Thursday, April 16, 2009

Health of the Nation

I had a minor medical emergency on Tuesday night. It was nowhere near life threatening, however I was in a great deal of pain and it was serious enough that it needed to be dealt with sooner rather than later. Unfortunately all the walk-in clinics were closed, so the only option left was a trip to emergency. Fun times!

I was there all night long, got the necessary treatment and prescription for antibiotics and fell exhausted into bed at 5:30 in the morning, grateful for modern medical science and wondering how in the world I would manage to get through a workday on two hours of sleep.

As I sat in the emergency waiting room and looked around me, I wondered about all the resources that are required to keep a hospital functioning 24 hours a day, 7 days a week. How much electricity? How much coal? How much oil? How much gas? Water? Food?

When I was called to a bed and waited for the doctor to come in see me I looked at all the medical implements around me. Everything was an individually packaged, single use item, mostly made of and wrapped in plastic. How much waste does a hospital generate?

I saw biohazard boxes, dispensers of antibacterial cleansers, bottles of disinfectants, industrial strength cleaners. How many chemicals get disposed of, flushed down toilets and rinsed down drains?

I wondered what a hospital's ecological footprint would be. I suspect it's pretty darn big. I also imagine that a lot of it is really necessary. For example, it is not appropriate to reuse most medical implements. But I also think there is probably room for improvement. How do hospitals source and prepare their food? How much do they waste? How do they dispose of it?

I then wondered what the future of health care might look like in an era of energy scarcity.

Every single aspect of my trip to emergency was reliant on cheap fossil fuels, from the cab ride there and back home (with a trip to the nearest 24hr pharmacy in between) and including my antibiotics. (Here is an interesting article on "Medicine After Oil", about health care in the US, that gives a really good overview of how much oil goes into our medicine.)

In the future, will I be able to rely on a fossil fuel dependent system if I am faced with another health crisis? What alternatives will be available? Is anybody even thinking about large scale alternatives?

On a personal level, I am learning about alternatives I can use to administer to my own health and I've written before about how my kitchen is my medicine cabinet, but not everything can be cured with herbs and spices. What will I do for more serious and complicated health issues that will most certainly arise as I get older? What about unexpected accidents? Broken bones? How will we be able to help the very medically fragile? What about all the baby boomers who will most assuredly have complex needs?

I have a feeling that many people don't think about this aspect of an energy crisis. Quite a few people think that peak oil means that we will simply drive and fly less, gas will be more expensive and we will get all our energy from nuclear power.

I think that we are much more reliant on oil than most of us who are so used to taking it for granted realise and that health care as we know it is just one of the many aspects of our taken for granted reality that is going to fundamentally change in the future.

My minor medical crisis on Tuesday cost me no more than cab fare, the price of my prescription and a nights sleep. In the future, could it cost me my life?


Wendy said...

Hi Amber,

My last blog was about workplace waste and as I work in a Nursing home, I guess you and I have voiced concern about the same sort of thing. When I did the math yesterday, I figured that speaking of med cups alone, we must dispose of in excess of 500 per day. I haven't the heart to multiply that by 365. I am going to hunt around and see if anyone knows of a solution to this problem. The good news is that I found out that they are now composting the leftover food. YAY!

Hope you soon feel better...


sdrv said...

I hope you feel well soon.

I had similar thoughts last year when I had a serious medical problem that was beyond what our naturopath could help with. In fact I ended up requiring some major surgery.

During August and September I spent a total of 18 or so nights in the hospital, and then in October I had the big operation.

Anyway, I too found myself looking around at all that is involved in running a hospital, all of the equipment, staff and resources. It really is mind boggling.

I wrote about my experience at the time: Can We really Complain About Our Health Care System in Canada? but it was really only in the months afterward that it hit me just how much is involved in maintaining our modern medical system, and the impact that has on our lives and environment.

If we begin looking at how to reduce that impact, there will be no easy answers, but it is worth discussion.

I do believe though that if all of us got on board to start living "lighter lives", which includes focusing on a more natural, processed food free diet, then we may find that there can be a reduction in some medical conditions which would in turn reduce visits to hospitals and allow for the resources used to be lessened.

I realise that is a very simplistic view, and that there is so much more involved in a topic like this, but discussion and solutions have to start somewhere.

Amber said...

Hi Wendy,
Wow that's a lot of med cups, and that is just one facility. Multiply that by all the other nursing homes, long term care places, hospitals, hospice homes etc....

That's really great news that they are composting leftover food though!

I am caught up on sleep and feeling much better today. Thank you.

Mr. Writer,
I agree that there are definitely health benefits to living lightly which would take a lot of pressure off the system.

Not only that, but if we can practice conservation now, and reduce our dependence on resource intense stuff, we might be better equipped to properly allocate and distribute resources and energy supplies to where it is needed the most in the future.

How this might look 'on the ground' I don't know, but like you say, the conversation has to start somewhere.

Anonymous said...

Hope you feel better soon!

yes, these the kind of issues that I think will be foremost in our minds. not how to recycle, or make potholders out of plastic bags. The really hard questions: security, health. The "smaller" ones: how to have safe childbirth & contraceptives, stay warm, find information, how to keep culture, literacy, music going...

Anyone up for life w/o weather forecasts, eye glasses, dentists, allergy medicine? Life were an a small infection or pneumonia might well kill you.

If course, it all depends on if we have a slow decline or go with a bang.

Kiashu said...

You're focusing on cure and forgetting prevention, but I'll get to that in a moment.

Plastics worldwide use only about 4% of all oil. That's still a substantial amount, a couple of million barrels a day - but it's something we could keep doing for centuries if we wanted to.

The energy's another matter, of course.

Much of the waste comes simply from malpractice suits. Scalpels can be sterilised and reused, but if even 1 out of 12,368,098 people getting cut with a scalpel get an infection because it wasn't properly sterilised, the hospital is going to want disposable scalpels. So if you want the right to sue the hospital when they screw up, you're going to get this waste (along with high healthcare costs - malpractice insurance is about $30,000 a year for physicians, patients have to pay for that).

In a post-peak society, all that suing would be forgotten, I think, so we'd get less waste. But again, still the energy is needed.

Hippocrates said you should let your food be your medicine, and your medicine your food. Bear in mind that across the world, most illnesses come from food and water. This is where prevention rather than cure comes in.

In the Third World people die from cholera and diaorrhea, which are basically diseases from not having clean drinking water. In the developed water, the biggest threat to our quality of life is our diet - too much meat, not enough plants.

In a post-peak society our diet will change to have less meat and more plants, whether we like it or not. And so the big trouble becomes having clean drinking water.

This is quite achieveable with relatively few resources, little energy and effort, the question is whether we think of it. There's a great project called open source farm which is trying to produce simple and cheap designs for small-scale manufacturing, so that villages - whether in the West or the Third World - can live decent lives without huge amounts of energy and resources. However, with all their brilliance they've forgotten the importance of clean water. Coming from the West, they take it for granted and don't realise its importance.

So again, if we have decent food and clean water, that cuts out most of the causes of illness and death worldwide. In a post-peak society decent food will be around, but clean water might be a problem. So we should bear that in mind.

Artizan said...

Those are some great insights Amber and respondents.
The medical system is a regular weight on my mind. This could be very sever indeed, but I have hope. A decrease in the availability and convenience of oil and gas would force people to be physically active. No TV, more walking and biking, more home gardening, more organic food, more human reliance, more team work, more family time, more seed saving and sharing and even more music art and culture Anonymous. People will just be creating their own.
As for things like Cholera Kiashu, I have an acquaintance from Zimbobway who told me the recent outbreak was in fact cheap chemicals from China and only effected the high density areas, ie, the poor....hmmmmm? Is it true? Who knows but it makes one wonder.

As for illness from food, everything in the news lately has been big monoculture production. When have you ever heard of people getting sick from their organic back yard gardens? Humans make food and water unhealthy. Hippocrates existed before pesticides, environmental destruction and industrial waste. I wonder what would he say today?

Cleanliness is essential. That means clean water. That's a tall order, but people are working on better ways like using plants for filters. As we 'Unstuff' as a society, we will hopefully find and implement better ways.

We've made lots of "stuff" that can be reused and reformed. We have come so far. Much has been lost , but much has been gained. Broken bones are set and held in place for nature to heal. This will still be able to be done. Some things won't heal. Some will have pain and some will die, just like today. Some will be healthier and happier.
I think our biggest obstacle will be keeping the faith and working together, and building community spirit. Sites like this one are great for re-educating people and learning to be creative and conscientious.

We all participated in creating these problems and dependancy and we can all participate in fixing them. I believe it will be individuals and communities who make the difference more than our governments and corporations.

I could go on and on and on and on, so I'll leave it at that.

Keep up the great work Amber! I hope you have a speedy recovery.


Amber said...

Kiashu, thanks for putting plastic use into perspective.

The question that I have then, is will we have the energy to manufacture and transport medical supplies and pharmaceuticals?

And will we order our priorities properly in the future, so that we ensure we have the resources for these necessary things, rather than say, big screen tvs or the Big 3?

I absolutely agree that prevention is the best medicine, and good food and clean water go a long way in keeping people healthy. However, even in the west where much of the population has access to good food and clean water, people still choose to eat processed food, drink pop, smoke and drink too much.

Granted, people might not have this choice in the future but in the long, slow grind down, there will still be millions of people with diabetes and heart disease that will put pressure on the health care system.

In the Third World where people are already dying from lack of good food and clean water, I imagine that this will only get worse.

And of course some things can't be prevented. Accidents happen. Children fall out of trees and break limbs.
Old age can't be prevented. We can control how well we age to a certain extent, but most of the baby boomers I know who are in their 50's and 60's are of the aforementioned processed food eating, pop drinking, smoking and heavy drinking kind.
Healthy women have difficult pregnancies and births.
20% of otherwise healthy women get bladder infections.
Millions of people have asthma or allergies that result in anaphylaxsis.
Millions of people have physical, intellectual and/or psychiatric disabilities.

So though I agree that we should always focus efforts on prevention, I'm still worried about how we will be able to deal with what cannot be prevented.

Amber said...

Hi Artizan,
Thanks for your comment. I too try to have faith and hope.

Mostly likely there will be a wide range of scenarios. As you say, I think some things will improve as people are forced to walk more, watch less tv and are exposed to less processed food and meat. Many areas and communities of people will be more resilient than others. Those that are less resilient will suffer more.

On a personal level I do my best to try and prepare for a variety of possible future outcomes. I plan for the worst while hoping for the best.

Sitting in the emergency room this week, exhausted and in pain, I felt very vulnerable and completely dependent on a system that is not sustainable. That was a difficult place to be in.

Kiashu said...

"So though I agree that we should always focus efforts on prevention, I'm still worried about how we will be able to deal with what cannot be prevented."Most of the examples you give of accidents, childbirth and so on remind me of what a doctor I dated once said to me, "most of medicine is simply making people comfortable while they get better by themselves."

For example, broken limbs heal themselves; the doctor just makes sure the bones are in the right position to heal straight rather than crooked, and puts on a cast to stop the bones being bumped around while they're healing. This is a person with skills, rather than using much resources.

Much the same goes for difficulties in childbirth, and so on. Much of "medicine" is a person with skills applying those skills, rather than drugs or a heart-lung machine or whatever.

Around the world, we find that one-sixth of the world consumes one-half its resources. Likewise with medicine - relatively few patients take up most of physicians' time and hospitals' resources.

Post-peak then, if we have general scarcity and are too stupid to put in renewable energy and the like, we can see that most medicine could keep on happening. We'd miss out on the quadruple bypass and the organ transplants, but that's only a small percentage of all the people who pass through clinics and hospitals.

Consider Cuba: it's a Third World country, suffering half a century of sanctions from the US. Yet they have free universal healthcare, and a higher life expectancy and lower infant mortality rate than the US.

Yet they use around one-fifth the energy of the USA per person, and have one-fifth the per capita income. Their doctors are very poorly-paid, but they don't have to worry about malpractice insurance, and they have no student loans since their education was free; and they tend to get lots of gifts from their patients, they have low grocery bills because everyone gives them food.

Of course Cuba is no paradise, they're a communist country with all the dreadful oppression and inefficiency that implies. But they do have a decent healthcare system.

So I think you're confusing how much resources and money a decent healthcare system needs with how much your country's system uses.

It's all about how well-managed the whole thing is. As a non-healthcare example, here in Melbourne our train system operator struggles to transport half as many people as were transported by a smaller system with manual signals in 1950. And all of us have seen in workplaces that two people given the same workload, one will cruise through it and another panic and scream. It's all about how competently you can manage things.

A healthcare system which is, to put it mildly, a complete clusterfuck in wealthy times, it's going to be even worse in hard times. But you never know, scarcity might be just what it needs to fix it. There's many a tale of the wealthy spoiled kid who, tossed out onto the street and their own devices, got their shit together and sorted themselves out.

Theresa said...

Glad to hear you are feeling a little better and more rested. :)

I have a feeling that in the future people will have to become more accustomed to waiting for the body to heal itself after receiving some rudimentary first aid. And, well, more people will probably die, at least in the first generation or two after TSHTF. But I think humans could possibly become healthier overall, in the longer run, provided there is decent food and clean water as has been mentioned. Probably things like diabetes, heart disease, and even cancer may well diminish once we stop filling our bodies and environments with toxins and start working more physically again. But I have no data or statistics to back this up - it is just speculation on my part.

I hope you get the chance to recuperate further over the weekend!