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INFECTIOUS
DISEASES

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entrepreneurs selling “raw water.”
What a luxury.
It is a cruel reality of inequality and resource mismatch across
the globe when those without resources are clamoring for them,
while those with resources refuse. Whether based on religious or
individuality protests in conservative communities or “natural” ways
of life in more liberal communities, the result is the same ignorance
of science and reason. What a luxury.
But a heavily and densely populated globe interconnected by the
increasing ease of international travel means that one person’s de-
clined influenza vaccine might mean another person’s influenza
death. The case of Ebola virus disease transported from Liberia to
Dallas, Texas in 2014 highlighted how quickly and easily infectious
diseases can spread across borders.

In a world of finite resources (yes, even in
America) when does the conversation about
personal responsibility turn to individuals

implementing what is available to them to
benefit their global community?

In a decade as a family medicine physician in the U.S., I had never
before seen a death due to cervical cancer. With our suite of widely
used screenings, diagnostic technology, and range of surgical solu-
tions, cervical cancer-related deaths are exceedingly rare. And now
that we have deployed the vaccine, Gardasil, cervical cancer rates
worldwide have been cut in half.
“If only this woman had had access to Gardasil,” I thought to
myself. Instead, the 82-year-old matriarch tried to maintain her dig-
nity in the face of a spreading cervical cancer, urinating on a plastic
tarp in her niece’s concrete open-air house and controlling her pain
with ibuprofen and oral liquid morphine. If only she had had access
to that luxury to prevent her cancer. With a little public will, perhaps
her great-granddaughters — and mine — will.

Travis Bias, DO, is a family medicine physician who once
practiced in Texas and now practices in California. He also
is a medical and public health educator. Dr. Bias was an active
member of the Texas Medical Association while in the Lone
Star State. Connect with him at his blog, The Global Table,
or on twitter @Gaujot.

24 San Antonio Medicine • May 2018