International Community Health Conference

I just returned to my village after attending the first International Community Health Conference. It was exciting to learn again and be surrounded by motivated, diverse, and at the risk of sounding snobbish, educated people. I tried to absorb as much as I possibly could. I will post the link of the conference's information in case anyone is interested. I hope to write several posts about different aspects that stuck out to me. Most will just be small moments that clicked in my head or question marks that may take me very long to ponder, so I thought we'd ponder together.

During the last day of the conference, I had this feeling that just resonated with me. This sense that I was finally beginning to see things more clearly. Thank goodness it only took 26 years and a four day conference to get to that point. But before I really dig in and try to convey this abstract thought process, answer these questions:

1. The age old, what is a 'good death'?
2. What do you see as one thing that society absolutely insists that you achieve in life? What if that one thing almost surely meant death for you?

Do you have your answers? …I'll go on. Amidst the lectures with grisly statistics and a keynote by Paul Farmer about communicable diseases, there was a sense of justice being achieved. Medicine could bring justice. Life can be unfair, just ask anyone, but death can go so much more beyond that. It can strip a person of their dignity, it can turn the finger around and blame the victim, it can make family and friends lose all pride. Even if a person is alive for decades, they can be defined for their act of dying.

She was a fighter.
He always smiled through it, even when all the hair fell out.
She was brave and stared death in the face.
He went for every experimental treatment.
The doctors fought and fought but science just wasn't fast enough with a cure.
She never lost her faith.
There was nothing they could do…

There's the good death. The death where you can be a warrior. You are fiercely fighting and there's an army of medical professionals behind you. But what if your death was nothing like that. What if there's been a cure or a successful treatment for your illness for decades or even centuries? What if you were set up to fail? What if your baby dies because there wasn't a vaccine campaign close enough to your village? Or your husband dies because the health center couldn't transport fast enough? What if you die from a disease because of sheer ignorance or just plain old poverty? Where's the pride in that? How can you ever tell people the story of your mother, who was so strong and fearless, and yet succumbed to a disease that even infants can fight off in other parts of the world? How can you not be angry at someone or something for failing you?

I ask these questions because I only have half answers. I know I'd be out of my mind angry at the circumstances of life, and yet that's just too much to hold on to. There are people who die like this every day. Heck, there's even people in the US dying because they don't have health insurance. One version of poverty looks a lot like the next. One person is deemed more worthy of modern medicine because their pockets are deeper. What if we let everyone be warriors? What if we gave everyone a fighting chance? I think I got a glimpse of what those efforts would look like this week.

The second question struck me more as a woman than anything else. I'm going to try and make it applicable to everyone. Coming up with something off the top of my head, I'm going to say that society expects us all to … learn how to walk in on our two feet at some point in our lives (actually more true than I wanted to make it but let's go with it). Some people will be overachievers and end up running marathons. Some of us will only get to the kneeling position or maybe just crawling. Some will try and try excessively but fail every time and not know why. Then there will be some people who will walk, they really will! and then they will cross the street and get hit by a bus. Society kind of saw this one coming when it dared us to walk but that doesn't make society evil. It knew what would make you more productive and more fulfilled. It didn't mean any harm. Did I mention that not trying is not an option?

Now imagine that you are a woman, especially one in the developing world. Society has told you that you must produce children. Not just one either, we're talking marathon style here. Pick one of these following reasons why multiple pregnancies are in your future: a) you are very poor and you know that a percentage of your children will die so several is better than one. b) any form of birth control is just not an option. c) society puts so much pressure on you that you believe only true happiness comes from having children. Now look around at your village. There isn't a health center within a day's walk for you. You are afraid of the delivery but you have to stay near your fields for as long as possible because your husband likes his beer more than he likes farming (sorry for the jab, men). You can get a midwife to help but everyone knows the chances of hemorrhaging. There is a good chance that just having one baby could be your death sentence. But society isn't just whispering in your ear, it's screaming at you. Babies must be had, and death must be stared in the face.

Pregnancies aren't the same on every continent. For the poorest of the poor, women are literally expected to die in troves just for doing what they were told or rather doing what they couldn't stop in the first place. I think we all need to spend a little more time thinking about maternal morbidity rates. As one lecturer stated, mothers are the greatest indicator of development. They are the greatest stepping stone to progress.