Greetings students. I'm here again from the Duke Campus. In our module we're going to be learning some, the most basic concepts of global health. These concepts will not only be important for subsequent modules but will give you some tools that you need to understand all global health issues, as they arise, and as you read or learn about them, throughout the rest of your life. And I think one of the best ways to introduce some of the concepts, and how they might fit together, would be to take you to Bolivia. [MUSIC] [NOISE] Hi class. I hope you're doing well today. I am currently in Bolivia. I'm actually in Lake Titicaca in Isla del Sol, which according to the beliefs of many indigenous people was actually the birth of the sun and the moon and perhaps of the human race itself. You know Bolivia is an excellent place to begin as we talk about global health because like many countries that have made rapid improvements, they're still are many health issues that, that, that remain. For example, things like diarrhea and lower respiratory infections still kill many people and cause lots of suffering. There are high rates of maternal and child health. But at the same time there are chronic diseases such as cardiovascular disease, stroke, and increasingly as diets change, diabetes and kidney failure. There are many reasons behind this and only some of them have to do with access to medicine. Reasons such as where one is geographically. There is more malaria in the, tropical parts of Bolivia than there ar ehere in the highlands. Whether you live in a urban area or a rural area can make a difference. And rural areas, there's not as much access to health care. Economies that people have are actually much, much less and they have to depend a lot on herbal medicines. In fact I just got to experience, actually a very interesting ritual with a shaman asking for good health and good luck on the island. In urban areas, there may be more access to healthcare and socioeconomic conditions may be better. But the urban poor are always less healthy than the urban wealthy. We actually call this the wealth-health gradient, and it's something we'll talk about throughout this semester. Likewise as globalization takes place, we get more cars, which leads to more things like road injury and pollution. In other words, health is a very complicated thing that depends not simply on medicine, and is not simply a matter of not having a disease. It's a matter of how you fit into your social environment, and whether that environment is such that it helps produce good health outcomes, or on the other hand, it reduces your possibility for good health. A lot of work being done in Bolivia. There's a public health system. And, while it's a little bit strained right now with all the demand, there are marvelous organizations such as Hospital Arco Iris, which sees many, many patients every day. Which is actually working to try to bring better health to the urban poor. In other words, we're going to be talking about a lot of these issues, Bolivia, this beautiful country, simply emblematic of that. Now, if you didn't understand some of the words that I used, don't worry about it. By the end of this week, you're all going to be experts. This is Doctor Boyd from Bolivia signing out.
