Maria's Response to "Not Enough Money"--December 21, 2006
Author-
Maria King Carroll
December 21, 2006
Here’s some information from an article in the September 2003 issue of Pediatrics entitled: “Inequity in Child Health as a Global Issue”.
“Half of the world’s population, 3 billion people, lives on less than US $1.30 per day. The world’s 225 richest people have a combined wealth equivalent to the annual income of the poorest 2.5 billion people, nearly half of the world’s population.”
Included is a table that lists The World’s Priorities (Annual Expenditures). We spend $6 billion per year for basic education for all but spend $8 billion per year for cosmetics in the US. We spend $9 billion per year for water and sanitation for all but spend $11 billion per year for ice cream in Europe and $12 billion for perfumes in Europe and the US. We spend $13 billion per year for basic health and nutrition for all but spend $17 billion for pet foods in Europe and the US.
So the resources are there.
I think some of the challenges are getting people: to acknowledge and care about the problem of poverty; realize that the resources do exist, and (the hardest part), to make personal sacrifices to alleviate the poverty.
Each individual’s resources are limited. I think people who want to make contributions make decisions based on their experiences and knowledge. I don’t think there are right or wrong answers here. Some considerations people take into account are: severity of suffering, how well their money will be used, and the proximity of the cause.
I will make a case for Haitian Hearts, but I don’t want to do this by denigrating other causes.
First of all, why Haiti? Haiti is the poorest country in the western hemisphere, 600 miles from Florida. If you read the history, an arguable conclusion is that the United States contributed to this distinction, from not recognizing Haiti when it was founded to “escorting” President Aristide out of the country a couple of years ago with a lot of not-so-nice stuff in between. So severity of the poverty, proximity to the U.S., and past crimes by the U.S. are three reasons that I think Haiti is a worthy place for you to focus your charity dollars.
Why children with heart problems? John has been going to Haiti for more than 25 years. Haitian Hearts grew out of his general medical work there. He kept coming across children who either had congenital heart problems or rheumatic heart disease. In 1995, he brought his first patient to Peoria. Many medical centers around the country, including OSF, have international programs, so the infrastructure, so to speak, exists to help these children. BTW, when HH was based at OSF it wasn’t entirely a charity endeavor. HH volunteers raised more than $1 million, which went directly to the Children’s Hospital of Illinois to offset medical costs.
The biggest reason to contribute to HH is to save the life of the child. I have to speak more from the heart now, but hopefully we make decisions with our brains and our hearts. There is something so cool about seeing a child who couldn’t walk or play, who was gasping for breath get up after recovering from surgery and get to be a kid and get to have a future. There is something so cool about bringing hi-tech, cardiac surgery to a poor Haitian child. I was privileged to witness one of these open-heart surgeries and it is an absolute miracle that doctors can cut open a person’s chest, hook them up to a bypass machine, stop the heart, fix the problem, and restart the heart. It is practically routine now in the U.S., but I tell you, it’s a miracle. I think it’s reasonable to suggest that U.S. medical centers share some of this technology and expertise with children from Third World countries.
“Why should I help Haitians whom I don’t know?” This is where John and I and others involved in HH have an advantage: we do know these Haitians and their families. And this also is one of the benefits of the program. HH introduces these children to communities around the country. When these children are here, they personalize the developing world and all of its problems; it’s not some abstraction anymore. I believe that hosting and getting to know these children has been a life-changing experience for people. Many of our HH host families continue to have relationships with these children and their families and also are involved in Haiti in other ways. There’s no denying that if you have an emotional attachment to a person, you’re more likely to want to help them. We help our own children first, then our neighbor’s children, etc. Bill Gates has said that if the children from the developing world lived next door to us, we would not allow them to suffer the way they do. Well, for a few months, these children do live next door to Americans.
As far as John’s credibility, I can tell you (and other people who know him can vouch for it), he lives a very frugal life, by any American standards, much less by the standards most doctors live. This doesn’t seem to be a big sacrifice for him, and it has allowed him to dedicate thousands and thousands of his own dollars to HH. He has paid for many of the children’s plane tickets and also even a couple of surgeries. It has also allowed him to spend months each year working in Haiti. John takes no salary from HH. So, the founder of the program is fiscally conservative and is very concerned with how HH funds are spent.
There is mercy work and there is justice work. Mercy work responds to an immediate need, while justice work corrects the situation that leads to the problem. Digging wells to provide clean water so that children don’t get typhoid and other diseases is justice work. Providing them with heart surgery is mercy work. Both kinds of work are important. Correct me if I’m wrong, but it seems like there is an implication that it’s somehow wrong or irresponsible for a child in Haiti to have heart surgery when so many other children suffer from more easily treatable diseases. But perhaps it’s wrong or irresponsible for a person to buy a $30,000 vehicle when a $15,000 one will do just as well. The extra $15,000 could then be spent on either wells or heart surgery. I am probably not making this argument very eloquently, so I would recommend the book “Mountains Beyond Mountains”, by Tracy Kidder, a biography of Dr. Paul Farmer, a physician who works in Haiti, Rwanda, Peru, and the prisons of Russia. He is someone who has changed reality by helping to drive down the price of HIV-AIDS meds. Towards the end of the book, some of his associates fly a Haitian child who is sick with cancer to Boston for treatment. Dr. Farmer has interesting things to say about this case that apply to Haitian Hearts.
Coincidentally, as I type these words on the evening of 12/21/2006, Maxime Petion, a Haitian Hearts patient, is flying to Cleveland where he will be assessed for surgery. We are grateful to Cleveland Clinic for accepting Maxime.
-----
My comments in 2021--
Less than 10% of the world’s health research budget is spent on combating conditions that account for 90% of the global burden of disease like malaria, tuberculosis, and AIDS which scourge Haiti too. The resources to treat exist. We don't use them equitably.
I just can’t make the leap in logic that just because a Haitian child has a hole in their heart, they are “too expensive to treat”. When is a person “too expensive to treat”? When is a child anywhere “too expensive to treat”?
Money and morals are the issues in Peoria and folks are uncomfortable that the two are related and colliding. People don’t want to lose their jobs or their friends and colleagues by questioning policy in Peoria. They don’t want their kids losing scholarships. Taking on big embedded local systems is fraught with danger. Criticizing Colin Powell and the war in Iraq is much safer than criticizing your local hospital.
John A. Carroll, MD
www.haitianhearts.org