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  • Good morning, Hank. It's Tuesday.

  • In your video last week, you mentioned this New Yorker profile

  • of Partners in Health co-founder Ophelia Dahl,

  • and ever since reading it, I've been thinking about Ebola.

  • Remember Ebola?

  • An outbreak of the virus in 2014 killed over 10,000 people, and to quote some 2014 headlines,

  • Ebola was a global health crisis, a pandemic, and above all, an emergency.

  • And I think in general, humans are quite good at responding to emergencies.

  • We rally together in the immediate wake of disasters, we raise money, we lobby our governments,

  • But we really struggle when it comes to long-term solutions to long-term problems.

  • Back in 2014, the world responded to the Ebola emergency with big health care investments

  • in the nations affected by the outbreak: Guinea, Sierra Leone, and Liberia.

  • And then, to quote the New Yorker article, "as soon as Ebola appeared to be stabilized, the money evaporated."

  • The influx of aid in 2014 did help end the Ebola crisis, but it did very little to address the long-term crisis.

  • Like, when the outbreak began, Sierra Leone, a nation of over seven million people, had fewer than 200 doctors.

  • And over five percent of them died of Ebola in 2014. For context, my home state of Indiana, which has a

  • slightly smaller population than Sierra Leone, has over 16,000 practicing physicians.

  • Short-term aid did not fix that problem. Sierra Leone still has far too few health workers who are paid far too little.

  • And facilities are hugely inadequate. More than half of the public hospitals in Sierra Leone lack running water,

  • and drugs and other supplies are often out of stock.

  • And all of that has real, catastrophic consequences. Nine percent of kids born in Sierra Leone will die before they're five.

  • And I want to say here that I am totally unconvinced by the argument that these problems are not our problems

  • or that the inadequacies of Sierra Leone's healthcare system should be fixed entirely within Sierra Leone.

  • I just think that ignores so much complexity and also so much history.

  • The history of slavery and colonialism, but also much more recently, that Sierra Leone was

  • forced for decades to spend less than five dollars per person per year on health care

  • by misguided global loan regulations.

  • And we also can't ignore how deeply interconnected and interdependent we are as a species.

  • Like, when inadequate stocks of drugs and lack of health care facilities mean that people's tuberculosis treatment

  • gets interrupted, the multi-drug resistant tuberculosis that spreads is not only a problem for Sierra Leone.

  • As Ophelia Dahl put it, Ebola was acute on chronic.

  • That's what they call it when someone has smoker's lung and then suddenly something precipitous happens like pneumonia.

  • As long as the world fails to meet basic health care needs, we will continue to experience acute on chronic emergencies.

  • In fact, in Sierra Leone in 2014, twice as many people died of tuberculosis as died of Ebloa, and

  • almost all of those TB deaths were preventable.

  • But training and paying more healthcare workers, improving facilities, spending money on ongoing

  • restocking of drugs, all of these require long-term investments.

  • These are changes we chart over years and decades, not over days and weeks, but we can see changes,

  • like life expectancy in Sierra Leone is low, but it's rising.

  • The healthcare system is woefully underfunded, but it is nonetheless better than it was 10, or 20, or 50 years ago.

  • Now, none of this is to say that we should stop responding to emergencies.

  • Like, let's definitely stay stay good at that, or even try to get better at it.

  • To me, this is not an either/or proposition, it's a both/and proposition.

  • Let's both respond to emergencies and try to focus more attention and resources on long-term problems and the long-term solutions they demand.

  • There's a link below to that article about Ophelia Dahl and Partners in Health. It really is fascinating.

  • By the way, for those who don't know, nerdfighteria has donated more than a million dollars in total

  • over the last several years to Partners in Health.

  • I think it's helpful to understand how far that money has gone, but also how far we still have to go.

  • Frankly, it's infuriating to think about the hospitals that have had to close since the Ebola money dried up

  • and the lives that have ended as a result.

  • I guess we can only hope that these outrages, and all outrages, spark empathy and commitment

  • instead of fear and resignation.

  • Hank, I'll see you on Friday.

Good morning, Hank. It's Tuesday.


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B1 中級

緊急時について (On Emergencies)

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    林宜悉 に公開 2021 年 01 月 14 日