The world did not end yesterday. At least, not for you. Not for me. Yet in places like Syria, Pakistan, and South Africa, individual worlds = came to an end. The culprits? Not the dreaded riders of the Apocalypse, but well familiar stalwarts like hatred, greed and violence.
Earlier this week the United Nations launched its largest appeal ever, for nearly £1 billion, to address the crisis caused by the war in Syria. The months of fighting have provoked supply shortages, mass migrations and huge numbers of wounded against a background of intensifying cold, grief and devastation. And what will the UN do with that money? The multi-billion dollar international humanitarian industry is virtually locked out of Syria. It simply does possess the skills and capacity to work effectively in what can only be described as a very modern humanitarian crisis: security risks, lack of authorisation from the government, and an insufficient ability to negotiate and maintain access in such circumstances.
Even MSF has struggled enormously to open hospitals inside Syria, vitally important to those reached and yet insignificant compared to the larger needs. Put simply, in the midst of such epic crisis, and despite Herculean efforts of Syrian doctors and nurses, ordinary Syrians have preciously poor access to drugs or medical care.
It’s not the obvious cases of civilians in war – old people, women, children, and even babies –wounded in bombings and shrapnel injuries. Or the psychological trauma. It’s the slow fade that shocks me, the banality of chronic conditions: diabetics who run out of medication, children with asthma, and women who need caesareans. Where would I get my resupply of statins in a place like that? I’d have to give up sausages.
Earlier this week in Pakistan, polio immunisation campaigners were assassinated in a series of targeted attacks. No medical work can be carried out effectively in the atmosphere of mistrust caused by years of deliberate misinformation, rumours, or such a blatant abuse of the medical act as having spies pose as doctors (see my earlier blog on the good doctor Afridi or humanitarians as spies).
Humanitarians can’t shoot their way into town. If you headed an NGO, would you be able to ask people to go out and vaccinate? Where a nurse “armed” with nothing more than a syringe might end up between the crosshairs of a weapon? The pursuit of political and military objectives erodes trust in healthcare itself, and children fall ill and die of diseases – diseases for which prevention is simple in theory, but dangerous in practice.
And far from the week’s headlines, in places like Uzbekistan, Swaziland and South Africa, highly virulent strains of tuberculosis (TB) spread. Increasingly resistant to treatment, TB causes people pain, suffering and debilitation until death liberates them. Those who are “lucky” enough to access treatment are administered a highly toxic drug regimen that lags on for years – and given an only per cent chance of cure.
Syria, Pakistan and South Africa lie far apart on the map. The common denominator of much suffering in these nations, as in so many others, is the space between people who need care and people who can provide it. This lack of access – and the deaths that result – is as preventable as polio; it is not the doing of cosmic forces beyond human control. No, I’m afraid the world does not end in one big bang – it blinks out in the bits and pieces of human lives.
[I drafted the original version of this blog as a letter to the editor but it didn’t get picked up. P and S from the office contributed a great deal to the editing. Thanks]