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| 11/12/2003 | Email this article • Print this article
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| Kathryn B. Brown, FNP |
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Health NW: Health and disease in Bangladesh
Kathryn B. Brown, FNP
Health Care Writer
I’ve just returned from a two-week trip to Bangladesh, a small Asian country surrounded by easternmost India. This wasn’t a vacation; Bangladesh is not a place where tourists flock. I went there on a brief assignment for the Peace Corps, filling in for the medical officer who is responsible for the health of U.S. Peace Corps volunteers.
Traveling to poorer, developing countries always helps me put my beliefs about health, health care and life in general in perspective. For the 20 percent of the world’s population who live in economically developed counties (such as the United States, Canada, Japan, Australia and most of Europe), staying alive and well is relatively easy. Our life spans are long and our risk of infectious disease is low.
I jumped at the chance to go to Bangladesh, and was interested to compare a developing country in Asia with Togo, a small country in West Africa where I worked for two years. Although most of the diseases the people of Bangladesh face are quite similar to those found in sub-Saharan Africa, they face different health challenges.
In southern Asia, overpopulation and water sanitation problems are foremost. In sub-Saharan Africa, the AIDS epidemic is the No. 1 concern.
To understand how densely populated Bangladesh is, imagine how crowded it would be if half of all Americans squeezed into an area the size of Iowa. Bangladesh’s population is now 140 million; this is predicted to double by 2050.
To understand the climate of Bangladesh, image the hottest, most humid summer you’ve ever experienced, and add heavy rains and flooding during half the year.
To understand the challenges of staying healthy in Bangladesh, imagine living in a flood zone, surrounded by water polluted by pesticides and sewage. Many wells are contaminated by naturally occurring arsenic. Diseases such as hepatitis, typhoid, cholera, dysentery and tuberculosis are common. Mosquitoes carry malaria, dengue and Japanese encephalitis. In the cities, air pollution burns your eyes and lungs.
The average income of a Bangladeshi is $364 per person per year – compare this to the per capita gross national income in the United States at $35,858 and in Mexico at $5,319.
There is some wealth in Dhaka, the capital. I went shopping and was awed by the consumer goods available: cell phones and electronic equipment, jewelry, brilliantly colored silk, leather goods, bootlegged compact discs and DVDs.
The 75 percent of Bangladeshis who live in rural areas would never be able to afford these luxuries. Malnutrition is common. Children tend to drop out of school to work; the literacy rate is only 56 percent. Infectious diseases are a part of life.
Peace Corps volunteers in Bangladesh are exposed to the same diseases as Bangladeshis, but most complete their two-year commitment without major health problems. Unlike the average Bangladeshi, they have plenty of money for food and bottled water, and know how to reduce their chances of diarrheal diseases. They are educated to avoid mosquito-borne diseases and are given medicine to prevent malaria.
We tend to think of diseases such as typhoid, cholera, tuberculosis, malaria and yellow fever as tropical diseases, but they all once existed in the United States. We were able to eliminate most infectious diseases by improving nutrition and sanitation, providing access to health care and immunizations, and educating Americans about public health issues.
It is easy to avoid thinking about the 80 percent of the world’s population who live in developing nations. We as a nation need to make a stronger commitment to help poor nations reduce poverty, eliminate diseases and reduce the suffering of their citizens. Public health efforts are cheaper than weapons systems, and they spread goodwill and make the world a safer place for everyone.
Kathryn B. Brown is a family nurse practitioner with a master’s degree in nursing from OHSU. Is there a health topic you would like to read about? Send your idea to kbbrown@eastoregonian.com.
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