Today I mark the start of my eleventh summer in Angola. In 2004 I received a kind invitation from Steve Foster and the fledgling Lubango Evangelical Medical Center (CEML) to join them in development of this unique primary care and surgical training center. Right off today I received a stark reminder of the interdependent relationship between disease/health, personal income, and education/literacy. Julia, the eighteen month old is this permitted photo, has neither grown nor physically developed as she should. The reason? Well, the medical side of me points to her clinically obvious congenital heart defect: a “simple” ventricular septal defect.
But why by age eighteen months has this defect not been surgically repaired? Namibia, the nation to the south, has the full capability. As I spoke with Julia’s parents the reasons became more clear, and here is where the above mentioned interdependency comes into play. The child and parents visited the pediatric chest surgeon in Namibia. But the parents have no money to pay for the procedure. At their low education level, they each earn the national minimum allowable salary of $90 each week. Literacy and communication also play a critical role. Several times this mother exclaimed how she could not understand what the Namibian healthcare personnel were saying in English.
So indeed Julia needs chest surgery, and we at CEML will do our best on her behalf. But provision of medical/surgical care is only a component of the necessary resources. Comprehensive health development also means comprehensive community development, with attention to education, literacy, jobs and income. They are all interconnected.