Where Does Your Loyalty Lie?

My research mentor for most of my undergraduate career.

As an undergrad at UW, I was fortunate to work in James Thomson’s regenerative biology lab. Jamie (as he was fondly known) was the first cellular biologist in the world to derive the first set of human embryonic stem cell lines and in 2007, matched his previous brilliance with a new ability to program adult skin cells into becoming pluripotent stem cells. Although rather demure in nature, Jamie’s novel work catapulted him into not only the limelight of scientific endeavor but also the ire of certain conservatives as well. His breakthroughs were discussed in terms of not only medical impact and potential for progress but initiated tangents on moral and ethical guidelines. From the Bush administration to the Obama administration, regulating stem cell research is a topic still laced with obstacles and contrived of many ill-formed perspectives. The promise stem cells hold in terms of treatment towards many debilitating diseases on the face of planet today is boundless and immense—something I won’t even attempt to approach in this blog. Likewise, the amount of funding poured into such research endeavors stands to be astounding, especially if the president is allowed to lift the limit on how much funding can be provided.

This abandoned building was supposed to be an expansion of the General Hospital in Grenada five years ago. The builders, apparently, constructed five floors before realizing the individual floors were too small. Now it’s just a stark reminder of what could’ve been…

While research is pertinent to advancement, without which our power to understand is greatly diminished, I can’t help to think that if only a fraction of the emphasis on research, development, and treatment methods in this world were placed on public health enterprises, the pace of progress might gain a stronger momentum. Resting on our laurels and only ameliorating treatment and diagnosis is like thinking Sarah Palin’s only flaw is her geography acumen—as convincing as your argument may be, the issue at large still remains unaddressed.

Nevertheless, we are overwhelmingly a nation of movers, shakers, doers, and thinkers. Yet when it comes to healthcare, why is our area of concentration inordinately short-sighted? The US government allocates a mere 2-5% of funding for public health resources and many states have cut as much as $400 million dollars on public health just within the last year. However, a brief history lesson of the most prominent factors attributable to lengthening the life expectancy in the last 100 years will convey even to the dimmest and dullest the elephantine role public health plays in our lives. Of the 30 year increase in lifespan over the past century, 25 of those years are due to achievements within the realm of public health: vaccinations, fluoridation of drinking water, awareness of the dangers of smoking and tobacco, motor-vehicle-safety, elimination of workplace hazards…the list goes on and on and on. The funding unfortunately does not.

While taking a fieldtrip for a class this past Friday to gain exposure to the Grenadian healthcare system, I was overwhelmed at the thought that Thomson’s work would take an indefinite amount of time to ever positively impact the people residing on this southernmost Windward Island. Research, after all, is an endeavor for the patient. Will these droplets of conjectures, theories, postulations, and proposals ever crystallize into action? And when and if it does, how soon will those actions benefit the people of Grenada? There is no precise estimate.

The waiting room at a community health center.

Shouldn’t we, then, focus a little bit more on the tried and true methods of health advancement? All things considered, after a number of breakthroughs, you think governments, out of all institutions, would exemplify some sense of loyalty to a field that has drastically transmuted the way we live today. After spending five years in three different research laboratories with fields ranging in stem cells to hematology to gastroenterology, I’m in no way advocating foregoing the pursuit and challenge of scientific dogma and comprehension of the human body. However, equitable distribution funds for all healthcare sectors seems a much safer bet than going “all in” towards one particular field, especially when the chips are really people’s lives and perfectly preventable conditions are claiming more and more beings (smoking, anyone??).

This little island, 21 miles long and 7 miles wide, has much to dispense regarding healthcare approaches that

A sole patient in the pediatric “ward” at one of the hospitals. By “ward,” I really mean “room.”

much of the developed world could stand to benefit from. Community health services are provided in 6 health centers and 30 medical stations throughout the country. These centers serve as medical meccas for anyone and everyone within the community seeking medical attention in about as many areas as there are products within a Super Wal-mart (can you tell how much I miss the convenience of American consumerism?). There are district medical officers, community health nurses, district nurses, nurse practitioners, community health aides, pharmacists, dentists, social workers, and environmental health officers dealing with reproductive rights, HIV testing, mental health, prevention, awareness, education, and occupational health hazards. Some of these practitioners actually venture into the community, while others balance their time between these publicly-funded centers and other private facilities.

As much as the Grenadians have to offer in terms of healthcare, they, simultaneously, also have a lot to learn. As great as these hubbubs of medical convenience are, social stigmas still persist and still pose great harm. We visited a mental health hospital where many of the patients there are free to be discharged but have nowhere to go since many are shunned from their original homes out of embarrassment and nonexistent support systems. Also, many of the residential care facilities built to accommodate the needs of older citizens house younger patients permanently, many of whom are disabled. Lack of attention and critical care by their loved ones force many to use these facilities as home. Also, due to the largely religious context that envelops the governmental infrastructure, many birth control and protection methods are either not available or not permitted to be discussed within professional settings—quite alarming when considering the fact that Grenadian adolescents are among the youngest in the world to engage in sexual behavior. Abortions are also illegal here, prompting many to deal with their unwanted pregnancies by inducing miscarriages in damaging ways.

The Operating Theater at the General Hospital in Grenada.

Some antiquated equipment.

However, Grenadians are quite aware of the prevalence of these issues and are finding innovative ways towards breaking down these barriers. One way in which I benefit is their desire to utilize the school of public health. Their warm reception and ever-permanent smiles welcome us into their schools, their television stations, their radio broadcasts, their parliamentary procedures, and their newspapers, bolstering the notion that awareness and prevention are their biggest allies in changing human behavior and that a vigilant yet vigorous campaign will help sustain attention on the health burdens that matter most. They realize that while funding research and promoting advances in medical technology serve to meliorate avenues of intervention, it is unpractical to funnel funding, which at times can be scarce already, towards research, all the while ignoring affairs of public health. Afterall, poor lifestyle choices, disparities and stigmas cannot be combated against with latex gloves, pipettes, and test tubes. You need far stronger ammo to permeate creatures of habit that glorify obstinacy. Recognizing this means reclaiming a brighter future.

To summarize, I feel that the “Jamie Thomsons” of the world are just as essential as the preventers, mediators, and health educators. Saying this is one thing, getting much of the developed world to see it, however, is quite another.

This is completely unrelated to this post, but it just wouldn’t be the Caribbean if I couldn’t add in a beach picture to every post!


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