Our society has always faced divisions and divisiveness. What we face today is nothing new and has been brought to the surface by recent changes in public policy, as well as the election of Donald Trump. The country, though previously divided by events such as the Civil War, women’s rights movement, and gay marriage legalization, is now facing a great divide in light of recent events which were implicated as part of the election of, and policies set in place by Donald Trump. For example, currently Americans are split down the line on the issue of funding the proposed border wall; opposed, in fact, to the extent of a government shutdown for thirty-five days. It is not merely the wall that we are fighting about though, but the issue of public safety and citizen equality. In essence, Republicans are concerned that if we do not increase border security there will be a threat to the safety of American citizens; whereas Democrats are more concerned that without helping others, we are not that great of a country. 

Robert Leonard brings up a riveting perspective in his essay Why Rural America Voted For Trump, regarding that the core philosophies of Democrats and Republicans are so intensely different, that it will be near impossible for the two to come to a resolution. He stated that Republicans see people as instinctively bad, while Democrats see people as instinctively good. I can see his point, and find it rather true. I would argue that most people I know, both Democratic and Republican, see that all people are good and bad. 

Given results from the popular vote in 2016, we can see that the country is almost perfectly evenly divided into two parties, “Clinton received 65,844,610 votes, or 48.2% of the total vote. Trump received 62,979,636 votes, or 46.1% of the total vote.” (The Splinter, McDonough). J.D Vance brings up an excellent point that I believe is a key component to the divide. In his essay Hillbilly Elegy, Vance mentions an interaction with a classmate who clearly did not understand the views, struggles, or experiences of  “the other side.” I believe that one major cause of the divide we are experiencing today is the lack of understanding, or refusal to learn and interpret the views and ideologies of others.

However, this divide has been obvious since 1776, starting with the Revolutionary War and the divide between the colonies and Great Britain. The country was ominously divided then and has been since. Though we have moved on from fighting about whether or not we should support declaring independence from Britain and form our own country, we have moved on to different and perhaps even more controversial topics of debate. For example, there was a dangerous divide between the north and south during the Civil War and the fight to end slavery. As well as the issues in the sixties around fighting for civil rights and equality. There have been many different sectors of division through the last few centuries, and outside of our country, dating back to the beginning of mankind and basic civilization.

Some may argue that America has gotten better since the ‘80s. In fact, during his speech at Howard University, President Barack Obama spoke about the improvements made in America since he graduated in the ‘80s. Others may declare that since the divide is so defined now, it is the beginning of a new type of divide; one that is more severe and exclusive of minorities. Though this is a valid point, I do agree that there is currently more discrimination against Hispanic individuals, than there is against African American people; whereas during the pre-civil rights movement time period there was profoundly more discrimination against African Americans than there was against Hispanics. Overall I would tend to disagree with that statement given that there has always been some level of discrimination against some marginalized group of people, and that discrimination has almost always shown itself with violent hatred and unsavory reactions to the mere existence of the minority. 

Furthermore, I would integrate an argument played by Michelle Alexander in her book The New Jim Crow; Alexander uses an example of a young man who was incarcerated to illustrate her idea that the criminal justice system is racially swayed. In her introduction, Alexander states “Today, Jarvious Cotton cannot vote because he, like many black men in America, has been labeled a felon and is currently on parole,” though Alexander brings up a good point about racial inequality in the justice system, she fails to mention the context of Cotton’s incarceration, being that he mugged and shot a seventeen-year-old boy. I do think that Alexander has a valid point in her argument, however, failing to mention why Cotton was labeled a felon excludes the hard facts of the situation, and thus passes as deceiving. There is surely an issue with racism in the courts, and that is not okay, but using that specific case, and failing to explain the context, leads me to be weary of the rest of what she says. However, she does bring up a riveting point about how racism in prisons is a big problem. There are a number of cases of police brutality that never get justice, and there are a ton of innocent black men who get sent away. However, regardless of ethnicity, I personally believe that a person guilty of a violent or malicious felony should not hold the same rights as those who are not. 

I would argue that since that divide has always been here in one form or another, it is still the same divide but wearing a different mask. I personally do not believe that we will ever be able to completely rid ourselves of that divide, because it is something that fuels us. I think that without protests, without activism, without disagreement, and even without violence, there would be no variety and therefore there would be no interest in bettering the standing of our country and its relationship with the world. I feel that civil unrest is necessary to breed progression, and given that there is no end to progression, removing the civil unrest could potentially bring a halt to the advancement of the country. 

Regardless of the larger scale divide throughout the country, we can fight and resolve the divide on a smaller level, higher education. Gabriella Moro (Minority Student Clubs: Segregation or Integration) informs us about the self-segregation that is taking place in the very colleges that pride themselves as carriers of diversity. She states that having specific racial or ethnic groups on campus could be preventing diversification within the student body. Others argue that these culturally based groups create a safe and inclusive environment for minorities. I can see both sides of the discussion, and I discovered a resolution. I think that these clubs are beneficial for minorities, but also create a level of segregation on campus. By requiring all culturally based clubs to meet with each other once a month, we could create an environment where diverse students will interact with one another. 

Danah Boyd makes a very enticing point to which I almost full heartedly agree with. Danah states that we can reach diversification if we make the effort. She claims that humans as a general, tend to self-segregate (i.e. the Mean Girls lunch table arrangements). She also states that institutions like colleges and the military are essentially enabling this relatively socially destructive behavior. For example, she reminds the reader that military personnel have dropped substantially since the ‘80s, and declares that this is in relation to the privatization of combat teams. The military is hiring private organizations to supply them with already trained, professional soldiers. Their reasoning behind this comes from their understanding that these pre-formed teams have the trust in each other that is needed to be successful on the combat field; however, Danah argues that because these soldiers are all so similar and already know each other, they never have to experience the diversification that comes from randomized troops. Danah also states that nowadays more and more college students are researching incoming freshman, finding who is the most similar to themselves, and asking to switch roommates with that person. This is voiding young adults of gaining the ability to communicate and work with a diverse field of individuals. I do agree with Danah that diversity is lacking and we should try harder to make it a priority, but I would argue that there is a certain je ne sais quoi located in the security of normality. So, I do think that we should definitely practice a more diverse lifestyle, but I don’t think it’s bad to have friends you “fit in with.” I feel that having that sense of normality can make the rest of life less draining and scary. But I can see both points, and honestly, I can’t say I am 100% for either. 

However, I most certainly think that though there is a divide, each segment of the divide gets solved as they come. For example, one group may be fighting for equal work equal pay, and eventually win, but two years later another group will need to fight for better job opportunities for immigrants, and they must fight that battle until they achieve their goal. I think conclusion is needed, and the need to solve problems as they come will always be in a roller coaster of frequency and severity. 

 I believe that there has always been a divide to some extent. That divide may become larger or more defined at certain periods, or it may become smaller and less problematic, but overall, it is always there. Without disagreement there is nothing to agree on, without division, there is no point of democracy, and without hate, there is no need for love. I would certainly love to see a world in which there is no turmoil and everyone holds hands and sings kumbaya. I know that logically that is not possible. In history, we can see that there has not been a single moment without disagreement and division. From the Revolutionary War, to women’s rights, to civil rights, gay marriage, and abortion laws, there will always be something to divide us. I think that is necessary, I feel that if everyone agreed on everything, there would be no real point to a governmental system, voting, or legislation. I think that just like differences of opinion in a relationship help keep conversation alive, differences in opinion throughout the country help keep democracy and humanity alive.  I do not think there is a way to resolve the divide we have, and honestly, I hope no one comes up with one. I feel that division is important. Without it, there is no real point in unity. 

Works Cited

Alexander, Michelle “The New Jim Crow” Graff, Gerald, et al. They Say/I Say: With Readings.          Fourth Edition. W.W. Norton, 2018. Pp 230-247

Leonard,  Robert  Why Rural America Voted For Trump Graff, Gerald, et al. They Say/I Say:  With Readings. Fourth Edition. W.W. Norton, 2018. Pp 279-285

 McDonough, Katie  “Here Is the Final Popular Vote Count Of the 2016 Election Just in Case You Want To Feel Bad” https://splinternews.com/here-is-the-final-popular-vote-count-of-the-2016-electi-1793864349

Barack Obama Howard University Commencement Speech  Graff, Gerald, et al. They Say/I Say: With Readings. Fourth Edition. W.W. Norton, 2018. Pp 296-314

 D.J Vance “Hillbilly Elegy”  Graff, Gerald, et al. They Say/I Say: With Readings. Fourth Edition. W.W. Norton, 2018. Pp 251-267

King’s Park was opened in 1885 and became a state hospital in 1895. Originally called a “lunatic farm” the hospital began with only a few wooden buildings and an intention to rehabilitate those with mental illnesses. By 1916 the hospital was entirely self-sufficient. With both staff and patients running the farms, kitchens, clothing, and cleaning, there was no need for outside interference. Despite being a prominent figure in the revolutionization of mental health rehabilitation, kings park was no starring entity of pure good and welfare. The horrors within have come to light in recent years, much in thanks to the documentary based on the personal experiences in the hospital. Stories of over-worked therapists, abuse by other patients and workers, and over tasked staff have arrisin, bringing a new prospect of understanding some reasons behind deinstitutionalization of the mentally ill.  

There were many reasons for the deinstitutionalization of the mentally ill; from economic, social, and political topics, ultimately, the unfortunate demise of mental institutions was a long time in the running. One of the reasons behind this was that psychiatrists realized how many people were in the hospitals that shouldn’t have been, so they started letting people out in the masses, and with that, they let out many who shouldn’t have been let out. Additionally, many people believed that scientists had created a penicillin that cured psychosis. On the political side of things, yet another reason for deinstitutionalization was that during the 1960’s president Kennedy signed a bill to shut down mental institutions and replace them with therapeutic health centers. The idea was of good intent, but it was never followed through with. So the institutions got shut down, but there were very few therapeutic centers. In fact, not only did patients who were previously in places like kings park end up on the street, but also in prisons, nursing homes, and dead. 

The deinstitutionalization of the mentally ill affected the social system profoundly. Since the 1960’s, people have been struggling to find ways to care for the severely mentally ill.  Though this has been a series of trial and error, some instances have been successful. For example, The National Association of Suicide Prevention, section eight housing, and psychiatric wards in state and private hospitals have helped profoundly in both preventative and reactive programs surrounding mental health. One way in which human services was affected as a whole due to deinstitutionalization was in that it became a priority for communities to help care for one another now that those who were previously tucked away as the conventional “embarrassments of society” were neighbors. It became a need for programs to help the mentally ill become functioning members of society, and to supply programs to assist those who were unable to provide for themselves.Though there has been progression since the ‘60s, there is still much to be done. For example, we need to resolve the fact that there are ten times as many mentally ill people in jail, than there are in state funded psychiatric hospitals.

My opinion on the continued trend of deinstitutionalization is that it needs to be resolved. And fast. The fact that suicide is the tenth leading cause of death among all Americans, and the fourth leading cause among teens (homicide being third) speaks loudly for the state of mental healthcare in America. Of course we have made progression, but over 26% of Americans are diagnosed with a mental illness each year, and we still don’t have enough care for everyone. 

(I had to stop here because one more sentence and It went to page three.)

Works Cited

About the Movie. (n.d.). Retrieved February 24, 2019, from https://kingsparkmovie.com/about-the-movie/

Kirsch, T. (2018, January 22). Kings Park Psychiatric Center. Retrieved February 24, 2019, from https://opacity.us/site3_kings_park_psychiatric_center.htm

LastWeekTonight. (2015, October 04). Mental Health: Last Week Tonight with John Oliver (HBO). Retrieved February 26, 2019, from https://www.youtube.com/watch?v=NGY6DqB1HX8

Lyons, R. D. (1984, October 30). HOW RELEASE OF MENTAL PATIENTS BEGAN. Retrieved February 24, 2019, from https://www.nytimes.com/1984/10/30/science/how-release-of-mental-patients-began.html

Mental Health Disorder Statistics & Facts. (n.d.). Retrieved February 26, 2019, from https://www.hopkinsmedicine.org/healthlibrary/conditions/mental_health_disorders/mental_health_disorder_statistics_85,P00753

National Center for Health Statistics. (2010, May 05). Retrieved February 26, 2019, from https://www.cdc.gov/nchs/products/databriefs/db37.htm

I’m sure that everyone has had experience with “the battle of the sexes”, and no, I’m not talking about the board game. From corporate job positions to home life and parenthood, men and women seem to be in constant competition over who is superior in the role they are playing.  There is most certainly an issue surrounding gender equality and work-home balance. The first resort whenever speaking about the work-home balance is to resort to the belief that women are given the worst hand possible, and men have a deck of aces and kings; and that it’s all men’s fault. For example, in his article “Why Men Still Can’t Have It All”, Richard Dormant informs that in most dual income houses, men and women work roughly the same amount; women having less workplace hours and more home hours, and men vise versa. Let’s be honest here and assess the grand fact that there are just as many struggles surrounding this topic for men as there are women, but on the flip side. Women often times struggle to climb up the corporate ladder, and find they have to do twice the work for half the credit. Whereas men often are victim to judgement for opting to be more involved in family and household affairs than work, or as Andrew Reiner put in, be emotionally in touch. The battle of the sexes has been here for generations; and it is both toxic and beneficial.

Ever since the beginning of man, there has been a constant battle of the sexes. Let’s go back all the way to the Mezatonian area; women were in power, then Christianity came along and men took over. Even if we just reduce this down to America, take a look at suffrage. Women fought for the right to vote and for probation, while some men fought with them, many fought against. Now I’m not saying all men are bad and all women are saints, in fact, women in certain situations, are just as guilty. It is standard to believe that women are the stay at home caregivers and men are the ones who “bring home the bacon.” Though most people want to eliminate this stigma, most people, including women, have a tendency to raise a brow when a man states that he is a stay at home dad. 

On the toxic side I would like to incorporate an article written by Anne Marie Slaughter titled “Why Women Still Can’t Have it All.” In her article she states that women have to work harder to get to high level positions than men do, and that there are significantly less women in those same positions than men. In fact, during her TED Talk, Sheryl Sandberg (second in command at Facebook) explains that out of 150 heads of state, only nine are women. This is an obvious problem not only in the section of equality, but in the desire for equal representation in law and government. 

On the other side of the battle of the sexes, I would argue that there is a benefit held within the arms of competition. Though the competition level is extremely uneven, it still instills the desire to improve within both sexes. I believe that healthy competition can improve workplace performance and skill overall. However, I do think that in order to be productive, this competition needs reformation. Specifically, the see-saw of competition needs to be even, meaning that men and women need to feel the same level of pressure to succeed within themselves and against others.

The battle of the sexes could theoretically be resolved in a variety of ways. In work protocols allowing women to take time off or leave work early because of her children without having to worry about being fired, should be developed. Additionally, we could make it mandatory in work environments that both women and men have enough flexibility in the schedule to spend time with their family. Doing these things would not only increase desirability of a workplace and overall employee happiness. But will increase the length of employment and thus loyalty and understanding of the company. Doing this would overall increase the quality of the companies working positions and the companies product. 

However, I do not believe that it should be resolved… yet. Now I don’t mean I think workplace misogyny shouldn’t be resolved, or that women should have to work harder than men to get to the same place. What I mean is that the competition needs to change. We need time to create an in depth understanding of the issue in people. If we fail to ensure that understanding and appreciation, we will end up semi-solving the problem, momentarily. We can’t do a “half-assed” job on this one, we have to do it right; and that will take time, energy, and hard work. 

Gender inequality has been an issue since far before the present day. From wage gaps, to marriage relations, to a woman’s right to abortion, gender inequality is highly prevalent in U.S history. Gender inequalities are a major issue because they prevent women from having equal opportunities when compared to men. Though there are many examples of gender inequality, three of the instances that proved to change gender relations as a whole are the most influential. These instances are the suffragette movement in 1917, the Women’s March For Equality, and Roe v Wade.

The suffragette movement in 1917 was a monumental time for women. Not only were they fighting to ban alcohol to combat the alcoholism running rampant in their husbands; but they were fighting for the right to vote. Since most women were for prohibition, men of the same persuasion wanted more votes, and knew they could get them from women. Pretty soon the men for prohibition were voting for women’s suffrage. Eventually, in 1920, women were finally granted the right to vote. This change in federal policy opened many doors for many people, and supplied the government with more voters, and thus a better opportunity of justly serving underserved populations. 

The Women’s March for Equality in 1970 was a monumental event that is still celebrated today.

The goal of the march was to fight for equality for women in the home, schools and offices. Held on the 50th anniversary of the 19th amendment, the Women’s March was spearheaded by the women in charge of the National Organization for Women, and was held on August 26th, 1970. Feminists from 40 different American cities, France, and the Netherlands banded together in the fight for gender equality. In NYC alone, over 10,000 people gathered together in the march. The women linked arms like “suffrage veterans” who came before them. 

Roe v Wade is one of the most debated congressional decisions to this day. In 1973 the Supreme Court  made the landmark decision to illegalize restricting access or criminalizing a woman’s access to safe abortion. The choice was made when the Supreme Court decided that it goes against a woman’s constitutional right to force her to carry an unwanted pregnancy. The reasoning for this is that a woman’s body and what she chooses to do with it is a private matter between her and her doctor, and therefore, interfering with that would display an abuse of right to privacy.

In conclusion, though there have been many events in history that have made incredible differences in women’s equality, these three highlight the prevalent changes. The suffragettes gave women the right to vote. The Women’s March demonstrates the power women have when they work together. And Roe v Wade gave women true ownership of their own bodies. These events in history demonstrate how gender equality is a progress, and it is constantly being worked on and revised.

 To me, starving has always been under one big bracket. It was interesting to learn that many children are malnourished, but each level receives different amounts of public attention. I don’t think I could ever be in a position where I get to decide who lives and who dies. That’s way too much power for any human to handle, even if it’s not direct. I think that the most surprising thing to me was that the most severe cases get less attention than the mild or moderate cases. I suppose I understand; you have to save the ones that actually have a standing chance. I don’t like it, but fiscally, I get it. This brought me back to earlier in the book, it talked about essentially deciding who lives and who dies. The value of life, burnt down to a matter of who will be the most fiscally productive within a given economy. Deciding who survives, based off of who has the best chance of survival, will never sit right with me. Then again, neither does most of modern society. 

According to the reading, it is in a nation’s best interest to ensure that the youngest children have the best diets. This, to put it in simple terms, is like gardening. If you have a sapling, and you want it to become a strong tree, you fertilize it, water it, and take care of it while it’s still growing. By providing the youngest members of society with proper nutrition, a nation is ensuring a larger future population of able bodied citizens. A proper diet is linked to decreased morbidity and mortality, limits stunting of growth, and assists in proper maturation which leads to strong adults for the workforce, and thus boosts the economy in the long run. Many children die every year from malnutrition related ailments such as vitamin deficiencies, diarrhea, and higher susceptibility to infectious disease (UNICEF, 1998). Given this, by not giving children proper access to nutrition, the nation would be facing a variety of problems rather than just one. In developing crowded countries, infectious disease would likely spread quickly, in part due to the abundance of young hosts with already susceptible immune systems. Additionally, diarrheal illnesses would likely spread quickly as well, due to the lack of sanitation and abundance of hosts. As can be seen, nutrition is not all black and white. There are many implications from lack of nutrition, and likewise, many benefits from access to a nutritious diet.

However, food is not the only step that needs to be taken to reduce the many problems associated with undernutrition. The author of the article points out that there are three underlying causes of undernutrition at a family level. These include food, poor sanitation and health services, and maternal and child care practices (Martorell, 1999). Of these, I believe that maternal and child care practices would be the easiest to address through a health intervention. This is due to the fact that through simple education programs and access to food and vitamins during pregnancy and infancy, the child would be receiving enough vital nutrients in the first thousand days, and would escape being set up for nutritional failure at birth. My mom worked with an organization in Guatemala that provided mothers with prenatal vitamins, clean water, formula, and parenting/nutrition education. If more programs like this could be implemented in developing countries like Bangladesh, where the prevalence of low birth weight is as high as 50%, a lot of children might be saved (Martorell, 1999).

By improving the diets of young children, we would not only be saving or improving lives, but would also be increasing the child’s chances of success later in life. As the article stated, children who are malnourished suffer from reduced intellectual capacity and lower work performance as adults. This fact points towards the idea that the environment plays a larger role than genetics. If a child is malnourished from the time they are in utero, they will not have the strength needed to learn and adapt. In simple terms, you can’t study if you’re starving. Not only that, but a brain needs nutrition to develop correctly. Without the proper vitamins, you are essentially running on empty. I personally have experienced being malnourished. I was Anorexic for close to two years, and I had a BMI of 14.0. Though this was due to mental illness, and not at all comparable to the children who have no choice but to be severely undernourished, I can attest to the fact that life is a million times harder when you don’t have nutrients to keep you running. I was anemic, I had a sodium deficiency, about every vitamin I needed in my body was way too low to do anything, and I developed heart and gastrointestinal problems because of this. I was in the ER normally two or three times a month to get IVs and be pumped full of vitamins. Running on empty took a huge toll on my body, even to this day. Children who don’t have access to ERs and IVs, or supplements and dietary support, have so little chance of ever getting out of that terrible place physically. Children in developing countries likely have diets a million times worse than what I had, as well as limited or no access to the simple medical interventions that may have saved my life. 

The figure in the article did not really show one place to begin the cycle of improvement; however, I think that the best place to start is with social sector investments. When you start from the beginning, i.e kids, nutrition, education, etc, you get a population of healthy, able bodied working adults who contribute to the economy. Once you’ve done this, the rest of the boxes will follow. In other words, investing in social sectors is like laying the foundation of a house. You can try to build the roof first, but it will just keep falling in on itself until you address the underlying problem. In order to address the problems that stem from lack of nutrition in childhood, such as lower IQ, less ability to work, and higher rates of mortality and morbidity, you have to start at the beginning. For example, by providing expectant mothers and young children with vitamins such as zinc, folic acid, or vitamin A, diseases such as cretinism, anemia, and vitamin A deficiency, as well as various intellectual impairments, could in large part be avoided or reduced significantly. Additionally, lasting health effects, such as diabetes, insulin resistance, hypertension, lower energy, and much more, could be cut significantly by preventing malnutrition in children (Martins et al, 2011).

In conclusion, investment in social sectors, improved child nutrition, and base level interventions, such as improved water, food, and sanitation access, can greatly improve overall quality of life, and in turn, lower morbidity and mortality. While reading this article and researching further, I was shocked by how simple a solution that could save millions of lives goes far under executed. My only idea as to why goes back to the value of life. Donors and governments want a public pay off that is quick and easy, but with investing in children, the return on investment takes years. Whether on purpose or simply as a side effect of their choices, the people in power get to decide who’s life is worth more. I have always wondered if their choices would change if they met the people they are letting live or die, in person. The whole situation reminds me of something my ecology professor said the other day, “We do not truly care until we understand.” His example was having students spend time in nature so they would be more passionate about it and thus more protective when it comes to environmentalism. Conversely, I wonder if by having donors, government officials, and medical professionals spend time with the children whose lives rest in their wallets, they might decide that a child’s life is worth a whole lot more than they originally thought. 

References

Martins, V., Toledo Florêncio, T., Grillo, L., Do Carmo P Franco, M., Martins, P., Clemente, A.,   Sawaya, A. (2011, June). Long-lasting effects of undernutrition. Retrieved October 11, 2020, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3137999/

Reynaldo Martorell, “The Nature of Child Malnutrition and Its Long-Term Implications.” Food and Nutrition Bulletin, 1999, 20(3): 288–292. 

 United Nations Children’s Fund (UNICEF). The state of the world’s children 1998. Bringing science to bear. Oxford, UK: Oxford University Press, 1998.

Water is rarely the first thought that pops into my head when I hear about illnesses in general. I have mostly thought about water borne illness in reference to Ebola or bacterial infections; but never on a large scale. I have heard about diarrhea being such a massive problem before, but I have never actually looked at how it became such. The idea that so many illnesses develop because of fecal to oral transmission is very gross to me, and learning the statistics of how many people live in conditions where it is common to ingest contaminated matter, made me realize my privilege having grown up in an environment where I didn’t really have to worry about that stuff. Growing up, I would play in rivers and ponds, drink water from the hose, and play in puddles for hours at a time. I never had to worry about what was in this water, or whether there was human waste in it. This chapter made me realize how the things in life that I deem as normal, are the same things that others deem as a luxury. In other words, it made me realize how much I take advantage of. 

WASH (water, sanitation, and hygiene), are noted as the forgotten foundations of health. Many individuals believe that funds should be allocated more towards reactive care, i.e hospitals, medicine, etc, than preventative care, i.e clean drinking water, safe plumbing, etc. The public media often reports on matters surrounding “the big three,” HIV/AIDS, Malaria, and Tuberculosis, but fails to provide enough awareness surrounding water borne illnesses, such as diarrhea, which kills more people than all of the big three combined (Boschi-Pinto, et al, 2008). One possible reason for the gap in funding for preventative care, in my opinion is that because of the media, donors do not hear as much about the impact that their donations could have on health. Additionally, reactive care provides a much more cut and dry emotional pay off. Donors are able to see that their funds helped heal someone. Whereas with preventative care, donors are not able to see that effect for a while, since their funds are going towards making sure no one gets sick, they can’t see that they helped them heal. 

As I read about the effects that WASH has on global health, I was surprised to see how many people do not have access to safe indoor plumbing and clean drinking water. My idea of “improved sanitation” has always been having access to clean water, a flushing toilet, and safe drinking water. Upon learning the actual definition of improved sanitation, I realized that a lot more people than I expected live without what I, as a person who grew up in America, would deem close to the bear minimum. I have traveled to over thirty countries, and I have visited some areas that likely suffer from water insecurity. But every time I have visited these areas, my mind went mostly to their poor housing conditions, limited access to food, or inability to access health care. Water to me has always been sort of a given, and it was eye opening to see how many people go without safe plumbing and clean water.

In the reading, it was mentioned that water and sanitation are top priorities for the poor. I completely agree with this statement, for the simple fact that these are basic necessities for humans to survive. By having access to clean water and sanitation, the rates of water borne illnesses could plummet. This brings me back to a book I read when I was a kid. It took place when the Mayflower came to America, and it was a diary of a teenage girl. I remember that a lot of people died because of starvation, unclean water, bad weather, etc. But one part that I remember very well was that her mother got very sick with stomach problems and diarrhea. They were trying to rehydrate her, but the only waters they had access to were either dirty fecal contaminated ponds, or the salty ocean. Her mother ended up dying, and I have always wondered if she could have been saved if she had access to clean water. Though this is a very different situation to what the textbook was referring to, it goes back to access to safe water. This happened hundreds of years ago in America, and was considered an awful time to be alive. But what they don’t talk about in school prior to college, is that it still happens in so much of the world. By helping people gain access to safe water and sanitation, illnesses, disabilities, and deaths could be prevented in large amounts.

I believe that governments should invest more into preventative care such as sanitation, clean water, safe housing, education, etc, rather than pooling all of their resources into reactive care. I keep going back to the bodies in the river example from earlier in the textbook. To put the same analogy in different words, consider a broken train track. If there is a section of train track in a city that broke, and the train travels off the track, it will wreck many buildings and cars, and likely kill many people. You can run after the train and try to hop on and pull the emergency break, but by the time you succeed, the train will have caused tons of damage. A much more effective method would have been to make sure the track was built correctly and was safe to use before the train started. By identifying the break in the track and repairing it before any damage was caused, millions of dollars and hundreds of lives could be saved. It’s the same with global health. By implementing measures to prevent illness, governments could save millions of dollars in medical costs every year. Aside from the mere financial aspect of global health, by ensuring their citizens have the tools they need to stay healthy, they will likely see an increase in productivity, since their citizens will be alive and well. Conversely, the return on investment for water supply interventions shows that $1 U.S brings a return on investment between $5-$46 U.S depending on the intervention. This comes not only from money saved from medical costs, but time saved retrieving water as well (Hutton, et al, 2007).  Overall, preventative measures, in my opinion, should be a high priority for every country.

As can be seen, access to clean water and proper sanitation play a vital role in global health. By ensuring that people have access to these basic necessities, years of life lost (YLL) and disability adjusted life years (DALYs) could be prevented in large amounts. It has always astounded me that so much of the earth is made of water, yet so little of it is safe to consume. By investing in low cost preventative measures such as water filtration straws, sand dams, building new wells, etc, the rates of water borne illnesses will see a drastic decrease. This decrease will provide less of a financial strain on governments by limiting the amount of medical care and hospitalizations needed. Not only would investing in preventive measures provide a more cost effective method for governments, but most importantly, it could save thousands of lives. For example, South Africa experiences 115 deaths every hour that are linked to poor hygiene, sub par sanitation, and unsafe water (The Last Well, 2020). That is 1,007,400 preventable deaths per year in South Africa alone. Once this number is expanded to include all areas affected by water insecurity and bad sanitation, we are looking at a massive part of the world population that was killed due to something that was easily preventable. There are many benefits to investing in preventative measures, ranging from fiscal to humanitarian, and each reason goes further and further into showing that more funds should be invested into this area.

References

Boschi-Pinto C, Velebit L, Shibuya K (2008) Estimating child mortality due to diarrhoea in developing countries. Bull World Health Organ 86: 710–717

Hutton G, Haller L, Bartram J (2007) Global CostBenefit Analysis of Water Supply and Sanitation Interventions. J Water Health 5: 481–502. 

The Last Well. (2020, January 21). Ways to Get Clean Water in Africa. The Last Well. https://thelastwell.org/ways-to-get-clean-water-in-africa/. 

I found this reading to be very interesting. I have never thought about how climate change affects humans, other than in the very simple explanations. I have always wondered why death tolls from water related natural disasters (i.e hurricanes, floods, etc) are so high. I had always assumed those numbers merely reflected the number of deaths from drownings, debris, and other immediate causes. When I read about how many people die from waterborne illnesses after a natural disaster, I was astonished. Additionally, it was interesting to learn how much of an effect air pollution has on health. I never realized how many things contribute to air pollution, much less how many deaths result from that. I have Asthma, and looking back on it, I have had more asthma attacks when I am in big cities than when I’m in small towns. The idea that air and water can both contain so many microscopic organisms that can kill you is dumbfounding. I have often wondered if the effects of global warming could ever truly be reversed. I wonder also, if humans would even be willing to take that step forward if it means cutting down on certain luxuries such as cars, plastics, planes, etc. 

The model shown at the beginning of the article showed the effects of climate change in a very surprising way (George Luber, Climate and Health Program, Centers for Disease Control).  Again, I have always thought of climate change in a very simple blanket term, such as its effects on sea levels, crops, fires, etc. I was surprised to see how many effects climate change has on health. I never realized how many illnesses were aggravated by heat, cold, or air pollution. I had also never thought about the political impact of climate change in regards to migration and global conflict. Thinking about the conflicts between the U.S, Mexico, Guatemala, and other southern developing countries, the relationship between heat and political strife becomes clear. Certain areas in these countries have hotter climates, less access to clean water, and limited access to safe sanitation. Due to this, they likely have a higher prevalence of illnesses, less able bodied citizens for the workforce, and more strain on the economy, which leads to more conflict between citizens and government, and thus an increase in migration and immigration. I showed my friend the model, and she was just as surprised as I was. There are so many things that can be caused by climate change, yet everyone turns a blind eye because no one wants to face the music. 

I have seen many people, whether they are acquaintances, politicians, or anything in between, deny that climate change is real. This has always baffled me. Why would you deny the truth of something that is simply fact? The only conclusion I’ve been able to come to has been that people simply do not like to face the fact that something is wrong. Especially when it means their behaviors have to change. As a society, we like to bask in ignorance and pretend everything is ok. If people give weight to climate change, they have to limit their luxuries, factories have to slow down production, cities have to move to mass transit, etc. Humans are creatures of habit, and do not adjust well to change. We want to keep our luxuries, to some, even to the expense of our descendants’ survival. 

In the article, the authors name three main pathways that climate change affects health. These include extreme weather, novel infectious disease, and complex humanitarian emergencies (George Luber, Climate and Health Program, Centers for Disease Control). In my opinion, the most severe of these pathways would be extreme weather. I say this due to the fact that extreme weather can lead to both infectious disease and humanitarian emergencies. When a natural disaster occurs, it leads to an overabundance of bacteria, homelessness, political strife, medical costs, and inability to access sanitation and safe food and water. As can be seen, natural disaster can cause the rest of the options, but the other options cannot cause natural disasters. For example, in 1998 a flood in Bangladesh, India, killed over 2,000 and displaced more than 20 million people. Though many died by drowning, being carried away by water, or by debris related injuries, there were also a number of deaths related to health afterwards. After the flood, there was an outbreak of diarrhea that resulted in 276 deaths in West Bengal (Kunii O, Nakamura S, Abdur R, et al. (2002).  

One important topic regarding climate change and global health is resilience of infrastructure. Each type of infrastructure comes with its own set of benefits and drawbacks.  For example, urban cities have more concrete and less vegetation, and thus have higher temperatures on average than rural communities. Conversely, though in hot summers this may be a drawback, in cold winters, it could serve as a benefit in reducing hypothermia rates. resilience of infrastructure is a community’s ability to adapt, in this case regarding the effects of climate change on infrastructure. For example, some cities install flood walls along river banks to hold floods away from buildings and people. Other towns may utilize houses on stilts for flooding, or hurricane doors for big storms. Resilient infrastructure is simply about ensuring that the infrastructure in a community can withstand or bounce back from a damaging event (George Luber, Climate and Health Program, Centers for Disease Control).  

One thing that shocked me about the entire correlation between climate change and global health. For example, I thought it was interesting to learn that individuals who live in cities with higher than average temperatures, have a lower heat related mortality rate than those living in average temperature locations during a higher than average heat wave (Luber, G., & McGeehin, M. (2008). This reminded me of my environmental science class. Last week we were talking about how some species are extremely adaptable, while others can only really survive in one climate. I am curious if rather than adaptability as a species, humans differ more on adaptability based on geographic region. If so, I wonder if individuals who live in warmer or cooler climates are more adaptable. 

The effects that climate change has on mental health are astronomical. I remember in 2011 when the big flood hit upstate New York, so many people were homeless and fighting food and water scarcity. Even after the floods, I know plenty of people who have shown symptoms of PTSD related to storms, rain, and floods. Many people have heightened anxiety, depression, and PTSD following natural disasters. Given that climate change increases the rate and severity of natural disasters, we will see an increase in mental illnesses as well. Natural disasters result in loss of homes, jobs, and even loved ones. These are normal triggers for mental illness, and areas hit frequently with natural disasters are likely to be hit more frequently with mental illness. 

In conclusion, climate change and global health go hand in hand in many ways. Though climate change is a proven scientific fact, many people choose to ignore or deny its existence, and thus can be argued to be compliant in the deaths of millions every year. Going into this week, I had no clue how much climate affects health in any abstract manner. But after reading this article and gaining more insight, I can say with absolute certainty that there is a huge problem on this planet that needs serious attention before it becomes irreversible. Many communities are taking action against climate change by recycling, using mass transport, banning single use plastics, banning fracking, limiting the number of factories allowed in a general area, encouraging local produce shopping, and much more. Through all of these initiatives, people are helping the planet. Hopefully many more communities will follow in the footsteps of those before them, and together, perhaps, we can save lives.

References

Brown, P. J., & Closser, S. (2019). Foundations of global health: An interdisciplinary reader. New York, NY: Oxford University Press.

Kunii O, Nakamura S, Abdur R, et al. (2002). The impact on health and risk factors of the diarrhoea epidemics in the 1998 Bangladesh floods. Public Health; 116:68–74.

Luber, G., & McGeehin, M. (2008). Climate change and extreme heat events. 

American journal of preventive medicine, 35(5), 429–435.

This is a topic that is near to my heart on many fronts. I understand both sides of this debate, however, I do firmly believe that the greater good should always outweigh the rights or privileges of individuals. When I was six weeks old, I was given the Hepatitis B vaccine. I had a very serious allergic reaction, and I was hospitalized for two weeks. I periodically stopped breathing, and I developed sleep apnea. It was decided definitively that this was a reaction to the vaccine. Additionally, my mother had a severe reaction to the flu shot in 2015, and developed a nerve disorder because of it. Though to some people these instances might provide support to the anti vaccine movement, I personally believe that these are two examples of why people should be vaccinated.The majority of people do not have these severe reactions, and are completely able to be vaccinated. If everyone who can safely be vaccinated received their vaccinations, they would be protecting those of us who cannot do so.

I have two friends with AutoImmune Disorders, neither of whom can be vaccinated due to their immune systems. I have watched both of them taste death because of illnesses as simple as a cold. Society is wreaking havoc over temporary mask mandates, but my friends have been wearing masks in public from the time they could walk. In the documentary, The Vaccine War, one of the anti-vaxx mothers argued that since diseases such as Polio no longer exist in the U.S, it makes no sense that children still need the vaccine. Excuse my lack of formality here, but I desperately wanted to slap her across the face through the screen. Polio is gone because of the vaccine. If we stop vaccinating against it, and someone from another country comes to the U.S with Polio, we will have to start the whole process over. We vaccinate because it works. 

I understand that parents are scared. There are a ton of chemicals in vaccines, and I do think that they need to be improved. However, and I say this as a future mother, I would rather have a child with Autism than a dead child. Speaking of Autism and vaccines, it drives me crazy that people still use Dr.Wakefield as a reference even though he has been discredited. I would be willing to come to a compromise and meet in the middle. For example, instead of a vaccine exemption based on personal beliefs, perhaps there could be an alternative schedule for vaccine delivery for parents who feel uncomfortable with their child receiving so many vaccines at once. I do not think that non immunocompromised children should be permitted to remain unvaccinated and attend a school setting with immunocompromised children. In cases of illnesses with high mortality rates, I believe vaccination should be mandatory barring a legitimate medical exemption. For example, illnesses with death rates of over 1%, such as Smallpox, Polio, Diphtheria, and measles, all of which have high death rates (ranging from 3%-30%), should have mandated vaccines.

Overall, I would argue that the only reason individuals should be able to receive an exemption is due to a medical inability, such as cancer, autoimmune disorders, or AIDS. Other than that, I do not think that you should be able to put thousands of people at risk because you believe in conspiracy theories regarding vaccines. Again, I would support an alternative schedule of vaccination, but not a complete elimination. As was noted in the documentary, since vaccines became common practice, life expectancies were extended by 30+ years.  It seems clear to me: the good significantly outweighs the bad. Additionally, so many studies have been conducted trying to find links between vaccines and the accused side effects, and virtually none have supported the claims of the anti-vaxxers. As was stated in the documentary, many individuals opposed to mandatory vaccinations continuously move the finish line in regards to what is safe and what is not. 

References

Miller, M. (1970, January 01). Vaccine-Preventable Diseases. Retrieved November 19, 2020, from https://www.ncbi.nlm.nih.gov/books/NBK2284/

The Vaccine War. (n.d.). Retrieved November 19, 2020, from https://www.pbs.org/wgbh/frontline/film/vaccines/

I had no idea of the lengths that the WHO and other entities went through to eradicate smallpox. For example, I, though an ignorant assumption of course, always chalked the eradication of smallpox up to a vaccine being given to people without much resistance. I had no clue that there was so much force involved in distributing the vaccine. I wonder if we will face a similar situation in regards to the Covid-19 vaccine. In the short time that COVID-19 has been prevalent, we have already seen a monumental divide between those in support of the greater good, and those in support of individual rights. Whether that divide is on the topic of masks, vaccinations, social distancing, or shutting down businesses, there is a very prominent difference between the values held by citizens of not only America, but the world as a whole. This substantial divide leads to massive discrepancies in death rates through countries and regions. For example, in Belgium, the death rate for COVID-19 is 1,292.14 per one million. On the other end of the spectrum, the death rate for COVID-19 in Ecuador is 749.7 per one million (Best. R, 2020.) The reasons for these differentiations may vary tremendously from region to region, but one fact remains the same: something must be done.

           The Smallpox eradication efforts were carried out in controversial ways. Force, coercion, and other forms of abuse of power were continuously utilized during the efforts to eradicate smallpox, even going as far as to break down padlocked doors and drag people from their homes. For many individuals, this was a gross misuse of power, and represents a negligent part of humanity. Though I am perhaps unusual in my opinion, I think that in the case of diseases like smallpox, with a mortality rate of 30%, the actions of the teams attempting to eradicate smallpox were justified. Diseases like smallpox have such a tremendous effect on society, both socially and economically. Over the years, millions of dollars have been spent surrounding Smallpox, and an estimated 300-500 million people died of the disease (Smallpox, 2014.). Though individual rights are important, in my eyes, they never outweigh the rights of the majority. Regardless of religious, personal, or philosophical beliefs, with a death rate that high, everyone who is medically able should be legally required to get a vaccine, and if they don’t do it voluntarily, then it makes sense that force would need to be used. However, I think that the same needs to apply across the globe, not just in areas traditionally used as experiment sites. Every human being deserves to be treated the same. As the article mentions, the same must be done for individuals in Buffalo or Birmingham as those in India or Bangladesh. A country’s economic development should not dictate the value of its citizens. If everyone in Bangladesh is forced to have the vaccine, everyone in Birmingham needa it too. Millions of people could still be alive today if they had been protected by heard immunity, and millions more in the future as well. We must vaccinate ourselves to protect those who cannot. 

        In some of the scenarios described in the text. I would argue that human rights were violated. However, I suppose it would depend how each country defines human rights. In the first story we heard, regarding the starving woman, her human rights violation was simply traded- lose your bodily autonomy in turn for food. No one deserves to starve to death, just as no one deserves to die of smallpox. Just the same, however, everyone deserves the right to decide what happens to their body… in some countries. What may prove as a human rights violation in America could be common practice in another country. For example, prior to learning about Female Genital Cutting, I firmly believed it was a human rights violation. Though I still do not love the idea, I understand that in countries that practice it, it is commonplace and not a human rights violation at all. What I’m trying to say, is that the definition of a human rights violation differs drastically from region to region. In order to say definitively whether or not forcing vaccines on people is a violation of their human rights or not, there must be a universally accepted definition of what is and what is not a human right. In the culture I was raised in, bodily autonomy is absolutely a human right. As a child, my parents were able to say what medical care I received, what vaccines I got, and which doctors could care for me. Given that, in my opinion, certain aspects of the Smallpox campaign were violations of human rights (I.e breaking into homes and physically forcing vaccination.) However, I still believe that regardless of this, the greater good outweighs individual rights. I would rather violate one person’s rights than allow ten others to die because of their choice. 

        The efforts of EIS officers would have been drastically different had their goal been to control rather than eradicate Smallpox. For example, they likely would have been able to respect individuals choices to not get vaccinated based on religious reasons. By demanding a complete eradication of the disease, they were unable to provide any sympathy for those who did not want to be vaccinated. They wanted Smallpox gone, and they were willing to do practically anything to succeed on their mission. Though I personally believe that they handled things the way they had to be handled in order to save as many lives as possible, I know many people may disagree with me, and I understand why. Perhaps the EIS officers could have handled things differently and still had the same outcome. But the truth is, we will never really know. All we can be sure of is that due to the insistent and tiring efforts of health organizations, we have not seen a single case of Smallpox since 1976, and hopefully we never will again. 

     One of the main components that made the eradication of Smallpox possible was teamwork. Many health and government officials had to work together in order to reach their desired outcome (Smallpox eradication by December.) This proved to be very difficult for many professionals due to the sensitive nature of their work. Some professionals wanted to work on a classic contact tracing vaccination program, while others wanted to mass vaccinate everyone possible. This caused a lot of turmoil between professionals, and led to discrepancies in execution of vaccination. For example, some medical professionals were reporting vaccinating whole villages when they hadn’t even gone to them. I believe that a lot of this mistrust and miscommunication could have been prevented by providing professionals with training in communication, global affairs, and global health. I have seen a lot of the same behaviors nowadays between governments and medical professionals. It has really become a game of he said she said, and the punishment for stupidity is 1,340,000 dead bodies. 

       Overall, I believe that when something is as deadly as Smallpox, every effort needs to be taken to rid the world of it, even if it comes at the cost of individual rights. I suppose this is a reflection of my own political views, which of course, is a reflection of the world I grew up in. We all come from different backgrounds, and value different things; but I personally hope and pray that in the end, we value life over rights. I don’t know that the same efforts should be taken for COVID19, since it has a much lower death rate, but I do think that other forms of individual rights might have to be taken away for the greater good. For example, I firmly believe that masks should be legally required in all public forums until things get back to normal. It’s the small things that make all the difference.