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> He's right. Poverty, disease and basic things like that are things about _survival_, the internet is not. I'd say he's at least partially wrong. Diseases ar

> He's right. Poverty, disease and basic things like that are things about _survival_, the internet is not. I'd say he's at least partially wrong. Diseases are often cause by lack of knowledge and education, outburst can often be contained with good means of communication. I know people doing projects that use the internet (or cellphone text messages) to allow remote villages to better manage the available health resources. Internet connectivity allows the local healing person, often a nurse or similar level to send pictures and descriptions of wounds and health issues to a qualified doctor. This allows the doctors to actually go to the villages where they're needed most - actually saving lives. So the internet may very well be a live-saving thing. The other point that people forget is that it's extremely hard to completely eradicate a disease. The only disease that I know of that's completely eradicated is the small pox. Polio, leprosy and even the black death are merely contained to a varying degree, often only in developed countries even though vaccines or cheap, effective treatments exist. So investing in connectivity and helping to spread information may actually be a viable path.

vidarh 13y ago
> Diseases are often cause by lack of knowledge and education Case in point: Polio is endemic in only three countries today: Afghanistan, Pakistan and Nigeria. While in Afghanistan it'd be possible for it to be down to the war, in Pakistan and Nigeria it is down to skepticism and misinformation from religious groups (often based in past experiences) that are often amongst the most important information bearers in their communities. When people don't have other sources than a government they don't trust and other biased groups giving them false information, it's no wonder many misinformation proliferate.
- legulere 13y ago
  Also there's an outburst in syria lately.
  - Xylakant 13y ago
    There was an outbreak in the USA in 2005 though no one suffered permanent damage: http://www.nytimes.com/2005/11/08/health/08iht-polio.html?pagewanted=all&_r=0 http://www.nytimes.com/2005/11/08/health/08iht-polio.html?pa...
  - vidarh 13y ago
    There are small outbreaks in lots of countries now and again. Combination of international travel and patchy vaccine coverage causes that. The difference with Afghanistan, Nigeria and Pakistan is that it is endemic at least in parts of the countries, meaning it is regularly found in the population and that it is self-sustained. Elsewhere the outbreaks are sporadic and isolated enough that they die back.
- makomk 13y ago
  I'm sure the CIA operatives posing as vaccination teams didn't help make vaccination any more popular in Pakistan either.
ivanca 13y ago
It's an egg-and-chicken problem then; you cannot manage the "available health resources" if those are nonexistent, so having those is a priority and that is more similar to what the BMGF is already doing.
- Xylakant 13y ago
  A lot of countries in the developing world have existing health care resources, such as doctors or nurses, but managing them is a major problem in a state such as namibia or botswana where the population of a small city is spread out on a territory as large as germany. It helps if you can have a local, less qualified health care worker communicate with a remote specialist before either moving a doctor to the patient or the patient to the doctor. A medium to high bandwidth connection, eventually capable of video transmission helps a lot here.
  - ivanca 13y ago
    You are painting a fairy tale outcome, poorly based on reality. Even in Colombia, were there is high-speed internet connections the coordination, willingness and education to make a fruitful use of this resource is scarce. So it's not like "Give them internet and they will figure it out!", it's a lot more complicated than that.
    - Xylakant 13y ago
      That's not what I'm saying. The same could be said about a malaria vaccine. "Develop it and all will be good" is a fairy tale outcome as well. Even "develop it, make it cheap and malaria will cease to be a problem" is a fairy tale outcome. The real world tends to be much more complicated than that - all I'm trying to point out is that there is a real problem managing available resources, especially in countries with low population densities. We can even see that in some less populated areas of eastern Germany (some areas of Mecklenburg-Vorpommern), but at least we in Germany can luckily afford to throw money at that problem.
      - ivanca 13y ago
Qom 13y ago
Note that internet does not necessarily help education. Most people waste their time on the internet, including most of us on HN. You can have as much info available to you as you want, if you go in the wrong direction or take no real action then it will all be for naught.
- Xylakant 13y ago
  Well, in that case nothing necessarily helps education. Even books or teachers, people waste so much time in school. I for myself must admit that I tend to think of HN as very educating. I get exposed to information that I'd never find otherwise and to opinions of people I'd never meet otherwise. That's certainly much more educating than a lot of facebook.
  - sanoli 13y ago
    Maybe, but the one thing a poor country can't do without are schools for fundamental education. You can do without internet for everyone, you can do without tv. But if you don't have schools and teachers, which some countries don't have (what they have only passes as schools and teaching) you're pretty much doomed as a country.
deskamess 13y ago
Communication is the key.... and the internet is generally pretty awesome for that. However, for rural medicine, the prerequisite (assuming infrastructure exists) is the ability to retrieve and parse the information. You need to be literate, have access to an internet enabled device, and know how to search for what you think ails you. Language could be a barrier too. Use of social worker and nurse pairs to do rural visits and vaccinations are much more effective. Verbal communication in the local language can communicate any extra information they need. Question and answer sessions are more fruitful. There is much more information to be gleaned about the community as a whole with a visit. The social worker and nurse can always update data when they get back to a location with internet access and provide a lot more medical context than the residents. I agree it is not an either or proposition. However I believe the more effective solution, under current conditions, is the human visit. While that happens, continue to build up the infrastructure around these areas; not just internet, but access to clean water, roads to take people to hospitals, access to electricity (local or from a grid), etc. Steps have to be taken in all directions to grow the radius of community well being.
- Xylakant 13y ago
  > roads to take people to hospital The population density in some developing countries is extremely low. Botswana for example has roughly 2mio inhabitants of which roughly a quarter live in Gabs and yet another maybe 10% in the next 5 bigger towns. That leaves the rest of the country with an average population density of less than 2person/square km. Bringing people to a hospital by car on a good road can easily take a day or more. It's also not viable to have an educated doctor able to make that choice in each of the remote villages. So you really really need to find a good way to offload that decision to a person that's remote. n.b. Botswana is a fairly well developed country, I just choose it as an example since I have family ties there and know the situation better than say Namibia which is similar in the population distribution.
dodyg 13y ago
Connectivity goes both ways - go check the fireband anti vaccine movements in the US.
Swannie 13y ago
You're talking about telecommunications - not the internet. There is a difference. You don't need the internet for telecoms. You don't even need a mobile phone (though in today's Africa, generally a mobile will do a lot more for you). Africa are still fighting to get get decent telecommunications cover. Let alone internet. Telecoms is important, and undoubtedly saves and enriches lives. The internet, yes that too, but to a lesser degree. Telecoms is available world wide for a price, via satellite. Internet is also available worldwide for a price. Broadband is coming in the next few years, worldwide, for a bigger price. Health revolution worldwide is not even on the horizon.
- Xylakant 13y ago
  The internet is not only facebook and youtube, but a general purpose communications network. Having satellite internet available does not imply it's in any way affordable for local individual or organization. Having terrestrial internet for acceptable prices would allow for a variety of uses that are currently not possible, some of them undoubtedly beneficial for health care professionals.
  - XorNot 13y ago
    The problem is, these places have treatable diseases running rampant for a variety of reasons. There is no one principle cause of ongoing survival problems in various parts of the world today, and no one solution to it either. Endemic poverty is a complicated social and political phenomena which is maintained due to a variety of causes. Even if tomorrow you eliminated malaria, it's very doubtful the conditions in any country where it's a problem would improve. A case in point is famine - we have more then enough food today to feed a population of 10 billion or more people on the planet fully. But people still starve to death every day. And even when we give food aid for free, we still keep having the same issue - even when we're actively giving it. When you start trying to order your problems by perceived importance, we get nothing done. Sure you think, I'd hate to die of malaria. But you live in a first world country - if you don't die of malaria, you don't then imagine that you'll still have nothing to eat tomorrow, or that you lack all of the education you take forgranted. Or that there'll be no jobs, or that even if you work hard you'll still be paying bribes just to get a driver's license. Or come the local elections if you don't guess the right side to be seen supporting you'll be murdered or raped, or both.
sanskritabelt 13y ago
It's true that diseases are often caused by those things, but in this particular case malaria is caused by the /Plasmodium/ organism and transmitted via infected mosquitoes. If you're imagining a situation in which one individual in an outlying community gets sick with mysterious symptoms that turn out to be malaria, you have simply failed to grasp the magnitude of the problem.
- Xylakant 13y ago
  I have family ties in Southern Africa, I've been there multiple times, I've seen it and I still don't think I grasp the magnitude of the problem. However, on thing I know for sure: The problem is not limited to large portions of the population being infected with malaria. They also have a wide variety of other, quite nasty diseases that will all still be around once you eliminate Malaria - if you succeed at that. The sub-Saharan countries for example suffer from a massive AIDS/HIV epidemic, at some point the estimate was that every third adult in Botswana is infected. Things are better now with about 24% infection rate - that's still a quarter of the population. A common belief was that having sex with a virgin would cure your infection - with predictable results: Think anywhere on the range of merely spreading the epidemic to flat out rape of young virgins. I'm very sorry to respond in kind: I think you fail to grasp the magnitude of the problem.
Shivetya 13y ago
No he is more right than wrong. We already have communications options available in those regions. The very same ones used over the last decades, whether its radio, hardline phones, cellular or even satellite. Doctors and nurses out there already have communications. The issue here is that spending money to provide internet to the masses there is not as beneficial as making sure they live to use it.
- vidarh 13y ago
  Providing internet to the masses is one way of improving their chances of living to use it. Doctors and nurses may have communications, but many countries do not have doctors and nurses even in every city, much less every little village. It's clear we should be careful about not displacing funding for basic health care improvement with basic internet access, but they are not nearly always in opposition, and besides providing health care information, uses such as improving economic opportunities by giving access to market/pricing information also matters - for someone having to spend days getting their stuff to market, going to the right town to get the best price will also affect health: ability to afford sufficient food and shelter for starters.
- Xylakant 13y ago
  I'd say he's more wrong than right. There are basically no landline connections in large parts of Africa, since it's basically infeasible to cover the large distances involved with cables. Satellite is unaffordable for all practical purposes - when I'm talking about doctors and nurses I'm not talking about western foreign aid people but locals. If your average income is in the range of single digit USD a day, satellite comm is infeasible. Also, the communication system must be manageable and maintainable by locals with a basic eduction. So the best available communication is often cellular, if any. On the other hand malaria is a disease that only affects some parts of the population - namely the one that lives in malaria affected regions. Large parts of southern Africa are mosquito-free, hence no Malaria. To make up for that there's a ton of others diseases, so if you eliminate Malaria, you still have to fight Schistosomiasis [1], Trypanosomiasis (sleeping sickness) [2] HIV and a lot of other diseases for which treatments may or may not exist. In a country where the average infection rate with HIV hovers at about 30% the gain from eradicating Malaria is limited at best. Let's not get into poverty and access to most basic health care. It's not a simple problem that allows for a simple solution and even eliminating every conceivable disease that affects people in developing countries will only be one minor factor to improving the situation there. Those people need access to knowledge and information as much as they need health care and water. Otherwise they'll forever be stuck on western subsidies - just healthier and longer. [1] http://en.wikipedia.org/wiki/Schistosomiasis http://en.wikipedia.org/wiki/Schistosomiasis [2] http://en.wikipedia.org/wiki/African_trypanosomiasis http://en.wikipedia.org/wiki/African_trypanosomiasis

vidarh 13y ago

> Diseases are often cause by lack of knowledge and education Case in point: Polio is endemic in only three countries today: Afghanistan, Pakistan and Nigeria. While in Afghanistan it'd be possible for it to be down to the war, in Pakistan and Nigeria it is down to skepticism and misinformation from religious groups (often based in past experiences) that are often amongst the most important information bearers in their communities. When people don't have other sources than a government they don't trust and other biased groups giving them false information, it's no wonder many misinformation proliferate.

legulere 13y ago
Also there's an outburst in syria lately.
- Xylakant 13y ago
  There was an outbreak in the USA in 2005 though no one suffered permanent damage: http://www.nytimes.com/2005/11/08/health/08iht-polio.html?pagewanted=all&_r=0 http://www.nytimes.com/2005/11/08/health/08iht-polio.html?pa...
- vidarh 13y ago
  There are small outbreaks in lots of countries now and again. Combination of international travel and patchy vaccine coverage causes that. The difference with Afghanistan, Nigeria and Pakistan is that it is endemic at least in parts of the countries, meaning it is regularly found in the population and that it is self-sustained. Elsewhere the outbreaks are sporadic and isolated enough that they die back.
makomk 13y ago
I'm sure the CIA operatives posing as vaccination teams didn't help make vaccination any more popular in Pakistan either.

ivanca 13y ago

It's an egg-and-chicken problem then; you cannot manage the "available health resources" if those are nonexistent, so having those is a priority and that is more similar to what the BMGF is already doing.

Xylakant 13y ago
A lot of countries in the developing world have existing health care resources, such as doctors or nurses, but managing them is a major problem in a state such as namibia or botswana where the population of a small city is spread out on a territory as large as germany. It helps if you can have a local, less qualified health care worker communicate with a remote specialist before either moving a doctor to the patient or the patient to the doctor. A medium to high bandwidth connection, eventually capable of video transmission helps a lot here.
- ivanca 13y ago
  You are painting a fairy tale outcome, poorly based on reality. Even in Colombia, were there is high-speed internet connections the coordination, willingness and education to make a fruitful use of this resource is scarce. So it's not like "Give them internet and they will figure it out!", it's a lot more complicated than that.
  - Xylakant 13y ago
    That's not what I'm saying. The same could be said about a malaria vaccine. "Develop it and all will be good" is a fairy tale outcome as well. Even "develop it, make it cheap and malaria will cease to be a problem" is a fairy tale outcome. The real world tends to be much more complicated than that - all I'm trying to point out is that there is a real problem managing available resources, especially in countries with low population densities. We can even see that in some less populated areas of eastern Germany (some areas of Mecklenburg-Vorpommern), but at least we in Germany can luckily afford to throw money at that problem.
    - ivanca 13y ago

Qom 13y ago

Note that internet does not necessarily help education. Most people waste their time on the internet, including most of us on HN. You can have as much info available to you as you want, if you go in the wrong direction or take no real action then it will all be for naught.

Xylakant 13y ago
Well, in that case nothing necessarily helps education. Even books or teachers, people waste so much time in school. I for myself must admit that I tend to think of HN as very educating. I get exposed to information that I'd never find otherwise and to opinions of people I'd never meet otherwise. That's certainly much more educating than a lot of facebook.
- sanoli 13y ago
  Maybe, but the one thing a poor country can't do without are schools for fundamental education. You can do without internet for everyone, you can do without tv. But if you don't have schools and teachers, which some countries don't have (what they have only passes as schools and teaching) you're pretty much doomed as a country.

deskamess 13y ago

Communication is the key.... and the internet is generally pretty awesome for that. However, for rural medicine, the prerequisite (assuming infrastructure exists) is the ability to retrieve and parse the information. You need to be literate, have access to an internet enabled device, and know how to search for what you think ails you. Language could be a barrier too. Use of social worker and nurse pairs to do rural visits and vaccinations are much more effective. Verbal communication in the local language can communicate any extra information they need. Question and answer sessions are more fruitful. There is much more information to be gleaned about the community as a whole with a visit. The social worker and nurse can always update data when they get back to a location with internet access and provide a lot more medical context than the residents. I agree it is not an either or proposition. However I believe the more effective solution, under current conditions, is the human visit. While that happens, continue to build up the infrastructure around these areas; not just internet, but access to clean water, roads to take people to hospitals, access to electricity (local or from a grid), etc. Steps have to be taken in all directions to grow the radius of community well being.

Xylakant 13y ago
> roads to take people to hospital The population density in some developing countries is extremely low. Botswana for example has roughly 2mio inhabitants of which roughly a quarter live in Gabs and yet another maybe 10% in the next 5 bigger towns. That leaves the rest of the country with an average population density of less than 2person/square km. Bringing people to a hospital by car on a good road can easily take a day or more. It's also not viable to have an educated doctor able to make that choice in each of the remote villages. So you really really need to find a good way to offload that decision to a person that's remote. n.b. Botswana is a fairly well developed country, I just choose it as an example since I have family ties there and know the situation better than say Namibia which is similar in the population distribution.

dodyg 13y ago

Connectivity goes both ways - go check the fireband anti vaccine movements in the US.

Swannie 13y ago

You're talking about telecommunications - not the internet. There is a difference. You don't need the internet for telecoms. You don't even need a mobile phone (though in today's Africa, generally a mobile will do a lot more for you). Africa are still fighting to get get decent telecommunications cover. Let alone internet. Telecoms is important, and undoubtedly saves and enriches lives. The internet, yes that too, but to a lesser degree. Telecoms is available world wide for a price, via satellite. Internet is also available worldwide for a price. Broadband is coming in the next few years, worldwide, for a bigger price. Health revolution worldwide is not even on the horizon.

Xylakant 13y ago
The internet is not only facebook and youtube, but a general purpose communications network. Having satellite internet available does not imply it's in any way affordable for local individual or organization. Having terrestrial internet for acceptable prices would allow for a variety of uses that are currently not possible, some of them undoubtedly beneficial for health care professionals.
- XorNot 13y ago
  The problem is, these places have treatable diseases running rampant for a variety of reasons. There is no one principle cause of ongoing survival problems in various parts of the world today, and no one solution to it either. Endemic poverty is a complicated social and political phenomena which is maintained due to a variety of causes. Even if tomorrow you eliminated malaria, it's very doubtful the conditions in any country where it's a problem would improve. A case in point is famine - we have more then enough food today to feed a population of 10 billion or more people on the planet fully. But people still starve to death every day. And even when we give food aid for free, we still keep having the same issue - even when we're actively giving it. When you start trying to order your problems by perceived importance, we get nothing done. Sure you think, I'd hate to die of malaria. But you live in a first world country - if you don't die of malaria, you don't then imagine that you'll still have nothing to eat tomorrow, or that you lack all of the education you take forgranted. Or that there'll be no jobs, or that even if you work hard you'll still be paying bribes just to get a driver's license. Or come the local elections if you don't guess the right side to be seen supporting you'll be murdered or raped, or both.

sanskritabelt 13y ago

It's true that diseases are often caused by those things, but in this particular case malaria is caused by the /Plasmodium/ organism and transmitted via infected mosquitoes. If you're imagining a situation in which one individual in an outlying community gets sick with mysterious symptoms that turn out to be malaria, you have simply failed to grasp the magnitude of the problem.

Xylakant 13y ago
I have family ties in Southern Africa, I've been there multiple times, I've seen it and I still don't think I grasp the magnitude of the problem. However, on thing I know for sure: The problem is not limited to large portions of the population being infected with malaria. They also have a wide variety of other, quite nasty diseases that will all still be around once you eliminate Malaria - if you succeed at that. The sub-Saharan countries for example suffer from a massive AIDS/HIV epidemic, at some point the estimate was that every third adult in Botswana is infected. Things are better now with about 24% infection rate - that's still a quarter of the population. A common belief was that having sex with a virgin would cure your infection - with predictable results: Think anywhere on the range of merely spreading the epidemic to flat out rape of young virgins. I'm very sorry to respond in kind: I think you fail to grasp the magnitude of the problem.

Shivetya 13y ago

No he is more right than wrong. We already have communications options available in those regions. The very same ones used over the last decades, whether its radio, hardline phones, cellular or even satellite. Doctors and nurses out there already have communications. The issue here is that spending money to provide internet to the masses there is not as beneficial as making sure they live to use it.

vidarh 13y ago
Providing internet to the masses is one way of improving their chances of living to use it. Doctors and nurses may have communications, but many countries do not have doctors and nurses even in every city, much less every little village. It's clear we should be careful about not displacing funding for basic health care improvement with basic internet access, but they are not nearly always in opposition, and besides providing health care information, uses such as improving economic opportunities by giving access to market/pricing information also matters - for someone having to spend days getting their stuff to market, going to the right town to get the best price will also affect health: ability to afford sufficient food and shelter for starters.
Xylakant 13y ago
I'd say he's more wrong than right. There are basically no landline connections in large parts of Africa, since it's basically infeasible to cover the large distances involved with cables. Satellite is unaffordable for all practical purposes - when I'm talking about doctors and nurses I'm not talking about western foreign aid people but locals. If your average income is in the range of single digit USD a day, satellite comm is infeasible. Also, the communication system must be manageable and maintainable by locals with a basic eduction. So the best available communication is often cellular, if any. On the other hand malaria is a disease that only affects some parts of the population - namely the one that lives in malaria affected regions. Large parts of southern Africa are mosquito-free, hence no Malaria. To make up for that there's a ton of others diseases, so if you eliminate Malaria, you still have to fight Schistosomiasis [1], Trypanosomiasis (sleeping sickness) [2] HIV and a lot of other diseases for which treatments may or may not exist. In a country where the average infection rate with HIV hovers at about 30% the gain from eradicating Malaria is limited at best. Let's not get into poverty and access to most basic health care. It's not a simple problem that allows for a simple solution and even eliminating every conceivable disease that affects people in developing countries will only be one minor factor to improving the situation there. Those people need access to knowledge and information as much as they need health care and water. Otherwise they'll forever be stuck on western subsidies - just healthier and longer. [1] http://en.wikipedia.org/wiki/Schistosomiasis http://en.wikipedia.org/wiki/Schistosomiasis [2] http://en.wikipedia.org/wiki/African_trypanosomiasis http://en.wikipedia.org/wiki/African_trypanosomiasis