Ebola, Rubber Gloves, and Public Education


By MatChem121 (Own work) [CC-BY-3.0], via Wikimedia Commons
More on the Ebola-Public Education front:

How can it be that after decades of unprecedented financial investments in healthcare in developing nations, and in particular on the African continent, health facilities are still missing the most basic supplies?

In answer to this question—and in light of the tragic irony that in Liberia, home to the “largest single natural rubber operation in the world,” health care providers don’t have enough rubber gloves—the author explores the problem of “temporal and spatial logics of global health.” This reference is to the singular focus and interventions that large international projects, such as the UN or Gates Foundation, bring to their efforts to combat health problems in developing nations.

For many, the focus on vertical interventions and technological fixes was, and continues to be, pragmatic: the promise is that with the appropriate tools and benchmarks, progress can be measured and the messy realities of international politics and local infrastructures circumvented for more effective results. … Spatially, the logic is one of parachuting specific interventions into selected places. It not only leaves out many places, but also many diseases and illnesses. It is a logic of patchworks, adjuncts and circumvention, or an ‘archipelago of care’ (Geissler, 2013; Rottenburg, 2009). [Bold added]

That’s the “spatial” aspect of the logic of global health, according to the author. In terms of “temporal,” she explains:

Interventions are not only patchy, but they are also time-limited. Today most come in the form of projects, a process that has been discussed as ‘projectification’ (Whyte et al., 2013). Under the label of evidence-based medicine, new intervention strategies and technologies are trialed, scaled-up and then all too often handed-over to Ministries of Health that lack the financial and operational means to sustain the interventions (note, most Ministries of Health do not lack the expertise!). [Bold added]

Hmm, let’s see. A focus on vertical interventions and technological fixes that are handed down to local organizations that lack the resources to sustain them. Sound familiar, edu folks?

Our analogy of schools as ecosystems has developed out of a critique of such “pragmatic” approaches. We argue for a more holistic account of schools, in which we recognize that in order to administer effective support and instruction in the midst of great complexity and uncertainty, we require a 360 view of how all components are greater than the sum of their parts and work fluidly together. Such a view necessitates systems thinking and a recognition of the fundamental importance of contexts and infrastructure.

Author Beisel argues this point for global health:

Health care infrastructures cannot be circumvented when one aims to improve health care sustainably.[1] Well-functioning infrastructures are flexible and adaptive, able to change gear and respond to shifting disease landscapes. Just like the harvesting of rubber and the production of gloves, they are rooted in history and configured in specific political economies. The predominant logic in global health is based on and has led to an impoverished understanding of health and wellbeing. We assume we know which diseases and ailments are relevant and crucial to address. Ebola teaches us that we are well advised not work from this bold assumption. A humble version of Socrates’ classic “I know that I know nothing” seems to be a better guide to navigating complex and rapidly shifting disease landscapes. The lack of gloves, personal protective equipment and skilled personnel in West Africa’s health facilities is not only a result of war or weak states, but also of the spatio-temporal logic of global health, and it presents us with an urgent call for change in global health approaches and logics. [Bold added]

As in global health, so in global economics, and so in education.

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