Time journalist (and newly minted Nieman fellow in global health) Christine Gorman recently gave a talk at the Global Health Council's annual meeting. Christine discussed topics that get a lot of press--such as HIV/AIDS--and others that occasionally bubble up to the surface, such as malaria and non-infectious global health issues like female genital mutilation. However, she also noted stories that are rare or missing in mainstream health journalism--more on those after the jump.
First, she notes a dearth of stories that "cut across lines, across diseases, across silos." Much like the increased push for interdisciplinary research scientists face, there's also a need to tell stories that cut across these lines. It's not easy, but she links several successful stories that manage to successfully bring together diverse threads. But there are still gaps:
Here are my top three:
1. The foundational roles that clean drinking water and basic sewage treatment play in promoting health.
2. The growing threat of all the drug-resistant microbes combined--staph, strep, tuberculosis--and our own role in making matters worse.
3. The preference for pills over people--doctors, nurse, health community workers--when it comes to funding basic healthcare infrastructure.
I've mentioned the first one many times here, and have another post coming up tomorrow. I bring up the numbers also in a global health lecture I've given several times to medical students--it's amazing how many of them have no clue the extent of the water crisis around the world. It's interesting she brought up #3, since there was just a story on that (mentioned here) a few days before her talk. Related to that is another angle she asks about:
Any real critical analysis of the Gates Foundation's effect--both positive and negative--on global health efforts. It has certainly grabbed a lot of people's attention. And done a lot of good. But does it have too much power? Is it scaring off other donors? Shoving aside effective, more home-grown or low-tech efforts?
She brings up several other angles as well--what journalists (and "fake" journalists like myself, and potentially many of you readers) can do to get our messages out in the age of Web 2.0 and the changing face of health journalism itself--an interesting bit of insight from someone who's been covering these topics for 20+ years.
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It is great to see Christine Gorman advocate for more people to get involved because as she said it is needed. Perhaps the twin forces of Gorman and Laurie Garrett will generate momentum. Laurie Garrett has recently been raising the point of focusing on infrastructure and getting away from the silos mentioned above. But this is a very difficult thing given that everyone has their turf (policy makers, epidemiologists, economists, clinicians, etc.) and because not everyone has the ability to see outside of their disciplines.
As far as the Gates Foundation, the money distributed by them (annual budget larger than WHO) makes its influence more ubiquitous and thus harder to criticize. In my opinion when we look back in 30 years people will say that the entrance of the Gates Foundation was revolutionary. As a counter to this, someone who has articulately offered some criticism on part of their approach is:
Anne-Emanuelle Birn
Lancet 2005; 366: 514-19
http://image.thelancet.com/extras/04art6429web.pdf
Gates's grandest challenge: transcending technology as
public health ideology
You don't have to be a billion dollar foundation to give aid. Cuba takes care of its own people and sends thousands of health care workers to poor countries.
http://www.yesmagazine.org/article.asp?ID=1733
http://www.saludthefilm.net/ns/main.html
Speaking from the perspective of a staff member of the Global Health Council, I have to say that I thought Christine was right on target with her messages about the stories that are not receiving their due attention as well as challenges to the global health community to think more broadly about the challenges journalists have in covering global health stories. Let me just add here, as was emphasized at the closing plenary of the conference, that one of the biggest stories not being told is the fact that we continue to lose 10 million children under age 5 every year from largely preventable causes. The interventions are known and most are very affordable, and families dread nothing as much as the loss of a child, but there are few journalists who seem interested in this story. Among the numerous health issues that fail to get public attention, this one is particularly troubling. I would love to hear from anyone who thinks I'm wrong about this or has an explanation for this.
It is great to see Christine write such an eloquent statement about the hugely under-recognized global health issue of safe, affordable, and sustainable sources of drinking water and adequate sanitation. I hope this will spur an increase of writing and speaking about this crisis that kills up to five million people annually and yet has so many solutions at hand.
Anne-Emanuelle said "not everyone has the ability to see outside of their disciplines." One of the things that I like most about journalism is that even when we follow a particular beat, we're on a constant search for the big picture. We can be witnesses to the world beyound the silos. And thanks for the Lancet link.
Thanks, John. I hope you'll also make common cause with those who are fighting polio and other childhood diseases, as well as those who support girls' education and women's political and economic rights--all overlap fundamentally with water issues.