Collateral Damage

I scored a 5 out of 10 on the Health Equity quiz, which was lower than I expected. I was incredibly surprised to find out that the US life expectancy is only  29th in the world. I assumed that because we have had so many medical advancements and have vast access to health care and resources compared to many other countries that this ranking would be closer to the top ten or so. What I also found interesting was that the greatest difference in life expectancy between counties in the US was 15 years. I find this to be a better indicator of life expectancy because it is not as general and takes into account environmental and lifestyle factors. This statistic also played into wealth being the number one predictor of some ones health as there are many suburbs in America in which wealth is concentrated and other urban cities that are poverty stricken.

I chose to elaborate on the ‘Collateral Damage’ video. I find it ironic that we usually think of urbanization and globalization as indicators of wealth and prosperity, while in the Marshall Islands, disease and poverty are a direct result of these developments. In this nation of islands, Tuberculosis is 23 times more prevalent than in the US. This rampant disease, which spreads easily in densely populated areas, is the result of the overcrowding of the island of Ebon, which at one mile long is home to ten thousand people. Ebon is the perfect environment for tuberculosis to spread because with up to twenty people living in one house, if one person is sick more often than not everyone in the home will become sick. These conditions of poverty lower compromise the immune system, and the stress of poverty can contribute directly to this malnutrition.

To make room for nuclear testing during World War II, the US military resettled thousands of people on different islands, tearing apart their culture. The Marshallese community structure broke down and there were significant impacts on health through the stress of not being able to grow food, becoming diabetic through a western diet, and contaminated land. The Marshallese were not an urban group of people but we forced them to urbanize and infectious diseases such as tuberculosis took off with overcrowding. In order to eradicate tuberculosis, the Marshall islands need improved living conditions, alleviated crowding, and improved nutrition, which are all factors we imposed on them through US development and urbanization of the islands.

Politics: The island with the military base is home to many affluent white contractors that live there with access to medicine and grocery stores while Marshallese workers have to take a ferry home everyday to their dense, overpopulated living conditions.

Economics: The Marshallese cannot afford care for tuberculosis at hospitals and they have to rely on public health officials to provide them with medicine for the treatment of tuberculosis.

Culture: Many of the homes on Ebon do not have inside toilets so inhabitants have to travel to public restrooms that do not have sinks and are unable to wash their hands until they return home, which allows for the spreading of disease.

Biology: The treatment of tuberculosis involves a strict drug regimen and if not completed the disease can come back in a deadly drug resistant form that is very dangerous.

Individual choice: People of the Marshall Islands are ashamed to admit they have the disease and will not seek treatment for it, which in turn will further spread tuberculosis.

5 thoughts on “Collateral Damage

  1. Your post reminded me of the video which I watched titled “Bad Sugar” in which Pima Indians were more likely to develop type 2 diabetes as a direct result of urbanization. It shows that urbanization does nothing to help the health of those whose lifestyles they disrupt. In fact, it often makes their own health degrade. I think that in order to alleviate problems like this, they should not happen in the first place. We should be much more mindful of what is actually happening when we are urbanizing an area. If we are disrupting a local population, in my opinion we should re-evaluate if we should even begin urbanizing the area. If we do, we must ensure that we put the local population first. In this case, the Ebon people should have been prioritized, but due to World War II they were simply an after-thought. Of course this would contribute to health problems. Instead, we should have integrated them and given them the best living conditions possible. However, this would likely be very expensive to do and would have taken the priority away from nuclear testing. It’s for reasons like this that I believe we should simply not urbanize areas where a local population has been living healthily without our “help”. We will simply lower the health of the population and forward our own shallow and selfish ambitions.

  2. I feel that as with most health related problems, potential solutions are very complicated involving many political, biological, individual and economical factors. However, for the sake of simplicity, I will focus upon a political solution. In this instance, I personally feel that politics are the root of the issue. If the Mashallese people had possessed some sort of political protection in the beginning, then they would not have been weak to usurping of their land by a foreign entity such as the United States. I believe that the Marshallese should be given specific indigenous rights and it is simply inhumane for them to be forced into such close quarters without protection by way of health support. I also believe that this atrocity is the fault of none other than the United States government and that the Marshallese should be compensated well for their losses and current situation which is a result of the U.S. government’s military appetite. I think that an initiative should be implemented which provides support to these people, either by way of volunteer engineers which could build compost toilets or something similar for safe waste management, or a doctors without borders sort of group to teach locals sanitary practices and provide care. The government should be doing something about this, it is unjust that these people suffer. Potential pros of this solution include improved overall health over the Marshallese population. However, the cons are a bit more troublesome as such an initiative would require resources such as time, money and volunteers all of which the United States government does not have in excess.

  3. I think that the key to helping the health problems of the Marshallese people would be to basically “undo” the development and relocation that occurred during World War II. Families were forced to relocate and pushed into extremely small living quarters on contaminated land, unable to grow their own food, and introduced to the unhealthy American diet. All of this led to the creation of an environment that became a breeding ground for disease as well as an unhealthy cultural environment. My solution would be to provide government funding to the people so they could move to healthy land so they can begin to grow their own food again. This will help improve nutrition and hopefully decrease the prevalence of diabetes. This should also allow people to spread out; living in areas that are less crowded would help slow the spread of infectious diseases. The government should also take measures to increase sanitation and access to medicine, since they cannot afford hospital care. My solution is political and economic with responsibility falling on the government. The pros of this plan benefit the Marshallese people by increasing healthy practices. The cons fall on the government in the form of financial burden. The policies that would need to be put in place to make these changes would be very expensive but I think that since the government forced changes upon these people it is their responsibility so set things right.

  4. Prevention would be the first step by raising awareness of tuberculosis. Informing people of the disease, how it spreads, how fast it can spread, and what you can do to prevent it. For example, there can be pamphlets in public health offices where tuberculosis is treated, or on the way to public restrooms(even inside stalls) where people can see these signs. With that said, it should be the responsibility of the locals, the individual, and the doctors to always inform each other. Although irrigation and plumbing is an expensive task, the Marshall Islands need to have enforced hand washing stations with provided soap(or some sort of anti-bacterial wash), whether they be located in or near the restrooms. The only way a country can become developed is by having irrigation and proper plumbing. This reminds me of a documentary that I saw of rural Indians who had washing machines, dish washers, and high tech things to make their homes run better, but no bathrooms in their homes. So they would use a lake nearby to do their business, but in consequence this lake has become a massive body of methane liquid, and now that water is actually recycled. The importance of the treatment of tuberculosis should be enforced by the government. Without proper funding in these basic living ways it becomes difficult and almost impossible to keep tuberculosis out of many peoples lives. Government action first, individual awareness second.Cons would be that spending in other areas might be cut to fund this plan, but in the long run it can save money for individuals who no longer have to seek treatment.

  5. Great contributions! Globalization certainly can change things in positive ways but it’s important to think about all of the implications it has for health and economic stability.

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