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Nigerian National Assembly, take note.

US Official Apologizes for Joke About Gadhafi

"A senior State Department official said Tuesday he's sorry for a joking remark he made about Libyan leader Moammar Gadhafi that prompted Libya to threaten diplomatic retaliation unless he apologized.Chief department spokesman P.J. Crowley said he regretted any offense caused by his response to a reporter's question about Gadhafi's recent call for a holy war against Switzerland. Libya said last week it might take action against American business interests there if a formal apology was not made."

...for want of mad men...

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This was definitely worth another post this week.

Maybe by now, some of you have figured out beyond my penchant Nollywood, the mindless sputterings (made-up word, I think) of old Igbo men - such as this one and oh man, this one - I also have some interest in chronic disease management outside of the West (it's a budding interest, but an interest, no less). Even diseases traditionally thought of as acute (meaning you either get over it or die really quickly) are increasingly requiring a paradigm shift towards long-term care (namely, AIDS). Unfortunately, poor health infrastructure means that it is next to impossible to address such chronic disease care issues in the developing world (I know, I hate generalizations too, but bear with me)...I mean, seriously, check out the case of this guy...who happens to be the (former?) President of the the largest African nation, but has recently been relegated to receiving health care services at a glorified car park.

Developing nations find themselves in double jeopardy - battling acute infectious diseases while remaining horribly unprepared to face the rising threats of "first-world" health issues such as cardiovascular disease, cancer, motor vehicle accidents, mental illness, etc. Large-scale disease-centric interventions, at times serves to weaken overall health infrastructure, placing focus (and funding) on one or two diseases to the neglect of others - most oftentimes non-communicable or chronic diseases (NCDs). Consider NCDs as the latest addition to the category of Neglected Tropical Diseases (NTDs).

A recent study published in the the journal PLoS medicine (H/T Kaiser Daily Global Health Policy Report) found that high NCD burden served as a major barrier to achieving the UN's Millennium Development Goals (MDGs), which excludes NCDs among its list of health priorities, but includes HIV, tuberculosis, infant and maternal mortality. In regards to progress towards MDGs, reduction in NCD burden by 10% was nearly the equivalent to a 40% rise in GDP (or at least five years of economic growth in developing countries). The study highlighted the fact that NCDs plays an important role in the complicated relationship between poverty and health and as a result, greater emphasis should not only be placed on addressing NCDs, but health systems as a whole.

Our findings suggest that achievement of feasible reductions in the impact of these chronic diseases on poor households could greatly enhance progress towards existing health MDGs. If not adequately addressed, high rates of NCDs in low-income countries may further impede progress towards the health MDGs.

To bring it closer to home, the World Health Organization estimates that Nigeria loses about 400 million dollars a year in national income from premature deaths from heart disease, diabetes, and stroke. I wonder, if that figure includes revenue lost from exporting the healthcare of our presidents to other countries...

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Faith-based organizations recently received some good press over the weekend with the publication of Nicholas Kristof's New York Times op-ed piece - Learning from the Sin of Sodom. In it, Kristof chastises liberal do-gooders for their "snootiness" towards Evangelicals and sings the praises Christian NGOs and churches for engaging in the thankless task of battling the "common enemies of humanity" such as poverty and exploitation. Considering the complicated past of foreign missionary work during colonial times and the recent Haitian adoption scandal by American missionaries, I am sure that religious communities everywhere are grateful for the article. Indeed, the church has been responsible for bringing about some good to the communities they serve in the developing world. When working in a long-term capacity, churches and other faith-based organizations have established schools, hospitals, and other needed infrastructure that rivals that of some secular organizations and local governments.

While I commend the efforts of Christians to live out the tenets of our faith through service, I find problematic some of the more recent trends I have personally witnessed amongst churches and individuals - primarily the interest in short-term international missions projects. One to three weeks long, such short-term projects are typically glorified (or should I say, church-ified) versions of slum tours. Merely donating to an established local entity is not enough. Rather, some feel the need to "experience first-hand" the raw poverty and pestilence that plagues the non-western world. No real training or skills are needed other than a heart for down-trodden people (or an eye for poverty p*rn). The emphasis is thus taken away from selfless Christ-like service, and is rather placed on fulfilling the short-term missionaries' desire to be needed.

In providing the lay person with this short-term experience, oftentimes, no thought is given to long-term implications of the excursion. In the case of short-term medical missions projects, which are sometimes conducted independently of local hospitals and resources, thousands of patients are attended to but little consideration is given to follow-up care. The goal is to reach the greatest number of people in an allotted time frame. More than 70% of patients with chronic, non-communicable diseases live in the developing world; and therefore long-term management of such patients is required. To say that short-term medical missions is like putting a bandage on a festering wound would be an understatement. I guess it's more like saying to a brother or sister without clothes or food, "Go, I wish you well..." without doing anything for their physical needs.

I also find that with short-term missions projects, there exists little discussion on evaluation or assessment of their interventions. In order to meet fundraising goals, emphasis is placed on the wow factor a project can evoke - "we saw x amount of patients," "we donated x number of y," etc. And because record-keeping remains virtually non-existent, no one can definitely measure the long-term impact of such excursions on target populations. Such projects are only answerable to their congregations, who may not be terribly familiar with the nuances of outcomes measurement.

Admittedly, the aforementioned also applies to secular non-profits and organizations. However, I feel as if some of these issues are particularly aggravated in the Christian community, where motive trumps means or outcome. The attempt to shuttle scores of Haitian "orphans" to the Domincan Republic by a church group, highlights such pervasive attitudes. It seems as if faith has provided us with the license to embark upon hastily organized projects and missions, because regardless the means or outcome, our intentions are sanctioned by God. While Christian organizations such as World Vision, highlighted in the Kristof's oped piece, should be commended, I do think that for a vast number of faith-based organizations and initiatives, our strategies need to be re-evaluated.