Of Dollars and Drugs

October 17, 2006

Typhoid 0.5cc IM.
Tetanus 0.5cc IM.
Hepatitis A 1cc IM.
Polio 0.5cc IM.
Mefloquine Hydrochloride 1/1 week.

When you travel from the United States to other areas of the world, you are strongly advised to renew your boosters: a couple of days of discomfort to stave off life-threatening or life-shorting diseases endemic to your destination. Mefloquine HCl is the latest in a long series of anti-malarial drugs, the evolution of which has closely followed evolution of the parasite itself, as it builds resistance to current treatments, rendering them useless. It has a number of potential side-effects, some of them rather nasty and potentially permanent, if you have a tendency toward the depressive or have struggled with psychological problems.

“Efforts to eradicate malaria by eliminating mosquitoes have been successful in some areas. Malaria was once common in the United States and southern Europe, but the draining of wetland breeding grounds and better sanitation, in conjunction with the monitoring and treatment of infected humans, eliminated it from affluent regions. In 2002, there were 1,059 cases of malaria reported in the US, including eight deaths. In five of those cases, the disease was contracted in the United States. Malaria was eliminated from the northern parts of the USA in the early twentieth century, and the use of the pesticide DDT eliminated it from the South by 1951. In the 1950s and 1960s, there was a major public health effort to eradicate malaria worldwide by selectively targeting mosquitoes in areas where malaria was rampant. However, these efforts have so far failed to eradicate malaria in many parts of the developing world - the problem is most prevalent in Africa.” from Wikipedia: Malaria

An effective drug plus infrastructure plus education plus sanitation equates to a level of physical security most of us can’t help but take for granted. That is a security which can, to some extent, be shared.

India is cited as having the largest population of undernourished people in the world, at a recent census pegged at 212 Million. To give some tangible scale to that number, the number of undernourished in India is 2/3 of the current population of the United States. Nearly 80% of all Indians live on an income of less than $2 per day. And which of these – many of them children – could afford a single dose of the preventative medicines I have received against my month of travel? Eight hundred million people are exposed to debilitating disease on a daily basis, for the duration of their time on this planet.

You might be offended by a statement such as this. You might well say: it’s not as easy as that. And why not be grateful of the great gains western science has brought you, the safety western economies have brought their inhabitants?

I am not indignant; I am pained. If you are to be truly human – and everyone should try, while they are on this planet, to shed the self-dedicated thinking, and realize we are all in this together – if you are to live more humanly and humanely during this brief life of yours, then the experience of the great moving experiment which is our species, and of the planet on which we dwell, is part of you. You are strong enough and safe enough to comprehend another’s loss: what is felt when the child dies, or the child loses both parents. Imagine, for a moment, that you are much more powerful than you have been led to believe. Imagine that, compared to many, you are inconceivably wealthy, in spite of the insecurities which salesmen, and their pawns the media, whisper in your ear. Whether they are selling beauty products or sexual enhancement or war.

Once you’ve got a handle on that, even if it’s rather a slippery handle, you can’t do much other than look around, look around everywhere, for a way to give a hand up to the general lot of living beings around the world.

There are over one billion people in India, and try as I may, I can’t find a metaphor to make such a number tangible. I can imagine its impact, as I have lived on the island of Java, where the population is as great as the entire landmass of Brazil, but the territory (126,700 sq km) is a mere 1.5% of Brazil’s, making it the most densely-inhabited place on the planet. Amazing intensity of community there, and a premium on earth beneath one’s feet. Still… the weight of one billion people, the movement of two billion feet over a patch of earth, an enormous procession from conception to birth to death to ashes… the number one billion is difficult to comprehend. You can’t even see one billion stars in a perfectly clear night sky!

So here I sit in my medical armor – hopefully an armor without chinks in its plating, and an armor I will make an effort not to test – having spent what is an insignificant amount of my salary to buy it. Meanwhile, the currency of hope is dollars, or Marks or Francs or Pounds Sterling. While it has an economy which becomes more robust on the strength of a growing middle class, India does not do its daily business in any of these currencies. The maladies which have been “eliminated from affluent regions” are constant companions in poor ones, and the nation reports (for example) the highest incidence of AIDS in the world. Remember that Aids has not been a disease of sexual preference for years now, and many of the afflicted are women and their unborn children.

Polish poet Czeslaw Milosz once wrote:

“One must not raise a pen simply to communicate one’s own despair and defeat – that is too cheap a commodity.”

It is a cheap commodity – but perhaps not so cheap as complacence, and not so ubiquitous as silence.

In my travels, I have lived within and alongside a certain poverty: within it, perhaps, but never of it, since the ladder back up to my Midwestern home was never far from my fingertips. Sometimes I witnessed a material poverty and a wealth of being alive; sometimes material lack was accompanied by moral or spiritual poverty as well. I look at India from a distance far greater than what can be measured in miles, or at this point, in hours: I look at it from the distance of ignorance. I wonder, as I walk its roads, and learn its words, and speak with its people, will I be able to hold my own, my own humanity, remember I am stronger than I know, strong enough perhaps to feel compassion for what may be a flood of misery?