During the past summer, I had the honor to attend the Harvard University Pre-College Program. As someone who aspires to be involved in the medical field, I decided to sign up for a public health class. We were assigned the biography, Mountains Beyond Mountains: The Quest of Dr. Paul Farmer, A Man Who Would Cure the World by Tracy Kidder, to read throughout the course. Reading this biography became one of the most enlightening events in my life and it has completely changed my views on medical practices around the world. It also became my inspiration to research more about the extraordinary Dr. Farmer and global health. I’ve always taken the medical care available to me for granted. Not only do I have access to some of the best hospitals and doctors in the world, my family can also afford to pay for them. However, this wonderfully written book has made me realize that my privilege is a true and unfortunately, unattainable luxury for the citizens of many countries.

As Dr. Farmer repeatedly emphasizes, an efficient healthcare system has the following four things: staff, stuff, space, and systems. The 4 S’s. Countries need competent doctors, a stable supply of medicine and equipment, hospitals, and a well-established, government-run healthcare system. Through my research, I was surprised to learn that even America was lacking in the 4 S’s. Medical advancement has created miracles for many types of disease. However, the majority of the people that they are intended for cannot afford these life-saving treatments. For example, in Haiti, Dr. Farmer “spent between $150 and $200 to cure an uncomplicated [tuberculosis] case. The same cure in the United States, where most TB patients [are] hospitalized, usually cost between $15,000 and $20,000” (Kidder 22). It is shocking that the same cure administered by Farmer and his staff costs 100 times more in the United States!

This statistic highlights the fact that the medical industry has become incredibly commercialized and has victimized patients. In a highly developed country like the United States, a large part of the population’s health care still gets affected by their financial status. Just like how Haitians can’t afford to pay for the medical services available to them, many people in America will go into severe debt in order to pay tens or hundreds of thousands of dollars for treatment. The example, a normal case of tuberculosis, isn’t particularly hard to treat. If Farmer can do it in a country like Haiti, American hospitals should have no difficulties. Therefore, the problem is not the treatment; the problem is the American healthcare system exploiting the population, preventing access to basic services.

One may be surprised to know the extent prejudice can influence healthcare. There are two main type of prejudices that affects not only the United States, but more specifically third world countries: gender and financial status. Many women lack the same level of medical care as their male counterparts in already disease-stricken countries. The most notable example is prostitution: it is a reality for women who have been left with no other choice or have been sold by human traffickers. However, prostitution is illegal in many countries and the demeaning judgment by society is of no help either. It is unrealistic to hope that men would someday stop seeking for sexual services. Therefore, legal protection and dissolvement of sexist traditions can not only give women equal access to healthcare, but will also encourage them to seek for medical attention.

Discrimination against the poor is even more prominent. The attitude of the world during the 2014 West Africa Ebola outbreak clearly demonstrates the prejudice. Sure, there were donations that provided desperately needed relief but if one was to browse the internet then, it was unbelievable how many people expressed that the victims deserved it. Not wearing proper protective equipment? Blame the careless poor people. Burying the dead with skin-to-skin contact because of what tradition commands even though the Ebola virus can be transferred after death? Blame the superstitious poor people. Not being able to read the warning pamphlets? Blame the stupid poor people. However, many forget that the poor have no control over their situations. They did not choose to be born and live in a place of poverty and grow up with no education. Desperate times, as seen repeatedly throughout history, often lead to beliefs in supernatural beings and God. People want to believe that something out there is acknowledging their suffering and can help them. But yes, blame the poor people without even trying to understand them. Helping the poor offers no monetary benefit and they are seen as less than humans, undeserving of being given priority. If the epidemic happened in a first world country, it can almost be guaranteed that the response would have been quicker and more effort would have been put in to discover and approve the distribution of a cure.

Finally, although it is great that humanitarianism is heavily promoted nowadays, it has taken the wrong direction. It has become a “trend”, therefore it is being treated as such; media is constantly exploiting appalling situations for coverage and the world is fixated on only the surface problems. Band-aid solutions are being applied to epidemics that need surgery because it is cheaper and has become the norm. People, especially donors and health organizations, love selective primary health care. It concentrates on treating specific problems instead of healthcare as a whole. The fact that it offers “clear targets, measurable outcomes, and a high return on health investments” is incredibly appealing (Keshavjee & Farmer, 2012). Who wouldn’t want their money to be used as efficiently as possible? However, is it effective though?

With all the focus on efficiency, people have forgotten about efficacy. A perfect example is the tuberculosis epidemic in Peru today. The World Health Organization convinced Peru to adopt a selective health care agenda for the tuberculosis crisis but the results were disastrous (although the Peruvian government and WHO are still reluctant to admit). Because diagnosis was not made using tests that can identify different strains of tuberculosis (as they are more expensive), a set of first-line drugs were used for everyone that were identified with tuberculosis. The problem was that many Peruvians already received treatment with different first-line drugs in the past. After a lack of funding to the government’s medical programs, many of these treatments were stopped without the tuberculosis being treated completely. Overtime, many citizens developed resistance towards the first-line drug they were given initially. The result after the WHO program was implemented recently? Multidrug resistant tuberculosis that is many times more difficult to treat and more expensive. So in the end, was selective primary health care actually cost-effective?

In conclusion, there are many gaping holes in global health today. Healthcare systems are not keeping up with medical advancements, therefore the latter is not put to use as effectively and efficiently as it can be. In order to improve response to future crises in the United States and other countries, there needs to be change at the government level and also in people’s mentalities.