Tuesday, November 10, 2009

Poverty isn't Contagious (and why we should support a genetically modified government)

We all know most governments feel compelled to take action when the public feels threatened.  That's why the US invaded Afghanistan and Iraq after the September 11 attacks.  Maybe we can be grateful that India's responses tend to be less drastic, though we've rattled our share of sabers and set up our share of questionable encounters over the years.

But what if the threat were not a terrorist attack, but a disease?

Last week, the Times of India reported that 100 people in Pune have now died from H1N1; this week, we learned that the all-India death toll has reached 500.  H1N1 is scary stuff, of course, which is why we see signs of it everywhere: face masks, stories in the media, notices from the schools our children attend, etc.   Not surprisingly, government officials at all levels have felt the need to do something.  This is why, over the past few months, schools, colleges, and even shopping malls have been ordered to close at times, even if this strategy has questionable benefits.  

But imagine we were faced with a much, much bigger threat.  Imagine more than 50 Indians began dying, not every day, but every hour, from a sickness which was largely preventable.   Imagine most of those dying were children.  What would we do then?  Cancel school?  Shut down the airports? Call for the resignation of high-level government officials?

In fact, as many of you may have guessed, more than 50 people are dying each hour in India--from diarrhea--and we hear precious little about it. The exact hourly rate, 52, adds up to 1250 deaths a day and more than four lakh deaths per year, 386,000 of which are children.  

Of course, diarrhea is not just an Indian problem; it kills 1.5 million children world wide. It even kills some people in rich countries -- but not very many.  This is because over the last century, the introduction of clean drinking water and improved sanitation and nutrition has drastically reduced this problem in the developed world.  Among developing countries, there has been progress, but these efforts have largely stagnated since 2000. India, for it's part, is doing better than Afghanistan but much, much worse than China. The story and numbers, by the way, is very similar when it comes to TB,  which is also mostly treatable, given proper medical care.

How can we sleep at night with this constant carnage going on? When I started writing this post, I did some research on why it is that people tend to worry about some things that happen very rarely--like plane crashes, terrorist attacks, or deaths from H1N1--while we ignore other things that happen much more frequently--like deaths from TB or diarrhea.  I learned that there are several major theories of risk perception and that no one theory perfectly explains the irrational ways in which people perceive risks

Except you and I know that there is nothing at all irrational about the way the media, the government, and most of middle and upper middle class India ignores TB and diarrhea, while we go on wringing (and hopefully washing) our hands over H1N1. This behavior is perfectly rational, because diarrhea is not, for the most part, killing residents of posh colonies in South Delhi or South Mumbai--it's not even killing middle class urban Indians, most of whom have access to clean water, decent health care, and adequate sanitation and nutrition.  It's killing poor people, and people who live far from doctors.   And, as most of us know, poverty is not contagious!

So until diarrhea and TB mutate into sicknesses that threaten the people who matter most in this country, progress in the fight against them will be slow.  Unless, of course, the government itself mutates--into one that puts common people at the forefront of more than just slogans. That's the kind of genetic engineering even a good green could get behind!


  1. Very true and as you say, it's a question of risk perception. It may be worthwhile to look at the role of the media here which created a hue and cry over H1N1. If it did the same over diarrhea, I have no doubt that more will happen.

    However, this is probably the point at which we need to put things in perspective. We're so caught up in calling India, China etc the "developing world" that we're losing our perspective. If we look at historical values of stats like infant mortality, per capita income etc. we find that India for example is in the same state that a country like the US was in just a few decades ago.

    One of my favorite lecturers is the Swedish speaker Hans Rosling who gave an awesome, humerous and inspiring talk on ted.com where he takes a look at how poverty levels are dropping the world over and how we need to put things in perspective.

    It really gives us hope - and we badly need that in a pessimistic world where all we (including myself of course) see is the hopeless apathy of the powers that be.

  2. @Thanks Bhagwad, I look forward to looking at your link. But I confess, I am wary of falling poverty rates. This weekend I was re-reading a chapter in "Everybody Loves a Good Drought" by P. Sainath. He explains how the government in the early 90's showed a huge drop in poverty in a several month period, just by changing the way poverty is calculated! (His chapter on the Plague of 94 makes essentially the argument I make here, but I swear I'd already drafted most of this!

    I'll try something lighter soon, I promise :)

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