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Go down the street to the national humerus fracture program

December 12, 2012

“I’m sorry, we’re the national TB program, go down the street to the national humerus fracture program.” – Paul Farmer.

As well as being a rather humourous quote (sorry), it also drives home a message that Farmer has been making for a very long time, and one he restates in this speech to HSPH. Diseases cannot be viewed or treated in isolation.

I work in a disease silo, where we have specific outputs that focus on a single malady and its symptoms. There is no doubt that we are having success – we know this because the number of malaria cases here is in steady decline. This in itself is a very good thing, and the spillover effects will be felt elsewhere. Other programs in our organisation address other specific and urgent health needs. Similarly, the health systems that needed to be built are steadily being put together, if somewhat slowly and at the cost of increased ill-health in unaddressed areas; NCDs are approaching us with speed. Nevertheless, the points made make me wonder how we could do things differently, and whether addressing things that communities ask for would give us a better set of outcomes.

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