May 27-29, 2006

Dave Hilton, MD

You may end up somewhere else! If you don’t know where you are going...

1. Stand up 2. Join two persons you don’t know 3. Complete the sentence: “Health is......”

Health is a dynamic state of complete physical, mental, spiritual, and social well being and not merely the absence of disease or infirmity. World Health Organization, 1998

Medical science has no vocabulary or framework to deal with the concept of well being. Jonathan Mann, 1994

But the Christian community does:

Shalom, n., well being I have come that they may have life, and have it to the full. John 10:10 Be perfect, (NIV) therefore, as your heavenly Father is perfect. Matthew 5:48 (NIV) complete

Be all you can be!

Health is a dynamic state of complete physical, mental, spiritual, and social well being and not merely the absence of disease or infirmity. World Health Organization, 1998

After ten years of doing all the “jungle doctor” heroics at a mission hospital in northern Nigeria, seeing this cartoon changed my life.

1. Describe the picture. 2. What is the problem? 3. Where does this happen in real life? 4. Why? 5. What to do?

10million 7million 3million Tobacco is the worst human disaster of the century. WHO, 1990 Annual Deaths Globally predicted

Why do we allow tobacco companies to continue to entice our children and grandchildren to use their deadly product?

$ Tobacco is not a medical issue! Continuing thousands of deaths daily from tobacco are an issue of justice.

McKeown, T., Lowe, C.R. An Introduction to Social Medicine, Oxford 1974, p 237 Standard of Living No effective medical intervention

medical services Mortality rate % GDP for medical services UNITED STATES Source: National Center for Health Statistics hundreds % 13 14

“DISEASES OF POVERTY” Tuberculosis AIDS Malaria

Poverty suppresses the immune system.

Côte d’Ivoire DHS, 1994; Bolivia DHS, 1998; Kyrgyz Rep. DHS 1997; Burkina Faso DHS 1992/3; Colombia DHS, 1995; India National Family Health Survey 1992/3; Indonesia DHS Source: WORLD BANK Infant Mortality and Poverty

+ Low prices for natural resources + So called aid - High prices for imports - High interest on external debt = Billions in capital drain Hemorrhage of capital from Africa

FREE MARKET? FREE TRADE?

The most important determinant of health is social justice.

“Woe to you Pharisees, because you give God a tenth of your mint, rue and other garden herbs, but you neglect justice and the love of God.” Jesus (Luke 11:42)

May 27-29, 2006

We pray, “Thy will be done on earth as it is in heaven.”

It seems clear that the minority in the world with power and money will not voluntarily use it to change significantly the plight of the poor. Dave Hilton, Contact 106, December 1988

$ $ $ $ $ $ $ $ = white men from wealthiest nations $ FEUDALISM DEMOCRACY ?

$ $ $ $ $ $ $ DEMOCRACY $ = white men from wealthiest nations = women of color from poorest nations $

What to do about tobacco? Letter writing campaign to the chosen leaders of your national community: a. Ban all advertising of tobacco products. b. Remove tobacco from the Free Trade Act list c. Require the same warnings on exported tobacco as in the U.S.

Economic and social development, based on a new economic order, is of basic importance for the attainment of health for all. WHO, Declaration of Alma Ata, 1978

The people have the right and duty to participate individually and collectively in the planning and implementation of their health care. WHO, Declaration of Alma Ata, 1978

Go to the people. Live among them. Learn from them. Begin with what they have. Build on what they know. And of the best of leaders, when the task is done the people will say “We have done it ourselves.” Lao Tsu 300 BCE

HELP Empowerment LISTEN Facilitate thinking, speaking & acting (mobilize individual and community resources) Change Dependence Status Quo Health (well-being) for all Give to, Do for, Tell

MAKE SURE THAT YOUR HELP IS HELPFUL ALWAYS COMBINE RELIEF WITH EMPOWERMENT

Paulo Freire Pedagogy of the Oppressed Training for Transformation by Ann Hope & Sally Timmel

LISTEN strong feelings reflect back input Paulo Freire as described in Training for Transformation by Hope & Timmel think decide act assess The Role of the Facilitator

Isaiah 65: “For I am about to create new heavens and a new earth; the former things shall not be remembered or come to mind. But be glad and rejoice forever in what I am creating; for I am about to create Jerusalem as a joy, and its people as a delight. “I will rejoice in Jerusalem, and delight in my people; no more shall the sound of weeping be heard in it, or the cry of distress. No more shall there be in it an infant that lives but a few days, or an old person who does not live out a lifetime; for one who dies at a hundred years

will be considered a youth, and one who falls short of a hundred will be considered accursed. They shall build houses and inhabit them; they shall plant vineyards and eat their fruit. They shall not build and another inhabit; they shall not plant and another eat; for like the days of a tree shall the days of my people be, and my chosen shall long enjoy the work of their hands. They shall not labor in vain, or bear children for calamity; for they shall be offspring blessed by the LORD--and their descendants as well. Isaiah 65:17-23

Health is a dynamic state of complete physical, mental, spiritual, and social well being and not merely the absence of disease or infirmity. World Health Organization, 1998