All My Children
We have spent some time—782 Tuesday morning essays to be precise—talking about our kids. As well we should. With the possible exception of a slice of warm cherry pie with a scoop of lactose-free vanilla ice cream, my kids are my greatest joy. I was over the moon when my kids and I went on our first bike ride together; when they first beat me at 5K; when they started showing on their fingers how many times they had heard the same Dad Joke (“What kind of music do windmills like?” “They are huge metal fans.”)
But rather than talk about my kids this week or your kids. I want to focus on somebody else’s kids.
Specifically, I’d like to talk about the children whom Dr. Hans Rosling served in Mozambique—at that time the poorest country in the world—in the early 1980s. Indeed, the paragraphs that follow are taken from Factfulness, Dr. Rosling’s extraordinary 2017 account of what pretty much everybody gets wrong about the world.
Dr. Rosling begins Chapter Five describing an argument with another doctor about the level of care provided to the young patients in the Nacala District. The arithmetic was brutal. With one doctor for 300,000 people, care was desperately inadequate. Attending to one child for more than a few minutes necessitated that there would be no time at all for the dozens of other children waiting for life-saving treatments.
Mozambique in the early 80s was The Trolley Car Problem on steroids. One child in four died before their first birthday. (By comparison, in the US at that time, fewer than two children in a hundred died that young.) Dr. Rosling was tasked with keeping as many children alive as possible, given absurdly scarce resources. There were not nearly enough oxygen tanks, blood transfusions, intravenous drips, or trained medical staff to go around. As a result, sub-standard care was the standard.
Dr. Rosling called it “the cruel calculus of extreme poverty.”
But the situation was actually even worse. Because as bad as the odds were for children who made it to the hospital, many more kids died at home. There were few roads and fewer cars. Bicycles, never mind motorcycles, were unheard of luxuries. Babies too weak to breast feed died in their mother’s arms. Over 98% of children had no access even to the low-quality, under-staffed, poorly funded hospital. Diarrhea, malaria, pneumonia could have been treated before they became life-threatening. But were not.
Dr. Rosling’s insights into an intractable, perpetual problem were beyond brilliant. I would have thought that progress would have involved building more hospitals, hiring more doctors, purchasing more supplies. But Dr. Rosling made momentous progress using the little money that was available rather than the fantasy amounts in my delusional thinking. Rather than waiting for the children to become deathly ill requiring funds that were not available, Dr. Rosling began stemming the problem at the source.
“Organizing, supporting, and supervising basic community-based health care... would save many more lives than putting drips on terminally ill children in the hospital… So we worked to train village health workers, to get as many children vaccinated, and to treat the main child killers as early as possible in small health facilities that could be reached even by mothers who had to walk.”
An ounce of prevention is worth ten thousand pounds of cure. Brilliant. Imagine teaching a woman to read (inexpensive, doable) so that she can understand the instructions on a bottle of pills and avoid a two-day walk to a over-burdened hospital (costly, unlikely.)
To return to our beloved children, I can think of at least two takeaways: that we have nothing to complain about is manifest. Forty-five minutes waiting and a forty-five-dollar co-pay to obtain antibiotics and lifesaving medical guidance impresses this author as beyond miraculous.
Nipping the problem in the bud is also worthwhile. If you’re arguing with your fifth grader about her math homework, maybe something has already gone wrong. Maybe establishing rapport, helping her to enjoy arithmetic, examining the curriculum, changing your expectations, should have been considered before escalating quarrelling.
I am sensitive to how inappropriate it is to equate the unspeakable tragedy of the needless deaths of children years ago to our beloved and privileged kids. Perhaps it could be argued that we are, in some small way, honoring the memory of those heartbreaking losses. And there’s the most important lesson. You don’t have to decide whether to pay your rent or fill a prescription. If you are reading this essay, you live indoors and have a computer. Your kids don’t have a life-threatening disease. You get to go on a bike ride with your kids, have them beat you in a footrace, and roll their eyes at your Dad Jokes.
Something to be said for that. I’m glad we got to say a word honoring the memory of Dr. Rosling and children all over the world.
