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José Federico is a new kind of health worker. His mission is to connect sick, impoverished Guatemalans with the care they need. When he meets Crecencia Buch, a mother of seven with late-stage cervical cancer, he faces a dilemma. The price tag to treat her disease is almost $10,000. And at best, it will buy only a few years of life. That money could instead fund a thousand pap smears — a cost-effective way of catching cancer before it's too late.

Across the globe, at an underfunded hospital in a rugged corner of Nepal, Muna Bhul needs an emergency C-section to save the life of her baby. Dr Shree Ram Tiwari is in place to do the procedure, but his expertise does not come cheap. His salary could pay for five junior doctors who would treat more patients, but do less for them.

How do we decide how to spend limited health care dollars? Some argue powerful computers should crunch the numbers and make the decisions for us, determining which interventions deliver the most bang for the buck.

It's an approach that could save millions of lives, but others question whether Big Data can truly capture the complexities of real life.

As the debate over the role of data in health care intensifies, José Federico and Dr Tiwari remain caught on the front lines, where they don't treat statistics, they treat patients.

In The Life Equation project, journalists Rob Tinworth and Miles O'Brien follow stories in Nepal, Guatemala and the US to explore a deeply challenging question. Who should decide who lives and dies: Doctors on the front lines or cold mathematics?



navy halftone illustration of a female doctor with her arms crossed


Health Inequities

Health Inequities