Why is education and awareness raising so important?

Well, first and foremost, consider the issue of family planning: there is no doubt developing countries need to lower their birth rates dramatically to reduce the social, environmental and economic burden of providing education, healthcare, food, water and jobs amongst other things, to so many people. For sure, some of the poor in those countries understand this and want to have less children but cannot, for reasons including sexual pressure from males, lack of access to (or awareness of) contraceptives and reproductive health knowledge. 

But, for many they are not aware of the impacts their children will have: the impacts on the child, on the parents, on the wider family, on the country, or on the environment. They have not done the calculations: if they have they probably still believe that having more children helps provide for the family in the medium-term, and for their parents in the long-term. Overlooked is the real short-term needs as well as a sophisticated understanding of longer-term impacts from splitting land up between children for example. Of course it is on the larger-scale where most of the problems lie, and this falls to the government to deal with (i.e. in providing social services, employment, food etc).

Thus it is hugely important for governments to take the lead, for their own self-interest, in in-expensive education and awareness campaigns for their citizens to better understand the impacts their children might have. Without creating this desire, through role-models, peer pressure, media, peer-to-peer education and so forth (varied and thought-out campaigns utilising all available channels), the poor may never even want to limit their family size.

Once such a desire is created, then specific education on family planning and contraception can be provided along with increased access to a variety of contraceptions and other longer-term social activities to address larger issues such as coerced sex, female empowerment, poverty etc.

As previously proposed, many of us 'rich' are unable to take responsibility for our own lives. We need the government to build barriers in the road to stop us crossing the road when it is unsafe, we need companies to reduce their promotion of bad foods, as we cannot stop ourselves eating too much of them, we need regulations to restrict smoking, because we smoke too much. This is not new, but it is depressing. However, we are educated, and we know what choices we are making and the sacrifices we are making.

The poor though, are not as well educated, so do they have an excuse for making such bad choices, which an interesting article in the Stanford Social Innovation Review proposes they regularly do, with significant negative impacts. As the author notes:

The consequences of bad choices are bad for everyone, but even worse for the poor, who lack the resources—financial, psychological, social, and political—to compensate for their errors.

A recent field study in Sri Lanka reveals that more than 10 percent of poor male respondents regularly spend their entire incomes on alcohol.

More generally, poor people “could easily save more without getting less nutrition by spending less on alcohol, tobacco, and food items such as sugar, spice, and tea,” Banerjee and Duflo conclude. For example, the typical poor household in Udaipur could spend up to 30 percent more on food if it did not spend money on alcohol, tobacco, and festivals.

Evidently education is not the answer to this conundrum, since the rich have education too -or, a fairer comparison might be that the poor in the rich countries have good education (comparatively) but still make the same mistakes. Or is the answer that our education, one that is influenced by school, peers, families, media and more, all geared towards taking away our sense of personal responsibility, or focusing too much on short-term, or personal, gain? If it is, then this could be changed. Whereas, if this is more genetic and evolutionary, then it might be harder to change. Food for thought...

Substituting the very bad for the bad

Sometimes it is just not possible, or too hard to actually solve a social problem, in which case it might be easier to try to just reduce the problem. 1 example would be to decide to use biofuels instead of oil for energy, in that using biofuels is better than oil, in terms of the impact on climate change (though still debatable), but it still has many other negative impacts (food prices increase being one of them).

Another example, rather more interesting, is the issue of alcoholism which leads to health problems (such as harming the liver) and social problems (such as abusing others or not working). This article talks about a solution in Africa where local alcohol is highly alcoholic and dangerous, but extremely cheap. So if something less alcoholic (and thus less dangerous) can be provided for the same price, people might switch. It is an interesting solution; and what i like about it is that it still tries to create local economic benefit (which presumably, the local dangerous alcohol does) in order to keep costs down.

A parallel can be drawn with cigarettes and providing low-tar cigarettes (or 'light' cigarettes) instead of regulars. Though, is this the best solution compared to promoting nicotine patches or just by trying to stop smoking altogether? It depends on the problem, since now the problem is seen less as the health impacts on the smoker and more on the health impacts of others (and the nuisance factor). Presumably promoting such low-tar options, though helping reduce the harm on the smoker, does not really reduce the nuisance factor and still harms (though maybe somewhat less) other passive smokers.

I wonder what the side-effects of the above mentioned experiment is Africa are -would the local alcohol growers/sellers start campaigns against the cheap beer?, and whether there has been any studies on them. Well, if DfID get involved, I am sure there will be plenty of studies!

Smoking in China

It is interesting to hear that 18 months after China ratified the WHO’s framework convention on tobacco control, China has now finally announced it is going to do something to meet its commitments. This is not just a ’smoke-free Beijing’ slogan which in effect means nothing; it is potentially a new law that can be relatively easily enforced. The government can stop companies from advertising and it can stop advertisers from accepting advertising; by enforcing the law from both directions it might actually be enforced -at least in the big cities. It will be interesting to see what happens in the countryside and what what strategy the tobacco companies come up with (maybe just focusing on promoting the brand of the company rather than its products, like Western tobacco companies; or maybe resorting to more underhand tactics and increasing promotion online, ‘on-the street’ or through other less regulated channels).
It is about time that China accepted that the profits the government makes from tobacco (taxes as well as from the State Owned Enterprises in the industry) and the number of people employed in the industry (including many poor urban residents selling cigarettes in tiny shops or from make-shift stands on the sidewalk) is not a reason to continue to support an industry which such devastating impacts on people’s lives, their productivity and their household economy (it is no wonder that most NGOs prefer to support women more than men when so many men spend their pocket money on cigarettes when women spend pocket money on food, education or clothes for the family).

I wonder, though, how the tobacco lobby in China (and though Western companies are a part of this lobby, evidently the major players are all Chinese) let this happen? China is a huge market for the tobacco industry and one of the few countries where (I believe) the number of smokers is growing. I also wonder how high up this decision goes and whether the decision was purely an economical one (i.e. taxes received =lower than cost to health system for dealing with impacts) or also motivated by other reasons.

Smoking itself is one of those industries CSR people love to talk about with the question: Can tobacco companies be responsible? In one way, the answer is no, since the companies’ product kills people that consume the product, and those who do not and particularly harms the vulnerable in a household (i.e. the women and children who suffer from second-hand smoke but do not smoke). In another way, the answer is yes, since the companies’ product is not illegal, employs millions of poor people (especially farmers and those involved in distribution) and contributes high taxes to the governments that need money for health sectors. Does anyone know of any Chinese Tobacco companies that have ever said anything about CSR (not just charity)?

Public health -the public's responsibility?

I've mentioned before how it seems that individuals are losing their responsibility and nowadays it is up to companies and governments to help/tell people how to live their lives responsibly. In a health context this is more extreme: if a person wants to be fat and eat junk food and not do exercise it is surely up to them. They need to make informed choices, for sure; once a government (or a company) has made the relevant information available, why should they still be involved?

Well, moving past this kind of health topic to ones of public health, like SARS or avian flu or HIV/AIDs, one can see that increasingly companies are having to play a much greater role; in a supporting role to gvernments to help governments deal with these kinds of crisese. Why? Because they will be affected -as with any CSR issue- they will start to be impacted through a lack of employees, customers etc. But where is the impact? This involvement is purely a risk management investment. But how many investments must companeis make in risk management? What companies can afford these investments and should they be bearing these costs, probably disproportionately?

HIV/AIDs as a reflection of our society

just watched a movie called A closer walk which I encourage everyone to watch; one of the many very good points is that HIV/AIDs and our failure to stop it spreading reflects about our society in general. Of course every society is different between regions, countries, cities etc; but there are some interesting thoughts that came into my mind.

First I started thinking about social stigmas -related to sex, related to old or disabled people, related to people of other races and sexes. And the obvious truth that we start with a negative stigma of almost anything different or anything we do not understand, but once we come into close contact with it and reach across the divide to make a personal connection, then we can lose the stigma. But the problem is if we think this way then we start with holding stigmas towards so many people and have to work to overcome them -rather than the opposite. I understand the evolutionary perspective of having to earn trust and fear people or things that are different or we do not understand for own survival; but today we come into contqact with so many people and things that are different: much more than in the past; and we effect so many more people that are so different to us, without even knowing it!

How can we change these stigmas? Are we as humans, humane people? It seems not. Despite knowledge and awareness we often do nothing, for so many reasons -some simple and some complex. The more reasons there are, the more solutions there are -which makes it harder to solve on one hand, but also offers more opportunities for us to do something -just pick one small solution that fits our personal situation. Despite evident visibility on our own streets of people less fortunate, we as humans don't seem to do anything about it. It's not often about desire, or about means, or ability (though all often are missing); but more generally about behaviour.

What does it take for society to change? To take responsibility for itself? I mean, our society is killing itself in so many ways... Yes, there are 'bigger picture' ideas: of there being more people creating more diseases killing more people, of poverty being inevitable no matter what and so on.. but what strikes me, is that we COULD actually do something about it.. it is not just out of our hands!

Now for a problem I do not have an answer for- if in some countries 40% people have HIV/AIDs and whole families and friendship networks are dying from it; why is HIV/AIDs becoming a bigger problem? Surely everyone is affected by it; surely they can see it, see the effects and will want to stop it -for their own, selfish sake -but this is not happening. If there are cultural reasons for this (man involving the role of women in society) then how come the culture does not change? Yes, we need to understand different cultures, respect them etc. But there is no point in preserving a culture if it is not fit for the modern society.. if by preserving a culture it wipes its own people out. They need to change their culture to survive (and not necessarily change to a certain or specific culture; but make some kind of change)!

Finally a point was made by the Director of the movie, that there are somethings that are fundamental rights and others that are a privilege: The rich may have more priviledges than the poor, but we should not have more rights.