Thanks David 

A Rat's Ass

In the Oct. 24 “The New Yorker” is an article by Michael Specter: “What Money Can Buy: Millions of Africans die needlessly of disease each year. Can Bill Gates change that?”

Bill Gates is one we all seem to love to hate. That's mostly because of the behemoth Microsoft is and hardly about his charitable work, although many are convinced much of his charitable work is also good business. Bono on the other hand is widely loathed because of his charitable work, especially by the more left-leaning punditry.

I'm a poor fool and know it so don't think criticism will hurt me much. Still, I tend to go against the tide of opinion against Gates and Bono and admire their work.

Stephen Magesa, an entomologist with Tanzania's National Institute for Medical research commented about Gates:

“Every year, a million more kids die. A decade ago, they were saying, 'Let people die; there's nothing we can do. Then Gates came along and said this is not acceptable. That was more important than his money. He put malaria back on the world's stage.”

With an endowment of more than 28 billion dollars The Bill and Melinda Gates Foundation is putting considerable resources in play, so Magesa's observation of what's most important about Gates stuck out.

Kent Campbell, a former chief of the malaria branch at the Centers for Disease Control brings the issue into greater relief:

“I don't think most Americans give a rat's ass about the death of millions of African kids each year. I don't think they ever have.”

Well, that's one reason for admiring Gates: he cares about global health. The article points out that when Melinda first suggested that they concentrate on global health:

“Gates didn't get it: he was interested in population control and thought that improving the world's health might even run counter to that goal. (“It was only when I dug into it a bit that I came to understand that better health leads to lower populations with more resources,” he said)”

Both the “rat's ass” comment and the conclusion that Gates reached when looking into the matter that better health will help not hinder global population growth were subjects swirling around in my nearly incoherent post “Turtles All the Way Down” Specter's article provides some good reasons for not imagining world-wide deaths to preventable disease as a good thing.

When I was a boy visiting my grandmother out in the country there wasn't much to do; no kids to play with. The hillside behind the house was very steep and the remnants of more than a hundred years of trash dumping were visible with bottles sprouting form the ground. My grandmother was quick to point out that at no time had they ever dumped their trash there, so it was garbage of a generation once removed. She also alluded to the previous inhabitant's of the place heavy drinking. I found little evidence of that, but what I did find were medicine bottles, some with the word “Consumption” on them. My mother informed me that consumption was TB, tuberculosis. And I also got a whiff of the shame attendant with that disease.

The first apartment my parents ever had was upstairs in a house. The owners lived downstairs, a mother and daughter. The daughter was my parents' age and they socialised with her often. My parents lived there about a year and before the year's end my father was a pall-bearer at the daughter's funeral. She died of TB. There were other ways that as a boy I came to learn about TB; one was that my mother had to present an x-ray of her lungs every year to her local school board as a condition of her employment. She'd been exposed, but never developed the disease.

I don't have the citation, but I've read that more than a billion people have died from TB since 1700. Malaria like TB is an ancient scourge. I fail to see why we here in the USA think we are immune to these diseases running rampant across the globe. I'm happy that “Bird Flu” is in the news, but a bit perplexed that there's no similar foreboding about TB and malaria.

People often take Darwin's “survival of the fittest” personally; that is as a measure of their own fitness, instead of seeing that it's the survival of the species that's the crux of the matter where individuals are of slight significance. Diseases are human problems that demonstrate our interconnectedness better than anything else I know.

As far as giving a rat's ass, I'll admit that my attention to malaria was really only piqued by knowing the suffering of my friend Nathan. I've been thinking a lot about Kabanda John, Nathan's brother since he died. Something that comes to mind is the time he was summoned to the school to collect Nathan, so sick with malaria no one expected him to live. John wrote to me and cared for his brother until he got well.

Nathan matters to me very much because he is my friend. But it's also very easy for me to understand that Nathan's life is very important to his community. I've corresponded with a number of very nice people who live near Nathan. With the ups and downs of what we've been trying to improve the situation there, Nathan is the one who never gives up when others do. How hard he works only to see one project after another come to naught and he only works harder. Nathan is indispensable.

Millions of deaths annually are not merely unfortunate, they hasten humanity's own demise even here in America. With drug-resistant TB we are but one drug away from untreatable TB. Malaria was endemic in every major city in the USA at one time. We've no magic bullet against it; should it emerge again here the death toll will be great because partial immunity is not widespread here. So give a rat's ass.

Our friend Mark Knobil did the cinematography for an important series on PBS “Rx for Survival” The six-part series begins Nov. 1 and airs at 9 PM.