[Translated from GegenStandpunkt 1-08]
In the cold autumn of 2007, not only party congresses, statisticians and talk shows concern themselves with poverty, but also medical science in a “joint publication show of strength by 234 international specialist journals” and the October 23, 2007 Süddeutsche Zeitung devote themselves to this “enduring scandal.”
From militant pathos – “Make health inequality history!” – …
“The findings are frightening ... In view of its preventability, the high child mortality worldwide is not a geographic-climactically caused inequality, but a socio-economically and politically caused injustice” (German Physician newspaper 43/07). “Poverty causes disease. Poverty leads to people dying earlier and suffering more often” (SZ, October 23 2007). And the medicine men are familiar with this: “Physicians have known this for a long time. Yet global inequality between rich and poor continues to grow.” This “yet” is a bit bold. It lives on the idea that poverty cannot be allowed to be based on the decisive interests that “socio-economically and politically cause” poverty when the doctors nevertheless know and point out that poverty is harmful to health. This has something of the medical megalomania that humanity cannot do otherwise than obey their advice when they know what is good for it.
… through the medical endeavor to stay healthy in spite of poverty …
In comparison with the preceding pathos, having something against “global inequality between rich and poor,” the united effort of the guild then has a somewhat more modest thrust. They are driven by the medical endeavor of helping people and alleviating their suffering. From this perspective they dedicate themselves to poverty, and from a fairly single minded perspective: poverty interests them as a bad condition for health. That is why poverty even for them is not the object of investigation, but the question to what extent it causes illness or hinders treatment. Consequently, the medical expertise sets on exactly this problem situation and seriously tries to decouple the treatment of damaged health from poverty. It researches antidotes in order to annul the connection they themselves determined – as if it was dealing with an infection against which it only has to find the correct inoculation or a suitable antibiotic. Then it would also be possible to mitigate the worst effects of poverty on health and to make living in poverty possible without serious health damage.
Under this parameter there is plenty of need for the “exploration of the connection between poverty, health and human development.” As a first step it is a matter of a waterproof scientifically documentation that poverty really causes sickness – with a demand for an observational study on 94.4% of the world’s population that proves a highly significant correlation between low income and increased mortality (British Medical Journal, October 27, 2007). And indeed in poor and in rich countries, for all age groups and both sexes! Who could have thought this? Obviously the researchers with their discovery did not at all intend the banality that poverty ruins humans physically and psychologically with considerable necessity; to say such a thing would probably only be social criticism and not scientific. They hold remarkable and worthy of scientific clarification the question of exactly which diseases and to what extent this connection exists. Then indeed they find a lot of evidence for it, but just as many questions that still need to be investigated. In this way, with all their statistical evidence they qualify and obscure the starting point that poverty is obviously the reason for the described illnesses.
Next, global misery must be combed through for its harmfulness to health. And lo and behold, there really are risk factors specific to poverty, e.g., “Breast Cancer: Poverty is a Carcinogen” (German Physician newspaper). In addition, there are many new connections to fathom, among other things vicious circles of the following kind: “Disease causes unemployment or unemployment causes disease?” (German Physician newspaper) In order to penetrate this, better cooperation between doctors and work agencies are needed to prevent the “revolving door effects of the social security system from intensifying health problems.” The therapy recommended by the welfare state-medical joint venture allows no doubt about the arising effective measures: “Old age unemployment among the still able bodied should no longer be tolerated with a wink (e.g., a sick note or a courtesy appraisal): this often makes one sicker and, besides, is no longer financially viable.” Therefore, the best thing for the health of a Hartz IV recipient is still work and not well-intentioned consideration for their ruined body.
Then known forms of therapy are to be verified for whether they can be adapted and made effective in the conditions of poverty. In Guinea Bissau, for example, malaria therapy for children could be “significantly improved by simple measures” (British Medical Journal). Previously, the children got their dispensed tablets only inadequately; sometimes some of the nurses secretly sold the drugs on the cheap to supplement their starvation wages, sometimes the families were unable to afford the malaria pills for their children anyway. And what helps health here? Correct: a little bit more control over the distribution of the pills, a small premium given to the successful nurses – and already the “effectiveness of the treatment is doubled”! It is nice that so little must be changed in poverty so that concerned doctors can also be satisfied with the state of health of slum-dwellers!
In addition, one can infer from these efforts how the doctor’s fight against the poverty-caused diseases necessarily turns out. If as high-official representatives of the health system they worry about the victims of the capitalistic world, then their massive and permanent poverty, on which the articles report in such detail, is for the medical profession natural. So they do not need to deal any further with why it all comes about so inevitably next to the wealth produced worldwide; obviously they do not want this, but rather they presume poverty as the starting point of their helping and curing. And if they then treat patients according to all the rules of their modern health system, they always orient towards the free market conditions that produce poverty and take as the level of treatment whatever the states consider compatible with capitalistic growth – no study gets along nowadays without the criterion in what respect its findings help save costs.
… to the petition to politicians for more support
With all this they have in mind as helpers the authorities who are responsible for all the poverty: “Not only is disease economically and socially determined, but the antidotes are political will, money and social responsibility” (SZ). The hopeful appeal is made to these authorities that they may support the medical profession in their efforts: “The situation has never been so favorable and the need for action never as great as now in order to break the vicious circle of poverty and disease – as said by the American Institute of Health” (SZ). Where the doctors get their confidence, given the enormous need for action, is very puzzling. By this logic, the same states under whose regime the deplorable conditions arise and are to be cared for are actually willing to be improved. However, whoever looks at poverty strictly from the perspective of its harmfulness to health, for them the “socio-economic and political interests” that ultimately cause disease only appear as incorrectly adjusted knobs. If then medicine just takes part in a concerted action to “raise awareness about these problems,” “to awaken interest,” and “explore connections,” then apparently the most advantageous conditions for the fight against poverty are already available! And so that medicine can do its service and search for “antidotes,” it needs more money for the medical search for ways “to break through the vicious circle.” The petition to state authorities consists in the fact that in the end they should give more resources to research the connection between poverty and health.
Well then! Then really just a few professor chairs for poverty medicine are necessary, and nothing else stands in the way of a guaranteed healthy life in poverty …