Tuesday, May 23, 2006

Against Bill 112: A Theory of Relativity

While writing a post about a certain gift I recently received, I had occasion to learn a little bit about Malawi. I am embarrassed to admit that, prior to this point, I knew virtually nothing about the country other than that it was located somewhere in sub-Saharan Africa, and that I probably couldn't have found it on an unmarked map without outside assistance.

After undertaking a smidgen of research, I discovered that Malawi sits just to the north of Mozambique, and that it has the unfortunate distinction of being one of the world’s ten poorest countries. By way of illustration, the average annual income of a Malawian is less than $100 US, while the country’s per capita GDP is $596, the world’s lowest. The statistic that really knocked me on my ass, though, was Malawi’s average life expectancy rate, which presently stands at 41.7 years. Worse, the rate has fallen since 1981, when the World Bank and the IMF began implementing market reforms. Oops.

By contrast, Canadians have, on average, a life expectancy rate of 80.2 years, a figure that has climbed steadily since the late nineteenth century, irrespective of our smoking habits. Although we lag slightly behind Japan, Hong Kong, and several Scandinavian countries, we remain firmly entrenched in the top five percent of global longevity rates, ranking above both Britain and the United States. Even so, we are hungry for more. I mean, why settle for eighty years of life when we could have eighty-five, or ninety, or ninety-three? Surely, if we just ate better, smoked less, and exercised regularly, we could make it to a hundred? Couldn’t we?

This begs the question: what is the maximum possible life expectancy of a human being? As a recent CNN health special suggested, there is, at least in theory, no reason why we ever have to die. With the adoption of a rigourously healthy lifestyle, combined with the right pharmaceutical advances, immortality need not be a condition reserved for the particularly pious, but one that we can all enjoy right here, right now.

As a layperson, I have no way of knowing if CNN's claim is true or not, but what I do know is this: the majority of the world’s population can expect to live for considerably fewer years than we do. I also know that the citizens of the ten poorest countries will not, on average, make it to “middle” age, while those of Lesotho, Botswana, and Swaziland will be lucky to see their mid-thirties.

Taking Malawi as our case study, there are a number of reasons for this awful fact. The first is poverty, which is the single most important factor in determining longevity rates. The second is the African HIV epidemic, which has cut a wide and impossibly cruel swath through a whole generation. The third is the lack of availability of vaccinations and basic health care, which is not entirely unrelated to the first. Add to this a primarily agricultural economy that is prone to drought, intermittent famines, and the crushing weight of debt to First World nations, and you have a country in which a nineteen-year-old has already lived out half of her natural life.

Thinking about it, I can’t help but wonder what the average Malawian thinks about our earnest efforts to become centenarians. Do they see us as greedy, gorging on our own health much as we do the world’s food, natural resources, and wealth? Do they question why we think we are owed our extended lifespans, and why we seem to think they are not? Do they ask themselves, as I sometimes do, why people who are so comfortable, so privileged, so insulated from the ravages of life as much of the world knows it, are still so desperately afraid of death?

I also wonder what would happen if we directed one ounce of the political will we invest in smoking bans, anti-obesity campaigns, and other First World obsessions towards addressing the health inequities that affect millions, if not billions, of our fellow global citizens? What might we achieve? The eradication of HIV, which has orphaned over 700,000 Malawian children to date? An end to malaria, a treatable disease that kills more than a million people every year, the vast majority of them in sub-Saharan Africa? The prevention of obstetric fistulas, which cripple or kill millions of African women and their children?

Um, okay, we know about HIV and malaria, Vila, but what’s a fistula? I’ll let an accredited medical professional explain:

Dr. Waaldijk remembers one patient well. She managed to push out only her baby's head before collapsing from exhaustion in her hut, he said. Her brother carried her, balanced on a donkey, to a road, where a bus driver demanded 10 times the usual fare to take her to a hospital. She half-stood, half-sat for the trip, her dead baby's head between her legs, her urethra ripped open. "This is what is happening," the doctor said. "Nobody will believe it."

I nearly vomited when I read the New York Times article Dr. Waaldijk was interviewed for, and I confess that I still have difficulty imagining what it is like to live a life in which the experiences he describes are not only normal, but inescapable. I do understand, however, on the same gut level, that it is one of the reasons that people in other parts of the world hate our fucking First World guts, my own very much included.

I suppose that I am being heavy-handed, but I don’t know how else to write about the chasm that exists between our concern with our own health and that of the rest of the world’s. It ought to haunt us, just as Dr. Waaldijk’s memory of his young patient does, if for no other reason than that in being haunted, we at least acknowledge that the chasm is there. And then maybe, just maybe, we will get our priorities straight.

Oh, and quite incidentally, the most common crop grown by Malawi’s impoverished farmers? Tobacco.


chris said...

I don't think Bill 112 has anything to do with Third World health problems or tobacco farmers. I think it has to do with the provincal government, or any government, trying to make people's choices for them. There was an article in The Economist about the phenomenon a couple of weeks ago called soft paternalism.

BTW, I find it kind of hard to believe that decline in demand for tobacco in either the North American or European trade zones is in any way affecting Malawian tobacco farmers, considering the massive import duties on tobacco in both blocs. I could be wrong though.

Vila H. said...

If you take the time to click on the links I've provided, you'll see that it quite clearly does. This doesn't negate your argument about soft paternalism; I'm just looking at a slightly bigger picture.

christopher hearns said...

I don't buy the there are other problems in this world so let's not focus on this problem argument. Let's face it, the problem with poverty isn't the fact that we try to be healthy, the problem is that we have an economic system that only functions with ever increasing consumerism. When Canadians alone are spending twenty billion a year on Christmas and it only takes eighty billion a year more to end world hunger, well, I think I can see what's actually causing the problems. And it's not eliminating smoking. It's consumerism. If we scaled back our lifestyles, we'd have more than enough money to balance this world.

And no I have no idea why I'm responding to these arguments you're putting forward. I mean, no one's going to be convinced, and no one has to be, this is the direction North America is going in, and there's no turning back. So my opinion, yours, don't much matter. It's as inevitable as gay marriage.

chris said...

To clarify, the emphasis in my second paragraph above was on the word Malawian. The big North American and European tobacco companies have set up shop all over Africa, and are probably responsible for most of Malawai's tobacco industry. But independent Malawian tobacco farmers would probably not find it cost effective to export to the USA or Europe because of heavy import duties.