Rhiannon Bryant
For Health Explain why LEDCs and MEDCs Face Different Challenges for the Future.
Health is the state of complete well being, both in body and mind. It will be impossible to achieve total health throughout the world so we can only look to the future to strive for improved health. However, LEDCs and MEDCs face very different issues now, and most certainly in the future. MEDCs have the economical and scientific developments to protect themselves against many infectious diseases. However, the social factors and lifestyle of the people in the UK simply mean that it is the non-infectious aspects of health that poses the biggest risk. The developing world lacks so many aspects needed to fight both kinds of disease but it is the infectious diseases such as AIDS that pose the biggest threats to whole communities, particularly in sub-Saharan Africa. Such issues are always changing, but not always for the better. It is the future that will inevitably play the key role for the improvement of such health issues. And although these issues are strongly recognised, they are not always acted upon.
AIDS – A contrast of MEDCs and LEDCs
AIDS has become a world-wide pandemic since it was first recognised in the late 1970s and even after years of extensive research there is still no cure, or vaccine. An estimated 40 million adults and children over 15 years are living with HIV/AIDS, with 5 million alone being infected last year. (UNAIDS, end of 2001)
Reasons for the spread
The AIDS epidemic started in sub-Saharan Africa and the Western world at roughly the same time yet Africa has over 70% of the world’s infected people.
- Sub-Saharan Africa
- United Kingdom
Future for AIDS
From the graph, we can see that in sub-Saharan Africa there is a particularly high proportion of deaths in comparison with the amount of people that are using Antiretroviral drugs. This ultimately suggests that in order to decrease the death rate from AIDS, the use of such drugs are more than vital. However, things are not so simple. The answer does not lie within the treatment of the already suffering, but more so in prevention of transmission in the first place. From the above tables we can see that both the UK and South Africa need a much improved education system if they wish to tackle this problem effectively. Although AIDS and HIV is still an issue in the UK the number of new infections was reduced by 27% from 2001 to 2002. This suggests that they must be doing something right, but in order to really beat such a extensive on-going problem, the UK needs to concentrate on the areas in particular that are being overlooked, and where transmission is not reducing. i.e. Transmission through intravenous drug use. However, sub-Saharan Africa faces a very different set of challenges, each more colossal and complicated than the last. The UK provides free health care, which automatically sets its people up for a chance of treatment. Health Care in Africa is very limited in both is abundance and its quality so there is little chance that the poorer communities could ever have the chance to be treated without charity intervention. However, the problem does not lie solely with the health care. The issue of poverty seems to be at the roots of many problems. Large numbers of children growing up in poverty will adopt precisely those behaviours that lead to HIV infection. They will, in effect, become the next cohort of the HIV infected; a state of affairs that will permit the epidemic to continue and intensify. The HIV epidemic has its origins in African poverty and unless and until poverty is reduced there will be little progress either with reducing transmission of the virus or an enhanced capacity to cope with its socio-economic consequences. Yet such developments are hugely challenging to such a less economically developed country. It is here that we see the biggest challenge to the more affluent countries. Not only to better the situation in their own country, but to provide the health care, funds and support to the very countries that are at such dire risk. As Dr Peter Piot, executive director of UNAids says, “In order to overcome the epidemic on a global scale, the international community must muster even greater political commitment, action and, above all, resources.”
MENTAL HEALTH
Mental Health around the world faces very different challenges for a number of reasons. It is just as important to our well being as physical health. It is thought to be far less recognised publicly, even in MEDCs. And out of those who recognise it, there are very few that understand it. It is estimated that one in four people will experience some kind of mental health problem, however severe, over the course of a year. By 2020 the World Health Organisation estimates that mental illness will be the most common illness in the developing world.
Table 1: Prevalence of major psychiatric disorders in primary health care
aCIDI: Composite International Diagnostic Interview.
Source: Goldberg DP, Lecrubier Y (1995). Form and frequency of mental disorders across centres. In: Üstün TB, Sartorius N, eds. Mental illness in general health care: an international study. Chichester, John Wiley & Sons on behalf of WHO: 323-334.
Out of the four Cities that have a higher than average number of all mental disorders, 2 of which are MEDC cities and 2 of which are LEDC cities. This shows that mental health issues are apparent in both MEDCs and LEDCs. However, in many circumstances mental illness is not reported so we can expect that in the area where health care of this sort is unavailable, mental illness goes untreated.
Reasons Why
Like many other health issues, there is a strong link to mental illness and poverty. Poverty can often cause ill mental health, and vice versa. The implications of which are outlined below.
In extreme cases, severe poor mental health can result in suicide and as shown below, in some regions, suicides outweigh homicides. Europe notably, has a particularly high suicide rate, which would suggest that such MEDCs face particular challenges regarding suicide. Richard Taylor of the school of public health at the University of Sydney suggested that under favourable social and economic conditions an individual with risk factors for suicide is less likely to decide to commit suicide than under conditions where life prospects are bleak or uncertain. If life is not worth living it is because there is nothing to live for. If this proves to be the case, then LEDCs face the added pressures to improve the country’s social and economic conditions, while MEDCs face the challenge of maintaining these conditions.
However, suicide is an extremity of mental illness, and the rate of suicide does not directly show the number or people affected by mental illness.
There is a whole host of other mental health issues that affect every country. Although poverty is more common in developing countries, mental health is still a huge on-going issue in developed countries. It is generally the lifestyles of the people that contribute to the minor, but prevalent health concerns, such as depression. Such conditions are driven by stress and the workload of today’s school children means that mental illness is becoming more common amongst younger sufferers. WHO predicts that by 2050 the stress-related mental health condition, depression will becomes the world’s second largest form of disability. The situation is exacerbated by the media. Experience tells us that most people who understand mental health issues are unhappy about the way the media portrays them. Ill-conceived images used by the media add greatly to the distress of having a mental health problem because they reinforce stigma and prejudice in the general public. Sufferers become more reluctant to speak out, often advancing their own downfall. However, reasons for a silent approach in an LEDC may differ. Health care is not so readily available so even if the sufferer did require help, they may not be an option for it. If they are particularly poor they often wont have the time to dwell upon their condition, as they are fighting day by day to survive. They can often turn to alternative strategies, such as alcohol or drugs, which presents supplementary problems for the governments concerned.
Resources and services for mental and behavioural disorders are disproportionately low compared to the burden caused by these disorders in both developing and developed countries. Even where the number of beds available is high, this is still for only 9 people in 1000 in Europe where mental disorders effect between 9.8% and 26.3 % in certain countries. Arguably it is not necessarily a bed-ridden condition, but in the cases where it might be, there are few beds available, particularly in Africa and South-East Asia. Community care is commonly used in MEDCs, which is valued as a more humane approach, as it has known that in some areas of South-East Asia, those regarded as mentally ill are locked up in asylums.
Unfortunately there seems to be very little LEDCs can directly do to improve the state of mental health. As poverty seems to be the main instigator of poor mental health in LEDCs, they must first try to beat the poverty. With other current lying issues such as the AIDS pandemics, and poverty in general, mental health is often overlooked. Particularly if there is minimal recognition, the government cannot improve something they are not fully aware of. So perhaps, again the responsibilities lie with the MEDCs, who have the experience, the knowledge, and the money to make these people’s lives better. However, mental illness has limited recognition in MEDCs such as the UK, so it may not be possible to help the LEDCs until we have better understanding ourselves. Unfortunately, due to the nature of the illnesses, there are still great numbers of people who will not seek help for their illness. This is perhaps the main challenge of MEDCs. To try to monitor mental health on a long-term basis to try and improve it and to influence people to ask for help. As after all, the more it is dealt with the more experience we can get, giving MEDCs a better chance of aiding LEDCs in need.
CONLUSION
Its is clear that MEDCs and LEDCs face some very different challenges for the future. Developing countries carry 90% of the world’s diseases but have only 10% of its health care resources. Most infectious diseases are uncommon in the UK and North America, and as they no longer vaccinate against eradicated diseases such as small pox, they are vulnerable against the risk of biological warfare, especially against the Eastern countries that have limited technology to attack in other ways. As far as AIDS in concerned it would seem that the UK have their pandemic under fair control and this is due to the wide use of Antiretroviral drugs, something that is not so common in sub-Saharan Africa. While sub-Saharan Africa is trying to improve resources the future of AIDS still lies with the developed world to a certain extent. They are under pressure to produce new drugs and even a potential cure. They even provide some developing countries with Antiretroviral drugs to help control the pandemic. But this alone is not enough. It is the governments of the countries, at both stages of development, that have the real potential to make a difference. Finally, Africa is beginning to reduce rate of infection but it will be decades away that we see a stable and controlled state, perhaps not even before a vaccine is found. However, mental health currently poses very different problems. It is becoming more and more prevalent in both MEDCs and LEDCs and as long as poverty is left to thrive the issue of mental health will not be resolved. It is clear form the research that both developed and developing countries lack vital resources, but to get a better idea about how many people are in need of help, they should be encouraged to come forward. The non-government organisations such as The Samaritans offer support and advice but it would seem only experts have the knowledge to deal with such situations. If the public were more aware of poor mental health, they may recognise it in friends and family, giving the sufferers the support they need. Equally, this type of support is vital in all parts of the world and just as charities with food and supplies may mission to deprived areas, perhaps mental health experts could join then giving people in LEDCs the chance of a better future. All in all, both problems link back to resources and financial support. But until annual expenditure is increased for these particular areas, there is little hope for a better future with better health.
However, in order to understand the true difference in challenges of MEDCs and LEDCs, perhaps single town or cities should be researched in great detail. AIDS will always be relatively simple to research as there are many resources available, and it is commonly considered as a world-wide issue. However, there are many ramifications making Mental Health a difficult case to study. The limited knowledge does not provide strong statistics, so perhaps until world mental health is understood on a greater level, we can not appreciate the true challenges that countries may face. On reflection, this situation may soon improve as the World Health Report 2001 focused on mental health as a future problem so it would appear the issue has been recognised, and with persistence, the future of World Mental Heath looks potentially promising.
For Health Explain why LEDCs and MEDCs Face Different Challenges for the Future.
BIBLIOGRAPHY
BOOKS
ISSUES FOR THE NINETIES: MENTAL HEALTH, volume 21. Independence 1995.
LEIGH, Vanora: TALKING POINTS: MENTAL ILLNESS. Wayland 1998. Pages 19 and 29.
POWELL, Jillian: WORLD HEALTH ORGANISATION. Watts 2000. Page 29.
WHITEHEAD, Margaret: Health Divide; INEQUALITIES IN HEALTH, 2nd Edition. Puffin 1992. Pages 247, 255-256 and 280.
INTERNET
TELEVISION
BBC2 – “CORRESPONDENT – The Horror Story of AIDS in South Africa” – 2002
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