Guided Reflection #2

  1. There is no denying that westernization is happening – everywhere. How can we prevent the westernizing of developing societies?  Do we want to?

This is definitely a loaded question with no simple answer. The first step to answering this question is to identify who is doing the “westernization” and what is its influence? I believe that the United States is a highly Westernized country that is very influential on other developing nations. We are seen as the country of opportunity, and many people from developing countries come here for jobs, school, etc. When people from these countries see how “successful” (it’s relative) we are, it creates the idea that our ways of life contribute to our success. I believe that this is why westernization is becoming increasingly popular and sometimes, increasingly harmful. I don’t necessarily think that we need to prevent westernization of developing countries, but rather alter the change that happens during westernization. Instead of adopting our unhealthy food and eating habits, iPhones, and other things that don’t run parallel with how advanced their society is, we should be focusing on helping with beneficial parts of our society: education and even higher education, healthy eating and living habits, medical advances, etc. It seems like some countries have a “leap frog” effect where they might not even have safe running water but they have iPhones, like was mentioned in class. This is extremely problematic because their resources are not being utilized in a way that is beneficial to their society. We need to prevent this type of westernization and replace it with using our money, technology, mission groups, etc. to influence these developing countries in a way that allows them to grow at a rate that is appropriate for their development currently. Like Robert Sapolsky talked about in his book, the organs of people in developing countries are literally not developed in a way that allows them to safely tolerate a western diet (Sapolsky, 1997, p. 203). Their pancreas, liver, and digestive system are all biologically designed to retain any salt or sugar that enters the body because it doesn’t know when the next time it will get some is. Western diets consist of a lot of sugar and high sodium foods, causing some major problems like hypertension, diabetes, high cholesterol, etc. when the members of developing countries eat those kinds of foods in excess (Sapolsky, 1997, p. 203, 209). Overall, I do believe some influence can be positive with westernization as long as it is the type of influence that is beneficial and easy to culturally adapt to for that specific country.

  1. Today in class we discussed the pros and cons of the polypill. Imagine you are 57 and have smoked all your life and live in a rural area where medical resources are rare.  Would you take the polypill?  Explain why or why not:

I would take the polypill. In class, we learned about exactly what it was and what made up the polypill. I took the stance of against distributing it to anyone over 55 in the general population, even those that have no risk factors. However, as a man over the risky age with a habit that is known to cause cardiovascular disease, and also in an area where normal medical care is scarce, I would definitely take advantage of it. N J Wald discusses how the polypill would “prevent 88% of heart attacks and 80% of strokes (Wald, 2003, p. 4). Those are wonderful odds, and based on their research only a small percentage of people suffered adverse mental effects from taking the pill. I believe that is worth it seeing as how I have smoked my entire life, and if I am in a rural area with scarce medical resources, I more likely than not have a poor diet and exercise regimen too, which further increases my risk of a cardiovascular disease.  In talking about the demographic of people who should take the pill, Wald states: “As 96% of deaths from ischemic heart disease or stroke occur in people aged 55 and over, treating everyone in this group would prevent nearly all such deaths” (Wald, 2003, p. 4). This is saying that it would be cheaper and easier to just administer/recommend the polypill to anyone over the age of 55 seeing as how that is the age of the majority of ischemic heart disease/stroke deaths. Due to the relatively cheap cost, low risk, low access to other medical care, and my own high risk factors as an unhealthy smoker over the age of 55, I would most definitely take advantage of the polypill.

  1. Assuming we are in Belize how would you administer a polypill medication to patients? How would you help patients adhere to polypill treatment regiment?

When in Belize, we would have to take a lot into consideration before administering the polypill. First, it is very important to gain as much of a complete medical history as we could for the patient. Due to the fact that the polypill is, as the name states, multiple drugs combined into one, it is important to rule out any potential allergies or comorbidities with other medications. Once we had as much information as we could gather, next would determining this patient’s risk for a cardiovascular disease to assess whether we think the polypill is the right treatment for them. The following factors would be what we would look for in making this determination: if they are over the age of 55, if anyone in their family has a history of CVD, do they smoke/drink, what their diet and exercise routines are, and physical measures like blood pressure and a respiratory assessment. Once we have determined this patient is a good candidate for the polypill, education is the next important step. The drug is useless if the patient is not going to understand or use it properly. I would educate the patient on how a healthy diet and an active lifestyle, even if that just means taking a walk or playing outside, can increase their cardiovascular health and explain that this pill is not “magic” and will not cure all their problems. I would then explain how the pill works to them and how in combination with a healthy lifestyle, it can really increase their overall health. In terms of helping patient adherence to the treatment regiment, I would get on a personal level with them and be honest about their poor health. Explain how they want to live a long and happy life, without the worry of having a heart attack, stroke, or dying too young. By explaining how simple it is to just take the pill once a day (or whatever the treatment is) you can significantly improve the quality of life. Perhaps also provide them with a spreadsheet that they can keep out or hang up somewhere visible to check off each day they take the pill to remind them. I would be honest but also empathetic with the patient, educate them on their own health and the polypill, and assist in any way possible to ensure they remember and continue to take it.

Works Cited

Sapolsky, Robert M. The Trouble with Testosterone: And Other Essays on the Biology of the        Human Predicament. New York, NY: Scribner, 1997. Print.

Wald, N. J. “A Strategy to Reduce Cardiovascular Disease by More than 80%.” Bmj 326.7404       (2003): 1-6. Web. 19 May 2016.