Tuesday 30 September 2008

Unhealthy debt


I'm sure the majority of us have heard something about the Wall Street crash, with the closure (and near bankcruptcy) of several major US banks and insurance companies (eg: AIG, or AIA for those from SG). If you haven't, here's a 30 second summary: basically, US banks and companies were using debt to create more debt. Kind of like borrowing money from 1 person to buy something from another person - just on a global, massive financial scale. Now the bubble has burst, and all the bad debt has caught up with these institutions - and overnight, people with investments/savings with these institutions have seen their life savings disappear. People stop buying, US stops importing, and other countries stop exporting - and the economy grinds to a halt (I know the economists will tear me up for this oversimplification!).

But why bother with this? Those of us who haven't been taking risks with investments aren't affected, right? Even more so for those of us in the field of health care - we'll always have jobs, so as long as we don't overspend and make risky investments, we don't need to bother, right?

Wrong.

The WHO definition of health is as follows : "health is a state of complete physical, mental and social [and spiritual!] wellbeing, and not merely the absence of disease or infirmity" The corollary of that definition is that "anything that affects physical, mental and social [and spiritual] wellbeing affects health".

So what?


As health workers in a wide variety of capacities, we have to recognise that the issues we deal with are not entities existing in a vacuum that appear to the beat of some biostatistical value, but are often presentations of wide socio-economic issues.

In the case of the recent Wall Street meltdown, we have to stop ourselves from compartmentalising it into an "economic issue" - instead, we have to recognise that this will, in the great interconnectedness of society, eventually translate into health issues. The 1978 declaration of Alma Ata states: "Economic and social development, based on a New International Economic Order, is of basic importance to the fullest attainment of health for all".

The "illnesses" seen in the market place and society will more often than not translate into the "illnesses" seen in the consultation room, the pharmacy, the counselling rooms and the dental clinics. With a recession hitting the streets and people losing their savings and financial security, it would be not unexpected to see changes in the burden of diseases within society. We would be looking at remergence of infectious diseases as people begin moving to more cramped accomodations with poorer sanitation. There may be rising rates of depression, and possibly alcohol abuse and substance abuse (with relevant medical consequences) as a means of emotional anesthesia. Financial stressors could lead to relationship breakdown and domestic violence, with consequences for the long term health outcomes for members of those families. Eating a healthy and balanced diet may be replaced by settling for whatever was on special on the supermarket, more often than not something less than ideal, nutrition wise. A global recession is more than an "economic issue" - it is fairly and truly a health issue as well.

As health workers - doctor, nurse, dentist, pastor, phamacist, counsellor, physiotherapist, dietician, OT, etc - we have been tasked by God to engage with and contribute to the health of populations. It is only by looking beyond our textbooks and our own working space, to engage with the emerging challenges to the health of the people, that we can truly fulfill the task God has laid before us.

1 comment:

manga_crack said...

O M G SING CHEE your blog is so gonna be daily read!