Barchi highlights inequality in world health care access


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Photo by Conor Alwell |

Francis Barchi tells a crowd of 200 people yesterday at the Robert Wood Johnson University Hospital that poor countries have different needs in terms of health care. She encouraged students to pursue careers in global medicine at the Global Health Fair.


The three richest people in the world now control more wealth than the 600 million people living in the world’s poorest countries combined.

This unprecedented inequality is one of several factors pushing global health to the forefront of medicine today, said Francis Barchi, a senior fellow in the department of Medical Ethics and Health Policy at the University of Pennsylvania.

Barchi, wife of the University president, spoke to a group of about 200 people last night at the Robert Wood Johnson University Hospital as a part of the Fourth Annual Global Health Fair.

She said the rapid growth of economic inequality has led to extremely contrasting health conditions throughout the world.

“Put simply, the poorest of the poor, anywhere in the world, have the worst health,” said Barchi, who plans to join the University’s School of Social Work faculty in January.

Barchi said inequality is most apparent in Africa, which holds 12 percent of the world’s population and 25 percent of the world’s disease burden but only three percent of its health workers.

The problem has led to a widening gap in the way populations of different countries gain access to health facilities, an issue Barchi said can be seen when comparing infant survival rates throughout the world.

“Can we actually find it fair that the chances of an infant dying before her first birthday is two in 1,000 in Iceland but 120 per 1,000 if born in Mozambique?” she said.

The social inequality has also led to a never-before-seen growth of urbanization in third-world nations, she said. According to recent studies, 22 cities are predicted to reach populations in excess of 10 million people by 2020, 16 of which will be developing countries, she said.

While some commentators have said urbanization will lead to a concentration of people living closer to health facilities, Barchi said a more likely scenario consists of overcrowding, substandard housing and poverty.

“With the growth of cities comes the growth of slums,” she said.

Barchi said global health initiatives continue to raise awareness on some of the most critical problems people face today like HIV/AIDS, which now stands as the leading cause of death for women between the ages of 15 and 49.

Yet Barchi said students who plan to enter the global health fields must keep in mind that one-size-fits-all solutions will not work on the larger scale.

“Recommending condom use to a woman who goes home to a sexually abusive husband will not work,” she said. “What works in one community may not work in another.”

President Robert L. Barchi, who has a Ph.D. in neuroscience, said his experience in single-patient operations humbles him when faced with some of the wide-reaching effects produced by global health initiatives.

“Medicine extends much further than the one-on-one contact that we tend to have,” he said.

Dr. Denise Rodgers, interim president at the University of Medicine and Dentistry of New Jersey, said the success of such initiatives can be seen in cases like the measles epidemic, which has been lowered from 3 million children deaths in 1980 to about 300,000 annual deaths today.

“If you look at the data, we are making a difference,” Dr. Rodgers said.

The fair included a display of 37 posters that highlighted different global health topics, eight of which featured the work of University students.

Benjamin Levin, a senior in the School of Arts and Science, said he became involved with global health programs after experiencing the conditions in Oaxaca, Mexico during a study abroad program.

Levin said there is currently one HIV clinic in the state of Oaxaca for people without medical insurance, a fact that forces many residents to travel up to 18 hours on a monthly basis to receive treatment for the disease.

“I think in terms of Rutgers students ... it’s good to have this idea of thinking about things from a global perspective ... so you can be well rounded,” he said.

Francis Barchi said her lecture was targeted directly at students interested in global health and suggested that those seeking change begin in their own neighborhoods.

“You don’t need to leave home to be involved in global health,” she said. “Poverty, inequality and hunger are not only the problems of elsewhere, global health is here and needing your attention.”


By Giancarlo Chaux

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