Sunday, February 10, 2008

Who put the UNI in UNICEF

I am in danger of being sucked into a black hole of self reference, but looking for the link to my third post yesterday I found an old post I had written from I-swear-on-my-balls-sterility actual quotes from med-students.
And last night I went to see Dr. Beat Richner's Cello concert after declining the lude facial expressions of the clerk in the hotel lobby when inquiring my interest in 'A little Lady'. And surprise surprise, Dr. Beat is actually doing that shit that most med students I have ever met, act like they do but nevertheless don't actually do. That is, put themselves out there to save lives.
His website is www.beatocello.com and he needs money to run the 5 childrens hospitals that are running in Cambodia. He makes some interesting points, but the most relevant part for me was his allusion to Universalism.
I haven't gone to check my facts yet but he was saying that one unfortunate thing about WHO and UNICEF is that the current ideology (just one of three factors Dr. Beat says causes the passive genocide of children in cambodia) says that 'treatment should reflect the economic reality of the nation' that is if you live in a really rich country, it should have all the best equipment, and if you live in a poor country it should have all the poorest equipment.
He pointed out some of the stocks of vacinations UNICEF has for developing countries and also held by the red cross are illegal to administer in his home region of Europe. That a lot of the treatment advocated by UNICEF and WHO is actually criminal. And that the genorosity of the Swiss public and other tourists to Siem Rep is what allows the effective treatment of children in Cambodia.
Furthermore, with relatively simple skills, and expensive equipment any old doctor can help treat the 24,000 cases of Denghi Fever and shock last year in Cambodia, and going further, whilst Australia has its own rural health crises in its backyard, and the forgotten third world in our back yard, the world at large has inexpensive and effective treatments available to treat the majority of its sick patients.
I hate doctors, I would never tell a doctor that when going under the knife, but I do. Some of my best friends are doctors, but at the same time, they have to pull their heads out of their arses. Beat is now one of 2 foreign doctors in the Siem Reap hospital, and every school kid that talks to me here wants to be a doctor. If Cambodian children can become effective doctors, then it suggests to me that Australia might be making it just a little too fucken hard to get into med-school, and whilst this does wonders for overpopulating nice inner city suburbs with practicing GPs, it hasn't proved effective at creating a well oiled machine of Australias healthcare system in the bigger picture, though anything seems to be better than the American capitalist health care model.
The point though, is that I have been reading on ethics, and what escapes me here is not that doctors are bad people, fuckwads, or whatever you like. Many do go to the other side of town and become good decent people like Dr.Beat and others then leach off the good reputation they aquire.
Health is the most basic of basic needs and as such, should not be revered but a given. And it is one of those places where risk spreading is good.
But again its all about Scope, and UNICEF and WHO are big organisations, so big I';d be curious to know how they missed the notions of 'Universalism' that is that whats good enough for me is good enough for you and vice versa, and also this notion that gets talked about a lot in business called 'worlds best practice'.
I find it hard to imagine WTO saying 'Corruption should be at a level that is appropriate for the Economic reality of the country' or the UN saying 'Torture should be administered at a level that suits the economic reality of the country' it comes back to Noam Chomsky's $ votes, which is unfortunate for the unborn future generations that don't have any money, and slightly less unfortunate for the worlds poor hungry masses.
Here it is explained for you:

The market is regarded as democratic because everybody has a vote. Of course, some have more votes than others because your votes depend on the number of dollars you have, but everybody participates and therefore it's called democratic. Well, suppose that we believe what we are taught. It follows that if there are dollars to be made, you destroy the environment. The reason is elementary. The people who are going to be harmed by this are your grandchildren, and they don't have any votes in the market. Their interests are worth zero. Anybody that pays attention to their grandchildren's interests is being irrational, because what you're supposed to do is maximize your own interests, measured by wealth, right now.

And more to the point, the WHO and UNICEF policies kind of reminded me that the whole system is a bit like the trickle down approach of Reaganite years, that is that if the rich get richer and better off, some of that trickles all the way down to the poor and thus the situation improves.
But when I think of it, what this means is that drugs, equipment, procedures and doctors should first and foremost be produced for a small number of rich people, and then maybe some will go to the masses of poor, malnourished people, instead of just universally applying the worlds best standards everywhere.
I mean that is what all the worlds best healthcare systems have in common, france is number one, Cuba is remarkable for such a poor country and demonstrates one of the upsides to command economies. Why can't the best things be practiced everywhere.
That's not my point, it is Michael Moore's and it is infact a conservative one, world's best practice. Same as insurance companies, what function do they perform?
A lot of insurance is unnecessary, however the ones to get are the ones that reduce a small risk from ever whiping out your entire existence, such as house burning down, or falling ill while on holiday in America or Japan.
Whereas the trickle down approach makes perfect sense when Chomsky puts it like this:
...so long as power remains privately concentrated, everybody, everybody, has to be committed to one overriding goal: and that’s to make sure that the rich folk are happy -- because unless they are, nobody else is going to get anything. So if you’re a homeless person sleeping in the streets of Manhattan, let’s say, your first concern must be that the guys in the mansions are happy -- because if they’re happy, then they’ll invest, and the economy will work, and things will function, and then maybe something will trickle down to you somewhere along the line. But if they’re not happy, everything’s going to grind to a halt, and you’re not even going to get anything trickling down.

We live in an age where knowledge is accessible and transferrable like never before, the press through the internet is arguably freer than it has ever been, as a blogger I can vouch, I can't chuck just about any old shit up here.
I don't want to fuck around with what people are interested in though, such as scandles by the Bush administration in the middle east. I am glad that Monash finally had a breakthrough and figured out how to train a doctor in only 5 years as opposed to Melbourne Uni's 6. I would have thought education be more efficient over the years, if not more enriching.
These days I'm told that while Medicine is still a no risk profession (ie very secure income) in Australia, the true beneficiaries of that are the companies that give a doctor an AMA approved application for a gold credit card and numerous other ways they hope to have doctors in debt by the time they graduate.
I still say, being a doctor should be a profession on par with other valuable essential services, a police academy student doesn't put on the airs my med student friends do, even though without rule of law, as Dr. Beat pointed out, the grift present in the public health system (cash in advance, cash under the tables) goes a long way to leaving Cambodian health in crisis.
Same same with teachers, infact a healthy Cambodian child in being healthy should want to get straight out of the hospital into school, and most of them are training to be doctors. Why so future generations may live through school, and thats where quality political leaders, teachers, police, designers, engineers, civil servants will come from.
That reminds me, I was talking about insurance. Insurance is a simple business, it goes and calculates the risk of things, then figures out how much it has to charge everybody so that if one persons house burns down they can cover the costs, they take $10 from you and $10 from me, and so fourth until hey give it to someone else who has suffered, excess they invest in business usually, so there's a double benifit there, not too many Investment companies leave the funds sitting around, they usually put them to work.
Same same with healthcare, everybody swims in tax, but everybody at least has their health. Its all just scope. If the scale was lifted not just from our backyards but to take advantage of all the other efficiences being achieved from offshoring, then a lot of people would be much better off, instead of waiting for some drops of goodness to trickle down.

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