- Paperback: 768 pages
- Publisher: Hachette Books; Reprint edition (August 15, 2001)
- Language: English
- ISBN-10: 0786884401
- ISBN-13: 978-0786884407
- Product Dimensions: 6.1 x 1.4 x 9.1 inches
- Shipping Weight: 2.2 pounds (View shipping rates and policies)
- Average Customer Review: 64 customer reviews
- Amazon Best Sellers Rank: #542,200 in Books (See Top 100 in Books)
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Betrayal of Trust: The Collapse of Global Public Health Reprint Edition
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What do Russia, Zaire, Los Angeles, and--most likely--your community have in common? Each is woefully unprepared to deal with a major epidemic, whether it's caused by bioterrorism or by new or reemerging diseases resistant to antibiotics. After the publication of her critically acclaimed The Coming Plague, which looked at the reemergence of infectious diseases, Laurie Garrett decided to turn her highly honed reportorial skills to what she saw as the only solution--not medical technology, but public health. However, what she found in her travels was the collapse of public-health systems around the world, no comfort to a species purportedly sitting on a powder keg of disease. In Betrayal of Trust, Garrett exposes the shocking weaknesses in our medical system and the ramifications of a world suddenly much smaller, yet still far apart when it comes to wealth and attention to health.
With globalization, humans are more vulnerable to outbreaks from any part of the world; increasingly, the health of each nation depends on the health of all. Yet public health has been pushed down the list of priorities. In India, an outbreak of bubonic plague created international hysteria, ridiculous in an age when the plague can easily be treated with antibiotics--that is, if you have a public-health system in place. India, busy putting its newfound wealth elsewhere, didn't. In Zaire, the deadly Ebola virus broke out in a filthy and completely unequipped hospital, and would have kept up its rampage if the organization Doctors Without Borders hadn't stepped in, not with high-tech equipment or drugs, but with soap, protective gear, and clean water. Most of the world still doesn't have access to these basic public-health necessities. The 15 states of the former Soviet Union have seen the most astounding collapse in public health in the industrialized world. But during a cholera epidemic, officials refused to use the simple cure public-health workers have long relied on--oral rehydration therapy. Many of the problems in these nations can also be found in one degree or another in the U.S., where medical cures using expensive technology and drugs have been emphasized to the detriment of protecting human health. The result? More than 100,000 Americans die each year from infections caught in hospitals, and America has a disease safety net full of holes.
A Pulitzer Prize-winning journalist (for Newsday and others), Garrett has deftly turned what could have been a very dry subject into dramatic reportage, beginning with the eerie silence on the streets of Surat, India, where half the city's population (including doctors) fled the plague, while a thick white layer of DDT powdered the ground. Fascinating, frightening, and well-documented, Betrayal of Trust should be read not only by medical professionals and policymakers but the general public, and should galvanize a change in thinking and priorities. --Lesley Reed --This text refers to an out of print or unavailable edition of this title.
From Publishers Weekly
On a par with Rachel Carson's Silent Spring, this chilling exploration of the decline of public health should be taken seriously by leaders and policymakers around the world. Garrett, a Pulitzer Prize-winning journalist for Newsday (The Coming Plague: Newly Emerging Diseases in a World Out of Balance), has written an accessible and prodigiously researched analysis of disaster in the making in a world with no functioning public health infrastructure. In India in 1994, neglect of public health for the poor led to an outbreak of pneumonic plague; the once-dreaded disease is now easily treatable with antibiotics, but the failure of Indian authorities to quickly reach a diagnosis and provide accurate information resulted in a worldwide panic. The former Soviet Union, for all its flaws, according to Garrett, assured every citizen access to health care. After the U.S.S.R.'s breakup, the Russian economy collapsed. With no funding left for health care, Russia was overwhelmed by a tuberculosis epidemic. Even the U.S., historically a pioneer in public health (this commitment was demonstrated by New York City's quick and successful response to an 1888 cholera epidemic, as well as the tenement reform movement of the early 1900s that helped eliminate diphtheria), is lagging today. During the Reagan administration, Garrett says, budget cuts dramatically weakened public health while also denying poor Americans access to medical care. The author believes that the medical challenges posed by the epidemic spread of AIDS in Africa, by drug-resistant microbes carried from one country to another and by the danger of biological warfare can be met only by a cooperative global movement dedicated to strengthening public health infrastructures. Garrett sounds the alarm with an articulate and carefully reasoned account. Author tour; NBC Today appearance. (Aug.)
Copyright 2000 Reed Business Information, Inc. --This text refers to an out of print or unavailable edition of this title.
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As energy declines, fixing infrastructure will not be at the top of the list, just as it hasn't been for many decades despite the energy and money existing. Garrett explains where this money went in her book instead.
When oil declines, rationing will begin. In the 1980 oil rationing plan, agriculture was to get what it needed first, and clearly the military will also have top priority so that they can continue to fight wars to keep the oil flowing (mainly from the middle east, where two-thirds of the remaining oil is).
Meanwhile, cities will increasingly become unpleasant places to live as diseases spread unchecked from untreated human waste and garbage piling up...
Garrett covers other topics of interest to anyone looking for ecologically sustainable areas to live in the future (also see America's Most Sustainable Cities and Regions: Surviving the 21st Century Megatrends by John W. Day and Charles Hall). Clearly figuring out how to obtain clean water should be one of your top priorities.
the interplay between simple public health measures and the horror of one
of the most feared diseases on the planet. Encouragingly, she shows that
such epidemics are beatable. Discouragingly, she also shows that nobody who
with power to implement solutions actually gives a damn. But the horrors
of Ebola fade somewhat before the horrors of the collapse of healthcare
in Russia. Garrett interlaces statistics with personal stories but its
the stats which I find more horrifying. Its easy to dismiss one bad
story as just that, but the stats show the deep horror of a failed
state. This is a big book and I'm less than half way through, but this
is a book which everyone should read ... particularly those who
thinks that "the market" can solve all problems.
What reviewers say about the lengthiness and sometimes meandering style is true. When I read her first book, I was reminded of a joke I heard when attending an exhaustive, three day long training about HIV/AIDS counseling and testing. One of the presenters quipped that you might feel like you were dying of AIDS even though you never had it.
Reading this book, you can feel wearied and overcome by the problems. But, if you go with her style, where she interweaves facts with stories of real pepole impacted by the very trends she cites, you get a greater sense of the dimensions of the problems and the reality of the issues.
As we watch our president dismantle so many care systems, I think the chapters on what happened to Russia when they did the same have extreme relevance.
The publish date of this fine book means that some of its data is aging but the representation of the problems and trend remain timely.