Be Thankful 1-2010
© Richard Grossman MD, 2010
“Whatever affects one directly, affects all indirectly.”
Dr. Martin Luther King, Jr.
I was riding in a taxi in New York City. The radio was tuned to music on a Spanish language radio station.
“Your accent doesn’t seem to be Spanish,” I remarked. “Are you Hispanic?”
“No, I’m from Haiti. But I like Spanish music.”
My driver had come north many years before, he explained. He had been an accountant in Haiti and had earned good money there, he said, by Haitian standards. “But I like it better here.”
The tragic earthquake of January 12th struck at the heart of Port au Prince, capital of Haiti. Badly constructed buildings crumbled with the terrible shaking, trapping many thousands of people.
Almost three quarters of the people in Haiti live on two dollars or less a day. This unbelievable poverty makes it the poorest country in the western hemisphere, and among the poorest in the world. Building codes are not part of such poverty. Migration to cities is common all over the world, including Haiti. It is ironic to realize that many people who were injured or killed in Port au Prince might have been safe if they still lived in traditional wood homes rather than modern concrete structures.
This devastated city has become the focus of the media, with minute-by-minute reports of horror. A few minutes watching CNN displays graphic accounts of private tragedies—bodies unceremoniously being spilled from a dump truck into a common grave, a beautiful eleven-year-old girl caught in a splintered building who was freed but died of injuries, people breathing through cloth to mask the smell of death.
We are privileged to live in an amazing age. We can see and hear immediately such personal stories of devastation. Highly skilled teams of helpers started to arrive within days with sophisticated equipment and trained dogs to free trapped people. Internet is used to send and receive word of friends and relatives in the affected area.
Those of us who live in a rich country (such as the USA) at this time in history often don’t appreciate how lucky we are. We have grown up with expectation of comparatively easy, relatively safe lives. Most people of the world do not share our good fortune, although the worldwide media make the disparity between rich and poor obvious.
The contrast between rich and poor was brought home to me by one of Durango’s expert doctors. He told me that he is sad that he cannot get to Haiti to help. I don’t think that he fully understands what would await him: scores of injured people and no organization, no laboratory tests, no x-ray machines, no medications, no casts for broken bones. Many people are dying alone, surrounded by collapsed concrete and the stench of death.
In addition to not being able to practice in any way that he is accustomed to, he would be using precious food and water that is needed by the Haitians.
Tragedy visited people in the past, too. In rich countries our expectations and ability to respond has changed immensely.
The explosion of the Indonesian volcano Krakatau in 1883 is an example of a catastrophe. Lava and superheated gases killed nearby people instantly. Tsunamis triggered remote devastation. The short-term death toll was over 100,000 people. In the long term the climate was two degrees Fahrenheit colder for five years because clouds of gas and ash shot into the stratosphere.
How has the world changed in the century and a quarter from Krakatoa to Haiti? Most of the world is financially much better off than a century and a quarter ago (although Haiti lags behind). What I perceive as the biggest change, however, is our acceptance of risk.
People died young in the nineteenth century. If you were involved in an accident, it was perceived as an act of God, not someone else’s fault. Accident prevention (including building codes) was undeveloped or didn’t exist at all. Medical care was rudimentary—just as it is in Haiti now.
One of the reasons that Haiti is so poor a country is that many of its most industrious people leave—such as my taxi driver. Another reason for poverty is the high fertility rate. The average woman will bear four children during her lifetime. The percentage of couples using contraception is low.
A tragedy such as hit Haiti is a horrendous way to reduce population. Acceding to people’s wishes to limit their fertility by providing modern contraception is much more humane.
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