Only

February 22, 2011

Matagalpa, Nicaragua

In his orientation to the six members of our United Methodist Volunteer in Mission (UMVIM) Team Dr. Francisco Gutierrez of the Accion Medica Christiana (Christian Medical Action) outlined the current status of health care in Nicaragua by citing numerous statistical studies.  These reports suggested that since 1995 infant mortality, maternal death and malnutrition rates had all improved in this Central American country of 5.4 million people.  These statistical benchmarks are used internationally within the health community and by governmental and non-governmental (NGOs) funding agencies.  Nicaraguan progress in healthcare had not reached targeted goals but there were definite improvements in their nation’s health and healthcare system.

One of the challenges that NGOs such as AMC face is that organizations like the World Bank and the IMF (International Monetary Fund) appraise their funding to developing nations on macro-statistics such as those cited.  For example, Per Capita Income (PCI) is a mathematical formula by which the Gross National Product (GNP) of a nation is divided by the total of their population.   In Nicaragua’s case GNP and PCI have increased in the last fifteen years.  Ironically this has resulted in decreases of international funding to Nicaragua, especially to their health programs, as such funding has been redirected to other nations with lowering GNPs.  These formulas may seem logical expect for the reality that PGI is not distributed equally in any nation.  In the case of Nicaragua the gap between rich and poor has increased dramatically within those same fifteen years in which their GNP has grown.  Dr. Gutierrez concludes that Nicaragua’s healthcare targets have not been reached in part due to this decrease in international funding inherently based to avoid or ignore the disparities in wealth distribution in a developing nation such as Nicaragua.

Working with the National Ministry of Health, AMC is doing fantastic, pioneering work in community health education and promotion with his nation’s poorest of the poor.  Despite their progress such a presentation was no cause for celebration for Dr. Gutierrez, no moment of boasting, no moment of satisfaction at the process of his life’s work. 

We can imagine the planners of the World Bank and IMF reviewing the statistics of Nicaragua and concluding that today “only” 40% of the population of Manuagua, Nicaragua’s capital city of 1.5 million, lives at the “extreme poverty level” of one US Dollar a day or that “only” 80% of the rural 350,000 inhabitants of the Matagalpa District survive in such poverty when fifteen years ago the rates were higher.

“Only”.

 Can a Pediatrician boast that the infant mortality rate for his nation had dropped from 25% to 18% in the same period of time?  As if 18% of the Nicaraguan children dying before the age of five is an “only” compared to the 25% of fifteen years ago?  There may be some doctors who could but this Pediatrician, Dr. Gutierrez wouldn’t or couldn’t.

Most who read this will have no idea what it must be like to live wondering if your children are going to eat tomorrow.  I know I don’t.  I can’t even imagine what it must be like to live in such a reality, who I’d be and what choices I would make to insure my children’s survival.  Those medical doctors who have dedicated  their lives to working with just such people, the 20% of the world’s population who live on a one US dollar a day (UNDF), do so not for accolades or momentary satisfactions, although both may come their way. 

My hunch is that until the day arrives that all of God’s children have enough to eat, a decent place to live and access to health care Dr. Gutierrez will not celebrate any statistical markers besides 0.

He, like others throughout time, has been compelled by God’s promised future, “the Reign of God” as Jesus put it, a future where everyone has enough.  That’s why they do this work.  That’s why they don’t give up.   

In 1974, it was estimated that 40,000 people….mainly women and children…died each day of malnutrition and nutrition related diseases.  40,000 a day.   Today, the United Nations World Health Organization estimates that number to be 24,000.  Big improvement to be sure.  Things are getting better, yes.  “Only” 24,000.

“Only”?