jeudi 2 mai 2013

CHOLERA AND TYPE 2 DIABETES: A METAPHORIC CONNECTION?


AN ENDOCRINOLOGIST THINKS ABOUT CHOLERA
CHOLERA AND DIABETES IS THERE A METAPHORIC CONNECTION?

When we talk about a CURE for Cholera, what do we talk about?
NOT ABOUT A VACCINE
NOT ABOUT WHAT SORT OF TREATMENT, SUCH AS REHYDRATION THERAPY
NOT ABOUT COMPLICATIONS OF CHOLERA

The Illness Cholera affects about 3-5 million people worldwide annually with about 100-200,000 deaths.
Biomedical oriented experts argue about the effectiveness of a two-dose cholera vaccine, antibiotics for mildly dehydrated patients, and also for severely dehydrated patients along with rehydration therapy.

But the Public Health Experts know, both in the UK and the USA, that long before Antibiotics, Cholera was eliminated:
Safe Drinking Water
Hygienic Sewage Disposal.
Why is an Endocrinologist thinking about Cholera? This endocrinologist is influenced by the effectiveness of Cuban International medical brigades at times of emergency and stability, who bring about improvements in the health status of poor people all around the world (in 79 countries in the last count).

I was prompted to write this down when I read the enthusiasm with which Paid Professors in American were enthusiastically endorsing a new medication for Type 2 Diabetes (with extremely attractive designer label names). Very few of these pharmaceutically sponsored professors would know or care about the Public Health aspects of Diabetes Prevention. Right now, more than 90 per cent of the money spent on Diabetes is about:
Medications and treatment of Blood Sugar and Cholesterol and High Blood Pressure and the Complications of these parameters which are poorly controlled despite so much money being poured into it. Only one in five patients in America with Diabetes have it under control along with control of Blood Pressure and Cholesterol. And of course, the clue is there: poor people have poor control of these and socially isolated and marginalized people suffer more complications.
It is like providing Vaccine for Cholera and Rehydration salts for treatment and expensive antibiotics but not paying attention to Safe Drinking water!
Food that is not plastic or is edible for the majority of the population, for example.
Only 2 out of 3 persons living poorer countries have access to water. 1 in six person in this world, that is 1 billion people, still use open space for defaecation, NO TOILETS!
It is unethical to withhold anti-retroviral medications just because the sufferer cannot pay; perhaps it is also unethical for every country, while boasting about their surging economies, but not paying attention to the basic primary needs of their populations.
As recently pointed out in an editorial in NEJM, the cost, which the governments are concerned about, has to include the benefits to Life of the individuals and also the benefits to the economy of saved lives.
Why is that Brasil, India, South Africa, China are all boasting about their surging growth whereas their children are becoming fat, the poor are dying earlier than the rich, Diabetes is affecting so many of their populations, while infectious diseases are killing adults and children?
There is little interest in investment by these trumpeters to improve the primary needs of their populations.
SOCIAL PROBLEMS CANNOT BE SOLVED BY MEDICAL AND TECHNOLOGICAL SOLUTIONS. At the beginning of the 20th centuries, politicians trumpeted that Poverty would be eradicated by the end of that century because of technological advances.  Where are we?
A similar situation exists in the world of type 2 Diabetes. All attention is to the treatment where money is generated for companies or individuals but not on the social improvement schemes whereby communities will improve their lifestyle, there are no political or individual capital gains!
We need to think the ethical aspects of the following:
The greed of the food/nutrition companies and their paid professionals (nutritionists)
Provision of Good Quality, chemical free Food; antibiotic free, Growth Hormone Free Meat for consumption by all, from animals treated well as they provide our sustenance.
Not a single person is going to DIE if all the Coca Cola were to disappear from the face of this earth- but quite a few lives are in danger, individuals, families and countries. While the sugar/chemical added fizzy drinks are in the market, the manufacturers and their agents in the market place prosper but the childhood obesity, adult diabetes would continue to increase … and the manufacturers and their agents wont take responsibility, it is unfortunate that the responsible individuals are in charge of some of the poorer countries as well.
Once again, visiting Belgium, and walking around in a suburb full of immigrants, it resembled a poor neighbourhood in America, with its fast food shops, no fancy shops but items sold cheaply that couldn't find a market elsewhere.. And OBESITY. I have not seen this kind of childhood obesity anywhere in Europe! Good bye Fish and Chips, welcome Kebab and cheap cooking Oil! (Used over and over and fanning the omega 6 inflammation)
Dear friends, here is yet another example of globalization! Immigrants, poverty, obesity, poor educational system … and when they get diabetes, the professors pandering to the drug companies fill them up with medications which they can exult about knowing fully well that none of the medications now in the market for type 2 DM is as good as the social medicine of Life Style Change!