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Forgotten People, Forgotten Diseases Rating: 9 on a scale of 10 Review This book is about what he calls NTD's, Neglected Tropical Diseases. It's been 35 years since I took parasitology in college and about 30 years since we covered it in medical school. My professor in college, Dr. McCorkle, always said that if you took away everything else in the world and just left behind the parasites and worms you would be able to see a faint design or outline of everything that is living, that's how many worms and parasites there were in the world. The image is a bit bizarre and macabre but probably correct. This book is about the diseases we tend to not want to think about much, they are forgotten. And, the people with them are largely unknown to most of us. In aggregate, these diseases are bigger than AIDS. Let's consider this thought for a moment. How is it that we might "forget" about something. Psychologically, one of the ways we forget things is when they are to difficult to hold in consciousness easily. When things are difficult to hold in consciousness we can repress them away into unconsciousness or cast them into the realm of the shadow side of our existence. The unconscious realm of things is in the dark figuratively speaking. I believe most of us are squeamish about dealing with various worms, parasites, and other little creatures who can take up residence inside of our own bodies. We seem to have been very fortunate in our country to have worked very hard to minimize our co-existence with various little critters that effect so much of the rest of the world. In this book, Peter Hortez tells us there are 2.7 billion people living in poverty, defined as making less than $1 dollar a day. There are at least 1 billion of these folks significantly to severely effected by these neglected tropical diseases. The book is about these diseases. He goes through discussions of soil transmitted helminth infections (Ascariasis worms of the gut, Trichuriasis worms, and Hookworm infections), Schistosomiasis (Snail fever), Lymphatic Filariasis (Elephantiasis), Dracunculiasis (Guinea worm), Onchocerciasis (River Blindness), Trachoma induced blindness, Buruli ulcer, Leprosy, Human African Trypanosomiasis, Chaga's disease, Leishmaniasis, Leptospirosis, Dengue fever, and Rabies. For most of us, the only familiar diseases on the list are rabies and leprosy. We know about rabies because we have our animals immunized against it. We know about leprosy because it was some sort of Biblical scourge. All of these diseases have fascinating histories in regard to how they have effected human beings over the centuries. Most of these diseases are ancient and have effected tribes, peoples, armies, and plans for millennia. In each chapter he gives us brief fascinating discussions of how each disease has effected human kind in history. These are diseases familiar to our ancestors. He describes each disease in general detail, but not to the level of a medical school or tropical medicine textbook. This makes it possible for anyone to read this book and appreciate what it has to say. Of course, I say this with an extensive medical background, so for the average person it might take a little work to become familiar with some new terms. You might think of this as your down payment on the price needed to "pay" to bring these critters up out of the "shadows". He gives a general description of how these diseases have been treated over time, how they are being treated today and what might be coming in the next few years. One of the key points for many of these diseases is that they are inexpensive to treat. Why then are we still bothered by them? The answer is complex, but relates to the reality that these diseases are closely linked to poverty and poorly functioning civil/government systems. We live in a country with superb infrastructure and government generally speaking. Other areas of the world have not been so fortunate as we have been. When you come at these problems from the perspective of Western culture, the problems seem solvable. As you read about the many facets of the problems they seem less and less solvable. Never the less, relieving a billion plus people of suffering would be a great accomplishment. Although these diseases are described as neglected and forgotten there does seem to be a fair amount of activity being put forth on many of them. Still, the issues around governments, accessibility, superstitions, poor civil and health care infrastructure, developing science, pesticide use, non-governmental organizations, the United Nations, the World Health Organization, etc, seems a bit overwhelming after a while. Freeing a billion people to no longer suffer fatigue, blindness, anemia, disfigurement, inability to work, loss of limbs, loss of life, etc, would be great, but as he points out it is complex and difficult to accomplish. This was a marvelous book in my opinion. I recommend it to anyone who is interested in the problems of the underdeveloped world. Though we feel fortunate and snug in our country, we are only a disaster away from things falling apart and disease taking hold and devastating us. The recent earthquakes in Indonesia, China, and now Haiti point out the risks to the world. Watching the television and seeing a small girl in full blown tetany in Haiti reminded me of the incredible benefits of immunizations, good building standards, and the need to help everyone out of poverty as much as we can. No one has said a word about the many diseases common to Haiti during the disaster, but I would expect they may see a resurgence of the neglected tropical diseases as this disaster progresses unless we are able help them out with excellent public health and primary care. The cure for poverty seems even more remote than for these diseases, yet the two are intricately intertwined, and it will take concerted effort and relationship building to rid the world of these scourges. All opinions are mine and only mine, Curtis Climer, MD Copyright 2010 |
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