Making a difference

Oxfam’s Rhona MacDonald discusses how doctors can help end global poverty and introduces Oxdocs, an Oxfam initiative for doctors and medical students

Have you ever had an experience that is of such importance that you now view your life in terms of before and after the event? The latest for the whole world was the devastating tsunami (earthquake floods) that struck millions of unsuspecting people in South East Asia on 26 December 2004, killing over 250000 and leaving millions of survivors homeless. But then you would have had to be in hibernation if you did not know about that.

“Post-tsunami”

In keeping with events of such importance, you will frequently hear that we are now living in the post-tsunami era. This is much more than a phrase coined to refer to the current massive humanitarian relief effort in the areas affected: it also refers to the change in people’s attitudes after this landmark event.

As Barbara Stocking, the director of Oxfam, said, “The tsunami was one of the world’s most tragic natural disasters, but the global display of compassion and solidarity that followed it could be equally historic—as the moment when people around the world decided that abject poverty and suffering must be stopped.”¹ Now is the time to act, to do something, to help make a difference to the lives of poor people around the world. And there is a tremendous amount that doctors can do.”

Why bother?

A lesson in mosquitoes

The simple answer to this is that you should do something to help end global poverty because the opportunities for you to do so are many, and despite what you may think your efforts do make a difference. As an African saying goes, “If you think that you are too small to make a difference, try sleeping with a mosquito.”²
Some 30000 people in poor countries die from prevent­able diseases every day—the equivalent to a man-made tsunami every week, according to Barbara Stocking.³ Box 1 shows a selection of other facts. The scale of preventable suffering is huge.

Why doctors?

Doctors should be more interested than most in global poverty because if you take the World Health Organization’s definition of health: “Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity,”⁴ then every action that combats global poverty is health related.

It’s all about health

In 1999, world leaders and governments signed up to eight Millennium Development Goals, international targets for reducing global poverty by 2015. They are listed in box 2.

Although there are four obvious health goals, the other four also relate to health. For example, providing the world with clean water is clearly crucial in improving health,⁵ but perhaps less obviously, as is education. An Oxfam report showed that each year of maternal education reduces child mortality by 8%.⁶ Furthermore, if children receive a complete primary education, 700000 cases of HIV in young adults could be prevented each year.⁷ The targets set in the eighth goal should mean that all countries have access to affordable medicines to treat infectious diseases, including HIV/AIDS.

Influence

You may forget this sometimes in the daily grind of work, but you are a highly influential and respected member of society. Doctors came top of a “most trusted among professionals” opinion poll, alongside teachers.⁸ Governments expect, and are used to charities and aid agencies asking them to do more to help poor people and countries. But they are not expecting this from doctors, a powerful sector of society, and will certainly take notice.

CHRIS YOUNG/EMPICS

Nelson Mandela and Bob Geldof at Trafalgar Square, London

A unique position

In addition to campaigning and lobbying, doctors are also in a unique position to give money and to go to developing countries and help (see below).

How can you make a difference?

Of course working in poor countries is an extremely direct and useful thing to do, and Médecins sans Frontières, Merlin, Médecins du Monde, and Voluntary Services Overseas are just some of the organisations committed to helping you do this (see Further information). But please don’t think that the only useful thing that doctors can do is to go out and help: most doctors are unable to work overseas because of other commitments. However, I believe that all doctors and medical students whatever their grade, job title, and specialty can do the following three key things to help end world poverty.

• Keep informed about the issues affecting world poverty
• Campaign and lobby the world’s governments demanding that they do more (the organisation Medact already does this—see
  Further information)
• Give money to support what ­charities and non-governmental organisations are doing in the world’s poorest countries.

Oxdocs, a new Oxfam initiative for doctors launched today, helps you to do these three things.

Oxdocs: the Oxfam initiative for doctors

Oxdocs, an Oxfam initiative for doctors, aims to inspire and encourage the medical profession to do something about global poverty. The initiative does not ask doctors to support Oxfam exclusively but rather encourages doctors and medical students to think about what they want to do to help make a difference and how they are going to do this. Oxdocs provides opportunities for doctors and medical students to keep informed, campaign and lobby governments, and financially support Oxfam, in particular with Oxfam’s health related work around the world (see box 3).

Helping you decide

To help you make up your mind about what part you want to play in helping to end global poverty, in future articles in Career Focus I will outline the three thrusts of the Make Poverty History campaign—aid, trade, and debt—and explain in more detail how doctors can help.

Many people around the world who do not have a voice, and whom the world has forgotten about, are relying on you. Please don’t let them down.

1. Oxfam. The tsunami and the bigger picture. A message from Oxfam GB Director, Barbara Stocking, about the tsunami crisis and Oxfam's work in 2005. www.oxfam.org.uk/what_we_do/emergencies/country/asiaquake/reports/barbara_060105.htmm (accessed 4 February).
2. The Rough Guide to a better world: how you can make a difference. New York: Rough Guides, 2004: 9 (introduction).
3. Times On Line. Q&A: World poverty. Peter Mandelson, Jeffrey Sachs and Barbara Stocking on whether the world is taking poverty seriously enough. http://business.timesonline.co.uk/printFriendly/0,,2020-17549-1457102,00.html (accessed 4 Feb 2005).
4. WHO definition of health. http://www.who.int/about/definition/en/
5. MacDonald R. Providing the world with clean water. BMJ 2003;327:1416-8 (20 December).
6. http://bmj.bmjjournals.com/cgi/content/full/327/7429/1416
7. Watkins K. The Oxfam education report. Oxfam International 2001. www.oxfam.org.uk/what_you_can_do/campaign/mdg/downloads/edreport/edreport.htm (accessed 4 Feb 2005).
8. Oxfam. How education for all would save millions of young people from HIV/AIDS. Global campaign for education briefing paper. www.oxfam.org.uk/what_we_do/issues/education/gce_hivaids.htm (accessed 4 Feb 2005).
9. MORI. Doctors win overwhelming vote of confidence from public. March 2001. www.mori.com/polls/2001/bma2001.shtml (accessed 4 Feb 2005).