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Monday, August 3, 2020

from economistuniversity.com -some amazing questions about health markets

my second most exciting moment in life (first = birth of my daughter) was meeting fazle abed- i have never learnt so much from one person - i hope i do justice to logging up these and other q&a with fazle abed which took place during 15 visits to bangladesh and the last 10 years of his extraordinary life

we welcome questions or editorial improvements
chris.macrae@yahoo.co.uk

1 how do you design a rural health service from scratch?

2 which do you think mattered more in building one of the tenth most populous health systems - health genii or financial genii?

3 why did 2 billion rural people find that rising out of extreme poverty was impossible until asian women's grassroots networks were empowered to build community health services?

lets have a look at these questions in reverse order
======
even as western man was landing on the moon, about 2 billion rural people in asia (as well as others) had no access to electricity grids nor running water; their life expectancy was 40 unlike the mid 60s or higher of advanced places- what that means is that up to one in 4 infants were dying; by custom village mothers were expected to have many children until at least 2/3 boys survived- if you are breeding and caring for 8 children in a village its almost impossible holding down any other job

so thats how and why the greatest  development economics miracle in population terms emerged from identifying which killer diseases of children and mothers depended on a local knowhow solution not  expensive expertise- as well as advice frm epidemilogists which makes tracing part of the culture of why asians network from the community up

both bangladesh and southern chinese people solved this puzzle from the late 1970s -in china search references to barefoot village doctors and women lift up half the sky- itr true that china had other multipliers - a successful diaspora ready to invest in the mainland and the law of one child per family which enabled women to become as valuable workers as men but which probably most nations people would nt agree to- probably a vast majority of chinese people of the 1970s agrred with this rule- they had just seen over 100 million people die of starvation- a system failing which caused the chinese to end the russian style of communism in 1968-


a cure for infants dying of diarrhea depended on mothers learning to apply oral rehydration
ten over basic village diseases were both easy to train a village woman to deliver and could be turned into a profitable small business - this was linked to vilage agriculture businesses to improve nutrition especially of infants first thousand days

when james grant saw whar grassroots village mothesw achieved with oral rehydration he asked sir fazle what favor he could do- sir fazkle said plase ask our president to support innoculation of every child- it was around these micrhealth and food scurity services provided by villagers  that average life expectancy rose to 60s and women staerted to have smaller families and beieve in their ow ability to create working livelihhoods



note you need to decide how sir fazle's special talents for all lives matter and historical moments in south asia impact adapting his solutions- but at least across the tropical asian continent he found that the most basic rural needs to end extreme poverty were more similar than different- its also of interest that coming from a family with historic responsibility for developing muslim people near what is now the country's far north east border with india- fazle number 1 cultural code for all the networks he designed was the brazilian paulo freire whose work in the 1960s celbrated franciscan servant leader cultures- an idea that appeared to chime with mpst of latin americans of the 1960s including the then young man from argentina who is now pope francis

sir fazle abed had trained at glasgow university to be an engineer (particularly on ships- 1960 was both the 200th year since smith and watt started up the world of markets and engines- and the last decade that scots and irish were world class shipbuilders- a market that moved to where ships were most needed namely japan and korea

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