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What I Saw As A Boy In India Shaped My View Of Global Health

A girl reacts as a health worker collects her swab sample to test for COVID-19 in Mumbai, India, Tuesday, April 20, 2021. (Rajanish Kakade/AP)
A girl reacts as a health worker collects her swab sample to test for COVID-19 in Mumbai, India, Tuesday, April 20, 2021. (Rajanish Kakade/AP)

“Are you ok? Did Mesho get vaccinated yet?” I emailed my cousins in India about my uncle with chronic medical issues as I slowly began to understand the growing devastation from surging COVID-19 cases.

For many Indian-Americans, the flickers of hope for normalcy in our lives here in the United States have been washed away by concern for our families in the midst of the crisis in India.

As I wrote, my mind jumped from worry for their safety to memories of my childhood visits to my ancestral home. I remember the first time I walked into a temple off the busy streets of Kolkata and found another boy who pleaded with me for money. Under his tattered clothes, I saw his emaciated body. Under the dirt that covered his face, I saw sad, longing eyes. His body and his being were ravaged by poverty. At 8 years old, I could not understand how our childhoods could be so different, and how the world could let him suffer so much. That haunting image began my journey to pursue medicine and work in global health.

Since I was a medical student, I’ve worked with the Child in Need Institute (CINI), a non-profit in West Bengal, India. As the COVID-19 news grew darker, I wrote to the founder of CINI, Dr. Samir Chaudhuri, to tell him I had started a fundraising campaign. He is a sage and gentle elderly man, but I felt his fear as he described oxygen becoming scarce and patients being turned away from hospitals. He also wrote, “This is a sad time for all of us as we saw marked improvements in health and nutritional status, school dropouts, and child trafficking among poor families since 1974, when I founded CINI. Now COVID-19 will set back the gains we made by two decades.”

Health workers and volunteers in personal protective suits wait to receive patients outside a COVID-19 hospital that was set up at a Sikh Gurdwara in New Delhi, India, Monday, May 10, 2021. (Ishant Chauhan/AP)
Health workers and volunteers in personal protective suits wait to receive patients outside a COVID-19 hospital that was set up at a Sikh Gurdwara in New Delhi, India, Monday, May 10, 2021. (Ishant Chauhan/AP)

Nearly a year and a half into this pandemic, we still have not developed a coordinated global response to it. Many in the U.S. are only now awakening to the impacts of COVID-19 in the developing world. As COVID-19 blazes through communities in India, it spotlights long-term global inequities that have been activated to unprecedented levels, resulting in humanitarian disaster. Without question, Narendra Modi’s government failed the people of India. And unmasked gatherings for religious festivities contributed to this surge. But the lack of resources available to respond to COVID-19 is also the result of a history of wealthy countries colonizing and extracting the resources of developing countries.

The same global inequities have caused disproportionate harm from the other global public health crisis we confront — climate change. It was just a year ago that I wrote to Dr. Chaudhuri to tell him I was raising money after seeing the devastating impacts of Cyclone Amphan’s 165-mile-per-hour winds on villages throughout West Bengal and Bangladesh. The historically powerful super-cyclone occurred the same week a major study further documented the fact that climate change increases the frequency of such natural disasters. Poor coastal communities face the daunting challenge of having to rebuild, only to live in fear of another natural disaster threatening their lives.

When a person across the world dies unnecessarily, it is a stain upon the fabric of our entire humanity.

My fundraising campaigns are not the answer. Too often, Americans think of global health solutions in terms of the actions individuals or organizations might take, and not in terms of reforming international systems. We need to move past giving charity and fight for international justice. The need to strengthen our global institutions has never been stronger. To thwart the next devastating pandemic, we must create an effective global response to novel infectious diseases that risk spreading quickly. We must develop equitable vaccine development and distribution systems.

We must end deforestation, a practice that brings humans into closer contact with animal-borne viruses like coronavirus and warms our planet. To mitigate climate change, we need to create more accountability for Paris Agreement commitments, and produce the financing needed to rapidly transition to a clean, sustainable global economy. We must more effectively address the refugee crises we will continue to face from climate-related forced migration. Revitalized, empowered global institutions are essential to face the extraordinary challenges upon us.

COVID-19 is possibly the greatest global challenge we have faced since World War II. In the aftermath of the war, the United Nations was founded and the Declaration of Humans Rights enshrined the principle of universal human dignity. How will we respond to this unprecedented challenge? Will we turn away from the nationalist sentiments that have dominated our recent political discourse?

The big crises of our time are the manifestation of the more central story of global health inequity. When a person across the world dies unnecessarily, it is a stain upon the fabric of our entire humanity. But we can turn course. It’s our choice. And billions of lives will be shaped by our decision.

I sometimes think of that little boy who helped me find my calling in medicine. I wonder if he survived into adulthood. After all these years, I am still left with the same question — how could the world let him suffer so much?

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Gaurab Basu Cognoscenti contributor
Dr. Gaurab Basu is a primary care physician, an instructor at Harvard Medical School and Co-Director of the Center for Health Equity Education & Advocacy at Cambridge Health Alliance.

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