Transcript No Slide Title

May 27-29, 2006
Dave Hilton, MD
If you don’t know
where you are going...
You may end up somewhere else!
1. Stand up
2. Join two persons you don’t know
3. Complete the sentence:
“Health is . . . . . .”
Health is a dynamic
state of complete
physical, mental,
spiritual, and social
well being and not
merely the absence of
disease or infirmity.
World
Health
Organization,
1998
Medical science has no
vocabulary or
framework to deal
with the concept of
well being.
Jonathan Mann, 1994
But the Christian
community does:
Shalom , n., well being
I have come that they may have
life, and have it to the full.
John 10:10
Be perfect, complete(NIV)
therefore, as your heavenly
Father is perfect.
Matthew 5:48 (NIV)
Be all
you can
be!
Health is a dynamic
state of complete
physical, mental,
spiritual, and social
well being and not
merely the absence of
disease or infirmity.
World
Health
Organization,
1998
After ten years of doing all the
“jungle doctor” heroics at a
mission hospital in northern
Nigeria, seeing this cartoon
changed my life.
1. Describe the picture.
2. What is the problem?
3. Where does this
happen in real life?
4. Why?
5. What to do?
Tobacco is the worst human
disaster of the century. WHO, 1990
Annual Deaths Globally
1970
1999
2010
predicted
3
million
7
million
Why do we allow
tobacco companies
to continue to entice
our children and
grandchildren to use
their deadly
product?
Tobacco is not a medical issue!
Continuing thousands of
deaths daily from tobacco are
an issue of justice.
D e a t h R a t e ( p e r M illio n C h ild r e n )
Deat h Rat es of Children under 15 , England and Wales
140 0
Whooping Cough
Measles
120 0
100 0
No effective medical intervention
80 0
60 0
40 0
Standard
of Living
Imm unizat ion
Generally
Available
20 0
185 0 186 0 187 0 188 0 189 0 190 0 191 0 192 0 193 0 194 0 195 0 196 0 197 0
McKeown, T., Lowe, C.R. An Introduction to Social Medicine, Oxford 1974, p 237
14
UNITED STATES
13. 5 %
13
Source: National Center for Health Statistics
% GDP for
medical
medical services
services
hundreds
17.5
17. 5
15
15. 0
12
12. 5
Mortality
rate
11
11. 5
10. 5
10
9
9. 5
8
8. 5
12.5
12. 5
7
7. 5
10
10. 0
6
6. 5
5
7.57.
5. 5
4
5
5. 0
4. 5
3
3. 5
190 0
1900
192 0
1920
194 0
1940
196 0
1960
198 0
1980
2000
“DISEASES OF POVERTY”
Tuberculosis
AIDS
Malaria
Poverty
suppresses the
immune system.
Infant Mortality and Poverty
Côte d’Ivoire DHS, 1994; Bolivia DHS, 1998; Kyrgyz Rep. DHS 1997; Burkina Faso DHS 1992/3; Colombia DHS,
1995; India National Family Health Survey 1992/3; Indonesia DHS 1997. Source: WORLD BANK
Hemorrhage of
capital from Africa
+ Low prices for natural resources
+ So called aid
- High prices for imports
- High interest on external debt
= Billions in capital drain
FREE MARKET?
FREE TRADE?
The most important
determinant of health
is
social justice.
“Woe to you Pharisees,
because you give God a
tenth of your mint, rue
and other garden herbs,
but you neglect justice
and the love of God.”
Jesus (Luke 11:42)
May 27-29, 2006
May 27-29, 2006
We pray, “Thy will be done
on earth as it is in heaven.”
It seems clear that the minority
in the world with power and
money will not voluntarily use
it to change significantly the
plight of the poor.
Dave Hilton, Contact 106, December 1988
FEUDALISM
DEMOCRACY ?
$ = white men from wealthiest nations
DEMOCRACY
$ = white men from wealthiest nations
= women of color from poorest nations
What to do about tobacco?
Letter writing campaign to the chosen
leaders of your national community:
a. Ban all advertising of tobacco products.
b. Remove tobacco from the Free Trade
Act list
c. Require the same warnings on exported
tobacco as in the U.S.
Economic and social
development, based on a
new economic order, is of
basic importance for the
attainment of health for all.
WHO, Declaration of Alma Ata, 1978
The people have the right and
duty to participate individually
and collectively in the planning
and implementation of their
health care.
WHO, Declaration of Alma Ata, 1978
Go to the people.
Live among them.
Learn from them.
Begin with what they have.
Build on what they know.
And of the best of leaders,
when the task is done
the people will say
“We have done it ourselves.”
Lao Tsu 300 BCE
HELP
LISTEN
Facilitate thinking,
speaking & acting
(mobilize individual and
community resources)
Empowerment
Change
Health (well-being) for all
Give to,
Do for,
Tell
Dependence
Status Quo
MAKE SURE THAT
YOUR HELP IS
HELPFUL
ALWAYS COMBINE
RELIEF WITH
EMPOWERMENT
Paulo Freire
Pedagogy of the Oppressed
Training for Transformation
by Ann Hope & Sally Timmel
The Role of the Facilitator
LISTEN
strong feelings
reflect back
input
think
assess
decide
act
Paulo Freire as described in Training for Transformation by Hope & Timmel
Isaiah 65: 17-35
“For I am about to create new heavens and a
new earth; the former things shall not be
remembered or come to mind. But be glad and
rejoice forever in what I am creating; for I am
about to create Jerusalem as a joy, and its
people as a delight.
“I will rejoice in Jerusalem, and delight in my
people; no more shall the sound of weeping be
heard in it, or the cry of distress. No more shall
there be in it an infant that lives but a few days,
or an old person who does not live out a
lifetime; for one who dies at a hundred years
will be considered a youth, and one who falls
short of a hundred will be considered accursed.
They shall build houses and inhabit them; they
shall plant vineyards and eat their fruit. They
shall not build and another inhabit; they shall
not plant and another eat; for like the days of a
tree shall the days of my people be, and my
chosen shall long enjoy the work of their hands.
They shall not labor in vain, or bear children
for calamity; for they shall be offspring blessed
by the LORD--and their descendants as well.
Isaiah 65:17-23
Health is a dynamic
state of complete
physical, mental,
spiritual, and social
well being and not
merely the absence of
disease or infirmity.
World
Health
Organization,
1998