Beer, Coke and Phone Cards, but No Health Care?
Last week, New York Times columnist, Nicholas Kristof, wrote a piece about families in the developing world spending more on beer, cigarettes and elaborate festivals, than on their children’s education. He pointed out some interesting dilemmas when it comes to where the finances of the family are spent. Why, after a hard day’s labor and living such a difficult life, shouldn’t a father or mother be able to enjoy a beer with their peers in the evening?
However, lacking in Kristof’s analysis was a look at the flip side of that equation. Why is it that beer, soda, cigarettes and phone cards are ubiquitous in the most remote regions of the world, but those same areas often lack basics like health care?
I’m seeing this first-hand in Tanzania at the moment, on a trip for Pathfinder International. On a 10-hour-drive on Saturday from Arusha to a remote area called Shinyanga, we went miles on a rutted dirt road without seeing anything, when suddenly, a small wooden shack with a mud roof appeared — a phone card provider (in countries like Tanzania you pay for minutes on your cell phone via phone cards). Was there a clinic in site? Or even any kind of provider who could help with medical needs? Probably not.
Once in Shinyanga I was amazed at the amount of advertising — all for beer, soda or phone cards. Even the local district hospital sign indicating where people can find care is a billboard for Coke. This is a town where every Sunday the electricity is shut off from 8am to 6pm. This is where the homes are made of mud bricks with grass roofs (one of our staff at Pathfinder saw a goat on the roof happily munching away on some fresh grass growing on the roof). This is where patients with HIV and AIDS routinely lack medicines to fight opportunistic infections because the hospital or pharmacy are out of stock. You may not be able to get medicine, but not to worry, you can go have a soda or a beer.
What’s frustrating to me is that clearly there are ways to get these goods to retail outlets regularly. Are there ever stock outs of soda? Doubtful. If there is a way to ship soda and beer to remote regions, why not condoms? Contraceptives? Medications? Medical supplies? One could argue that there is demand for these other goods — and Kristof’s column would be a good example. But there is also a demand for health care.
It’s too bad we can’t put condoms on soda bottles, HIV messages on the back of phone cards or even take advantage of these shipping opportunities to throw a few boxes of medical supplies in with the other goods.
Certainly, as Kristof argues, we need to educate families about the importance of investing in their children’s futures and funnel more funds to women (who spend more of the household income on improving the family). But we also need to rethink supply and demand, as well as distribution. We need to find out how these goods are in constant supply and then ensure that what people really need to save their lives, make it into those channels, as well.
Tanzania: Sala Lewis