Farticle%2F10.1023%2FA%3A1010088804348&token2=exp=1487435971~acl=%2Fstatic%2Fpdf%2F300%2Fart%25253A10.1023%25252FA%25253A1010088804348.pdf%3ForiginUrl%3Dhttp%253A%252F%252Flink.springer.com%252Farticle%252F10.1023%252FA%253A1010088804348*~hmac=2aedc016920e1bab65576c7e7b23c3b2c3e1017f81c5bcacfc8f64cd88f8be9a
"beleaguered public-health offi cer was recently asked why he did not come to investigate, he responded that, although he did have access to a jeep, he did not have money for gasoline. Meanwhile, in the United States, even the theoretical possibility of bioterrorism has moved hundreds of millions of dollars into research and conferences on a subject of dubious public-health signifi cance.[2]"
something I have seen happening in a number of developing countries.specially in India 2 decades ago when I was still there.I do not know if things have improved any in the interior rural areas.
"In his almost incomprehensible remarks announcing the initiative, Clinton allowed that “There is no market for the kind of things we need to develop; and if we are successful there will never be a market for them. But we have got to do our best to develop them.”3 In contrast to these hypothetical epidemics, very real epidemics are being ignored."
How about the purchase of jet fighters by India, Pakistan and Bangladesh? Which were one country just two generations ago?
" in a wealthy country, the spectre of biological warfare, for which there is exceedingly slender evidence, triggers a sort of officially blessed paranoia."
Meanwhile, a 23.5% jump in health spending includes an 11.54% rise for research that will help ambitious plans to eradicate four diseases from India: kala azar, a fatal form of leishmaniasis, slated for elimination by the end of this year; leprosy in 2018; measles in 2020; and tuberculosis in 2025.
At best, those of us working in places like Haiti can hope for trickle-down funds if the plagues of the poor are classed as “U.S. security interests.”[5]
Meanwhile ample evidence of MDR-TB’s epidemic spread within slums and hospitals and prisons, reviewed elsewhere,[11] is discounted because so many of its victims were coinfected with HIV— as if the virus added wings to the bacterium. Such exercises would be merely wishful thinking if they did not lull us into complacency and lead to ill-conceived policies.
Again, sub-standard care— endorsed by international authorities— led to the use of the wrong drugs for the substantial fraction of patients with drug-resistant disease. ( who are theses arseholes ?)
HUBRIS NOT HUMILITY
When the irrationality of improper recommendations was brought to public attention, it engendered mostly irritation, even anger. Humility has been in short supply among the experts.
s. But perhaps the most compelling justifi cation is to be found in considering the impact of differential standards of care for the poor. While the global era makes it increasingly diffi cult to live in ignorance of the suffering of others, it has not led to a more just partition of the fruits of science and technology.
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