Medical Inequalities around the world

For today's blog entry, I will be focusing on inequalities that exist in health care and medicine throughout the world. I will be specifically focusing on Iran for this entry, as I've found some interesting information about a relatively small country of the world. However, the problems that exist in Iran are different than those discussed for America in many respects. In the United States, we have such a mix that it is easy to find and discuss the differences that exist between races, genders, and classes and each of those areas varies greatly in different areas of the country. In other nations, from what I have found, most of the disparities exist due to gender and socioeconomic class, and not really due to race or ethnicity.

In order to discuss health disparities and areas that are lacking in proper health care or medical treatments, I'm going to focus on Iran. Iran is a relatively small nation that many people think of as being war-torn and full of conflict, but many never consider what it's like for the natives of Iran to live and work there. According to an article published by the Population Reference Bureau entitled, "Iran Faces Pressure to Provide Jobs, Address Health Disparities," an area of major health disparity in the nation is based on regional differences. Specifically, the article discusses the differences that exist between Tehran, the nation's capital, and Sistan-Baluchestan, a rural town located in Iran. In the comparison drawn, the article points out that rate of death at birth is much higher in Sistan-Baluchestan, and the life expectancy is much lower, as drastic as 9 years. As a reason for this difference, the article references the fact that health care professionals are paid a modest amount of money and there is no incentive for them to move into difficult and rural areas to do their work. I think it's important to point out the clear comparison that can be drawn with America on this topic. The United States has a similar problem with filling health care positions in the most rural communities and many of these differences exist here as well, although not as drastic. However, the United States offers incentives to doctors willing to work in rural areas such as higher pay or help with student loans or tuition in medical school.

Also in Iran, the same article listed above discusses the disparities that exist in reproductive health throughout Iran. Compared to 82% of women who use contraception and family planning in Tehran, only 42% are shown to use it in Sistan-Baluchestan. This disparity could be due to lack of education or lack of resources; the article doesn't make a claim for the cause of the situation. However, it is important to point out that what is seen as a disparity within a nation, can be shown to be related to an entire region. In the Middle East, contraception use and family planning are much lower than even the poorest and most rural regions of Iran. I found this extremely interesting because it makes me wonder the reasons why Iran seems to be much more educated and focused on the problems that come from failing to use contraception or family planning techniques.

In my research about Iran, I came across a study done by Hamid Sepehrdoust, a faculty member at Bu-Ali-Sina University in Hamedan, Iran, called "Eliminating Health Disparities Call to Action in Iran." In the study, he discusses health disparities that exist within Iran as well as in other countries, namely India, and he references many of the same ideas that I discussed above. However, what I found particularly interesting in this study is that in the "Main Findings" section, he offered solutions that Iran should use to decrease or eliminate the health care disparities that exist throughout the country. His first suggestion is to "provide national access to an adequate level of health care facilities for the population." This suggestion in particular made me see the connection between the United States and Iran. Amid all of the discussion and turmoil over the current Health Care Reform bill, I realize that the main point of the bill is to provide equal and adequate health care and insurance to all citizens of the nation. I think it's important to realize the parallels that can be drawn between the U.S. and Iran, as well as the other countries I've discussed throughout the blog. The second suggestion made in the study was to "bring just and equal distribution of financial burden on people with respect to health care expenditures without external effects on their socioeconomic status in life." The third is to "equip providers with permanent touch with knowledge of accountability and cost effective usages of the health care budget." The last and final suggestion made is to provide special attention to groups like women, children, disabled, and the elderly. All of these suggestions would seemingly help the inequalities that exist in Iran and could probably be applied to every country around the world to help alleviate problems that exist in health care and differences that arise due to region, race, class, ethnicity, or gender.

Health Care Disparities in the U.S.

In an area such as medicine, there are disparities that exist among certain groups of people throughout this country as well as other countries and the world as a whole. In order to best understand the disparities that exist around the world, I think it's important to first understand some of the disparities that exist here in the United States. There are incredible differences between those with access to health insurance and exceptional health care and those who can't afford or are denied by health insurance companies. While many people associate these disparities with socioeconomic class, there are disparities that exist due to race, ethnicity, and gender, among many other things.

The first important point to make is to define the differences that exist between races, classes, and genders as far as health and medicine, and to specifically define what is considered a "disparity." A health disparity, as defined in a Fact Sheet published by the American Society of Clinical Oncology, is a difference that exists in the prevalence, affects, and death related to certain diseases and health issues. This definition encompasses differences that exist in the treatment and diagnoses that patients receive as a result of varying gender, race, and class. Since there are so many health disparities that exist in the United States, I will be choosing one example that varies with gender, one with race, and one with socioeconomic class in order to highlight the categories of differences that exist.

First, I will focus on the differences that exist in health and medicine because of race and ethnicity. One of the major diseases that seems to differ among people of different races is cancer. According to the National Cancer Institute at NIH, African Americans have the highest rate of and fatalities from cancers, as cited in the fact sheet linked in the above paragraph. The fact sheet tries to outline reasons for the disparities that exist, and for the most part, I think that many of them are accurate and probably contribute a great deal to the differences that exist in cancer among African Americans. Specifically, the fact sheet points to lack of participation in cancer prevention initiatives by minorities, delayed diagnoses of minorities due to lack of insurance, differences in the outcomes of cancer treatment. All of these factors, among others, contribute to the disparities that exist between races, specifically involving African Americans and cancer.

Disparities in medicine and health care also exist due to gender. One of the main areas that professionals see health differences in between men and women is in the area of life expectancy. In some countries around the world, the gap between men and women can be up to 13 years, as it is in Russia according to an article published in the Population Reference Bureau. In the United States, the gap is smaller as it is in many other countries, but in all of the countries mentioned, women have higher life expectancies than men. As I've learned from this article and from other courses that I've had, women are more likely to visit the doctor and have short-term health issues, but men are more likely to die from an illness at an earlier age. It is important to recognize the difference between this disparity and the one listed in the above paragraph. This disparity may be partly due to hormones and biological factors, but much of it exists due to behavioral differences. Women are generally more likely to admit needing to visit the doctor and are also more likely to take medications and stick to treatment plans than men.

The last disparity I will discuss in the United States is based on Socioeconomic class. Rather than focus on a specific illness, I will be discussing the disparities that exist based on class in a more general way. While there are rarely disparities that exist because of low socioeconomic class, but rather that the low socioeconomic class affects the ability of individuals to get proper treatment for diseases that are treatable in most cases. Lack of insurance is a major problem facing healthcare today, and low income families don't have access to insurance and are often unable to visit doctors. When patients don't obtain treatment for mostly harmless illnesses, they can progress into deadly or much more serious diseases that are then even more difficult and expensive to treat.

In the next blog post, I will focus on health and medical treatment differences that exist based on race, gender, age, and class in other nations of the world.

Health care and education in India

In this blog entry, I have chosen to focus on the education related to technology and health care in India. India is a large, extremely overpopulated country, supporting over 16% of the world’s population. With the size of the country and the disparities that exist in the health care in India, it is interesting to view how a country handles providing health care to so many people if they do so at all. India is a major world power, and has extremely advanced technology, but their health care is often lacking and they are often unable to provide adequate health care to their billions of citizens. This entry will look at a few articles displaying how education and technology have helped certain areas of medicine and health care improve in India overall.
Although people don’t generally think of India as having a high rate of infection with AIDS, in 2005 reports, there were 5.2 to 5.7 million people infected with the HIV virus according to a BBC news article. Also featured in that article is the extreme drop that has occurred in that figure since 2005. According to BBC News, the figure has been cut almost in half, and is currently closer to 3 million, which it recognizes is still an extremely large figure. According to a press release by UNAIDS, the sharp drop in the number of citizens affected by HIV is a direct result of the Indian government expanding and improving it’s surveillance of the disease. The press release also cites the fact that education and better understanding of the disease helps the government to better monitor and track those affected by the virus. In addition to a better understanding, technology has infiltrated the government’s efforts to help better monitor HIV and AIDS, and they are now using more sophisticated methods of disease detection, including regular blood tests of those at high risk for the virus. The fight against AIDS in India gives us a glimpse into the effects that adequate education and improved technology can have on so many individuals in such a largely populated country.
While education of the government and health care professionals is important, education of the public is also crucial to maintaining health care in a nation with so many inhabitants. By educating the public about health care and disease prevention and care, the number of people needing to visit the area hospitals would presumably decrease and the number of people suffering from various ailments would also decrease due to more awareness of the causes. Two doctors in India, Dr. Aniruddha and Dr. Anjali Malpani, realized the need for public education about health care, and started an organization called HELP (Health Education Library for People), a resource center now housing over 11,000 books on disease and health, along with many other forms of information including pamphlets and magazines. More information about the resource center can be found by following this link: . The doctors realized that by educating the public, many serious medical problems could be prevented before becoming so serious a problem that patients would require intensive medical care that many facilities in India may not be able to offer. The resource center is located online, and this is a clear display of how technology enters into the field of medicine and affects the education that the public receives about their own personal health care.
Another aspect of education and technology in medicine that is important to understand, is the education and training of health care professionals in India, particularly the nations physicians. While I won’t delve into the complexities of the curriculum in medical colleges in India, I will point to a few problems discussed in an editorial by Rita Sood and BV Adkoli entitled, “Medical Education in India- Problems and Prospects.” Namely, the article discusses the lack of clinical experience that students gain while studying in an Indian medical school. Medical schools in India often concentrate solely on medical science, and assume that students will be able to use that knowledge to practice successfully in a clinical setting. However, as this article points out, that is not something that one can assume of every student. In addition, the lack of updated technology in medical teaching units makes it difficult for teachers to deliver the information and clinical applications in ways that are most beneficial to the students. Updating the technology available to students and teachers in medical schools throughout India would help physicians trained at those hospitals to finish with a better understanding of medicine as a practice rather than just a science.
While India is not one of the countries that many people first think of related to disparities in health care, such a large population makes it difficult for the country to provide adequate health care and education to its people. In future posts, I will come back to India as well as Africa and other areas of the world, and delve into other aspects of health care and technology in these areas so that by the end of the semester, each of us has a better understanding of the state of health care and it’s use of technology around the globe.

Medical Education in Africa

A major part of health care in other countries involves educating the native people about medical options and proper personal care. In addition to increased medical technology being used in the hospitals and health care facilities, technology is being utilized to educate people and to communicate about health care more effectively to the native people. This blog entry will focus on Africa in particular and the technology used in educating people about health care throughout the continent. In future blog entries, I will focus on the technology used to educate people about health care in other areas of the world so that a clear comparison can be made between various nations around the globe.

In a recent article featured in the Sunday Independent, a daily Nigerian newspaper, the use of 3G technology by Qualcomm is featured as being used for health care education throughout Africa. In the article by Emma Okonji, the project to use 3G coverage to assist in the distribution and monitoring of antiretroviral drugs for AIDS, which is prevalent in Africa, is discussed. Qualcomm began the project as a result of the current system used to monitor the use and circulation of antiretroviral drugs, as a steady supply of the drugs is essential for the survival of those needing the therapy. Prior to this initiative, manual record-keeping was used to keep track of the drug therapies utilized, and this system uses valuable time that could be spent helping to care for patients. In order to help reduce the time spent keeping manual records, Qualcomm is working to provide the centers for antiretroviral treatments with computers and wireless broadband connectivity. In addition to providing technology to these centers, Qualcomm is working to educate the people of Africa on how to use the equipment for improve efficiency. It is crucial for them to educate the native people on how to best make use of the equipment so that the initiative will actually help to improve quality of health care of those with AIDS in the long term. Since the project was piloted in 2005, it has grown to a global initiative to improve health care and communication throughout the world and could spread to help monitor the use of all pharmaceutical drugs in Africa and other nations around the globe. In the event that you would like to read more about this particular initiative, the article can be found by following this link:

In another widespread effort to improve the health care and education related to health care in Africa was initiated by GE. Their $20 million project, started in 2004, donated millions of dollars worth of equipment to the Korie Bu Teaching Hospital in Ghana, where doctors from all of Africa are trained before spreading throughout the continent to provide health care in some of the most underdeveloped countries in the world. This hospital was chosen because it is a teaching hospital that covers most of Africa and would therefore be able to have far-reaching effects throughout the continent. Among the many donations made to the hospital were: portable ultrasound machines, x-rays, anesthesiology equipment, and monitors. Also, being the major electricity company that it is, GE was able to provide power generation and refrigeration equipment to the hospital. While GE did not work to educate people directly through their initiative, they provided equipment to a major teaching hospital in Ghana to help educate doctors who serve throughout Africa in order to better the quality of health care. The technology used throughout Africa in medical facilities was improved because of the use of the technology donated in teaching hospitals like the one in Ghana. Education of the continent’s doctors has allowed for the spread of medical technology throughout Ghana and the other nations of Africa, and has improved the quality of health care throughout the continent.

Another example of the spread of technology and education in Africa with regards to medicine is related to the use of mobile telecommunications to help alleviate Africa’s healthcare challenges. In an article featured in a magazine called, This is Africa, mobile telecommunication technology is discussed in relation to its influence on medicine in sub-Saharan Africa. Prior to the beginning of many initiatives to improve health care in Africa in recent years, over 50% of the population didn’t have regular access to a modern healthcare facility. The mobile telecommunications initiative focuses on the ability of mobile technology to bridge geographical gaps that are created in Africa. The projects spotlight the ability of mobile telecommunications to help with patient monitoring, disease tracking, education and awareness, and healthcare worker training. At the present time, this initiative is in progress, and nothing has been proven effective. However, it seems intuitive that the initiative will help to educate people about proper healthcare and will help to allow those living in sub-Saharan Africa to have access to better medical care and technology. The article discussing the mobile telecommunications technology initiative can be found by following this link:

Education is a major factor in improving the health care and use of medical technology throughout Africa, and the several initiatives currently taking place are helping to educate both healthcare professionals as well as patients themselves in order to improve the quality of healthcare available. In the next blog entry, I will delve into medical technology and education related to health care in another area of the world so that a clear comparison can be made between Africa and other areas of the globe.

Health Care around the World

In order to begin discussing the technology used in medicine around the world, we must have some basic knowledge of the health care systems in other countries. While we all know what health care is like where we live in the D.C. Metropolitan area, it is most likely true that many of us couldn't say much about the health care available in more rural areas of the country, or in areas like the border between Texas and Mexico. So if we can't even speak about health care in every part of our own country, what can most of us possibly know about medicine elsewhere, especially in some areas of the world seldom traveled by Americans? This blog will help to explore the technologies used in health care around the world and throughout the United States in the more remote areas. However, in order to have a strong base of knowledge, I will discuss the state of health care in other countries right now.

In order to first discuss the idea of health care and medicine in other countries, I think it is crucial to discuss some of the misconceptions that people have about the medical systems that exist under different types of government from our own. While researching myths commonly held about health care in other countries, I came across an article written by T.R. Reid and featured in the Washington Post in August of 2009. His article explored some of the more common beliefs held about the structure of health care in places other than the United States. One of the myths that he explores is that all medicine is socialized around the world, but he points out that this is untrue and that in many countries, including Japan and Switzerland, there are private insurance companies as well as private health professionals and clinics. While this is obviously not discussing a developing country, it is important to discuss health care and medical technology around the world instead of only focusing on places that tend to draw a lot of negative attention like Africa or India. Throughout this blog, I will focus on various countries, ranging from wealthy ones like Switzerland to developing areas such as Kenya and Ghana.

A second, and even more important myth discussed in T.R. Reid's article is that "cost controls stifle innovation." However, while many may think that more limited health care spending hinders the production and use of new and innovative techniques and technology, that is contrary to the facts. For example, as T.R. Reid points out, many of the techniques used today in the United States came from places like France or England. It is crucial to remember before beginning to read this blog that countries besides the United States are advanced in the health care field, and many are gaining strength with each passing year.

In order to understand the current health situations existing around the world, it's important to hear some current information about a place considered much further behind in technology in general, especially in medicine. On a travel website called the "Africa Guide," there is a section detailing the various types of illnesses that are frequently encountered throughout Africa. These diseases and illnesses include: AIDS, Bilharzia (a parasite in the water), Cholera, Amoebic Dysentary, Hepatitis, Meningitis, and Polio, among others. Simply from looking at this list, one can clearly see that the areas in Africa where these types of diseases are common must be lacking in their medical technology and health care. Diseases like Polio and Cholera have not been a problem in the United States for at least 50-100 years. As I post more entries, I will focus on specific types of medical technological tools that are used in Africa related to the types of tools and technologies used in the United States.

Hopefully this blog entry allows you to better understand the current situations in health care in a few different parts of the world, and your knowledge, as well as my own, will be expanded throughout the semester as I focus specifically on countries and their use of medical technology and quality of health care. This entry should provide some strong background knowledge of health care, and I will discuss technological tools in more depth as the semester goes on.

Welcome to Medical Technology without Borders! Throughout my undergraduate career, I've always found myself particularly interested in health care, and the differences that exist in health care around the world. As a potential future Peace Corps volunteer, I also have a strong interest in the development of third world countries and the technologies that are slowly infiltrating the most remote corners of the globe. Throughout the semester, I plan to explore medicine in countries around the world, and contrast them with medicine in the United States. I will discuss how various medical technologies, including even simple things like X-Rays, have found their way into countries around the world that previously had no access to such advanced medical technology.

When choosing the topic for this blog, I knew that I wanted to include medicine in some way, and I was reminded of a book that I recently read entitled "Better" by Dr. Atul Gawande. In his book, Dr. Gawande describes what it was like for him, a United States trained physician, to enter into India and see the extreme differences in health care. He described the one decent hospital within many miles of the town he was visiting, and how people struggled to find adequate health care on a daily basis for problems much more serious than the common cold that Americans often visit the doctor about. The way that Dr. Gawande described the stark contrasts between Western medicine and medicine in a developing country such as India peaked my interest, and I am interested to find out more about medicine in other areas, including Africa and South America. I will look for any information available about the use of medical technology in countries around the world.

As I'm beginning this blog, my current knowledge of medicine around the globe is limited, and I look forward to expanding my horizons throughout the semester. Currently, I feel that America is incredibly advanced in medical technology compared to many countries around the world with the exception of China and much of Europe. However, as I said, I don't actually know many details about health care in other areas of the world, so I will be learning about the topic as much as the readers of this blog will. I look forward to exploring this topic further and being able to speak eloquently about the use of technology in medicine throughout the world. I hope you enjoy learning about my topic, and I look forward to sharing the information I find with each of you.