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Affordable healthcare a world away

By Tim MitchellFeatures Editor

Populations more than double that of Dalhousie University are struck off the map every day because of preventable diseases such as malnutrition, malaria, diarrhea and tuberculosis found in areas of poverty. We don’t worry about these things in Canada. It all sounds depressing, and far away.
But Dr. Robert Huish, assistant professor of international development studies at Dalhousie, says we have an obligation to help.
“People wonder: what benefit is there to us in helping others around the world?” Huish says, during a phone interview. “If you consider the severity and lack of healthcare, we shouldn’t need to rationalize it to support it.”
At the moment, Canadians are mainly interested in H1N1, the dreaded swine flu, rather than preventable disease worldwide. Never in Dal history has there been such a strong response to such a potential threat.
“It’s staggering the amount of money we put into H1N1 because of our moral responsibility to act,” says Huish. “But if it’s not an issue for us, than we don’t feel obliged to act.”
About 50,000 people die a day from conditions and diseases found in impoverished places, while about 500 die a day from H1N1, according to Huish. Two billion people suffer from poverty globally, while the most recent number of confirmed H1N1 cases is 883,000.
Over the summer, and next September, Huish wants to teach a third-year level class on global health as well as a fourth-year class on poverty and human rights. Dal is still reviewing his proposals. He hopes to have approval by January.
Huish questions the ethics of physicians and healthcare workers in the world who move to more developed areas to make more money. One Dal student is doing just the opposite.
Sunisha Neupane, a fourth-year student in combined international development studies and chemistry, is working hard toward medical school to be a doctor who works in development. Neupane, who moved to Halifax from Nepal three years ago, wants to practice medicine in Canada and return to Nepal every year to help people living in poverty.
“The thing that touched me really early were people dying of diarrhea,” says Neupane. “There are reasons why people die, but diarrhea shouldn’t be one of them.”
In Canada, becoming a doctor is a long road full of non-stop studying that takes about 10 to 12 years, and a lot of dedication. Yet Neupane would rather go through the system here than in Nepal, where she was in her first year of medical school before moving to Halifax.
During her time at school in Nepal, Neupane discovered it could take around seven years, after becoming a doctor, to get a license to practice in Canada. Nepal was wrapped in growing turmoil at the time. In a bizarre incident reported by the Western media, a prince of the royal family shot each member of the family, including the king.
“There were bad things going on,” Neupane says. “With the king dead, med school was closed for two months.”
That’s when her family decided to move to Canada.
When she becomes a practicing physician, Neupane wants to work in Canada most of the year. Here she can have a stable income and learn all the proper skills. But for several months of the year, she plans to go back to the rural areas of Nepal where she can use those skills to help people living in poverty.
“With some people, they forget where they come from,” says Neupane. “I am not going to be one of them. I remind myself every night of that.”
Huish’s research shows that Neupane’s selfless strategy is the right move.
For him, healthcare ethics is an important part of his work. And one of the world’s leaders in health care ethics is Cuba. While Human Rights Watch and the U.S. Government tend to see Cuba as the devil in disguise, the healthcare system there has exceeded most other countries in the efficient way they treat their sick, keep people healthy, and export doctors or other professionals to areas in need of proper medicine.
One example he uses to show the contrast in the Cuban and Canadian healthcare systems, is of the 2005 earthquake in Pakistan that left around four million people in poverty. Three weeks after the earthquake, Canada sent 60 people, among them, six physicians. Their focus there was on water treatment. After working in Pakistan for 15 months, they packed up and left, having treated several hundred thousand people.
Cuba, on the other hand, was on the ground within three days of the earthquake. Right away they started building field hospitals to treat people for a period of six years. Over this time 2,400 health workers treated millions of Pakistanis affected in the disaster. In addition, they flew some Pakistanis to Cuba for more intensive treatment, and some for prosthetic limbs. When the Cuban aid workers left Pakistan, they offered 1,000 scholarships for Pakistanis to attend medical schools in Cuba so they would eventually return to Pakistan and replenish the need for doctors there.
“We seem to approach everything in a very minimal (way),” says Huish. “In terms of the Cuban scale, we need to figure out how to match it. Why aren’t we matching it?”
Lately, he has been following one of the most heated debates in recent U.S. history.
Since January, the American democrats have pushed for healthcare reform. Their proposed policy would cover about 30 million Americans who currently can’t afford treatment if they become ill.
While the U.S. is struggling to offer healthcare to its own people, its arch nemesis, Cuba, is able to do so while also training doctors from other countries. Huish has added his input to the American healthcare debate.
“I’ve written Obama and Biden about it,” says Huish, who sent his professional opinion and research to the U.S. president and vice president. “They didn’t write back.”
“It’s something that requires conscious knowledge on the problems,” says Huish. “We can give moral and financial support to the development of healthcare. But if these concerns could grow, and if people could get emotional about this topic, than elected officials would need to act.”

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