What I believe

This week I would like change tack somewhat, and take some time to explain what motivated me to develop an interest in both Medicine and International Relations. I am compelled to do so because I have recently been spending a fair amount of time reading over other personal affirmations of motivation and belief that have been compiled by the National Public Radio segment entitled This I Believe. In so doing I have discovered that many of those who have contributed essay’s seem to have a common theme or motivation driving their tale. That theme is hard to define, being more a feeling than any stated category. That said, I can try to describe it as a combination of the enduring nature of the human spirit, the realization of the difficulties encountered in everyday life, and yet the persistency in believing that, despite odds and adversity there is a need to perform and appreciate kind deeds and all that is good, and might be good about the future.

This sentiment is expressed many different ways, as I am sure that each person has a unique reason for understanding it. My introduction to it came when I was around ten years old, on an avenue in east L.A. sometime after dark. Having lived in Los Angeles all of my life I had grown accustomed to the occasional tell tale signs of gang activity that are ever-present in most parts of the city. Graffiti and depressing nightly news stories about violence effecting innocent passers by were numbingly frequent. But I had never seen the stark pain and senselessness that accompanies such lawless behavior. That night I saw it first hand. It changed me.

My family and I were coming home from the city some time around nine o’clock. In order to get home from downtown we needed to pass through an area that is home to “The Avenue” gangs.As we drove down one of these avenues I noticed a huddled shape lying in the road. My mother, the driver, also saw the figure and as we drew closer, we all realized that the shape was a person. He was a boy, maybe slightly older then myself. His bicycle lay discarded nearby. He had been shot, what turned out to be four times, if I recall correctly.

My mother is a doctor. Though she practices dermatology, she is a veteran of what is dubbed “the knife and gun club”, the L.A. county ER. While I cannot remember the exact decision to stop the car, I do remember her tending to the wounded boy in the road. I remember her doing what she could until the ambulance arrived. I remember that she was able to help while no one else could. I remember her telling us later that he had been shot because, when asked by a passing car full of gang members where he lived, he had replied “a few blocks up”, and that had been the wrong answer.

That night has influenced me greatly. Over time I developed two distinct ideas in response to it. First, that I should make myself ready to help the injured or dying. For most people, thinking of a doctor brings memories of dentists’ drills, funny paper gowns, cold linoleum flooring and uncomfortable exams. Some who watch dramatic television picture legions of beautiful men and women pausing from sordid lives to help sympathetic patients in crowded emergency rooms. I think of that boy, bleeding in the gutter. I think of a stranger stopping to do everything in their power to make sure that boys’ life would not end there in the street. I think of medicine as a tool to bring people from vastly different backgrounds together, no matter what the circumstance, in order to save lives, and repair the damage done by cruel deeds.

The second idea was that I should always try to keep the safety of my community a high priority, and that supporting law and justice to protect innocent lives was of the utmost importance. But as I have grown, I think that is no longer enough. That night sensitized me to all the news stories I had come to believe were just a fact of life. I quickly realized that it was not just one avenue a few miles from my home where laws and justice had failed innocent people. I began to see that entire nations were at risk of similar victimization. A notion that was driven home as if by a sledgehammer in September a few years later.

Thus I have turned to studying both International Relations and Medicine. My hope is to learn, on the largest, and most personal scales, how to help people live their lives safely, and how to help when things inevitably go wrong like that night in the streets of Los Angeles, or the other day in Iraq. While I state sardonically elsewhere in this blog that I hope to cure all the worlds’ ills, that night has made me believe that by helping one person live to see another day, by fighting to repair an injustice, you can make a world of difference. It may be idealistic, it may be unrealistic, but that is what I believe.

It is Time to End Polio: The Final Stretch of a Terrible Race

We may be on the verge of a historic achievement, or we might soon be witness to an unacceptable failure. Recent talks between the leaders of global health organizations, doctors and politicians have re-ignited the drive in humanitarians and physicians around the world to do something that has only one precedent in recorded history, the complete eradication of a disease. That disease is polio. Over the last twenty-five years astonishing progress has been made to wipe out this once widespread killer. The maps to the left show just how far polio has been forced back since 1988. However it is still a little too early to pop open the champagne and celebrate. Though the disease is nearly gone, the few strands that remain pose a great risk, not just to those infected, but also to the world. They represent the last hurdle in this race, but concern is growing that this final obstacle is insurmountable. Hence we find ourselves at a crossroads in history. One course can see the end of a terrible disease, the other shows us the inability of modern science to capitalize on a golden opportunity.

To provide a degree context for these talks we should invest some time in understanding the virus. Poliomyelitis lives in the intestinal track and throat of its hosts, and once it is contracted it can never be removed. It is highly contagious, normally being spread though poor sanitary conditions, and as such is normally though of as a disease of the third world. While the disease spreads rapidly, it debilitating effects vary. As Polio.com points out though, "Although polio has the ability to cause paralysis and death, most people who are infected with the polio virus don’t get sick, but these people can still spread the virus to others.”

This is where the treat to those countries that have already beaten the disease hides. Because naturally occuring polio has not been seen in America since the 1970’s many children today may not undergo vaccination for the virus. Therefore should they come into contact with someone carrying the disease, perhaps from a foreign visitor or while traveling, they have the potential to spark an outbreak in polio free environments. The possibility of allowing a resurgence of polio is unacceptable. UNICEF points out that "At its peak, polio paralyzed and killed up to half a million people every year." Fortunately vaccination is a relatively simple process, only requiring an orally administered dosage, shown above, or a series of four injections. While vaccination efforts have caused that number to plummet to 2000 new cases per year, the risk of complacency in dealing with the disease is still great. Polio can kill within hours in some cases, so the threat posed by a possible resurgence of the virus within the United States could go from being strictly hypothetical, to demanding drastic action within days.

With this in mind the present opportunity to finish off the virus should be seized. Currently only four countries worldwide are still known to have naturally occurring polio. Those countries, Nigeria, India, Pakistan and Afghanistan, have all pledged to help end the spread of the virus. However there are persistent challenges to ending the virus permanently, and it is here that those concerned with international relations should be concerned. The major setbacks to stopping the disease have often been military instability in the effected countries, or insufficient funding to ensure that vaccination methods can be achieved. Many countries have to resort to importing the vaccine through small U.N. backed missions, while making use of anything and anyone that can help, as pictured on the left. One World Health Organization report, for instance stated the following: “The main reason for continued transmission in southern Afghanistan is the increasingly serious security situation in that area, which has a negative impact of the ability of health workers to plan, implement and evaluate SIAs.”

Increasing awareness of these types of problems should be of the utmost importance to scholars, civil servants and medical professionals who have understand how international conflicts are disrupting the eradication campaign. Only then can it be corrected. It is equally important that the rest of society takes part in advocating the continued funding and implementation of eradication efforts.

We are all truly close to a historic achievement. Should polio finally be driven off the face of the earth it would represent the culmination of one of the largest multinational humanitarian projects ever undertaken. It would be the final act in what has been a 5.3 billion dollar event, supported by 193 member states, to do something for the benefit of mankind as a whole. We must seize this chance to make such a valuable contribution to world. As Americans we have been the greatest supporter of this initiative. Let us insure that we finish this fight, and end polio now.