One world? ' Two worlds? by Georges Mikes A superficial acquaintance with the work of the World Health Organization is enough to make me realise that my views and remarks are those of a parochial West-European. People should not be ashamed of being West-Europeans, though many of them are . And neither should they be over-proud of it. Western Europe, or " the West ", includes such vast , non-European places as the United States , Australia and New Zealand , but all of them put together are only a small part of the globe , with very different prob- lems from the rest. Humanity be- longs to two main groups : the Third World and the First. (I know very little about the Second. It's never mentioned.) You have never heard of a Ugan- dan peasant or a Jamaican farm- worker on a banana plantation who does not have enough " exercise" . They all have more than enough. There are few Indian or Ethiopian villagers threatened by the dangers of over-eating. Their problem is under-eating. If they have a prob- lem about cholesterol , they need more of it , not less . That does not mean that we Westerners are necessarily health- ier than the people of the Third World. Americans may be the wealthiest but are certainly not the healthiest of all nations . Africans and Polynesians, and many others , disregard minor ailments which send us rushing to our doctors who then keep us in bed for days. If we drank the water some of these com- munities keep drinking we would die of cholera. They drink that wa- ter with impunity. (One has heard innumerable stories about concen- tration camp victims , during the second world war-middle-aged and middle class people who had 28 caught innumerable colds during their previously comfortable lives. When their brutal and monstrous captors made them stand in the snow almost naked for hours on end, many of them suffered no ill- effects) . World Health learnt with sorrow of the death of George Mikes, at the age of 75, shortly after publi- cation of his last book, "The Riches of the Poor: a journey round the World Health Organi- zation." Born in Hungary into a non-practising Jewish family, Mikes became a journalist and was sent by his newspaper to report on European affairs from London in 1936. Consequently he escaped the holocaust in which many of his friends and relations perished. As a refugee, he wrote a book intended "to hit hard at all the things the British held dear ... tea, sex, cricket." But-the way he tells it-he had under-estimated the British gift of being able to laugh at them- selves. He was labelled as a humorous writer and his book, " How to be an alien," became a best-seller. On his own health, Mikes wrote in his last book : "The last time I was really treated by a doctor was in 1957 . . . But as a young journalist I got blood poisoning. When my colleagues from the newspaper rang the nursing home, they were told that all hope had been aban- doned, so my paper published a warm and very flattering obitu- ary . .. The next morning, I read my obituary and was truly cheered up . Later I had the feel- ing that my Editor was annoyed. He hated any inaccuracy and felt that I had let the paper down by recovering." This however, is only one side of the picture. The other side is more discouraging. Once again two dif- ferent worlds are staring at each other with incomprehension . A great many illnesses which have been more or less eliminated in the West - polio, tetanus , tuber- culosis, whooping cough , measles (smallpox is in a different chapter) are still widespread killer-diseases in the Third World. (The Third World is nowadays called the "De- veloping Countries". Some of them are developing , others are not.) The two sides seem to be worlds apart. The problems of one (over- feeding etc.) are the dreams of the other. We live different lives ; we die different deaths. As we in the West are supposed to be more advanced, WHO's task seemed for a short while to be simple. The Third World must be brought up- up?- to the level of the First , or as near to it as possi- ble . This simple concept proved all right, even beneficial, in quite a few cases; in others it caused trouble and even disaster. It happened on several occasions that Western missions were horri- fied to see African or South Ameri- can tribes living with their animals (either animals sharing people's huts or people sharing animals ' sta- bles). They washed in the same wa- ter and, sometimes drank water in which animals had urinated . Yet they remained healthy. As soon as well-intentioned Westerners taught them a bit of hygiene , they started falling ill. Those wonderful West- ern methods destroyed their health . The moral is not that we all should drink water into which buffaloes have urinated . On the other hand I have heard a few success-stories. This one comes from Thailand . In one district people hardly ever washed because of the shortage of water. WHO taught them how to catch rainwater in a reservoir and how to separate rainwater and drinking water from water suitable for washing clothes and yaks and elephants but for nothing else . These newfangled ideas were received at first with the utmost suspicion, but the Siamese are too intelligent a people not to have been convinced by evidence in front of their eyes. The new system has changed their lives . Lots of dis- eases disappeared, the community W ORLD HEALTH, Jan./Feb. 1988 has become altogether healthier. Now that they have enough water in their reservoirs they keep them- selves much cleaner and this has improved their health further. Today they are prepared to pay for their water-supply-and that says a lot. Benefits are not always so obvi- ous as in this case. Most Western newspaper-readers have heard of the problem of powdered milk. African children were introduced to artificial milk and some of them died. The milk was blamed, but the culprits were the dirty water in which it was dissolved and the ex- creta of flies on the teats: impossi- ble to explain to any mother who has just lost a child, without sound- ing as though you were blaming her in order to excuse yourself. Or take vaccination. The practice is often received with resentment. Mothers hate seeing their babies being pricked with those long and menacing needles-and sometimes babies are inoculated only to die afterwards, in spite of it. Perhaps the needles were dirty ; perhaps the vaccination came too late ; perhaps the baby dies of some illness uncon- nected with the vaccine. Excuses won't wash. For the mother it was that jab with the horrible needle that killed her child. It is an old fallacy of the human race that it is enough to show rea- son for reason to be victorious. One would have expected the experi- ence of the eighteenth-century Ra- tionalists to cure us of this fallacy but this is not the case. African witch-doctors are often more intel- ligent than Western rationalists. Se- cretly they administer penicillin to their patients. People, of course, insist on the old hocus-pocus, too, so they get it from the witch- doctor. It is hard to say- as there are so many psychosomatic ill- nesses-whether the patients are cured by penicillin or by the hocus- pocus. One meets the equivalent of the witch-doctor in our own society. A very eminent specialist told me once that when he was treating a sick child whose life was in the bal- ance, he had gone to church to pray for his little patient's life. I am an old sceptic and am convinced that the "supernatural" never helps the patient; but sometimes, obviously, it helps the doctor. WoRLD HEALTH, Jan./Feb. 1988 0 0 • Mothers hate seeing their babies pricked with those menacing needles 0 0 ° Photo WHO/S. Jabao The West has absolutely no rea- son to expect reason on medical matters to prevail among Third World peoples. We all know about Copernicus's fear of being burnt at the stake, the tribulations of Galileo, the vituperations against Charles Darwin, and the attempts to oust Louis Pasteur from the medical profession. The list could be extended almost indefinitely. Einstein's theories on physics were received with doubt, Freud's on psychology with derision, and great artists (whose laundry lists, written out in their own hands, fetch for- tunes today) have starved. So why, should people unfamiliar with the principle of vaccination not mis- trust the injection needle? That people were reluctant to accept Darwin and Freud is un- derstandable. They undermined humanity's conceit, belief in itself, snobbery, so it would have been comforting if they had been wrong. But even when people are con- vinced that a teaching or discovery is right, they still resist it. Every- body knows that cigarette smoking -or all smoking-is destructive to health and a potential killer. Yet millions of people-brilliant, advanced "Westerners" among them-go on smoking, either fool- ing themselves that smoking will not harm them, or dismissing the whole idea as unproven. Indeed, they go much further. Nearly all the armies of the West go on issuing regular cigarette rations to the troops. It is very much in the inter- est of any army to keep its men and women in good health but, they say, it is even more important to avoid mutiny. Soldiers insist on their right to destroy their own health. I have heard of an eminent sur- geon who has saved countless lives, who carries out five- and six-hour long operations without smoking but chain-smokes as soon as he is out of the theatre. He explains: "I can do my work because I chain- smoke." That's how advanced, superior Westerners behave who often shake their heads with disapproving superiority over Third World Foolishness. When reason meets unreason- as a wise gentleman at WHO remarked -unreason always wins. In the West as well as in the "Developing Countries." Perhaps it is One World, after all. • (Extract from "The Riches of the Poor, A journey round the World Health Organiza- tion ," published by Andre Deutsch, 105 Great Russell Street, London WClB 3JJO Don Quixote illustration by Marie-Heli:~ne Jeeveso) 29
One world? ' Two worlds? by Georges Mikes A superficial acquaintance with the work of the World Health Organization is enough to make me realise that my views and remarks are those of a parochial West-European. People should not be ashamed of being West-Europeans, though many of them are . And neither should they be over-proud of it. Western Europe, or " the West ", includes such vast , non-European places as the United States , Australia and New Zealand , but all of them put together are only a small part of the globe , with very different prob- lems from the rest. Humanity be- longs to two main groups : the Third World and the First. (I know very little about the Second. It's never mentioned.) You have never heard of a Ugan- dan peasant or a Jamaican farm- worker on a banana plantation who does not have enough " exercise" . They all have more than enough. There are few Indian or Ethiopian villagers threatened by the dangers of over-eating. Their problem is under-eating. If they have a prob- lem about cholesterol , they need more of it , not less . That does not mean that we Westerners are necessarily health- ier than the people of the Third World. Americans may be the wealthiest but are certainly not the healthiest of all nations . Africans and Polynesians, and many others , disregard minor ailments which send us rushing to our doctors who then keep us in bed for days. If we drank the water some of these com- munities keep drinking we would die of cholera. They drink that wa- ter with impunity. (One has heard innumerable stories about concen- tration camp victims , during the second world war-middle-aged and middle class people who had 28 caught innumerable colds during their previously comfortable lives. When their brutal and monstrous captors made them stand in the snow almost naked for hours on end, many of them suffered no ill- effects) . World Health learnt with sorrow of the death of George Mikes, at the age of 75, shortly after publi- cation of his last book, "The Riches of the Poor: a journey round the World Health Organi- zation." Born in Hungary into a non-practising Jewish family, Mikes became a journalist and was sent by his newspaper to report on European affairs from London in 1936. Consequently he escaped the holocaust in which many of his friends and relations perished. As a refugee, he wrote a book intended "to hit hard at all the things the British held dear ... tea, sex, cricket." But-the way he tells it-he had under-estimated the British gift of being able to laugh at them- selves. He was labelled as a humorous writer and his book, " How to be an alien," became a best-seller. On his own health, Mikes wrote in his last book : "The last time I was really treated by a doctor was in 1957 . . . But as a young journalist I got blood poisoning. When my colleagues from the newspaper rang the nursing home, they were told that all hope had been aban- doned, so my paper published a warm and very flattering obitu- ary . .. The next morning, I read my obituary and was truly cheered up . Later I had the feel- ing that my Editor was annoyed. He hated any inaccuracy and felt that I had let the paper down by recovering." This however, is only one side of the picture. The other side is more discouraging. Once again two dif- ferent worlds are staring at each other with incomprehension . A great many illnesses which have been more or less eliminated in the West - polio, tetanus , tuber- culosis, whooping cough , measles (smallpox is in a different chapter) are still widespread killer-diseases in the Third World. (The Third World is nowadays called the "De- veloping Countries". Some of them are developing , others are not.) The two sides seem to be worlds apart. The problems of one (over- feeding etc.) are the dreams of the other. We live different lives ; we die different deaths. As we in the West are supposed to be more advanced, WHO's task seemed for a short while to be simple. The Third World must be brought up- up?- to the level of the First , or as near to it as possi- ble . This simple concept proved all right, even beneficial, in quite a few cases; in others it caused trouble and even disaster. It happened on several occasions that Western missions were horri- fied to see African or South Ameri- can tribes living with their animals (either animals sharing people's huts or people sharing animals ' sta- bles). They washed in the same wa- ter and, sometimes drank water in which animals had urinated . Yet they remained healthy. As soon as well-intentioned Westerners taught them a bit of hygiene , they started falling ill. Those wonderful West- ern methods destroyed their health . The moral is not that we all should drink water into which buffaloes have urinated . On the other hand I have heard a few success-stories. This one comes from Thailand . In one district people hardly ever washed because of the shortage of water. WHO taught them how to catch rainwater in a reservoir and how to separate rainwater and drinking water from water suitable for washing clothes and yaks and elephants but for nothing else . These newfangled ideas were received at first with the utmost suspicion, but the Siamese are too intelligent a people not to have been convinced by evidence in front of their eyes. The new system has changed their lives . Lots of dis- eases disappeared, the community W ORLD HEALTH, Jan./Feb. 1988 has become altogether healthier. Now that they have enough water in their reservoirs they keep them- selves much cleaner and this has improved their health further. Today they are prepared to pay for their water-supply-and that says a lot. Benefits are not always so obvi- ous as in this case. Most Western newspaper-readers have heard of the problem of powdered milk. African children were introduced to artificial milk and some of them died. The milk was blamed, but the culprits were the dirty water in which it was dissolved and the ex- creta of flies on the teats: impossi- ble to explain to any mother who has just lost a child, without sound- ing as though you were blaming her in order to excuse yourself. Or take vaccination. The practice is often received with resentment. Mothers hate seeing their babies being pricked with those long and menacing needles-and sometimes babies are inoculated only to die afterwards, in spite of it. Perhaps the needles were dirty ; perhaps the vaccination came too late ; perhaps the baby dies of some illness uncon- nected with the vaccine. Excuses won't wash. For the mother it was that jab with the horrible needle that killed her child. It is an old fallacy of the human race that it is enough to show rea- son for reason to be victorious. One would have expected the experi- ence of the eighteenth-century Ra- tionalists to cure us of this fallacy but this is not the case. African witch-doctors are often more intel- ligent than Western rationalists. Se- cretly they administer penicillin to their patients. People, of course, insist on the old hocus-pocus, too, so they get it from the witch- doctor. It is hard to say- as there are so many psychosomatic ill- nesses-whether the patients are cured by penicillin or by the hocus- pocus. One meets the equivalent of the witch-doctor in our own society. A very eminent specialist told me once that when he was treating a sick child whose life was in the bal- ance, he had gone to church to pray for his little patient's life. I am an old sceptic and am convinced that the "supernatural" never helps the patient; but sometimes, obviously, it helps the doctor. WoRLD HEALTH, Jan./Feb. 1988 0 0 • Mothers hate seeing their babies pricked with those menacing needles 0 0 ° Photo WHO/S. Jabao The West has absolutely no rea- son to expect reason on medical matters to prevail among Third World peoples. We all know about Copernicus's fear of being burnt at the stake, the tribulations of Galileo, the vituperations against Charles Darwin, and the attempts to oust Louis Pasteur from the medical profession. The list could be extended almost indefinitely. Einstein's theories on physics were received with doubt, Freud's on psychology with derision, and great artists (whose laundry lists, written out in their own hands, fetch for- tunes today) have starved. So why, should people unfamiliar with the principle of vaccination not mis- trust the injection needle? That people were reluctant to accept Darwin and Freud is un- derstandable. They undermined humanity's conceit, belief in itself, snobbery, so it would have been comforting if they had been wrong. But even when people are con- vinced that a teaching or discovery is right, they still resist it. Every- body knows that cigarette smoking -or all smoking-is destructive to health and a potential killer. Yet millions of people-brilliant, advanced "Westerners" among them-go on smoking, either fool- ing themselves that smoking will not harm them, or dismissing the whole idea as unproven. Indeed, they go much further. Nearly all the armies of the West go on issuing regular cigarette rations to the troops. It is very much in the inter- est of any army to keep its men and women in good health but, they say, it is even more important to avoid mutiny. Soldiers insist on their right to destroy their own health. I have heard of an eminent sur- geon who has saved countless lives, who carries out five- and six-hour long operations without smoking but chain-smokes as soon as he is out of the theatre. He explains: "I can do my work because I chain- smoke." That's how advanced, superior Westerners behave who often shake their heads with disapproving superiority over Third World Foolishness. When reason meets unreason- as a wise gentleman at WHO remarked -unreason always wins. In the West as well as in the "Developing Countries." Perhaps it is One World, after all. • (Extract from "The Riches of the Poor, A journey round the World Health Organiza- tion ," published by Andre Deutsch, 105 Great Russell Street, London WClB 3JJO Don Quixote illustration by Marie-Heli:~ne Jeeveso) 29
One world? ' Two worlds? by Georges Mikes A superficial acquaintance with the work of the World Health Organization is enough to make me realise that my views and remarks are those of a parochial West-European. People should not be ashamed of being West-Europeans, though many of them are . And neither should they be over-proud of it. Western Europe, or " the West ", includes such vast , non-European places as the United States , Australia and New Zealand , but all of them put together are only a small part of the globe , with very different prob- lems from the rest. Humanity be- longs to two main groups : the Third World and the First. (I know very little about the Second. It's never mentioned.) You have never heard of a Ugan- dan peasant or a Jamaican farm- worker on a banana plantation who does not have enough " exercise" . They all have more than enough. There are few Indian or Ethiopian villagers threatened by the dangers of over-eating. Their problem is under-eating. If they have a prob- lem about cholesterol , they need more of it , not less . That does not mean that we Westerners are necessarily health- ier than the people of the Third World. Americans may be the wealthiest but are certainly not the healthiest of all nations . Africans and Polynesians, and many others , disregard minor ailments which send us rushing to our doctors who then keep us in bed for days. If we drank the water some of these com- munities keep drinking we would die of cholera. They drink that wa- ter with impunity. (One has heard innumerable stories about concen- tration camp victims , during the second world war-middle-aged and middle class people who had 28 caught innumerable colds during their previously comfortable lives. When their brutal and monstrous captors made them stand in the snow almost naked for hours on end, many of them suffered no ill- effects) . World Health learnt with sorrow of the death of George Mikes, at the age of 75, shortly after publi- cation of his last book, "The Riches of the Poor: a journey round the World Health Organi- zation." Born in Hungary into a non-practising Jewish family, Mikes became a journalist and was sent by his newspaper to report on European affairs from London in 1936. Consequently he escaped the holocaust in which many of his friends and relations perished. As a refugee, he wrote a book intended "to hit hard at all the things the British held dear ... tea, sex, cricket." But-the way he tells it-he had under-estimated the British gift of being able to laugh at them- selves. He was labelled as a humorous writer and his book, " How to be an alien," became a best-seller. On his own health, Mikes wrote in his last book : "The last time I was really treated by a doctor was in 1957 . . . But as a young journalist I got blood poisoning. When my colleagues from the newspaper rang the nursing home, they were told that all hope had been aban- doned, so my paper published a warm and very flattering obitu- ary . .. The next morning, I read my obituary and was truly cheered up . Later I had the feel- ing that my Editor was annoyed. He hated any inaccuracy and felt that I had let the paper down by recovering." This however, is only one side of the picture. The other side is more discouraging. Once again two dif- ferent worlds are staring at each other with incomprehension . A great many illnesses which have been more or less eliminated in the West - polio, tetanus , tuber- culosis, whooping cough , measles (smallpox is in a different chapter) are still widespread killer-diseases in the Third World. (The Third World is nowadays called the "De- veloping Countries". Some of them are developing , others are not.) The two sides seem to be worlds apart. The problems of one (over- feeding etc.) are the dreams of the other. We live different lives ; we die different deaths. As we in the West are supposed to be more advanced, WHO's task seemed for a short while to be simple. The Third World must be brought up- up?- to the level of the First , or as near to it as possi- ble . This simple concept proved all right, even beneficial, in quite a few cases; in others it caused trouble and even disaster. It happened on several occasions that Western missions were horri- fied to see African or South Ameri- can tribes living with their animals (either animals sharing people's huts or people sharing animals ' sta- bles). They washed in the same wa- ter and, sometimes drank water in which animals had urinated . Yet they remained healthy. As soon as well-intentioned Westerners taught them a bit of hygiene , they started falling ill. Those wonderful West- ern methods destroyed their health . The moral is not that we all should drink water into which buffaloes have urinated . On the other hand I have heard a few success-stories. This one comes from Thailand . In one district people hardly ever washed because of the shortage of water. WHO taught them how to catch rainwater in a reservoir and how to separate rainwater and drinking water from water suitable for washing clothes and yaks and elephants but for nothing else . These newfangled ideas were received at first with the utmost suspicion, but the Siamese are too intelligent a people not to have been convinced by evidence in front of their eyes. The new system has changed their lives . Lots of dis- eases disappeared, the community W ORLD HEALTH, Jan./Feb. 1988 has become altogether healthier. Now that they have enough water in their reservoirs they keep them- selves much cleaner and this has improved their health further. Today they are prepared to pay for their water-supply-and that says a lot. Benefits are not always so obvi- ous as in this case. Most Western newspaper-readers have heard of the problem of powdered milk. African children were introduced to artificial milk and some of them died. The milk was blamed, but the culprits were the dirty water in which it was dissolved and the ex- creta of flies on the teats: impossi- ble to explain to any mother who has just lost a child, without sound- ing as though you were blaming her in order to excuse yourself. Or take vaccination. The practice is often received with resentment. Mothers hate seeing their babies being pricked with those long and menacing needles-and sometimes babies are inoculated only to die afterwards, in spite of it. Perhaps the needles were dirty ; perhaps the vaccination came too late ; perhaps the baby dies of some illness uncon- nected with the vaccine. Excuses won't wash. For the mother it was that jab with the horrible needle that killed her child. It is an old fallacy of the human race that it is enough to show rea- son for reason to be victorious. One would have expected the experi- ence of the eighteenth-century Ra- tionalists to cure us of this fallacy but this is not the case. African witch-doctors are often more intel- ligent than Western rationalists. Se- cretly they administer penicillin to their patients. People, of course, insist on the old hocus-pocus, too, so they get it from the witch- doctor. It is hard to say- as there are so many psychosomatic ill- nesses-whether the patients are cured by penicillin or by the hocus- pocus. One meets the equivalent of the witch-doctor in our own society. A very eminent specialist told me once that when he was treating a sick child whose life was in the bal- ance, he had gone to church to pray for his little patient's life. I am an old sceptic and am convinced that the "supernatural" never helps the patient; but sometimes, obviously, it helps the doctor. WoRLD HEALTH, Jan./Feb. 1988 0 0 • Mothers hate seeing their babies pricked with those menacing needles 0 0 ° Photo WHO/S. Jabao The West has absolutely no rea- son to expect reason on medical matters to prevail among Third World peoples. We all know about Copernicus's fear of being burnt at the stake, the tribulations of Galileo, the vituperations against Charles Darwin, and the attempts to oust Louis Pasteur from the medical profession. The list could be extended almost indefinitely. Einstein's theories on physics were received with doubt, Freud's on psychology with derision, and great artists (whose laundry lists, written out in their own hands, fetch for- tunes today) have starved. So why, should people unfamiliar with the principle of vaccination not mis- trust the injection needle? That people were reluctant to accept Darwin and Freud is un- derstandable. They undermined humanity's conceit, belief in itself, snobbery, so it would have been comforting if they had been wrong. But even when people are con- vinced that a teaching or discovery is right, they still resist it. Every- body knows that cigarette smoking -or all smoking-is destructive to health and a potential killer. Yet millions of people-brilliant, advanced "Westerners" among them-go on smoking, either fool- ing themselves that smoking will not harm them, or dismissing the whole idea as unproven. Indeed, they go much further. Nearly all the armies of the West go on issuing regular cigarette rations to the troops. It is very much in the inter- est of any army to keep its men and women in good health but, they say, it is even more important to avoid mutiny. Soldiers insist on their right to destroy their own health. I have heard of an eminent sur- geon who has saved countless lives, who carries out five- and six-hour long operations without smoking but chain-smokes as soon as he is out of the theatre. He explains: "I can do my work because I chain- smoke." That's how advanced, superior Westerners behave who often shake their heads with disapproving superiority over Third World Foolishness. When reason meets unreason- as a wise gentleman at WHO remarked -unreason always wins. In the West as well as in the "Developing Countries." Perhaps it is One World, after all. • (Extract from "The Riches of the Poor, A journey round the World Health Organiza- tion ," published by Andre Deutsch, 105 Great Russell Street, London WClB 3JJO Don Quixote illustration by Marie-Heli:~ne Jeeveso) 29