Views & Reviews Outside the Box

Development lesson

BMJ 2008; 336 doi: (Published 10 January 2008) Cite this as: BMJ 2008;336:100
  1. Trisha Greenhalgh, professor of primary health care, University College London
  1. p.greenhalgh{at}

    I was waiting on a dusty street corner in one of Africa’s poorest countries, with six teenagers. To pass the time, I invited them to give me 10 differences between “third world” and ‘‘first world’’ countries.

    “Easy,” said one. “We’re doing this in Geography. GDP.”

    “Okay, so people don’t earn much. What’s the impact of that?”

    They surveyed the rows of stinking slums. “People can’t afford nice houses. No kitchens or bathrooms. …

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