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Is the Black Death Alive and Well?

Navigating the Legacy of the Black Death to Modern Health Equity

Luckily for mankind, no. However, a case of the bubonic plague that caused the event termed the Black Death was reported in Oregon recently.

The patient is thought to have contracted the bacterium (Yersinia pestis) that caused the plague from a sick pet cat. With early symptoms similar to the flu, the infection progressed to the point of a draining abscess. Treatment with antibiotics was able to help the patient recover from the infection, and steps have been taken by medical authorities to curb further spread.

The bacteria is spread through fleas that feed on infected animals like rats. Those fleas then transmit the plague bacteria to humans and other mammals during subsequent feeding.

It is not surprising the speed of infection during the time of the Black Death, as rodents ran rampant, along with the fleas that fed on them.

The Black Death struck Europe and Asia in the Middle Ages, infecting millions. While the origin or the first patient of the plague is unknown, historians recorded its landfall when twelve ships from the Black Sea docked at the Sicilian port of Messina in 1347.

Imagine the horror of finding those ships; bodies of sailors dead from an unknown disease, and ones who were barely clinging to life covered in black boils that oozed blood and pus.

The Sicilian authorities couldn’t send the “death ships” back out fast enough. The brief contact was all it took to start the chain of infection. As other ships carrying the plague docked in other ports such as the port of Marseilles in France and the port of Tunis in North Africa, the disease spread quickly. By the end of the epidemic, it killed almost ⅓ of Europe’s population – about 20 million.

The Black Death ran its course by the early 1350s. Healthy People learned to separate themselves from the sick, and sailors arriving at the port were required to quarantine on their ships for a period of 30, and eventually, 40 days. A re-emergence of the plague once every few generations for centuries took place from the initial epidemic until the discovery and use of antibiotics to treat the disease.

Are medical advancements benefitting all?

Humankind’s knowledge of science and medicine has come a long way since the Middle Ages’ archaic treatments of bloodletting and purging. The discoveries made by scientists and doctors have increased our life expectancies and quality of life. Can you imagine hoping to live to 33 years (the average life expectancy) in the medieval era?

As a whole, humans have made great strides in our development, but on closer inspection, there are cracks of inequity that we must address.

Health inequity is “systematic differences in the health status of different population groups”, as defined by the World Health Organization (WHO). There are marked differences in distribution of health resources depending on the social conditions in which people are born, live, grow, work, and age.

Wide disparities in health status between different social groups due to governmental policies are unjust and costly to individuals and society.

Sub-Saharan Africa and Southern Asia are two regions with wide gaps of availability of services, where many health needs remain incompletely or inequitably addressed or unmet.

Maternal mortality rates are an indicator of the disparity in healthcare between the rich and the poor. The availability and quality of care women receive before, during, and after birth, is crucial to prevent maternal deaths. A study done of 2020, an astonishing 95% of maternal deaths could have been prevented in low and middle income countries, had those women received adequate medical attention.

Children in sub-Saharan Africa under the age of five are 15 times more likely to die, compared to the rest of the world. The birth location of a child is a key factor in their survival, as they are more likely to die from diseases and conditions that can be successfully treated by doctors if they had been born in a high income country. Most sub-Saharan children are dying from: respiratory infections, diarrheal diseases, measles, malaria, malnutrition and newborn conditions.

Millions with limited resources and suffering from noncommunicable diseases (NCDs) are pushed into extreme poverty paying out of pocket for medical treatment. Lowering the quality of life and increasing the level of stress leads to susceptibility of ill health, continuing the cycle of sickness and poverty.

Health inequity costs a lot, in expenditures, indirect costs, and opportunity costs. In US alone, health inequity is costing approximately $320 billion today, and could eclipse $1 trillion in annual spending by 2040 if left unaddressed.

Finding a solution can only benefit countries financially, not to mention a moral obligation that uplifts us as a species. To this end, the WHO has been calling on governments around the world to advocate for universal health coverage (UHC).

“WHO was born 75 years ago on the conviction that health is a human right. And the best way to realize that right is universal health coverage,” said Dr Tedros Adhanom Ghebreyesus, WHO Director-General. “Investing in resilient health systems, based on strong primary health care, is the most inclusive, equitable and cost-effective path towards universal health coverage.”

Other global organizations like the World Bank have chimed in on the necessity of UHC. World Bank Group President Dr. Jim Yong Kim says, "Investments in health, and more generally investments in people, are critical to build human capital and enable sustainable and inclusive economic growth. But the system is broken: we need a fundamental shift in the way we mobilize resources for health and human capital, especially at the country level. We are working on many fronts to help countries spend more and more effectively on people, and increase their progress towards universal health coverage."

“Setting goals is the first step in turning the invisible to the visible.” ~ Tony Robbins

Good health and well-being for all is the third goal out of seventeen under the Sustainable Development Goals (SDG) adopted by the United Nations General Assembly in September 2015. These goals urge countries to take action towards a 2030 agenda ending poverty and other deprivations, improving “health and education, reduce inequality, and spur economic growth – all while tackling climate change and working to preserve our oceans and forests”.

These noble goals direct us as human beings towards a future we can be proud of. Currently, we are far from reaching those goals. The urge from the UN for more immediate actions from countries around the world is insistent.

While we might not be in the position of power to decide on government policies, we can ask ourselves what actions we can take toward the realization of those goals. Where and how we spend our money, who we elect to office, and what we teach our children, are examples of choices we can make as individuals.

Life for Relief and Development (LIFE) has distributed over $8.5 million worth of medical supplies this past year, benefiting thousands in Sierra Leone, Lebanon, Mali and many other countries. Tailoring aid to each region's needs, Sierra Leone and Mali received vital equipment like oxygen compressors and syringes, while Lebanon received three hundred boxes of thalassemia medication. There were many more medical projects completed worldwide. These provisions have made a significant impact, supporting patients and medical practitioners and exemplifying LIFE's commitment to global healthcare accessibility.

We have a purpose to be alive at this time in history. Let’s not waste our opportunity to make a more equitable world and be thankful that we don’t live in the Middle Ages.



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