"Our programs are like medicine. Some of the medicine has harmful
side-effects, and there are real questions about what the dosage ought
to be. The best
that can be hoped for is that we are prescribing more or less the right
medicine in more or less the right dosage."
World Bank loans for agriculture, dams, mines and power plants often cause health problems as a side effect of environmental devastation. Take for example the eastern state of Orissa in India; experts found an astonishing 67% of men and 64% of women near a World Bank-financed coal-fired power plant suffering from fluorosis, [a bone-weakening disease]. Likewise, World Bank-financed dams around the world have increased the incidence of serious water-borne diseases like malaria and schistosomiasis because the stagnant pools of water in dam reservoirs are breeding grounds for malaria-carrying mosquitoes and schistosomiasis-spreading vector snails.
In Uganda, where malaria is already the leading cause of death in the country, the World Bank is planning to finance a major dam near Bujagali Falls on the Nile. And the World Bank has been a major supporter of agricultural programs around the world that have promoted the use of DDT, a toxic pesticide, that accumulates in the human body. Guatemala, a major recipient of pesticide-linked agricultural loans from the World Bank, earned the dubious distinction of registering the world's highest levels of DDT in mothers' milk and human flesh--185 times higher than limits set by the World Health Organization.
In addition, the World Bank and the International Monetary Fund, have played a major role in exacerbating health problems in the poorest countries of the world through the harsh economic policies that countries are forced to implement through Structural Adjustment Programs. For example in Zimbabwe spending per head on healthcare has fallen by a third since 1990 when a Structural Adjustment Program was introduced. In the Philippines, an IMF program has caused allocations to preventative health care budgets for malaria and tuberculosis have fallen by 27% and 36% respectively, and immunization programs by 26%. Several vitamin supplement programs have been withdrawn altogether.
The structural adjustment policies that Indonesia has been forced to adopt in order to qualify for loans after the financial crisis in 1997 has been a major cause of growing health problems like anemia. The Helen Keller relief agency reports that anemia, a key sign of malnutrition and a cause of permanent mental impairment, now affects 60% of Java's children while diarrhea rates have doubled in women and children. The first cases of marasmus, the severe emaciation seen in the worst African famines, are beginning to show up among children in remote villages of Java. The situation is expected to get worse as many pregnant women can no longer afford proper prenatal care and nutrition.
Child immunization had been nearly universal in Indonesia, but now common vaccinations for measles, mumps, rubella and other childhood diseases are too costly for poor families. Contraceptives, anti-diarrhea medicines and common antibiotics also have become prohibitively expensive and hard to find in many areas. Hospitals and rural health care clinics are starting to reuse syringes, increasing the risk for spreading AIDS. Tuberculosis is a growing problem. At the same time, Indonesia's primary health care system is collapsing. A system of 250,000 local health and welfare centers, or posyandu, are no longer working well because many of the million-plus volunteers have had to go to work to feed their own families.
'The World Bank has claimed that Zambia's reformed healthcare system is a model for the rest of Africa. "It's true that there are no queues," says Dickson Jere, a freelance journalist formerly with the Zambia Post, an independent daily. "But that's because people are simply dying at home."' In 1980, under the former socialist government of Kenneth Kaunda, the under 5 mortality rate was 162 deaths per 1,000 births. It's now 202 per 1,000. That means one in five children in Zambia dies before reaching the age of 5. The average life expectancy has fallen from 54 in the mid-eighties to 40 now. With the AIDS epidemic raging, this can only get worse.
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