Sustainable Good

The Dying Need Our Support, Not Partisan Backbiting

It is unfortunate that Sarah Palin’s irresponsible dismissal of end-of-life counseling as ‘death panels’ has created more sound than light on how to deal with terminal illness. She has taken advantage of people’s fear of death while preventing substantive discussion on how to make the dying process more comfortable, less painful and less full of fear.

My wife Emily’s grandmother, Betty Jean Seal, died last week, in her own bed, surrounded by family who prayed and sang for her in her final hours. It was as she wished. Having received helpful advice and support from a variety of sources, Betty Jean was able to decide the surroundings in which she would die. She wanted to be close to family, friends and community, rather than isolated on a hospital ward. She wanted to be in the house that she had lovingly dusted, swept and vacuumed for decades.

Health Care--What you don't hear

We have been hearing about health care all over the place recently: from screaming town hall meetings to vigils to facebook. I was reminded of something--strike that--someone, that has been left out of the debate: the global poor. I certainly agree that we need health care reform in the US so that more people are covered with better coverage.

As a matter of fact, for the last few days my facebook status has been: " Stephen Donahoe thinks that no one should die because they can not afford health care, and no one should go broke because they get sick. If you agree please post this as your status for the rest of the day....let's get up to speed with the rest of the civilized world and take care of each other!"

Then a friend brought to my attention that the global poor are left out of this conversation.

Diarrhoea: An Unpopular but Important Cause

Diarrhoea kills some 1.7 million children every year -- that over three times the population of Kansas City wiped out annually by a preventable disease.  And yet, given the 'gross-out factor' it is highly unlikely that this disease will ever get the kind of celebrity endorsements that have helped raise awareness of breast cancer and AIDS.  Likewise, few development professionals want to become known as a 'diarrhoea expert.'  There is no glamor, it seems, in excrement.

Sometimes I feel too powerless to make a difference.

I remember sitting in the library a couple years ago and finding out that a friend of mine from Malawi had passed away from a bad case of malaria.   I could do nothing but weep for Kathy and her family and think about how unfair the world is -- where people die of preventable disease for no good reason at all.  I also remember the time when my husband was working in a Malawian hospital and saw a woman undergo an emergency c-section.  There was no clean gauze available so the people attending to her were left no choice but to use guaze that had been collecting dust on a shelf.  The woman later died a painful death due to the infection in her wound.  It was another senseless death.   I remember feeling overwhelmed by grief and hopelessness.  The solutions seem so simple.  Yet, I knew of nothing I could do to make a real impact for the hundreds of thousands of people dying every day.  I wasn't a politician or a millionare -- and I didn't know anyone who had influence.  At the same time, as a white, middle class, American I knew that I inherently carried much more power than many of the friends I made in southeastern Africa. But that power only felt superficial to me.

Reflections on Water

I am visiting my brother and sister-in-law (Matthew Bolton and Emily Welty) in Kampala, Uganda. Although I have traveled to several countries before, this is my first visit to a developing nation. My visit is full of new experiences even for things as simple and essential as water.

Every morning I make a short trip from the basement apartment to the filtered water supply in the main house above. It requires a little practice and training to transfer the water from the supply bottle which can weigh up to 55 pounds to our five liter bottle (1.3 US gallons) without spilling.  Moreover, though we have running water for washing, our building has poor plumbing and electrical work. Pipes leak and visits to the sink or shower are frequently accompanied with a buzzing sensation or electrical shock.

Corruption, Poverty, Disease: It's all connected

  News keeps coming in of the hundreds of people (and counting) dying in Zimbabwe due to the cholera outbreak.  There is no real way to know the total of deaths because record keeping is difficult or non-existant.  Raw sewage leaks throughout the streets and runs into the river, infecting it with cholera.  Close by, vendors are selling vegetables and fruits because there is no other option.  Thousands of people are becoming sick but many of the hospitals are closing because there is no funding, leaving extremely ill people with nowhere to go.  There are no medicines to give them anyway, nor anyone to hand them out.  Nurses and doctors are on strike because they are not getting paid.  The deaths due to cholera are expected to rise due to the expected rainy season in Feburary.

World AIDS Day...today!

Today, December 1st, marks the 20th anniversary World AIDS Day. People all over the world have been coming together on Dec. 1st to commit to end the AIDS epidemic. Check out some of the ways that governments around the world marked the day this year. Also be sure and go to the World AIDS Campaign website where you can pledge to increase your committment to ending AIDS. I recommend figuring out what you would feel comfortable doing and then going the next step further. We all have to work harder in order to end this disease.

Some of the countries where Outreach International works are facing terrible AIDS crises. One of those is Zambia, where almost one out of six people is HIV positive! Read how one community is working together to overcome the struggles of AIDS.

-Stephen Donahoe

HIV and Poverty

As a new hospice physician in the Washington D.C. area, I’ve begun having more exposure to patients with endstage AIDS. The other night I attended a lecture that made my mouth drop. The topic was HIV and the impact it had on citizens of D.C. The lecturing began with a sobering statistic: Five percent of adults (that’s 1 in 20 adults) in D.C. have HIV and 1 in 50 have AIDS. This is more than double the national average.

Why is the prevalence so high? The answer is complicated, but poverty plays a major role. I’m learning US Congress makes many of DC’s decisions since the city does not belong to a state. Thus the school system is in shambles, the social programs are under-funded and under-prioritized, and sexual education and the prevention of HIV is victim to political wrangling.