Foreign Policy Blogs

Global Health Update: World Water Week, Misoprostol, and Overtreatment


Clean Drinking Water: The Cure for Malnutrition?

This week is World Water Week — which is timely, given the serious cholera outbreak in Sierra Leone and neighboring countries. The focus of this year’s conference is on food security, water scarcity, and their ties to food (and water) waste. As I’ve written before, up to 40 percent of food is wasted from farm to fork across the globe. The overview of the conference discusses the implications of water and food insecurity. It makes an interesting point about access to clean water:

The food production in the world is more than enough to feed all its inhabitants properly. Yet, a billion are undernourished, around two billion are overeating, and staggering amounts of food are lost or wasted. In addition, food alone will not eradicate hunger as up to 50% of malnutrition is related to unclean water, inadequate sanitation, or poor hygiene.

This is a small yet crucial point: Although we must focus on decreasing food waste and maximizing our agricultural outputs (while maintaining a good ecological balance), without clean water, sanitation infrastructure, and health education about basic hygiene, we won’t be able to turn the tide on malnutrition. Diarrhea and other illnesses related to drinking unclean water or contaminated food rob people, mostly children, of nutrients, stunt growth and development, and weaken immune systems. Furthermore, cholera, malaria and other illnesses are much more dangerous for malnourished children. It’s a vicious cycle, and one that we won’t break without a holistic approach to water, food, and development.

Misoprostol: A Way to Save Mothers or “Snake Oil”?

Sarah Boseley of The Guardian’s Global Health Blog illuminates the debate around misoprostol, a drug used in developed countries for gastric ulcers and off-label in the developing world to prevent bleeding during or after childbirth, a major killer of women in the Global South. Boseley presents recent arguments from two health experts, one of whom calls misoprostol “snake oil” in the journal for the Royal Society of Medicine. This researcher, Professor Allyson Pollock, decries the inequity of different treatments for developed and developing countries, presenting findings that majority of studies on misoprostol are inadequate. In response, Professor Malcolm Potts called on Pollock and her co-authors to “crawl on their knees and beg forgiveness” for their “naive” study.

Boseley points out that 45 million women give birth without a trained birth attendant every year and that the preferred drug for prevention of postpartum hemorrhage requires refrigeration and must be injected–while a woman could take a tablet of misoprostol at home. This debate brings up interesting points about appropriate technology and whether medical care can be, to use a rather loaded term, “separate but equal” between the developed and developing worlds.

 U.S. Healthcare: The Curse of Over-Treatment

Americans are known to overeat, but it turns out that we are also over-treated. A blog in the New York Times examines the rise of over-treatment in the U.S. health system, which might rack up US$210 billion a year in unnecessary on top of physical and emotional suffering and complications — including fatal ones. Tara Parker-Pope shares anecdotes of patients who defer to the expertise of overzealous or distracted doctors or who get caught up in the rats’ nest of specialists who do not communicate with one another. Of course, doctors also get paid by the test, another issue in the beleaguered U.S. system.

One simple fix would be the widespread use of electronic medical records, though we have a long way to go on that front. Bloomberg Businessweek published a great article in June discussing the issue–including the Obama administration’s efforts to get the U.S. health care system to go paperless.


Header photo by Carnie Lewis, via Flickr, CC BY 2.0.



Julia Robinson
Julia Robinson

Julia Robinson has worked in South Africa at an NGO that helps to prevent mother-to-child transmission of HIV and in Sierra Leone for an organization that provides surgeries, medical care, and support to women suffering from obstetric fistula. She is interested in human rights, global health, social justice, and innovative, unconventional solutions to global issues. Julia lives in San Francisco, where she works for a sustainability and corporate social responsibility non-profit. She has a BA in African History from Columbia University.

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