By Jessica Hergert
A presentation delivered at Rider on March 28, titled “Health Delivery: A Paradigm Shift for the Poor,” posed a focus question: Is health care a universal right or a privilege?
Sponsored by Rider’s Health Studies Institute, the event featured a lecture on global health care by guest speaker Joia Mukherjee, an associate professor of medicine at Harvard Medical School and the chief medical officer of Partners in Health (PIH).
Mukherjee began her presentation by reading an excerpt — recounting personal experiences she had with a patient abroad — from her newly published textbook, “An Introduction to Global Health Delivery,” to “give a sense of the battle we are fighting” for health care in developing nations.
Following the loud applause for the passage she read, Mukherjee spent the next half hour teaching the audience about “historical touchpoints,” such as the wealth disparity in African countries and the “modern notion of human rights” set forth by the Universal Declaration of Human Rights, a document adopted by the United Nations in 1948.
“If you don’t understand where we came from, it is very hard to understand where we are going,” she explained.
As Mukherjee began to introduce health care into the discussion, she focused on Africa.
“Africa is the richest continent [in terms of resources.] Every cellphone in this room can be traced to the Congo,” Mukherjee said.
Although countries like Ghana have a wealth of natural resources, she continued, the people do not own their resources and therefore, the countries “crawl back to their colonizers” to borrow money from the World Bank.
“It may enrich the top of the pyramid, but it drives inequality,” she said of the system.
The funds that are borrowed are allocated in a way that leaves just $5 a day per person for health care.
“[The African countries] fought for economic justice; what they got was political justice, but very little economic justice,” Mukherjee said. “The only thing that $5 could pay for is a bunch of health education and some limited prevention. We would see a kid with a broken leg, and all we could do is vaccinate that child. We would see a kid with pneumonia, and we would give them a vitamin A tablet. We would see a starving kid, and we would hold up a poster and say, ‘Mom, your kid doesn’t have enough nutrition.’”
She posed the question, “Is prevention better than cure?” to the audience, who echoed Mukherjee’s thoughts, “It doesn’t matter. They are both important. It’s a false dichotomy put there to solve a resource problem.”
During Mukherjee’s time abroad, there were two choices. “You can either do public health interventions and buy the line that prevention is better than cure; I’ve done that. Or you can work in a mission hospital with [people] who are trying to do the right thing.”
The key to changing the system, it turned out, was the HIV/AIDS epidemic. Although the anti-retroviral drug cocktail Zidouvdine (AZT) was saving lives in America, 8,000 people were dying per day in Africa, according to Mukherjee.
PIH brought AZT to Haiti and Rwanda and published a paper on the work the group was doing. “Activists got it,” said Mukherjee proudly, noting that money began flowing in.
“The battle is about health care, but HIV [gave] us a new energy to do something different,” she said.
Four changes were implemented: The staff was paid, drugs — besides HIV treatments — were stocked, the fees were reduced, and an “army of community health workers that can go and find the sick” was hired and paid, Mukherjee said.
Over a year, the average number of visits the clinics saw rose from 20 people to 400 people per day in Haiti. In Rwanda, numbers were equally astounding.
Following a short Q&A session, five of Mukherjee’s books were raffled off to lucky winners, and Rider donated $500 to PIH.
As the swarm of students and faculty left the auditorium, conversations were buzzing with enthusiasm. Senior chemistry major Joshua Tamuzza said, “Dr. Mukherjee had an inspiring story and gave me hope for the future of health care in developing nations and our evolution into a more compassionate global society.”
Junior biochemistry major Caroline Nguyen expressed similar thoughts about the presentation.
“Dr. Mukherjee did amazing work in transforming health care in impoverished countries,” she said. “But what was more amazing was the [way] she spoke to the hearts of the audience who have become inspired to continue to fight for health care as a right for all human beings.”