Ano is a Justmeans staff writer for health, and an instructional designer for the newly created Master of Health Care Delivery program (mhcds.dartmouth.edu) at Dartmouth College. Ano brings over a decade of evidenced-based health research and writing, and a Masters of Public Health from Dartmouth Medical School to the Justmeans Editorial section. Special interests include health policy, conflict ...
Commonwealth Games vs. Common Health goals in India
Along with the expected fanfare accompanying the opening of the Commonwealth Games in New Delhi, India this weekend there was a generous serving of controversy. While there are many good reasons for skeptics to raise concerns, this post will briefly consider three: Public health, dengue fever, and malaria.
Bluntly stated, health equals wealth. More specifically, greater inequalities in national distribution of wealth are correlated with worse measures of population health. Rapid economic gains in India have not been shared by all; one telling statistics is that the personal wealth of the richest 49 Indians accounts for a whopping 31% of India's entire gross domestic product, according to the newspaper Financial Express. The UN, meanwhile, reports that there are more poor people in just eight Indian states than in all of sub-Saharan Africa combined. The link between social status, wealth and health is well documented, and has many mediating factors (wealth equals greater access to education, for example, which is tied to better health.) It is hard to imagine that India will ever be able to overcome its population health disparities without wide-spread reforms, including overcoming the legacy of a cast system that continues to haunt underlying determinants of ill-health. It is also hard to see how games of sport contribute to such public health goals.
Large events such as the Commonwealth Games often lead to massive infrastructure projects that can have positive effects. Preparations in Delhi cost nearly $5 billion, and have had several unintended consequences. Vast construction sites, often covered temporarily with tarps, have harbored growing pools of stagnant rain water, which in turn is suspected of fueling an outbreak of mosquito-borne Dengue fever. The irony with dengue is that in Delhi it has targeted not only the poorest, but also the wealthiest neighborhoods, where clean water flows in fountains and waters the landscape of privilege. So far, public health officials report 1438 confirmed infections, 3,300 hospitalizations and up to 5 deaths due to dengue in Delhi.
Meanwhile, another vector-borne disease is not taking time out to celebrate the games, as India faces a busier than usual malaria season. Each year, around 1,000 Indians die of malaria, and this year infection rates are so robust that MSF (Doctors Without Borders) teams have been called in to help battle the outbreak.
It's a shame that India has not placed a more literal meaning on the word "Commonwealth", one that helps encourage common-health through better public health for its vast and struggling population.
Photo credit: cwgdelhi2010.org/