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  Why Won't Universal Healthcare Be Provided?
By Emily Spence
Upon receipt of a B. S. degree in biology, an acquaintance of mine -- let's call her Linda -- decided to spend the summer in Asia working at a small medical clinic that had a staffing shortage. The clinic was near a major river on whose banks were crowded thousands of families living in small densely packed hovels whose heaped together mass stretched as far as the eye could see.
Meanwhile, the shacks, tents and slapdash dwellings did not have access to electricity, indoor plumbing, nor cooking facilities. Consequently, hoards of people spent countless hours every day trekking to locate semi-private spots to undertake their toileting and find materials that could be burned for outdoor pit cooking. They, also, spent an inordinate amount of time trekking to and from the river to collect water for food preparation, cleaning and baths, as well as for any livestock and small gardens that a minority of the households maintained.
In addition, many people would become unwell from drinking the river water, particularly because lots of fecal waste, garbage and trash inevitably wound up in its currents. Especially young children whose immune systems were not fully functional and elders became stricken with intestinal infections, and would, doubled over with cramps, drag themselves to the clinic, a claustrophobic closet-like facility, for any sort of cure.
However, there was such a shortage of medicine that nothing of real value could be offered and, certainly, no one could suggest that avoidance of the river water was a necessity in order to make the illness, whichever type it was, permanently go away. As such, only sympathy could be offered, along with any other needed treatments that actually were available.
These included antiseptic ointment and gauze for wounds, splints made from slender tree branches for broken limbs, several other items and suggestions for bed rest, the latter of which was often an impossibility since one needed to move about to get the river water, fuel (primarily animal dung and small scraps of brush) and food from hawkers that included river fish and eels for meal preparation. On account, many people's health further deteriorated to the point that they prematurely died and, then, another problem arose.
This additional difficulty concerned a way to dispose of the bodies since the majority of the deceased persons' kinfolk did not have sufficient funds to carry out burials or cremations. As such, the waterway served another function, which was corpse recipient, and Linda noted that, nearly every day, bloated water-logged remains could be seen quietly gliding downstream.
A compassionate person, she found the sight disturbing and, while she enjoyed aiding individuals as best as she could at the treatment center, she felt largely helpless during her experience there. On account, she came to realize that, while she was grateful for the small remedies that she could provide in some instances, she really could not change much in the quality of life for the often desperate mobs, who patiently sorted themselves out so as to line up every day in a continual stream seeking help that, more often than not, couldn't be rendered.
Meanwhile, her realizing her limits was simultaneously sad, humbling and vexing. After all, it is demoralizing to have great hopes to help the world improve and learn that certain troubles are so great in magnitude that one will always feel insufficient unless he chooses to focus on the few small successes that he does occasionally manage to pull off. With such a conflicted understanding, she was relieved upon coming back to the USA after her summer job abroad was over.
At the same time, she felt grateful for the medical care, reasonable homes, clean water, indoor plumbing and food stores available in America. In a flash, she came to realize the reason that so many legal and illegal migrants want to come to first world nations even if those countries have job shortages.
It's really quite simple in the end. The alternatives seem dreadful.
Especially they would be so, she surmised, when their rivers and other water sources dry up after the glaciers that feed them disappear on account of climate change factors. She wondered about what they would do then.
Considering that the 18,000-year-old Bolivian Chacaltaya glacier, on which 77 million people rely for water, recently disappeared shocked her. She didn't wish to imagine that the many people who she'd met in Asia would, eventually, face the same plight.
Where would they all move? How would they eek out a living? Who would feed them and provide a new source of water? Where would they find homes and a sufficient number of healthcare clinics? She couldn't imagine any realistic answers to her questions.
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At the time that Linda was embarking for Asia, another woman, who'll be called Anne, had just received her undergraduate degree in philosophy from a different college than Linda's. She, too, entertained an idea to engage in social service volunteerism for the upcoming summer months. Yet instead of Asia, her plans inevitably took her to Africa where it had been arranged that she would work with the one doctor available in a region that covered roughly a hundred square miles.
In the territory, various interconnected tribes lived in small communities. Therefore, the doctor's job was to make the rounds and visit one site after another each month after which he would repeat his tour unless an emergency, like a major fire at one of the locations, were to immediately redirect him.
At the same time, each village had at least one paraprofessional health care worker, generally a woman, who delivered babies and provided a modicum of aid in the doctor's absence. So she would be the first person with whom he would consult upon arrival to each tribal compound so as to get an overview about what he was to do next.
Meanwhile, the American lived with one of the health workers near the doctor's hut so that she could learn further about medical intervention from the assistant. As a result, she learned many details about therapeutic care.
Likewise, she learned about its limits. For example, there was in this region, as there was in the area that Linda visited, a dire shortage of medical supplies. Therefore, they had to be doled out very sparingly and only to the recipients who best qualified (i.e., the ones who had the best chances of showing improvement upon receipt of intervention).
This choice naturally precluded people who were either too sick to get well or who were otherwise rejected, as were very old and very injured people. Moreover, the villagers all had a policy that, if someone were somehow grossly defective, he would be left to his own devises and shunned as there simply were not enough food and other supplies to give any to anyone who was severely impaired.
With such a custom in place, it was regretful that approximately a decade earlier a mother, who noted that her child had infrequent seizures, was forced to place him in the dump near to her settlement and he, despite being thought of as doomed to die, managed to stay alive by eating garbage, small grubs, worms, bugs and other discovered fare. So he somehow coped year after year in the trash, outgrew his early childhood convulsions and was, nonetheless, an outcast due to his prior history.
In addition, no one openly communicated with him except for Anne during which time she discovered that he felt ill. As such, she pleaded with the doctor to briefly visit with the boy, who was now a young teen.
In response, the physician got very angry with her and told her that he could get in trouble with the clan's rulers if he did so. Yet, she persisted about it and, finally, he, reluctantly, went to the dump and lightly examined the lad after which he gave him a few tablets and told him to take one a day.
After leaving the youth, he told Anne that she should never ask him to do such an act again and that he only gave the teen sugar pills. Why?
He explained that, aside from having to save the "real" medicine for the strongest members of his community, he realized, upon checking the boy, that he had less than two months to live from parasites that were currently in his intestines, but that were slated to move throughout his body. In short, he was bound to die in short order. Moreover, there simply were no pain drugs to spare to help him through that two month crisis period. No, there were none at all.
He further added, "I neither have the time, nor the supplies, to spend on a hopeless case like him. I need to use my energy and treatments for people who I CAN help."
"Unfortunately, your country and other wealthy ones have lured our doctors and nurses away with promises of high salaries. I am sorry that you have such a scarcity, too, but it makes my time all the more difficult as I have far too many people to tend and not enough money to pay for life saving medication, equipment and stores of simple things like thermometers."
"So if you pray, then pray for that boy. It is all that we can offer him."
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