dictators and democracies for health

Politics can have serious consequences for health. We need look no further than the US legislature for examples of the politics of health. The recent deeply partisan budget cuts threatened women’s health across the country and debates over the Health Care Bill easily demonstrates a democracy’s inability to provide basic health for everyone in its population. Other examples come from the USDA’s support for corporate farms over the population’s health needs amidst the growing obesity epidemic. Some of the best examples of health being politicized come from our own government, yet we rarely have to think about how the form of our government and political system has an impact on our health.

Whether it is a democracy or a dictatorship, politics influences health. Cuba has long held a spot as one of the top national health care systems as well as one of the top countries for medical education. Their system is completely government-run with no private companies controlling hospitals or clinics. Cuba has been innovative with their computerized system for blood banks, patient records, etc. However, their government is a dictatorship and this has created some negative effects on health (depending on who you talk to). During the 1990s, the loss of Soviet subsidies combined with other political and economic factors created a countrywide famine. Manuel Franco describes the Special Period as,

“the first, and probably the only, natural experiment, born of unfortunate circumstances, where large effects on diabetes, cardiovascular disease and all-cause mortality have been related to sustained population-wide weight loss as a result of increased physical activity and reduced caloric intake”.

Recently we have seen the horrifying impacts of dictators and authoritarian regimes crushing their own health care systems at the expense of their populations. In Libya, health workers have been shot at, ambulances have been bombed, and hospitals have been razed. Gadhafi has ruled Libya since leading a bloodless coup d’etat against the then King of Libya.

In nearby Syria, similar atrocities have been committed. A recent video from the protest against the Syrian government showed a pro-government Doctor beating an injured protester out of an ambulance. The main hospital in Deraa has reportedly received 37 bodies of protesters killed. Syria is officially a republic with a constitution and elected leaders. The real story is of a country run by one party handed from father to son that has been governed under “The Emergency Law” which suspends constitutional protections since 1963.

Chris Albon, author of Conflict Health, wrote an informative piece on how the protests in Bahrain are centered on the health care system. Protesters seeking refuge in the hospitals have been denied treatment by government troops and ambulances have been blocked. He notes a new report from Doctors without Borders that says, “the government has attacked and militarized the health system, making protesters and bystanders afraid to seek treatment.” Bahrain is a constitutional monarchy where people have long protested over their lack of personal rights and freedoms.

In another example of the difficulties of democratic politics to support health, Nigeria’s recent elections have fueled intense fighting across the country. Hospitals reported that over 300 people were seen for bullet wounds. The ethnic and religious divisions in Nigeria have long plagued efforts to build a unified democracy. Nigeria’s history of military rule and oil wealth has also exacerbated these divisions. When a democracy can’t hold elections without widespread violence, how can they provide health for their people?

Both dictators and democracies have the potential to instigate situations that have serious health impacts. Whether it is frivolous debate or armed conflict, the politicization of health has lead to serious health deficits around the world. No matter what country you live in there is always room for development when it comes to providing for the health of a population.

Featured on the American for Informed Democracy Blog, where I’m writing as a Global Health Analyst.

when conflict health becomes military tactic?

From refugee situations to border disputes, health crises that arise as a result of conflict are unfortunately quite common. Conflict health disrupts the ways that people access resources like food, water, and medicine. On the other hand, conflict health creates the circumstances where diseases spread, people are needlessly killed, and others are critically injured. These horrible results of conflict health are compounded by the destruction of infrastructure: roads, hospitals, etc.

What happens when conflict health becomes a military tactic? Since Medieval times (and before) armies attacking opposing castles would launch disease infested animal carcasses over the walls. In the 1800s, the US military gave smallpox blankets to indigenous North American groups in order to destroy their health and kill their populations. During apartheid in southern Africa, South African forces supporting RENAMO in Mozambique targeted health clinics and hospitals to cripple the health and infrastructure of the population.

During the World Wars, medics and vehicles with a red cross weren’t supposed to be targeted because they weren’t carrying out military actions. I had thought this idea was fairly widespread and that mercy was shown to health providers in times of conflict.

Recently, we have seen the complete opposite during the Libyan conflict. Libya’s pro-Gadhafi forces have targeted those attempting to provide health services to protestors and the population. In the early days of the protests it was reported that the military was entering the hospital to dump out blood supplies so that injured protestors could not be saved. In similar actions, Red Crescent medics and ambulances have been shot at, Colm O’Gorman, executive director of Amnesty International Ireland, said:

“This was a deliberate attack on medical professionals, who were wearing full medical uniform and arrived in two clearly marked Red Crescent ambulances.”

Ambulances have been bombed, The rebel spokesman confirmed that

“Gaddafi’s forces shoot three ambulances, killing two drivers.”

The Misrata hospital has been a flash point of intense shelling and fighting by Libyan forces. The hospital has been bombed from the air, shelled by tanks, and overrun by pro-Gadhafi troops.One person inside said,

“heavy tanks for Gadhafi troops start attacking the hospital – the bombs falling here 20 meters (66 feet) around us.”

The health of the Libyan people is under seige as much as the repressive dictatorship of Gadhafi. Many countries including Egypt, Morocco, and the UAE have established military field hospitals to be able to help the wounded who are leaving Libya. UNICEF is deeply concerned about the impact of the conflict on children and has distributed emergency health kits which contain enough drugs, medical supplies and basic medical equipment to cover the needs of 60,000 persons.

The conflict in Libya, through the blatant attacks on health providers and facilities, has demonstrated a new level of disregard for the basic health of a population. This is an obvious example that Gadhafi must be removed from power if the Libyan people are to regain their health and livelihoods.

Featured on the Americans for Informed Democracy Blog, where I’m writing as a Global Health Analyst.