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Tue, Jan

When Circumstances Make Me Question My Mortality

Thoughts From Afar
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This is because in our prime we fail to realise that when our health begins to fail, irrespective of our wealth, our life fortunes ...
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Ernest Hemingway in his book, A Farewell to Arms argues “If people bring so much courage to this world the world has to kill them to break them, so of course it kills them. The world breaks everyone and afterwards many are strong at the broken places. But those that will not break it kills. It kills the very good and the very gentle and the very brave impartially. If you are none of these you can be sure it will kill you too but there will be no special hurry.”

There is one thing most certain for humans after birth and that is the fact that we will all ultimately exit this world. However, the duration in between these two dates has much uncertainty. One major contributor to this uncertainty is the quality of healthcare a society receives. Therefore, it can be safely argued that every society, through its leaders, invests in health with the singular goal of improving the quality of life of its citizens and to increase their life expectancy. In a democracy, however, because these leaders are elected, the citizens choose as to who is most well placed to make such investments on their behalf.

Often, these decisions are based on the commitments those seeking public office make through their manifestos; or in instances based on their track record in government. In recent times, I have paused to think whether as a people we look beyond these promises when it comes to healthcare or that we just buy into the rhetoric. I ask this because though deaths in midlife have become very common, many of us brush them away as though this is the new normal and only feel the pain when it hits close to home.

In the past month, I have gone through a phase in life where due to several deaths I question my mortality. Over that period, I have also wondered how it is that advances in healthcare are disproportionately skewed at enhancing the life of the wealthy to the detriment of the poor. Whilst at it, I have realised that this is not the complete picture.  Relatively, poor people in certain countries have a better quality of healthcare than the more affluent in sub-Saharan Africa. You may choose to call it a disconnect, but it is a reality none can ignore.

This has brought me to the conclusion that perhaps our perception of wealth does not emphasize the adequacy of healthcare provision. This is because in our prime we fail to realise that when our health begins to fail, irrespective of our wealth, our life fortunes will be determined by whatever health system we have. In this failure, we become accepting of whatever those we elect deliver in the name of health improvement. As consumers of healthcare provision, we have neglected our role of holding them to account. Instead we become ignorant cheerleaders when our political stable is at the helm of governance. Our attitude towards healthcare is neither selfless nor selfish. I say this because we ignore the impact of healthcare inadequacies on others, and do not attempt to better our healthcare systems for personal benefit.

Ironically, though our health system has been speaking to us in a nonpartisan manner for years, with its failings resulting in the loss of life of people irrespective of their political colouration, we have failed to respond to it with nonpartisan togetherness. Instead, we prefer to tow our political lines and ignore the obvious.

I worry for us all if we continue down this route. I do because many in my generation are approaching the age where a failing health system must be a scary prospect. To start with, most of us though we may choose to deny are on some sort of medication. This means we require routine checks and monitoring of our chronic disease states. Often we relegate these health needs due to the pressures of life and it leaves us vulnerable to the unexpected. This is why we must all be interested in the outcomes of our country’s health investments.

Let me make this analogy. With the best equipment and diagnostic aids, most doctors will make an accurate diagnosis. Based on this and following proper guidance they would also be able to prescribe appropriately for their patients. Should the patient be concordant with their prescribed medication and follow an appropriate treatment plan, their treatment outcomes will be positive, their quality of life improved and so will their life expectancy. A failure in any part of this doctor-relationship, irrespective of how good the other components are, ultimately will result in poor prognosis and death.

Our health systems, for example emergency reponse procedure and hospital bed turnover rate, have similar behaviour. A failure in any component of the system can result in poor prognosis or death.  Our failure to perceive and identify the parts of ours that is not playing ball is the main reason why it is picking us one after the other as though it were a snipper on a practice range. For those fortunate enough to have had a near miss, it manages to break them too. Whichever way one looks at this health system, it is scary. Considering that we enter this world with so much courage and innocence, this cannot be our best foot forward.

We ought to regain control of the narrative, shed our tunnel vision and begin the fight back. The system cannot continue to break us. This flies in the face of the view that twenty-first-century medicine holds the key to prolonging the life of humankind.

For those of us who are fortunate enough to be alive and are hopefully stronger in broken places, we need to begin the process of using our strengths to ensure that our loved ones who succumbed untimely to the failings of our health system are not forgotten. In doing so we must challenge the rhetoric, question the narrative and hold those we have entrusted to invest in healthcare on our behalf accountable. That is the only way we can ensure that we also do not become a statistic and that even if we do, we can bow out knowing we played our part.

Edited By Winifred Awa

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