The C2S blog draws on the arts, the social and biological sciences to explore the many meanings of health and "dis-ease." Designed to be a locus where patients, their families and professionals can meet on a level playing field, it is the natural off-shoot of the Cell 2 Soul Online Journal. We encourage the submission of ideas, essays, poems, stories, humor, and timely reviews relating to the humanities and health care.
Hans Rosling, a Swedish physician became a pop-star statistician by converting dry numbers into dynamic graphics that challenged preconceptions about global health and gloomy prospects for population growth. He died on February 7th at 68 of pancreatic cancer.
The topic of Global Health and Social Determinants of Health has interested us greatly. It is covered in detail in Michael Marmot’s dense book, The Health Gap (that few will wade into). Rosling’s work makes this information palatable and easily understandable.
Rosling, his wife and daughter founded Gapminder, an independent Swedish foundation with no political, religious or economic affiliations in 2007. Gapminder is a fact tank, not a think tank. It fights devastating misconceptions about global development.
When is it ethical to design a health care system that caters to those who can pay?
An old Yiddish proverb runs: "If the rich could pay the poor to die for them, the poor would make a very good living."
Khawar Mann, OBE, a venture capitalist with the Abraaj investment group, travels around Africa scoping out hospitals to buy that seem likely to provide good returns on investments.
Private health care has been an interesting model in the U.S. which lags behind all other developed nations in outcomes. So why is the American system now envisioned as a viable model for Africa? Will this not just serve to widen the "health" gap between the rich and poor?
Mr. Mann says: "“Nairobi is a sweet spot for us. There is a big population that is growing. You have emerging middle incomes. And there is a massive need for health care.” (for those who can afford to pay in cash).
"Why do some
innovations spread so swiftly and others so slowly? Consider the very different
trajectories of surgical anesthesia and antiseptics, both of which were
discovered in the nineteenth century.
The first public demonstration of anesthesia was in Boston in1846. The idea spread like a contagion, travelling
through letters, meetings, and periodicals. By mid-December, surgeons were
administering ether to patients in Paris and London. By February, anesthesia
had been used in almost all the capitals of Europe, and by June in most regions
of the world. Within seven years,
virtually every hospital in America and Britain had adopted the new discovery.
the other great scourge of surgery. It was the single biggest killer of
surgical patients, claiming as many as half of those who underwent major operations.
Infection was so prevalent that suppuration—the discharge of pus from a
surgical wound—was thought to be a necessary part of healing.
eighteen-sixties, the Edinburgh surgeon Joseph Lister read a paper by Louis
Pasteur laying out his evidence that spoiling and fermentation were the
consequence of microorganisms. Lister became convinced that the same process
accounted for wound sepsis. During the next few years, he perfected ways to use
carbolic acid for cleansing hands and wounds and destroying any germs that
might enter the operating field. The result was strikingly lower rates of
sepsis and death. You would have thought that, when he published his
observations in a groundbreaking series of reports in The Lancet, in
1867, his antiseptic method would have spread as rapidly as anesthesia.
Far from it. It was a generation before Lister’s
recommendations became routine and the next steps were taken toward the modern
standard of asepsis—that is, entirely excluding germs from the surgical field,
using heat-sterilized instruments and surgical teams clad in sterile gowns and
A major thrust of
this important article deals with how oral rehydration therapy for diarrheal
diseases is only slowly spreading in the countries where it is most
needed. “In the nineteen-sixties,
scientists discovered that sugar helps the gut absorb fluid. Two American
researchers, David Nalin and Richard Cash, were in Dhaka during a cholera
outbreak. They decided to test the scientific findings, giving victims an oral
rehydration solution containing sugar as well as salt.” This cut the death rate from 30% to ~
3%. But 40 years later it is only just
starting to be taught on a large scale.”
It gives one hope – but this simple, inexpensive therapy is just not
sticky enough. Progress has been slow
Gawande’s article has much more of interest
is an important read for anyone interested in global health, public health, and
the spread of medical innovations.