Scalpel's Edge

A surgeon's notes

Lucky privilege

2015 07 04 11 45 43

I was impressed by a post I read over the last few days about the meaning of privilege.  The premise is that some people with disastrous lives make decisions or mistakes at sixteen that stay with them forever, like taking addictive drugs or having an unplanned pregnancy.  Furthermore, poor or disadvantaged people who have good luck – the care of another, a more promising friendship – can skate past those sort of life-definining decisions.  If you manage to learn from your decisions, or make choices that have more positive impacts, you are rewarded with the opportunity to reinvent yourself as you grow older – a new style in your twenties, a new job in your thirties, or a new relationship in your forties.

I have been impressed by these random effects since living in Nepal.  I was born in a first world country with government sponsored education and healthcare.  There are doctors on every corner, and schools closeby.  Houses may not all have airconditioning, but they all have flushing toilets, and running water that is drinkable from the tap.  Most families have access to a car or public transport and if I didn’t have access to transport, I would maybe have to walk thirty minutes to primary school, along footpaths.

My friends born in Nepal have a different experience. Most houses do not have internal plumbing, and if they do, the water from the tap is not drinkable.  Other water has to be fetched from the local tap.  Parents have to pay to access healthcare, and children are much more likely to be born at home.  Equally, if a child is unwell, they may not be taken to the doctor until they are really unwell, because it’s cheaper if they get better by themselves.  When I was born in 1975, primary education in Nepal was by no means typical, although it has been much improved in the last ten to fifteen years.  It is not uncommon for children to have to walk two hours each day to primary school, along main highways.  If parents have to work, then children supervise each other on these walks.  Vaccination is not universal.  

In Nepal, visiting doctors are shocked by the paediatric mortality, and we have to experience the open grief of a mother who has lost sometimes multiple children to illness. In Nepal the staple food is high GI rice, yet most people are underweight.  If they have a major illness, they quickly strip all their muscles and fat to turn into skeletal humans, with staring, sunken eyes, like all the images we’ve seen in documentaries about the holocaust.  I can’t remember anyone looking like that in a western hospital except those wasting away from cancer. There are numerous people who have never visited Kathmandu for any reason, and could never raise the resources to travel for specialist medical care.  In Nepal, the age of a patient is a key consideration when their family decide whether they can afford to treat an illness.  Cancer treatment is expensive and mainly useful for elderly patients.  In Nepal that means that lots of cancer goes untreated.

There are also people who here are born into privilege, and are able to afford education and prompt healthcare.  They can afford to travel outside the country.  They can treat diseases promptly, and take preventative medicines.  They can see a doctor when they are unwell, and can travel to see specialists and afford their rates.  They have fancy phones and TVs and satellite TV networks.  Because they have education, they speak two or three languages well and even go on to university for further education and training.  These things we would almost take from granted, but here they are a sign of extreme privilege.  But those people are not the majority, and they are surrounded by a country of poor with less opportunity.

It’s a cliche, but there, but the grace of God, go I.  I have had amazing opportunities, just because I was born in a first world country.  I have educated parents, with good incomes, and have had an excellent education.  I have had good preventative healthcare, and I have enough food regularly that I am overweight.  I even have enough money and resources that I can volunteer here for twelve months, and be confident that I will still have enough money for plane flights home. I have not achieved because I am particularly talented or hardworking.  I have just been ridiculously lucky in my life.

In fact, we are all lucky in Australia. For whatever reason the media or government or both tries to tell us that we have nothing to share.  I’m not entirely sure how they can make that argument stick, because we are educated enough to know there is poverty in the world.  We have enough access to the news to know there are poor in our country, and we know that people down the street are also struggling.  Surely, we can also realise that the poor in australia are usually much more wealthy than the poor of a third world country.  I’m sure we’ve all looked at genocide stories and wondered how the educated and privileged stood by and didn’t fight for the rights of others.  How can our educated and resourceful lucky country stand by and not look after the rest of the world?

I am lucky to be privileged and I refuse to deny it.


Image note: Zoe playing with baby goats in a neighbouring village.  This sort of house is traditional, and many of my friends have grown up in similar settings.  The couple in this house raise animals to support themselves, and if the monsoon fails they can grow less rice and struggle more for that year. 

2 responses to “Lucky privilege”

  1. SLuckettG says:

    Wow, hard to imagine walking two hours to get to primary school, especially in a country where healthcare is expensive and uncertain!

    I think that we can recognise that we are incredibly lucky while also seeing that we are talented and hardworking, which you certainly are. I think the beauty is that those of us who are both lucky and hardworking can make a difference, just as you’re doing now.

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