FORGING THE CHAIN

P
78
p80
POVERTY,
DISEASE,
POVERTY
“The people’s misery: mother of diseases.”
Johann Peter Franck, 1790
For poor families, the economic impact of a serious illness
is not just confined to the price of essential medicines
but to the loss of income from not being able to
work. Debts escalate – including time lost through not
being able to carry on subsistence agriculture – with
negative effects not only on the individual but also on
spouses, children, elderly parents and other relatives.
In addition, even after treatment, Chagas disease,
Buruli ulcer, cutaneous leishmaniasis and yaws
can permanently disfigure or disable. In many cases
patients are shunned socially or left physically unable
to work. They become burdens on their relatives and
their families are further mired in poverty.
Governments in many regions of Africa, Asia and Latin
America have scant resources available to fight tropical
diseases, the victims of which are often the poorest
of the poor.
The relationship between a patient and NTDs creates
a double bind: both the sufferer and the disease
are neglected. Living mainly in remote rural areas, with
no political voice and no funds to pay for health care,
these populations are trapped in a cycle of poverty
and disease. Lack of proper hygiene – no clean drinking
water, no proper sanitation, and no proper waste
disposal – exposes them to a high risk of infection.
If this were not enough, chronic malnutrition leaves
them vulnerable because it weakens their immune
systems. Flies and other vectors of disease thrive in
these situations.
A vicious cycle develops. Poverty leads to disease,
which leads to more poverty. That is especially true
when coupled with other factors – armed conflict,
forced population movements, illiteracy, lack of education,
lack of land ownership and gender inequality.
Women and children are most vulnerable and are
those most often infected. The result is that new generations
get off to a bad start.