Survival vs Infectious Disease; Who Wins?

In most developing countries, many survive below the international poverty threshold (poverty line). The poverty threshold is the minimum amount of income sufficient for a person’s nutritional, shelter and clothing needs in a particular country. The international poverty line measures poverty in all countries using the same standard. In 2015, the international poverty line was revised to $1.90 per day from the previous $1.25.

Living below the poverty line, means families have to work hard to survive on a daily basis. With the poor and rural populations surviving on small scale businesses and farming most of which are not sustainable, survival is indeed for the fittest.

 For rural communities, farm produce and livestock are their most valuable assets and source of income.

For rural communities, farm produce and livestock are their most valuable assets and source of income. As such, loss of a crop or animal deprives them of the needed income. This has led to some farmers making tough decisions, most of which overlook the associated risks. Cases have been reported (e.g in India, Bangladesh, Indonesia, Ghana, Kenya) of farmers selling meat from a sick or a dead animal carcass resulting into consumers and handlers being infected with anthrax. Some of the farmers sold the meat despite prior knowledge that the animal could be infected with anthrax. By selling the meat the farmer would make a bit of money than a complete loss of income from the death of the animal.

Does this imply that the need for survival in poor and rural populations surpasses the risk of disease? What is more risky losing money or an infection with a deadly disease or both?

Anthrax is serious bacterial illness caused by Bacillus anthracis. It is a zoonotic disease (i.e can be passed on from animals to humans), acquired through handling and or consumption of sick animals as well as inhaling  bacterial spores. Anthrax exposure can be through broken skin, ingestion of contaminated meat, or inhalation of bacterial spores. The disease develops within 1-7 days of exposure with varying symptoms depending on the route of exposure.

Losing a Job vs Losing a Life

In order to survive, while women tend the family and farms, men usually go to find work to earn money for the family. This is a common trend in rural populations of developing countries. For example there are certain villages where the population is comprised of women and children with their men in cities working. These men send money to their families, they are the survival line for their families. But at what cost? Most of these men will continue working even when they know and feel unwell. Instead of seeking treatment and losing a day at work or risk completely losing their only source of income, they resort to self medicating. This delay in seeking treatment has resulted in higher mortality due to HIV or tuberculosis (TB), and could contribute to ongoing community-level TB transmission before initiating treatment . A study from Blantyre Malawi has shown that as men endeavour to sustain their income, they often ignore their health needs.

Men endeavour to sustain their income, that they often ignore their health needs.

Culture vs Infectious Diseases

Culture and traditions are what make people and places unique. These cultures and traditions come with unique practices some of which may perpetuate the spread of infectious diseases.

For example under age marriages, and domestic violence/ abuse, have affected women’s ability to make choices. In Patriarchal societies, women may have less ability to make their own decisions. In some communities wives have ended up sleeping with their husbands without protection even when they knew that their husbands are HIV positive or have other sexually transmitted infections. Most of these cases go unnoticed because some of the women may not open up to these abuses in fear of stigma and loss of family support.

In some communities wives have ended up sleeping with their husbands without protection even when they knew that their husbands are HIV positive or have other sexually transmitted infections.

In other cultures funeral practices involve contact with dead bodies and or the water used to clean the body. This exposes those in contact with various infectious diseases including the Ebola virus.

Understanding the risks and challenges that culture and traditions pose with regard to infectious diseases in communities is valuable when designing and implementing infectious disease control and prevention strategies.

Who is at Risk

  • Communities in most developing countries are at high risk of consuming tainted food not only with anthrax but also other equally dangerous organisms. Is the money worth the risk? This question has various responses depending on who is being asked. While the public health personnel may lean more towards disease control and prevention, the poor farmer/small scale business owner trying to put food on table may have a different take.
  • The risk that men take in various regions to provide for their families while ignoring their health can not go unnoticed. More so the risks that women take to survive at the cost of contracting infectious diseases due to underlying cultures and traditions.
  • Changing years of culture and traditions is a difficult challenge. Consultation with the affected communities maybe a first step.

 Your Role

It is not about who wins, but finding solutions that can allow for poor and rural communities to meet their needs and reduce the risk of infectious diseases.

This is a challenge not only for the affected countries but also all stakeholders working to improve livelihoods of poor communities worldwide.

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