From Daily Planet Staff Reports

The health of human beings around the world is improving, statistics show, although there remains a consistent disparity in health care between urban and rural areas in developing countries, Dr. Jeff Heck said during a Dec. 1 lecture at UNC Asheville’s Owen Conference Center.

Heck addressed “The State of the World’s Health: The Diagnosis, Treatment and Prognosis From a Doctor’s Perspective” in a 30-minute talk, sponsored by the World Affairs Council of Western North Carolina. About 45 people attended.

Dr. Jeff Heck

Heck is the founder of Shoulder to Shoulder, an organization that promotes health, economic and social needs in isolated, impoverished peoples. More than 144 volunteers from the American health community have donated their services to Shoulder to Shoulder, he noted.

Heck, who lives in Asheville, works in family practice at the Mountain Area Health Education Center at 118 W.T. Weaver Blvd. and at Mission Hospitals.

“I’ve learned about global health by the seat of my pants — I’m not really an expert,” he said in his opening remarks.

Heck, who has worked directly with poor people, including in Kenya in Africa, said, “People don’t want just freedom from global diseases, but a happy, fulfilling life” as well.

“Contrary to what many people believe, in the last 20 years, since 1980, the life expectancy in almost every area of the world has improved. That includes the pre-age 5 mortality rate.

“The under-5 mortality rate has dropped  all across the world, with one excepton — sub-Saharan Africa ... A lot of it (the health-care problem) is sociopolitical.”

He added, “When we talk about health disparities across the world, there’s a great disparity between urban and rural areas,” with urban areas nearly universally offering better medical care than their rural counterparts.

For the sake of contrast with the West, Heck noted that, while in the U.S. there is one doctor per 1,000 people, in rural Africa, one doctor serves 100,000 people.

He added that one billion people in the world are poor, living on $2 per day. Further, Heck said a “vast number” of people live on less than $1 per day.

In his definition of poverty, Heck said he would include no running water, no latrine, one room for six or more people and — perhaps surprising to some — a lack of books.

Heck said he knows he is in an impoverished place when he there is “no written material in sight ... These kids grow up illiterate, with illiterate parents.” For most students, “they won’t go beyond sixth grade ... They would have abdominal parasites and lack minerals to fight of diseases.”

As or the so-called “magic bullets,” which Heck termed “the misconceptions in development” that he and his associates “learned early on,” he listed the following:

• “There really is no magic bullet.”
• The U.S. health care system does not translate to help other countries as a model.
• The communicable diseases are not the culprit, which instead “is the lack of a health infrastructure.”

As a result, efforts by Americans and others to provide health care in developing countries often amounts to little more than a system “that patches people up.”

However, Heck quickly added, “I, for one, believe there’s great value in every human life. But, in the long run, it’s not the answer ... In the long run, it’s nutrition, education — particularly of girls — and a whole myriad of things.”
The doctor contended that “for every year of education of a girl after the sixth grade, there’s a 5 percent decrease of under-five (infant) mortality.”

What’s more, he said, “It’s the same in every culture — women make the decisions involving the children.

Heck told of his group’s effort — “and it worked” — to put girls in charge in a sustainability project, which clashed with the people’s tradition of patriarchy. However, he cautioned, “It’s important not to pull the rug out” from under the people one is trying to help.

“Poor people are not stupid,” he said. “They lack the skills to pull themselves out of poverty,” but they possess intelligence in other areas.

As for his group’s efforts to help others in developing countries, Heck said with a smile, “We don’t do what we want to do. We do what they want us to do — within reason.”

In speaking abstractly, Heck said those who commonly help those around them are “our neighbors ... They’re the consistent ones — not the governments or the NGOs (nongovernmental organizations). So, we have to empower the neighbors.”

Through his experiences in working closely with people abroad, Heck asserted, “I have great faith in poor people and poor communities, as I do in all people. They all want the same thing....

“When you boil it down to people, people are important.” He then told of a poor elderly woman who once told him, “Doctor, consider the value of your own life. For everyone of us, our own lives are valuable.”

In closing, Heck said, “We can’t solve the whole world’s problems, but when it’s in front of us, we have to solve what we can.”