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A critical social analysis of poverty and zoonotic disease risk

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Presentation by Professor Jo Sharp of the University of Glasgow at the One Health for the Real World: zoonoses, ecosystems and wellbeing symposium, London 17-18 March 2016

Published in: Health & Medicine
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A critical social analysis of poverty and zoonotic disease risk

  1. 1. A critical social analysis of poverty and zoonotic disease risk Jo Sharp @ProfJoSharp
  2. 2. “The inequalities of [health] outcome I describe are, by and large, biological reflections of social fault lines. Exaggeration of patient agency is particularly marked in the biomedical literature, in part because of medicine’s celebrated focus on individual patients, which inevitably desocializes. The sickness [of the poor] is a result of structural violence: neither culture nor pure individual will is at fault; rather, historically given (and often economically driven) processes and forces conspire to constrain individual agency.” Rethinking poverty
  3. 3. “I have a fear of the payment, and not of the sickness. Treatment exists, good treatment that will cure quickly, but you worry you will not be able to find the money in time because a fever does not wait for you. You worry if you will be able to find the money to get treatment before the patient dies” Focus group, Dar es Salaam, Laurie 2014. “While ‘user fees’, ‘poverty’ or ‘inequality’ will not appear on death certificates, a social autopsy of such deaths would inevitably reveal these conspiring factors in such fatalities. Such deaths are born out of bureaucratic decisions made in distant conference rooms, unaccountable to any one individual.” Laurie, 2014, The embodied politics of health in Dar es Salaam. To take action, an individual needs to have a sense that s/he has the ability / power to make change Women’s access to healthcare
  4. 4. Poverty & gender “Bedouin women do not farm”
  5. 5. Coping strategies can lead to new risks: “To be honest, if I have 4 goats, 3 cow and 6 pigs, I will vaccinate only cows and leave the others because I don’t have the money to vaccinate all animals at once.” “When our pigs died, we called the livestock doctor and he said we could not eat the meat but he still wanted to be paid. … So, the way I see it, when the animal is sick, instead of looking for medicine to treat, it is better to slaughter.” “So, you get sick and stay at home for the whole week without going to the hospital, just taking anti-pain while you don’t know you which disease you are suffering from, and deciding what you can sell so that you can go to hospital.” Focus group discussions, northern Tanzania “The difference between going to the hospital and going direct to pharmacy is once you go for prescription you have to wait in a queue all day and pay for registration, then pay for the doctor, the doctor asks what you used before, writes a prescription and directs you to the pharmacy. So why go through those stages, pay the extra money, wait all day to end up in the same place? It makes no sense.” Focus group, Dar es Salaam, Laurie 2014. Consequences for disease risk
  6. 6. Livestock are key to livelihoods in social, cultural and economic terms “I don’t think any of us keep animals for the purpose of become rich but animals are our insurance because they help us to solve problem when raised for instance if someone is sick at home or school fees is needed then you can sell the animal and solve the problem you face.” Focus group discussion, northern Tanzania  Further emphasises the “social fault lines” that create an uneven distribution of vulnerability to disease. Thinking critically
  7. 7. Egypt: The Wadi Allaqi Project. Tanzania: The impact and social ecology of bacterial zoonoses in northern Tanzania (BacZoo); Social, Economic and Environmental Drivers of Zoonoses in Tanzania (SEEDZ); Hazards Associated with Zoonotic enteric pathogens in Emerging Livestock meat pathways (HAZEL). Thanks to who have contributed to:

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