Published 8 October 2008, doi:10.1136/bmj.a2008
Cite this as: BMJ 2008;337:a2008

Views & Reviews

Review of the Week

Out of the shadows

Brian Greenwood reviews a series of unsensational and scientific films about health in poor countries

Over the past decade interest in the health problems of the poorest countries of the world has risen remarkably. Topics such as HIV, malaria, tuberculosis, child survival, and maternal mortality now feature regularly at summits of the leaders of the world’s richest countries. Funds for the control of diseases of poor countries have become available on a scale never seen before.

An important and often unrecognised factor in this new interest has been the media of wealthy countries. About 10 years ago several major newspapers began publishing articles on diseases of poverty that would not normally have been considered of interest to their usual readers, and this process has accelerated. As someone who has lived through a period of neglect of diseases of the developing world I still find it surprising and gratifying to see a well written article on malaria or tuberculosis on the front page of one of Britain’s national newspapers.

Television has also played a key role in advocacy. In the past few years BBC World has produced a series of excellent programmes, made by Rockhopper TV, in a series called Kill or Cure. These films have looked at many of the health problems of people in the developing world and have shown what is being done to tackle them. A new series of programmes, called Survival, is now being produced for BBC World by the same company.

The series of eight programmes, produced by Alex Seaborne, covers a variety of topics on health in developing countries, with a common focus on how affected communities are tackling problems.

One of the films is set in Niger, one of the world’s poorest countries, and covers mass administration of drugs to prevent schistosomiasis, filariasis, helminthiasis, and trachoma by community health workers, using drugs donated by several of the world’s major drug companies.

Click on image to view video See a clip of the Neglected Tropical Diseases programme from the BBC World News series. To watch more of the series, visit http://survival.tv/thebriefingroom/

 
The film, superbly photographed, captures the stark beauty of the semi-desert landscape of much of Niger and some of the challenges faced by those who live on the brink of survival. The film is scientifically accurate, pointing out the enormous potential of simple and highly cost effective approaches to the control of some very disabling tropical diseases that don’t often kill but that may make survival a misery. It also points out correctly that repeat mass treatments will be needed for several years to interrupt the transmission of these infections. Sustaining the commitment to accomplish this will be a challenge. Viewers will be moved by the earnestness and quiet dignity of the villagers in learning how to give the treatments correctly and thus to help their community.

Another beautifully photographed film deals with the hazards of healthcare delivery in a rural area of Bangladesh, where access to skilled maternal health services is difficult. It contrasts the case of a young woman who is forced to rely on the caring but unsafe practices of a traditional birth attendant with that of another young woman, who is attended throughout her pregnancy, delivery, and postpartum period by a community midwife who has the skills and training needed to reduce the risks of pregnancy in an area far from a major referral centre.

Solving the health problems of the developing world will take time. A recurring fear for those of us whose job it is to help this process is that the political will and financial support needed to continue the progress that has been made will evaporate before the job is done. This must not be allowed to happen—and a key factor is making such an outcome unacceptable to the voters of the countries that are rich enough to provide the necessary support. High quality, scientifically accurate, and unsensational films like these show what can be achieved by people in poor countries, with a little outside help, and will help ensure that there will be no backsliding by our political leaders.

Cite this as: BMJ 2008;337:a2008

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Survival

BBC World News

Eight episodes from 4 October to 29 November 2008

Rating: ****

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