Lesson Plans

Stopgap Health Care in the Developing World

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Pedro Robles died from AIDS in a Tijuana, Mexico, hospice in 2013 without ever receiving treatment. Image by Malcolm Linton. Tijuana, 2014.

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Nilza Munambo listens to a fetal heartbeat. She's in charge of the maternity ward at Chokwe District Hospital and regularly performs cesarean sections even though she's not a doctor. Image by Bridget Huber. Mozambique, 2014.

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Mist in Port Loko, Sierra Leone. Image by Amy Maxmen. Sierra Leone, 2014.

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Freshly dug, child-size graves in Freetown, Sierra Leone. Image by Amy Maxmen. Sierra Leone, 2014.

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Dust collects in a schoolhouse in Kenema, Sierra Leone. Image by Amy Maxmen. Sierra Leone, 2014.

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Matshidiso Rebecca Moeti, the new Africa regional director for the WHO. “The WHO responded quickly,” to Ebola, she insists. The problem, she adds, is that the outbreak moved even faster. Image by Amy Maxmen. Sierra Leone, 2014.

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Dr. Foday Sahr, co-investigator on a trial to test survivor blood as a treatment: “Research can always be done, even in the middle of an epidemic.” Image by Amy Maxmen. Sierra Leone, 2014.

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Kadiatu Fofanah received an infusion of survivor blood at the 34th Military Hospital and lived. “The doctors at this hospital are the very best.” Image by Amy Maxmen. Sierra Leone, 2014.

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An Ebola treatment unit in eastern Sierra Leone opened after the worst of the epidemic had passed. Image by Amy Maxmen. Sierra Leone, 2014.

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New 4x4s sit at a UN compound, plastic wrap still over the seats. Image by Amy Maxmen. Sierra Leone, 2014.

Objective:

To learn about the state of health care in developing nations, and to draw conclusions about effective health care from their successes and failures. Students will also make predictions about the best way to allocate aid to hospitals and clinics.

Warm-up:

1. If you ran a clinic, how would you prioritize care? Rank the most important in each pair--if you had to choose one.

Doctors well-trained in their specialties

Doctors who are general practitioners, able to perform a lot of routine surgeries

Reliable equipment for diagnosing disease

Reliable equipment for treating disease

 

Effective disease prevention

Effective disease treatment

 

Trauma care

 

Chronic illness care

Paying doctors well

Making sure all patients have access to heath care, regardless of income

 

2. Discuss your choices with your neighbors. Explain the reasoning behind each choice.

Introducing the Lesson:

Many parts of the world lack the kind of medical infrastructure common in the U.S. In Mozambique, trained surgeons are scarce. Some West African Ebola clinics lacked adequate protection for nurses and chlorine for killing germs. And in Tijuana, Mexico, many hospitals simply don't have the resources to treat HIV. Today we'll examine each of these region-specific cases: Mexico, Mozambique, and West Africa (namely, Liberia, Guinea, and Sierra Leone) to learn how they cope with fewer resources, and how they could best change their circumstances.

The three projects we'll look at are by different journalists, all funded by the Pulitzer Center on Crisis Reporting. Keep in mind what these stories have in common, and the ways in which the three regions deal with similar problems.

Introducing Resource 1: “Mexico: No End in Sight”

1. This article uses a few key cases to demonstrate the state of HIV treatment in Tijuana, Mexico. Review the associated questions before you read the article, and underline while you read. Then, answer the questions in writing.

2. Share your responses with members of your group. (4-5 people)

Introducing Resource 2: “Mozambique’s Life-Saving Surgeons Aren’t Always Doctors”

1. Listen to the story on Mozambican health care, reported by the journalist Bridget Huber for PRI’s The World. Answer the attached questions as you listen.

2. Now, take turns discussing the big picture questions with your group.

Introducing Resource 3: “West Africa: How Slow Responses Made the Ebola Outbreak So Deadly”

Science journalist Amy Maxmen traveled to Sierra Leone in 2014, documenting Ebola clinics, front line workers—doctors, nurses, and gravediggers—and the scientists trying to cure Ebola for good. This article gives a rough timeline of events, chronicling both the spread of Ebola, and the disbursement of supplies and healthcare workers. As you read the article, make 2 lists:

  1. A list of the parties and/or individuals responsible for slowing down Ebola treatment
  2. A list of what you would have done to intervene at each of Maxmen’s checkpoints (1 month after, 3 months after, etc.)

Conclusion:

Think back to the tough choices you faced in the warm up. Consider how the three case studies we examined actually dealt with these choices. Draft one medical policy recommendation for each region: Tijuana, Mozambique, and West Africa. Address your recommendations to lawmaking bodies, making a persuasive case for each policy. Finally, draft a health care policy recommendation for the United States. What can we learn from makeshift health care systems in undersupplied countries?

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