On Zimbabwe, Cholera, and the Pump

The ever-fascinating Stuart Rennie at Global Bioethics Blog observes regarding the Zimbabwe cholera epidemic:

If you were ever wondering if politics is a 'social determinant of health', well, just take a hard look at Zimbabwe. A few decades ago, the country was the breadbasket of the sub-Saharan region, and it is now heavily dependent on food aid and imports, with an economy crippled by massive debt and astronomical levels of inflation. In fact, its chief export in the coming months, besides Zimbabweans, could be infectious disease.

Of course, anyone remotely familiar with Sen and Farmer's work, to name only two, understands that political structures are the chief determinants of health.

In a particularly nice metaphor, Rennie notes that

Epidemiologist John Snow is said to have removed the handle on the water pump on Broad Street in London in 1854, once he discovered that contaminated water from the pump was responsible for the city's deadly cholera epidemic. The outbreak dissipated soon afterward. In Zimbabwe, Mugabe is the pump handle.

Well-said.