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On Emergencies

2018-01-23 · letter vlog · John · 3:43 · watch on YouTube

Topic: Global development · mode: Personal essay · tags: heavy topic

Prompted by the New Yorker profile of Partners In Health co-founder Ophelia Dahl, John argues that humans respond well to emergencies like Ebola but neglect the long-term health-care problems behind them, as in Sierra Leone, and calls for both emergency response and long-term investment.

What is said

The parts of the video and what is said in each (★ — how much it matters to the video).

00:00:00 — The New Yorker profile of Ophelia Dahl from Hank's last video; remembering Ebola

  • ★★ John says Hank mentioned the New Yorker profile of Partners In Health co-founder Ophelia Dahl last week (week of 15 January 2018), and since reading it John has been thinking about Ebola. — 00:00:01 · Partners In Health, Hank Green
  • ★★ John recalls that the 2014 Ebola outbreak killed over 10,000 people and was called a global health crisis, a pandemic and an emergency. — 00:00:09 · global health

00:00:19 — Humans rally for emergencies but neglect long-term problems: Sierra Leone after Ebola, acute on chronic, a both-and proposition

  • ★★★ John thinks humans are good at responding to emergencies, rallying, raising money and lobbying governments, but struggle with long-term solutions to long-term problems. (hedged) — 00:00:19
  • ★★ After the outbreak the world made big health investments in Guinea, Sierra Leone and Liberia; as the New Yorker article says, once Ebola seemed stabilized the money evaporated. — 00:00:32 · Sierra Leone
  • ★★★ John says the influx of aid in 2014 helped end the Ebola crisis but did very little to address the long-term crisis. — 00:00:45
  • ★★ When the outbreak began, Sierra Leone, a nation of over 7 million people, had fewer than 200 doctors. — 00:00:52 · Sierra Leone
  • ★★ Over 5% of Sierra Leone's doctors died of Ebola in 2014. — 00:00:58 · Sierra Leone
  • ★★ For context, John's home state of Indiana, with a slightly smaller population than Sierra Leone, has over 16,000 practicing physicians. — 00:01:01 · Indiana, Sierra Leone
  • ★★ Short-term aid did not fix that problem: Sierra Leone still has far too few health workers, who are paid far too little. — 00:01:09 · Sierra Leone
  • ★★ Facilities are hugely inadequate: more than half of Sierra Leone's public hospitals lack running water, and drugs and supplies are often out of stock. — 00:01:15 · Sierra Leone
  • ★★ With catastrophic consequences: 9% of kids born in Sierra Leone die before they are five. — 00:01:22 · Sierra Leone, child mortality
  • ★★★ John is totally unconvinced that these problems are not our problems or that Sierra Leone's health system should be fixed entirely within Sierra Leone. — 00:01:29 · Sierra Leone
  • ★★ That view ignores complexity and history: slavery and colonialism, and more recently misguided global loan rules that forced Sierra Leone for decades to spend under $5 per person yearly on health care. (hedged) — 00:01:39 · Sierra Leone
  • ★★ Humans are deeply interconnected as a species: when drug shortages interrupt tuberculosis treatment, the multi-drug resistant TB that spreads is not only Sierra Leone's problem. — 00:01:53 · tuberculosis, Sierra Leone

  • ★★★ As Ophelia Dahl put it, Ebola was 'acute on chronic', the term for a sudden crisis like pneumonia on top of a chronic condition like smoker's lung. — 00:02:08

    “Ebola was acute on chronic.”

  • ★★★ As long as the world fails to meet basic health-care needs, we will keep experiencing acute-on-chronic emergencies. — 00:02:16 · global health

  • ★★ In Sierra Leone in 2014 twice as many people died of tuberculosis as of Ebola, and almost all those TB deaths were preventable. — 00:02:22 · Sierra Leone, tuberculosis
  • ★★★ Training and paying more health workers, improving facilities and restocking drugs require long-term investment, changes charted over years and decades, not days and weeks. — 00:02:30
  • ★★ Change is visible: life expectancy in Sierra Leone is low but rising, and its woefully underfunded health system is better than decades ago. — 00:02:44 · Sierra Leone

  • ★★★ John does not say stop responding to emergencies: it is a both-and proposition, respond to emergencies and focus more attention and resources on long-term problems. — 00:02:53

    “this is not an either/or proposition, it's a both/and proposition.”

00:03:12 — The linked article, Nerdfighteria's donations to Partners In Health, hospitals closed since the money dried up; sign-off

  • ★★ John links the fascinating article about Ophelia Dahl and Partners In Health below. — 00:03:12 · Partners In Health
  • ★★ Nerdfighteria has donated more than a million dollars to Partners In Health over several years; John finds it helpful to see how far the money has gone and how far is left. (hedged) — 00:03:16 · Nerdfighteria, Partners In Health
  • ★★ John finds it infuriating to think of the hospitals that closed since the Ebola money dried up and the lives that ended as a result. — 00:03:26
  • ★★ John hopes these outrages, and all outrages, spark empathy and commitment instead of fear and resignation. (hedged) — 00:03:33 · empathy

Threads in this video

Where the stories that moved here went next

Mentioned

Central: acute on chronic · Article about Partners In Health (linked) · Ophelia Dahl · Sierra Leone · Western African Ebola virus epidemic

Also: Organizations: Partners In Health

Concepts: child mortality · colonialism · Development aid · empathy · global health · life expectancy · pneumonia · slavery · tuberculosis

Places: Guinea · Indiana · Liberia

Only in the description or credits: The New Yorker · World Health Organization

Also centred on Western African Ebola virus epidemic: EBOLA! (...meningitis) · Ebola: What IS Terrifying

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