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Haiti and the world

Malcolm Potts, professor of population and family planning | January 29, 2010

Human beings are extremely social and highly empathetic, although in limited ways. We react strongly when more than one person dies in the same place, but we are numbed by numbers when millions of people die prematurely in asynchronous, isolated, private tragedies.

Our empathy is turned off by huge levels of human suffering. In a psychology experiment, Paul Slovic, University of Oregon, told the story of a starving African child to a test audience. On average, people offered $2.00 each to help her. When he added that there were one million more children like her, donations fell. People gave least if merely told the the bald statistics. Without a individual face, problems seem insoluble.

The media will cover any transport accident that kills hundreds of people or any earthquake or tsunami killing thousands, but these numbers are often small beside the burden of deaths taking place from a variety of courses every day, many of which are preventable.

I work in international health. To do that work effectively I need an emotional perspective, which alerts me to diseases and the suffering that can be ameliorated, and an intellectual perspective that drives a sense of scale. Only then can I divide my time, or allot other people’s resources, to help the maximum number of people

As Berkeley lives on top of a major fault we also could suffer an earthquake measuring 7.0 on the Richter scale tomorrow. We have good reasons to be particularly moved by the level of suffering in Haiti. The University is organizing relief for Haiti. The Dean of the School of Public Health has emphasized how assistance will be required for the next 10 to 15 years in Haiti to rebuild the destroyed transport, education and health infrastructure .

One report cites over 110 thousand have been buried and no doubt many more remain in the rubble. Whatever the exact number, over twice as many women will die from pregnancy abortion in childbirth this year, just as they did last year and will again next year. But maternal deaths are isolated events that will never make the headlines, or draw the attention of CNN camera crews. Today and everyday there are 140,000 more births and deaths in the world,  nearly all of them in countries already stricken by poverty, illiteracy and inadequate health care. World leaders flew to Montréal to raise funds and plan strategies for rebuilding Port-au-Prince.  Should world leaders gather every day to plan strategies to create infrastructure educational health facilities needed to accommodate the increase in global population taking place in the next 24 hours? After all one million people migrate to cities every week, and having been to Port-au-Prince and many other over crowded cities, I think the long term investment needed is similar.

I’m not suggesting we should not help those suffering in Haiti, but perhaps for every dollar we give we should donate a second one to help alleviate suffering from deaths that don’t occur in one place and which don’t make headlines or tragic images on television .

We cannot forecast or prevent earthquakes . We can look objectively and sympathetically at some of the worlds problems that are open to solution. I’ve just come from the world’s first conference on ‘Women’s Health and Safe Abortion,’ something that affects 20 million women each year and kills between 60 and 70,000.  Nearly all these deaths are in poor countries. We know exactly how to prevent them but we don’t value the lives of women and make the investments to overturn patriarchal laws forbidding safe abortion.

The Berkeley earthquake, when it comes, will probably take less lives than in Port-au-Prince. Haiti is suffering because of centuries of bad government, exploitation by others, and lack of access to education, health and family planning. Among the reasons so many buildings collapse are inadequate construction codes, corrupt developers and overcrowding .

There is a large unmet need in family planning in Haiti. Family planning has been over-medicalized, the doctors who are often socially remote and demeaning to those they should be helping.

Perhaps as the society is rebuilt, something will be done to empower local communities to take more control of health and voluntary family planning. Perhaps, also, policymakers will come to see the wisdom of overturning restrictive abortion laws and permit women to exercise their basic right to make choices about if and when to have a child. With the exception of oil-rich city states like Kuwait, countries like Haiti that double their population in a little over 30 years rarely escape the scourge of poverty. The next earthquakes could be even more lethal.

Keeping our emotional brains and our intellectual brains in balance in the face of such a tragedy is difficult – but important.

Comments to “Haiti and the world

  1. Reading through the first two paragraphs, I thought that while it didn’t make sense, it was true – hearing an individual’s story provokes more empathy than just being told millions of people are starving. If these studies can be put to use to encourage donations from the general population, not just for Haiti victims, but starving children etc that would be great!

  2. Hi Malcolm!
    You make some very valid points. It is very frightening to know that California could indeed suffer a similar catastrophe as Haiti is experiencing. One can only wonder how our country would be prepared to handle the situation. I’m sure we are more prepared than the third world countries who struggle with oppression, lack of education, and overpopulation. Although helping third world countries can seem daunting, it is something that we must take one day at a time in order to achieve success.

  3. Thank you for sharing Dr. Potts.

    The media has been prone to publicizing sensational news stories to elicit strong emotional responses from the public. We all know that such drama sells. These stories steal the spotlight from equally important but less publicly visible issues, such as chronic and preventable conditions that silently kill millions of people each year.

    To address this disparity in health reporting, I think it is vital to endow our future scientists and leaders in public health with a strong background in communication and journalism, so that they are able to effectively report compelling public health issues in print, broadcast, radio, and other media. The Berkeley School of Public Health (SPH) has already identified this issue and is at the forefront of creating a solution. The SPH has established a concurrent MPH/MJ program with the School of Journalism. The concurrent degree program allows journalism students to focus on public health issues and allows public health students an opportunity to develop media and communication skills. Graduates of this joint program will be invaluable to media outlets, academia, research institutions, and clinical practices. Currently in the Environmental Health Sciences Division of the SPH, we have had 2 Chinese visiting scholars with journalism backgrounds who apprenticed and collaborated with Professor Kirk Smith and myself on a China environment and health project. If we can apply this same model to other public health disciplines today, we will be able to invest in future leaders who can change the way the media operates tomorrow.

  4. Hi Malcolm,
    Thank you for your thoughts on Haiti. I do agree, we need to have an emotional pull in order to dig deep into our pockets. And what goes on day in and day out does not make for a good news story- even though it should.
    The problems facing so many third world countries are so huge, it sometimes seems useless to even start trying. But, try we should. If we each pick one project, and make small steps forward, in the long run we can get there.
    PS: My husband Eric Grigsby and I met you over dinner with Dean Shortell last year. Hope to have the chance for us all to catch up again sometime.

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