Pinoy Kasi -- New challenges for health professionals (November 20, 2003)

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20 November 2003

New challenges for health professionals

FROM YEARS of teaching, I've learned to mechanically rattle off the country's leading causes of death: pneumonia, heart disease, tuberculosis, cancer...

What if I suddenly mentioned WOT (War on Terror) and WTO (World Trade Organization) among those leading causes of death? It'd probably shock my students, but that is the message that comes out of a meeting of some 120 health professionals held in Manila from Nov. 8 to 10. The meeting was dubbed the International Conference on Challenges to Health Work Amidst Globalization and War, with delegates from Belgium, Canada, the Congo, Finland, India, Indonesia, Japan, Malaysia, Nicaragua, the Philippines and the United States.

I was unable to attend but one of the organizers, Sister Mayang Grenough, sent me the summarized proceedings. Mayang, some readers will remember, is my favorite "American Filipina," a nurse and Maryknoll sister who has lived in the Philippines for more than 40 years now, totally devoted to community health care.

Many of the other health professionals attending the conference have backgrounds similar to Mayang's, people working with the poorest of the poor. Amid the skyscrapers and the high-tech wonders of the 21st century, they see a global worsening of the health situation, which they blame on the policies of the developed countries, mainly the US government.

They point to the diversion of funds away from social services to George W. Bush's so-called War on Terror. The conference participants referred to war casualties, as well as the financial costs of the war: 81 billion dollars spent so far on the war in Iraq, with an estimated 50-60 billion dollars needed annually for the occupation.

It's not surprising that the conference included Americans speaking out against their government's policies. It's their taxes that are used for the wars and it's their young women and men who are sent off as cannon fodder. Their own public health budgets have been slashed back, even as 44 million Americans live without health insurance of any kind.

Global health suffers as well from the skewed priorities. One billion dollars a year could result in effective malaria control in Africa for example, or support global tuberculosis control programs that would decrease by one half the total deaths from that disease. Nine billion dollars could provide safe water systems for all of the world's poor communities.

The conference participants rejected Bush's claims of bringing democracy to Iraq and Afghanistan, seeing the wars there as part of the US government's effort to consolidate its control over oil sources in the Middle East. They also named the Philippines as an "epicenter" for still another US military strategy, that of "establishing a forward operation base in Southeast Asia."

But WOT is only part of a larger package to establish "monopoly control" over the global economy, according to the conference participants. They also lashed out at the WTO and its imposition of "free trade" policies that favor only developed countries. TRIPS (Trade-Related Aspects of Intellectual Property Rights) was renamed "Treason and Robbery by Imposters and Patent Swindlers," criticized for depriving developing countries of the medicines they need.

Besides the inequities of "free trade," the conference participants also criticized the way international financing institutions have forced developing countries to privatize health care while cutting down on what's left of government services.

There was also extensive discussion about brain drain, seen as a consequence too of global inequities. With countries like the Philippines unable to provide decent wages, it's not surprising that health professionals leave for developed countries where they end up "exploited, overworked, underpaid and de-skilled." (The de-skilling is, of course, best exemplified by physicians who end up working as medical assistants or as nurses.)

The conference proceedings got me to dig up some local figures that might help us to think of how WOT and WTO affect our health.

We might want to reflect on our 2004 national budget, currently proposed at 864 billion pesos. That's about 15.6 billion dollars, a paltry amount compared with the 399 billion dollars allocated by the United States for its military next year. But even that tiny budget for running the country is going to be further emasculated, with a third of the budget, or 271 billion pesos, going to debt servicing alone, much of it owed to international creditors. No wonder that while we need 44,000 new public school classrooms, the 2004 budget allocates only 1.64 billion pesos to build 4,375 rooms. How do we expect the next generation of Filipinos to think of healthy lifestyles when they have to bring their own chairs to school, share textbooks, meet outside and under the sun?

Another important budget-related statistic: Agriculture Secretary Luis Lorenzo was quoted in Tuesday's newspapers as saying that US and European farmers receive between 50,000 and 100,000 dollars a year in government subsidies, compared with about 20 dollars extended to our farmers by our government. Yet, our farmers and livestock raisers are expected to compete with US and European imports as part of the WTO's "free" trade policies. Think now of what happens to the health of a vegetable farming family in Trinidad Valley when their livelihood goes under, unable to compete with the imports.

There's more to illness than germs and diseases with kilometric tongue-twisting names. Sometimes they come deceptively simple, like WOT and WTO.