Written by Western Sydney Local Health District research and education network director Professor Stephen Leeder
The week commencing April 9 was a kaleidoscope.
I was in Pokorha, the second city in Nepal, for a workshop for 60 health professionals from Nepal, India, Bangladesh and Sri Lanka, exploring how epidemiology can help address the growing menace of chronic disease in these countries.
Today, the majority of heart disease occur in countries such as these. Those dying are – as they were in Australia 50 years ago – often middle-aged.
Beyond the walls of the Pokorha Grande Hotel where local practitioners and faculty from the International Epidemiological Association were conferring, the world spun on. The USS Carl Vinson battle group sailed for the Korean Peninsula. Twenty five Tomahawk cruise missiles, costing $2 million each, bombed a military airport in Syria. Trump kept everyone guessing. The world was wobbling.
And in Nepal? One afternoon between conference sessions, we visited a Tibetan refugee village and listened for an hour to the deep rhythmic thrumming of the monks chanting in their chapel. En route, we stopped at a hilltop Hindu temple, exuberant with celebration.
Another morning, we visited the Peace Temple, a stupa built by the Japanese on a mountain overlooking the Pakhora Lake. Then, in Kathmandu, we took one of 26 flights that day to view Everest from the sky on Easter Sunday. I am told there are shells on the mountain peaks, reminding us of their origin as a sea bed, heaved up by grinding tectonic plates, which re-awoken, caused the earthquake of 2015 in which 22,000 Nepalese were killed.
From these experiences and impressions, I drew three observations.
First, we easily forget the power of nature, typified by the Himalayas and the 2015 earthquake. Trump may drop his 11-megaton bomb but it’s small beer. Those who climb mountains or sail are not as ignorant as desk-bound people like me, of this power. But when we wrestle with illness that originates deep in our genome or in the crevices of society – both products of nature – maybe we should not be surprised how difficult and uneven the battle seems.
Second, the variegated pattern of religious observance in Nepal, mixed with ethnic and cultural diversity, reminds us that life goes on happily among millions of people untouched by economic rationalism, marketism, and debt reduction. These traits of our society are not of universal importance. Maybe we should occasionally question our fanatical engagement as a society with economic growth. There are good books out there that can help if this question strikes us as important.
Third – and this was an observation that struck me forcibly two months ago in Vietnam – we in Australia are incredibly fortunate in the structure, infrastructure, content and process of our health service. We can gain rapid access to new knowledge through the web – not so in most countries. Commencing and conducting medical research is a challenge in our country, but not insuperable. It can be like climbing Everest elsewhere. And the same applies to access to care. I thought, as I sat in our hotel in Kathmandu among teeming impenetrable traffic and snarled roads: “what hope would there be if I had a heart attack here?”
Medicine has exceptional opportunities to foster international relations and has a strong reputation for seizing them.
We may be able to do more. The gains could be great as today, we tackle common problems – chronic illness and the care of older people.
If we can avoid the insane catastrophe of war and continue to work to preserve the environment, a healthy future beckons, and we can be part of bringing it in.