[MUSIC] I'm Dr. Rob Murphy. I'm a professor of medicine and bio-medical engineering at Northwestern University in Chicago and Evanston, Illinois. I'm going to be talking, today, about global health and improving health around the world. The foundation of global health is working on infectious diseases. The poorest countries of the world are impacted severely by infectious diseases, primarily AIDS, tuberculosis, malaria, viral hepatitis, and now, Ebola virus. These infections cause the bulk of the morbidity and mortality around the world, in the poorest nations. As soon as a nation gets some resources and they get out of the category of being a poor country, and they get into the middle income categories, the first thing that happens is the amount of infectious diseases drops significantly. But as soon as that happens, what comes up? Cardiovascular disease, metabolic diseases like diabetes, cancer, dermatologic diseases, pulmonary diseases, and other non-communicable diseases. So, these just take the place of the infectious diseases. So, all that falls into the, the category of global health. I'm going to tell you now about a case history in the country Mali, in west Africa. It's one of the poorest countries in the world. Over half the population is less than 15 years of age. Life expectancy is only 51.4 years. That's incredibly low. This, however, happens to actually be an improvement since the year 2000, when life expectancy was only 46 years of age. I'm going to show you a couple of pictures of some scenes, typical scenes going on in in Mali right now. Some of the bombed-out vehicles from the recent war with the jihadists. A pile of actually unexploded rockets and bombs, which are just sort of scattered around the country right now. People returning to their homes in the north because they had fled during the Jihad Movement. Mopti, which is in the middle of the country, a beautiful city, one of the famous mosques in Mopti. It's a beautiful country with incredible buildings and mosques. The road to Timbuktu. There really is no road, it's just, you're just driving a car with four-wheel drive across sand in a desert. And then finally, more refugees crossing the Niger River and going home to Timbuktu and areas further north. Infectious diseases are endemic in a poor country like Mali. Malaria is particularly endemic and malaria affects young children under five and pregnant women are, bare the brunt of this infection. Only a quarter of the children sleep under bed nets. Treated bed nets are a very effective way to reduce malaria. One of the good aspects about infectious diseases in Mali is that the HIV infection rate is quite low. In Mali there's very few doctors. There's one doctor for every 9,000 people, compared to the United States where we have one doctor per 400. You can see there's really a very dramatic difference. Low income countries, including Mali, really prioritize their healthcare needs as follows. Number one, reduction in child mortality, this is the most important. Number two, prevention and treat malaria, HIV, and other diseases common in those regions. Three, they've got to strengthen the community health programs. Four, they have to expand health communication. People have to communicate about these epidemics and treatments and what's available. Five, finally, youth development and reproductive health. I'd like to summarize some of the challenges that you're likely to face if you go into global health as a career, or even an academic interest. The very first thing that you have to keep in mind is that you are there to help people identify their needs and support their needs. What you want is not necessarily what they want, and what they want is the most important. You have the greatest idea in the world, but if they don't want it there's going to be no point in doing it. So, identify the needs and work on the needs of the people in the region where you're working. Number two, work from the ground up. Start at a low level and build up, get the confidence and get the support and the, the approval of the people that you're working with, and, and build your way up that way. So, from the ground up, starting with your experience and all through the different levels of your relationship. Three, do something really unique and supportive from an educational viewpoint, something like the Peace Corp, something like a Fulbright Scholarship or some other program that has you working for a significant period of time. Not that a month or three weeks, or six weeks is, is not going to help but programs that are at least one year actually have the greatest amount of impact. So should, you should at least consider them somewhere along in your career, if you're interested in global health. Stay focused, build relationships, go back to the same place or the same area time after time again, so you become really familiar with them and they become familiar with you. And finally, promise only what you can deliver. Otherwise, you're going to lose all your credibility and that's going to hurt everybody. Good luck in your global health work. [MUSIC]
