When Paternalism Kills: How Public Health contributed to the death of Eric Garner

            Eric Garner died on July 17, 2014 while being arrested for selling cigarettes illegally.^[1]  The now infamous video shows Mr. Garner stating, “Every time you see me, you want to harass me, you want to stop me . . .  please just leave me alone.”  But by this time the police were already obligated to arrest Mr. Garner for selling loose cigarettes bought outside of the state.  And that obligation was placed upon them by Public Health.

Public Health and Syria: An Epidemiological Perspective on the Increasing Prevalence of Civil War

           The deteriorating civil war in Syria has been one of the greatest public health and humanitarian disasters in the last decade.  The UN has registered 2.9 million people as refugees, with an additional 6.5 million displaced internally, and an estimated 10.8 million in need of humanitarian assistance.^[1]  This alone would qualify it as a global emergency.  But even more horrifying is the rise of the Islamic State, which started as a collection of radical Salafist Islamist groups rebelling against Bashar Al-Assad’s rule in Syria but has grown into an entity that Al Qaeda could only have imagined.

The Challenges of Ebola Vaccination and Treatment

                Following the infection of several western aid workers in late July of this year^[1], progress towards production of viable vaccines and treatments for Ebola Virus Disease (EVD) has progressed rapidly.  This in and of itself is indicative of the human rights inequities surrounding this particular public health intervention.  Up until that point, the disease, though just as virulent and deadly, had affected only the indigenous populations of Liberia, Sierra Leone, and Guinea. So why has it taken 38 years for substantial progress to be made in treating and vaccinating against Ebola Virus Disease?

Infectious Disease Control Measures and Ebola

From its initial identification in 1976, there have been periodic outbreaks of Ebola Virus Disease (EVD) among the populations of Central Africa ^[1].  But the current West African outbreak is unprecedented both in its location and size.  And given the current rates of infection and transmission, as illustrated in Figure 1^[2], it can only be expected to get worse.  Many US politicians are calling for travel bans to the affected countries even now ^[3], despite the fact that no direct flights currently exist.  There may come a point where strict infection control measures become necessary, but people should be aware that these measures do not come without their own negative effects.

Ebola Infection Rate Increasing in West Africa

     Latest updates on the West African Ebola Outbreak.  There is a slight lag in officially vetted numbers and the current situations, usually 1-3 days.  I've consolidated pertinent facts and figures here from what I deem to be reliable sources.  Namely, the WHO, the CDC, two or more news organizations reporting the same fact, and my personal and professional contacts in the Epidemiology community.

Global Health and Security

   

     In medicine, we manage symptoms as best as we can, but the ultimate goal is always to address the underlying pathology.  When you fail to address the root cause of the problem, the side effects are destined to return.  So what is the underlying pathology of the worst Ebola Outbreak in history?  And what can we do to make sure that outbreaks of this size and scale become a thing of the past?

Inaugural Post

     After taking quite the hiatus from my previous blogging endeavor, I have returned to sharing my thoughts and opinions online and in a public forum!  So you are here to bare witness to the first post of what I hope will be a frequent and useful source of information and analysis, lucky you.

     First, a bit about myself.  I have spent the previous 5 years working around the world as a medic under the US Army Special Operations Command.  During that time I found myself drawn not only to the practice of medicine but also the wider objectives of expanding access, improving quality, and lowering the cost of healthcare around the world.  While I retain my passion regarding international affairs, geopolitics, and global security, I am now more focused on the role that healthcare can play in improving our increasingly interconnected world.

     As such, the new objectives of this blog are to provide a forum for discussion as well as repository of my own thoughts and opinions regarding global health, global security, and strategies for improving both.  Monitoring the worst Ebola Virus outbreak in history?  Check.  Advocating international cooperation in dealing with security challenges posed by the rapid expansion of the Islamic State?  You betcha.  Techniques for inserting a chest tube, conducting a malaria prevention program, or invading a sovereign country?  Sure!

     We live in a time where disease and conflict are but a shadow of their former selves, and where better outcomes for people are right at the edges of our grasp.  It is vital to discuss these issues openly, to challenge old and new ideas, and to determine the best path to take going forward.

Standard Disclaimer: The thoughts and opinions expressed on this site are representative of and belong solely to those who write them.  My statements do not necessarily reflect the views of the DoD, the US Army, the US Special Operations Command, the government of the United States, the Mailman School of Public Health, or Columbia University.  These are merely the ramblings of a poor graduate student and are, essentially, strategically irrelephant irrelevant.