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pece_annotation_1473270922

maryclare.crochiere

Paul E Farmer, Bruce Nizeye, Sara Stulac, Salmaan Keshavjee are listed as the authors of this paper. They work with the health workers  in suffering countries, like Haiti. Farmer is a co-founder of Partners in Health, as well as a physician and anthropologist. Stulac is an MD, MPH, specializing in pediatrics, and is also associated with PIH. Keshavjee is an MD, PhD, professor at Harvard of Global Health and Social Medicine. They are all professionals in the field of medicine, and through the PIH, they are well acquainted with responding to global health issues.

pece_annotation_1473296878

maryclare.crochiere

They researched a lot into tuberculosis/HIV and the social issues that were discussed. Articles on asthma were also reviewed and used, despite asthma not being directly discussed, as well as lead poisoning. This could indicate that more diseases are affected by social issues than discussed in the article, or maybe those diseases didn't show any correlation.

pece_annotation_1473296561

maryclare.crochiere

" For decades, those who study the determinants of disease have known that social or structural forces account for most epidemic disease. But truisms such as “poverty is the root cause of tuberculosis” have not led us very far. While we do not yet have a curative prescription for poverty, we do know how to cure TB."

"The debate about whether to focus on proximal versus distal interventions, or similar debates about how best to use scarce resources, is as old as medicine itself. But there is little compelling evidence that we must make such either/or choices: distal and proximal interventions are complementary, not competing"

" By insisting that our services be delivered equitably, even physicians who work on the distal interventions characteristic of clinical medicine have much to contribute to reducing the toll of structural violence"

pece_annotation_1473296088

maryclare.crochiere

The authors cite their own previous work and how rates of diseases and deaths changed. They also researched other programs and studies, similar to their own but in different areas or working on other issues. They also familiarized themselves with how things work within a physicians office - how diseases are presented, how promininent social issues may be, and other factors that the physician might see.

pece_annotation_1473295900

maryclare.crochiere

When community factors such as transportation and insurance status were minimized as factors preventing HIV/AIDs care, the playing field was leveled within a few years. No longer were those issues much more often seen in the patients that did not survive, rather, they were seen more evenly in those that did and did not survive.

Combining clinic treatments with home-visits and prescription drug deliveries has been found to be most effective for treating all people, regardless of social factors, in places from rural Africa to Boston, MA.

Mutli-faceted approach in rural areas were most effective and able to dramatically reduce Mother-to-Infant-Transmission of HIV. This requires more resources and organization, but it takes care of the issue most efficiently in areas that are very poor and have very rudimentary infrastructure, even worse than in poor cities.