There lies great power in the simple things

19 August 2014 | Graeme Wilkinson | Opinion

The chains of habit are generally too small to be felt until they are too strong to be broken. – Samuel Johnson

Graeme Wilkinson, author

The World Health Assembly (WHA), meeting annually in Geneva, Switzerland, is the supreme decision-making body of the World Health Organisation. At its 67th meeting between 19 and 24 May 2014, a record number of resolutions were passed.

Deliberations on antimicrobial drug resistance received news coverage in South Africa, particularly with talk radio picking up on the topic of the increased resistance to antibiotics in humans and animals. Talk-show panellists admonished us all for inappropriate use of antibiotics, blaming this for the development of strains of bacteria that are resistant to all known antibiotic remedies.

However, the message from the 67th WHA was far more sanguine: just wash your hands more regularly and practise good hygiene to prevent infection! From this we take the eternal lesson that there lies great power in the simple things. We are reminded, however, that often the full picture is far more nuanced.

The home-based care worker visiting her multidrug-resistant TB patient at home first has to help the family ensure the household’s immediate primary health-care needs of good hygiene (I’ve even helped sweep a shack on one site visit) and especially good ventilation, before attending to the specific pain management needs of her patient.

When working in communities, engaging with people in their homes in a holistic way, you appreciate just how much health care should not be seen as a linear progression (from prevention, to primary, secondary, tertiary and only then maybe palliative healthcare), but rather as a continuous circle.

With an estimated 6.2-million South Africans living with HIV, and an increasing number of people locally contracting non-communicable diseases such as cancer, hypertension and diabetes, pain and pain-management will increasingly demand attention from our health-care systems.

It is thus heartening that the 67th WHA recognised the importance of palliative care as a component of comprehensive care. We can be proud of the thousands of home-based care organisations in South Africa that have proven, through their daily practice as they bore the brunt of the HIV/Aids pandemic, that access to comprehensive care is not only possible but an essential human right.

I would argue then that it is not in the bombing of our bodies with short courses in antibiotics that we overcome the challenges of those many opportunistic threats to our health and wellness. Instead, it is in the small, ongoing, daily practices (such as washing your hands, opening a window … respecting the rights of others) that we can convincingly lay claim to long life, prosperity and peace.