The Impact of Austerity on Health

Budget cuts and crisis are the daily talk of many countries which are suffering from the contemporary economic crisis. Recently, several studies have been showing the impact of austerity on the health of the populations. The effects over mental health are enormous, and there has been a rise on the number of suicides, depressions, and of alcohol and drug dependent users. However, the access to basic healthcare is also threatened. Indeed, in Greece, Portugal or Spain, access to healthcare has become more expensive, even the one which is State-payed, leading many people stop seeking help when they are ill, or to stop vaccinating their children. On the other hand, infectious diseases are developing, something that had become very uncommon in “developed countries”. Greece for instance, saw the rebirth of a Malaria outbreak, which had not existed in the country since 1974. HIV is growing more and more, as a result of the cutbacks on its prevention. The examples are countless, and the more vulnerable populations such as homeless people, elderly or children, are the most at risk from the cuts on the budgets of health programs. A researcher at Stanford University and author of The Body Economic – Why Austerity Kills, Sanjay Basu, made a comparative study with other periods of economic crisis, such as the Great Depression of the 1930s, the post-communist period and others, and concluded that “Ultimately what we show is that worsening health is not an inevitable consequence of economic recessions. It’s a political choice”. Check out this Doctors of the World report or read more about it here!

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Emerging India: The largest democracy in the world and its paradoxes . by Rosa Perez

Over the last years, India’s status as both a democracy and a global emerging power is at its peak. This picture changes dramatically when considering the lower strata of Indian society.

The Indian Constitution, intending at building a democratic society, guarantees to all citizens equality before the law (Article 14), and has issued anti-discriminatory measures. These measures include the enactment of the Untouchability Offence Act, 1955 (renamed as the Protection of Civil Rights Act [PCR] in 1976), and the Scheduled Castes and Scheduled Tribes Prevention of Atrocities (POA) Act, 1989. Under the former, the practice of untouchability and discrimination in public places and services is treated as an offence.

Nevertheless, nearly after seventy years of Indian independence, caste and the ingrained caste hierarchy still remains at the core of Indian society. The lower castes, the Untouchables, now known as Dalits (a term that means “stepped on, broken, crushed”) have been ground down by those above them in the social hierarchy, which has frozen mobility within the social structure.

Ritual and social exclusion and discrimination are even more severe for Dalit women, who face extra-deprivation and segregation bound to gender asymmetry. Indeed, Dalit women have extremely low levels of literacy and education, thenceforth are mostly engaged in unskilled, low-paid, and sometimes damaging manual jobs. They are often victims of violence, sexual exploitation, and deleterious representations.

The Indian government has tried to inverse this social scaffold trough a policy of ‘positive discrimination’, in other words, through reservations in the public spheres to ensure proportional participation of the Dalits in public sector employment and to enable their entry into public educational institutions as well as various political democratic bodies. Concurrently, in the last decades, there was a remarkable upsurge in the assertion of Dalit identity. A resilient political movement has emerged among these marginalized groups throughout the country to aver their distinctiveness and self-respect and to challenge the cultural hegemony of the upper castes. To a large extent they have overcome to fill the cognitive blackout that they have historically been the object of and have claimed their legitimate share of representation of knowledge, asserting a consciousness that is not only cultural but also political.

However, although the Dalits make up about 16 per cent of the Indian population and number about 138 million, and despite the achievements that they have imprinted on the Indian political and cultural agenda, the majority of the Dalits dwell in villages were their identity is more visibly exposed and where preconceptions and prejudices die harder, therefore perpetuating the clash within and emphasizing the paradoxes of democracy.

Check out this documentary entitled “India Untouched” or read more about it in this book!

ROSA PEREZ is an Anthropologist, a Professor at ISCTE and Visiting and Institute Chair Professor at the Indian Institute of Technology (IIT) Gandhinagar, India. She lives in Lisbon, Portugal.

Where Is Science Going? . by Nuno Jalles

Science is changing fast and it is no longer hypothesis-driven as it used to be. Any kind of research now deals with increasing amounts of information and data. Fields such as astronomy, genomics, physics, drug research in biomedicine, and several other disciplines have been using Information Technology (IT) to analyze tones of data and make a sense of it. We’ve got to a point where the hypothesis are being generated after you get the data from experiments.

High-throughput computer technology combined with mathematical algorithms are used to answer questions. In other words, instead of generating data based on a specific hypothesis, you generate huge amounts of data and then you ask the questions, thus formulating a hypothesis – the movement is going backwards! There is a contemporary overlap between Information Technology and any kind of research. We have always used computers for specific tasks, especially in research, but now they are faster, the internet is even faster and we are creating an enormous gap. Science and young scientists (and I mean generally) are not prepared for this information overload named “Big Data”. We are generating more data in the last years than we have produced in our entire existence. A specific example is the ENCODE project that is trying to map all functional regions in a person’s DNA (check the article “ENCODE: Big Data to deal with human complexity ” for more information).

Science is facing an increasing deficit in people that can not only handle Big Data, but more importantly that have the knowledge and skills to generate value from this data. The problem is that researchers need a toolbox of techniques, skills, processes and abilities to construct new solutions based on this accumulation of information. We are now giving lots of credit to computational power and are forgetting the main scientific ingredients: human curiosity and instinct; computers do not have these two ingredients. We’ve reached a point where supercomputers are fast enough to crunch data just as easily as anything else. This could be good or bad, it depends on how we use this power. Time will tell.

NUNO JALLES is a Doctor and cycling lover – He lives in Lisbon, Portugal

Against a Tide of Evil, Mukesh Kapila . by Boban Thomas

“Our lives begin to end when we remain silent about things that matter; There comes a time when silence becomes betrayal” – Martin Luther King Jr.

A recent book about the now well-documented genocide in Darfur – Against a tide of evil – by Mukesh Kapila makes for inspiring reading. While it is a book about the genocide, it is about the harrowing personal experience of the author himself, who was the whistleblower that allowed the world to discover the truth of what was happening there. It is an inspiring story of courage because it takes something special to go against the tide.

Kapila, a physician by training, was the head of the UN mission in Sudan in the early years of the 21st Century, when the proposal for a final solution in Darfur was made by the Sudanese government in Khartoum. Eventually against the indifference of many even in the organization he represented, he blew the whistle through the media.

It is a riveting book, well-written and substantiated by documentation that the author had access to. Whistleblowers are usually not at the top of the organization, like Kapila was, which makes the story even more interesting. This book should be read by anyone who has any interest in international affairs.

BOBAN THOMAS is a Doctor and a good friend. He’s from Kerala, India but lives in Lisbon, Portugal.

The Work of Sebastião Salgado . by Carolina Fantini

Sebastião Salgado, a Brazilian-born photographer has just released his latest work of art: Genesis. As a recognized and awarded photographer, Salgado is well known for his long-term projects, dedicated to full immersion in the world’s most dispossessed and unknown places, in order to portray its life trough shoots, only using Kodak film. He tends to live with his subjects for weeks before he even takes a picture. On his previous work Migrations, Salgado pictured the humanity in transition. During this period, he lived through hard moments, most in Rwanda where he saw “the total brutality” watching the deaths of thousands every day, loosing his faith in humankind.

Just after that experience, Salgado was diagnosed with a series of diseases and infections, which according to his doctor were a reflection of all the deaths he had seen. Salgado was dying. The cure would be quitting photography. Yet, after a season in Brazil, he decided to return to photography, picturing the origins of the word. During eight years he travelled the globe picturing its most preserved species of animals and landscapes in order to raise awareness for the necessity to preserve them.

You can watch his TED talk here!

CAROLINA FANTINI is an International Relations Student in Brazil at PUC-SP. She lives in São Paulo, Brazil.

Alfred “Freddy” Heinekein . by João Pedro Carvalho

Alfred “Freddy” Heineken (November 4, 1923 – January 3, 2002) was a sharp businessman who served as Chairman and CEO of the famous Dutch breweries. Born in Amsterdam, he was the grandson of Gerard Heineken, the founder of the homonym company.

Famous for his natural charm and intelligence, he enjoyed the post-war years in New York where he fell under the spell of the innovative and creative American advertising and soon he recognized marketing as a powerful tool for growth and visibility.

With him (1971-1989), the brand went through a series of makeovers such as the introduction of the differentiating green bottle. What started as a famous Dutch beer turned into a worldwide famous and truly global company. Maybe because of this transformation and growth, Heineken shares are still known in the market as “Freddies”.

He lived a fascinating and glamorous life, enjoying the company of close friends such as Frank Sinatra. Famous for his rough sense of humour, he never lost his “star” not even after being kidnapped in 1983.

This inspiring legacy was continued by his daughter, Charlene de Carvalho-Heineken, after his unexpected death in 2002. His strategic acumen, friendly and strong personality earned him a page in history as one of the most successful businessmen in the world.
JOAO PEDRO CARVALHO – JP adores little curiosities and discovering culture. A guy with a quite unique sense of humor. He lives in Lisbon, Portugal.

Solving Piracy in Somalia: Lessons from the Past . by Vasco Cotovio

War torn since civil war began in 1991, Somalia is the classic case of what political scientists like to call a “failed state”. With no lasting government, the country has divided itself into different regions which, some more than others, claim control for themselves. The problem of Somalia is that it sits on the Horn of Africa, an area that is crossed by 24,000 ships every year.

The lack of government on land and rising criminality soon turned to the seas and piracy became an issue, not only for the region but for most of the world. NATO countries took the lead and tried to solve the problem by policing the entire region but their efforts have been useless since the area is just too big. NATO’s solution was destined to fail given that the alliance tried to tackle the symptom and not the disease.

The absence of public infrastructures, health, education are the causes driving young Somalis into piracy. Unemployment reached 54% in 2012 and youth unemployment peaked at 67%, one of the highest rates in the world. Numbers that illustrate the lack of future prospects that make piracy seem like a reasonable choice.

Piracy is not a problem of today, It is an issue as old as maritime exploration. The Mediterranean and the Caribbean are two of the places where piracy was common in the past. The solution came in the form of investment on land. The development of infrastructures, government and public services created more stable societies that were successful in enforcing the rule of law. When there were prospects on land, criminality in the sea became a last resort and piracy was extinguished.

A solution for Somalia must, therefore, take this – the whole political economy – into account. It is not difficult to provide alternatives to piracy, a way of life that has a 10% chance of getting Somalis killed, injured or arrested. Also, when all the costs are considered, piracy is only profitable for the leader of the gang. NATO should look to these examples if it hopes to find a solution in the foreseeable future.

VASCO COTOVIO is a freelance Journalist and International Relations MA student at Queen Mary, University of London. He comes from Lisbon, Portugal.

The Giant Is Awake

What started as a protest in the streets of São Paulo against the rise of the price of public transports, by R$0.20, has now become one of the biggest manifestations that Brazil has ever seen, leading millions of people to the streets . It has also become a threat to the realization of the World Cup 2014 and the Olympic Games 2016, that are taking place in that same country. The R$0.20 are evidently a symbol of a problem that is much bigger: a growing inflation in the brazilian everyday life in recent years, that doesn’t reflect on a rise of the well-being of most Brazilian citizens. More than that, those R$0.20 are the backdrop of a ever-growing inequality and of a feeling of broken promises by the government towards the people. The giant has awaken and this seems to be only the beginning. As the protesters explain in the streets, the educational system is not good enough, illiteracy rates are still too high, the national health system is very poor and bottom line, as the rich grow richer, the poor grow poorer. In parallel, there are huge expenses for the building of stadiums for the World Cup and the Olympic Games. The rise of prices has not stopped in the last few years, and the bubble that has been growing in Brazil, will necessarily explode in the next few years.

India Versus China

Last week we read an interesting article written by Amartya Sen, the 1998 Nobel Memorial Prize in Economic Sciences, where he portrayed the fundamental differences between China and India and its consequences. Although twenty years ago we would put both countries on an equal pedestal when talking about their economic potential, nowadays India can only dream of overtaking Chinese growth.

What is surprisingly distinct about the two Asian giants is that they are choosing complete different models of development. Of course both countries are highly unequal, but the truth is that China is doing much more to eliminate them. They have raised their life expectancy, they have extended public education and are developing their health system. India on the other hand, has done little to expand its elite schools for the privileged and its government spends half of what China does in health care.

Nevertheless, regarding political rights, modern India is an example as the world’s largest democracy and the country is gifted with a vibrant and free media. Indeed, “democratic participation, free expression and rule of law are largely realities in India, and still largely aspirations in China”. What is interesting is thus to understand if democratic means can achieve solutions for endemic problems. Can democracy be a pathway to reduce inequality? Is it harder to do it in a democracy? Is it more important to educate citizens and improve their health in a nondemocratic system or to develop democracy knowing that multiparty democracy may be slower to eliminate inequality due to less decisiveness?