Morbidity and Mortality Part I: A DAMMM Shame
This is the first post from Mission to Heal founder Dr. Glenn Geelhoed in a two-part series. Here, he explains the leading causes of mortality and morbidity in our world today – affecting the ‘bottom billion’ more than anyone else, but easily treatable with the correct resources and skills. Read part two of this series here.
These are the top five causes of mortality on Planet Earth – what I call a DAMMM shame. No, they are not heart disease, cancer, stroke – you have to be (1) wealthy, and (2) live long enough to develop any of these degenerative diseases of the US top Bills of Mortality. The first through fifth causes of death on earth still – if you can believe it – are easily treatable and all preventable and mostly affect children under five years of age.
- Diarrhea
- Acute Respiratory (Pneumonia and TB)
- Malaria
- Measles
- Malnutrition
This is what MORTALITY is mostly about on this Earth, from pre-history to present for the majority – and remains stuck in the Bottom Billion.
MORTALITY= LOSS OF YEARS FROM LIFE
MORBIDITY= LOSS OF LIFE FROM YEARS
This very year marks a turning point in human history with respect to the leading causes of MORBIDITY.
Previously, through all time to present, the non-emerging chronic debilitating diseases were communicable from the environment and are called the NTD (Neglected Tropical Diseases) – for which there is a group campaigning to control them, the infelicitously named ICCNTD – the International Consortium to Control the NTD. It is now better known as “Just Fifty Cents” for the investment needed for their control.
Neglected Tropical Diseases
- Soil-Transmitted Helminths (STH)
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- Worms giving micronutrient (e.g. anemia) and macronutrient (protein/calories) deficiency
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- Lymphatic Obstructive Parasitic Conditions
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- Filariasis, or Elephantiasis (please do not call it “Elephantitis,” which would be an inflammatory affliction of an elephant which I would not want to be anywhere near!)
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- Schistosomiasis
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- Parasitic chronic inflammation of liver and urinary tract
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- Trachoma
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- Cicatrizing conjunctivitis scarring and opacifying the cornea as a preventable cause of blindness (which in the Upper Nile Province of Sudan where I work is the leading cause of blindness, trumping the cataracts and diabetic retinopathy and more common developed-world causes). It is characterized by the vectors of transmission – the 5 F’s = Fingers, Feces, Flies, Families, Fomites, allowing the trachoma bacillus to be passed around in the limited moist places found in the dry season – like little kids’ eyes around which flies cluster.
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MORTALITY CAUSES need a CURE; MORBIDITY CAUSES need CONTROL
For the life-threatening conditions of MORTALITY, we must reduce to ZERO the communicable agents, that is CURE, since eliminating half of the organisms is only one doubling time away from once again taking over the host – and you know about multi-drug resistance of organisms like Mycobacteria – and TB has been edged up one spot on the bills of mortality to 18th place by the only other infectious disease killer with which it is often concommitant, HIV, now with HAART, moving to 19th.
For the life-limiting conditions of MORBIDITY, we seek not ERADICATION but reduction in the DISEASE BURDEN, i.e. CONTROL, as in reducing the worm burden allows the marginal edge for the student to study, the laborer to work a full day, and the pregnant woman to carry to term, with a public health environmental bonus of a gradual decrease in the contamination of the herd with improved control.
But now, with the HALVING of world poverty rates along Millennium Goals, the leading causes of world morbidity are now SURGICALLY CORRECTABLE CONDITIONS; now, for the first time in history trumping COMMUNICABLE DISEASE morbidity, uncovering this greater need of surgery as a marker of progress in public health control.
To learn more about how Mission to Heal reduces morbidity through surgery for the most remote and needy people, click here.
