The most important thing the US can do to improve global health over the next 15 years is to help people realize that health is not only a human right in an abstract sense but that it is a daily reality with numbers and figures both in health indicators and statistics as well as in economic expense that have direct impact on their lives’. People must gradually come to terms with the reality that their actions can have meaningful effect not only on their own health but on health policy, governance and accountability.

I live and work in Bolivia, one of the continents’s most relegated countries in terms of child and maternal health, life expectancy, general access to health care of any type and lacking in health infrastructure and resources. I cannot say that I am amongst those that felt destined for medicine from childhood but I do remember the emotional impact and admiration the first time I saw Eugene Smith’s photo essay “Country Doctor”. I didn’t think then of becoming a doctor, that would be later, but I felt that somehow I wanted to be like that man. Being a doctor means different things to different people and the reasons why one decides to become one vary accordingly, yet I’ve found good doctors tend to have a common desire and willingness to make a difference and will strive in that direction tirelessly. It’s the same with nurses, therapists, social workers and many other people involved in the area, that same dogged persistence to go the extra mile, to try and “save” someone. Nationality, race, professional degree, experience and field of work may vary but eventually one will find the same basic feeling and determination to help others. Sadly, after a while, one will also find the same frustration and anger at not being able to do more, not because it couldn’t be done, but because someone wouldn’t let you or because things “just don’t work that way in the system”.

I’ve been up the Madidi River, into the jungle to places where people accept the death of a child as a circumstance of life that has to them the same inevitability as poverty or abandonment or floods. I’ve seen people in need of help be turned away from hospitals because they could not afford a minimal cost and have also asked med students, nurses or strangers to donate blood for someone they had never met but needed it. I’ve had to tell patients and their families that even though much more could be done if we lived in a different country, we’d do what we could with what we had and hope for the best. I’ve tried desperately and many times in vain to convince patients not to abandon their treatment when the cost was so high it was running the entire family into the ground. I’ve seen my colleagues grow tired and jaded, accepting the inevitability of preventable death or disease in our people as endemic and beyond their power to create change. Now, I am at point in my life and career that could be considered a midpoint and also a crossroads. I have concluded a medical specialty, I have returned to my country, and have worked side by side with others to try and change things for the better. The road so far has not been easy and I’ve already had more than my share of dealing with negligent or corrupt authorities. I’ve listened to the endless promises of dubious politicians and authorities, realizing how fast one can become skeptic and cynical after being used by them to promote their agendas.

So, how can one change this? How can one fight and reign in a corrupt and failed administrative system that has historically served to enrich a few in countries such as my own across the globe? At this point in time I think the best solution, the smartest and most powerful one, is to make information truly transparent and accessible to the people. At present, an average Bolivian citizen would have great difficulty in knowing: how much money in aid the U.S. has destined to our country, how and for what this money is being used and what the decision making processes are in regards to these resources. If this information was made available and accessible, people would eventually start asking where all this money is going and what results are being obtained as well as who’s responsible for administering these resources. If government functionaries are identifiable, if invested monetary figures are accessible and if health impact indicators are available, society as a whole is then empowered to approve or reject government action. We can make a difference by helping people realize their true potential and right to make a difference for themselves.