Last Friday, James Orbinski spoke to a packed Chan Centre crowd about his experiences with Médecins Sans Frontières and the need for equality. Equality in healthcare and access to drugs, and more generally, equality in all things, born from a sense of solidarity.
The most effective moments in his talk, in my mind, were not the grand sweeping phrases like “refuse to accept the unacceptable”, but rather, the anecdotes he shared about his time with MSF. One in particular comes to mind: the story of a little boy he treated for a cut in his arm. The boy, who was poor and hungry, had gotten caught stealing from a street vendor, who had then cut his arm with a piece of glass in punishment. When Orbinski examined the cut, he saw two rows of tiny dots on either side of the wound. When he asked where they’d come from, he learned that the boy had gone first to the local hospital, where a doctor had stitched his cut. When the doctor discovered that the boy couldn’t pay, however, he had removed the stitches.
The cold deliberate nature of this act represents the ultimate in mercenary medicine. The mindset that drove that doctor to remove those stitches is the same mindset that allows drug companies to deny affordable drugs to those in extreme poverty and need. The “for profit” mindset that directly or indirectly drives many of society’s actions today. When that doctor no longer saw personal gain in that interaction with the boy, it became meaningless to him. There was no solidarity, no sense of empathy. He didn’t look at that boy and see a fellow human being; he saw a transaction.
The large drug company, Merck, has a library of literally thousands of natural products with the potential to cure the diseases of the developing world. They sit untouched. Why? Because there is nothing to be gained from curing people who cannot pay. And when a compound is found to be active, say against both a rare cancer and arthritis, and chosen to be developed as a drug, the disease it is developed to fight will be arthritis 99% of the time. Because people who take medicine for arthritis take it for the rest of their lives. And people with cancer are either cured or they die.
James Orbinski said this, more eloquently and with more authority, and called for a change.
A change in priorities, in mindset. So where do we start?
I don’t see this as isolated problem, certainly not one that applies solely to public health. And for what my two cents are worth, I think the fault lies partially in the values we’ve cultivated in the west. We spend a lot of time thinking about ourselves. How to improve ourselves. How to improve our lives. Thinking what’s in this for me. I think even those of us who try to break out of that pattern do it without being aware of the fact.
The name of Orbinski’s talk was “Creating the space to be human”, but while he told us to refuse to accept the unacceptable, he left me wondering how we go about cultivating that humanity that sometimes seems to be lacking.
did anyone else go see his talk?