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Rabeea, I especially appreciate your comment about how your schools have recruited students from diverse backgrounds. In my own experience, having personal friends from different cultures is a powerful way of building empathy and understanding for people who are different from myself.
Austin, I believe you were the only person in this thread to mention the role of breast-feeding and nutrition. Thank you! This usually abundance source of nutritious food carries along with it emotional bonding, effective anybodies, and helps prevent transmission of infectious organisms via often unsafe drinking water. Fortunately, even in high income countries, the temptation to defer breast-feeding is becoming less frequent.
Ronisha, regarding obstacles to global health you mentioned nutrition and access to healthcare. Both of these require trained and motivated personnel. Your participation in this course is one demonstration of your commitment to solving these challenging obstacles. Those with your kind of vision will be also those who are leaders in broading access to healthcare and realizing improved global health.
Vincent, your posts and replies to your classmates posts are quite fluent and complete. Well done! Regarding nutrition, you emphasized government policies and standards, which are often well considered. The primary obstacle is the lack of infrastructure necessary to carry out such policies and implement such standards. When I first moved to Angola, I met with the minister of health who laid out on a broad desk in front of me the health infrastructure of the nation. Then, he confessed with remarkable humility, that none of this actually existed and none of it would be possible until there was a piece accord to end the Civil War.
Jasmin, among your comments you’ve mentioned the importance of governments supporting universal healthcare. You drew the relationship between such universal healthcare and nutrition, but we realize that universal healthcare touch as many elements of overall health. Achieving universal healthcare is particularly problematic. It requires not simply financial resources but also personnel, health systems, physical infrastructure, supplies, communications, etc. A number of low income countries claim universal healthcare, but in actuality the level of service they are capable of providing is quite small.
Bethany, you drew a distinction between conditions that cause morbidity and those that cause mortality, and how progress is decreasing the mortality may actually strain the health system even more because of the care needs for those who continue to need attention for their ongoing morbidity. Since we value all human life, we need to address causes of both morbidity and mortality, and allocate sufficient resources to reduce them both.
Gracie, thanks especially for your comment about the role of highly processed foods – that is foods that contain increased amounts of saturated fats and salt, and often relatively Little nutritional value. Such foods are rather expensive to produce and sell, hence the financial incentive for companies to emphasize them. On the counter balance, foods that are not mass produced like these are generally more expensive but of higher nutritional quality.
David, in your post you mentioned small-scale farms. While these are not the most efficient modalities of producing food, they are important for providing redundancy within communities and for providing a degree of food independence for particular families. It also helps to increase the number of people who have familiarity with farming practices, leading to greater resilience within communities.
Safia, I am grateful for your diligence in pulling some of these high value references, including Global Burden of Diseases and Injuries in 204 countries and territories, 1990–2019. You and I are quite blessed to have access to such rich resources that provide the data and quantitative rationale for our priorities and interventions. In my own work, I have found the ever increasing availability of such objective data is making our INMED curriculum more strong and relevant.
Charity, thank you for such affluent response! I especially appreciate you including your personal experience with the elderly gentleman who would not drink the Ensure supplements, and how this was connected with his wife dying of cancer. Without such a thoughtful conversation, I doubt you would have ever discerned that particular obstacle. Thank you for being sensitive to his particular situation and discovering the reasons for his resistance.
Nikki, in your response you mentioned the move away from addressing specific nutritional deficiencies and instead promoting broader nutritional goals, such as provision of adequate calories and protein. I agree with this approach in concept. But I will also add that great progress has been achieved in addressing particular nutritional deficiencies, such as iodine deficiency that was all but illuminated through adding iodine to commercially sold salt. What a spectacular and effective intervention!
Prosper, you emphasized the ubiquitous role of poverty as an obstacle to progress in global health. I agree with you that innovations to reduce poverty are usually the most powerful of all antidotes to improving health. As economies grow, nutrition improves, industrial accidents diminish, safe drinking water is more available, and medical services are incentivized – all contributing to increase in the health of the community.
Emily, you were wise to point out the importance of cultivating nutritionally dense foods, rather than simply cash crops that bring greater income to the grower. Yet economic incentives for cash crops are difficult to avoid. Therefore, creative innovations, such as subsidies for certain crops, may be necessary and effective.
Milove, one element you mentioned was access to basic primary care medical services. Indeed, this varies enormously from place to place. In fact, in many cultures the idea of primary care or continuity care is quite foreign, so provision of such services requires not only personnel and financing, but also a degree of the community acceptability to in order to achieve provision of primary care.
Rabeea, you emphasized the multifactorial nature of global nutrition improvement, and I appreciate your insight. Indeed, land allocation, provision of modern seeds and fertilizers, transportation, market availability and community acceptability are all powerful elements in the food chain. In Privee nutrition for any particular community often requires a multidisciplinary approach.
