“Hope in Hell: Inside the world of Doctors Without Borders”

A new book i will “devour”

I was chatting to Rebecca online when i was asked about the reasons behind my interests in international health.

[jeff] well i guess it could be one of e reasons why i chose to embark on this career.
[rebecca] ur 5% doc now…after yesterday’s exam
[jeff] and i find it more fulfilling to treat and help someone disadvantaged
[rebecca] indeed
[jeff] who possibly get the illness or disease, as a result of not their own fault
eg. a new born baby get aids from aids infected mother, who is raped by aids infected men
[rebecca] ya
[jeff] or Infec disease
rather than treat pple
with coronoary heart disease who dun take care of their own health or smoke their lungs away and get cancer
but then again
i think u can do more good in a few months at a developing countries as compared to a few years in a devloped country
whcih is why a mix is good, cos after all, still need to settle down and have kids, see my parents etc
[rebecca] agreed!

we then chatted about providence of health care to the rich and the poor. Came up with some wild idea that maybe can set up some western medical center that gives free treatment to the underprivileged in the country. Thinking back its not really feasible. The government will most likely not approve. Because if they do, it reflects they recognise a problem or flaw in their whole public health care system. Our health minister Mr Khaw wouldn’t be so cok-up. Reforms are on the way, and as the no. and percentage of low-income (Govt’s definition + red-tapes to clear?), or unemployed people decrease, there is less focus on providing equal or fair health care to the general population. I reckon we are more tuned to the US model of providence of health care.

The Brits and Aussies believe that there should be equity in health care. “We give people free health care.” They believe even those alcholics and drug addicts who have no jobs should be on the dole and be taken care by the government and given money every month from taxpayers’ money. (who by the way slog it out for a good salary to lead a good honest healthy life so they can give a percentage of it to the g
overnment who will in turn spend it on these people on the lowest rungs of the societal ladder.) They believe on mere basis that they are citizens of their country, they should be given the same health care as everyone else. So the issue comes in when there is a liver available for transplant, one is for a 40-yr-old chronic alcohol abuser who doesn’t show signs of changing his alcohol consumption patterns and a 80-yr-old frail lady. Both will die if they don’t get the transplant. Who to give to?

On the other hand, the Americans are less interested in making sure everyone gets care. They accept not getting care now if they can see the opportunity to improve their position and succeed, so that, when they get the money, they will be able to buy great care the minute they want it. It is all about opportunity to them. They want that, not equity. That’s what they think is fair.

Singapore is a meritocratic society. “No one owes Singapore a living” You fight for your own status in society and your own happiness. You don’t rely on the government. Although we had been a nanny state, but there is a move now towards the people being given more responsibility to take charge of their own destiny (in general terms) This is good. I like it.

Gee. Enough of this THEME II (Health, Knowledge, Society) stuff, a part of my 4-themed MBBS course at Monash Uni. Or promoting PAP.

Delved into this because of my conversations with Rebecca about international health.

But yea, international health is interesting.

I will do a couple of attachments overseas in these settings if possible. And i’m adamant on going for a MSF mission one day. And statistics show there are no one-MSF-mission doctors. There are only doctors who keep going and keep going.

Rural clincal school in year 3, here i come!

CORRECTION 30 Sept 07:

- not intending to go rural in year3. metropolitan hospitals. we made our choices recently..