disease and health care

Cheating again today. A section from my book on life after the collapse. Which is now available, by the way. www.bisonpress.com
DISEASE AND HEALTH CARE
As discussed in the military section, health care will benefit from germ theory but suffer from antibiotic shortages. Simple sanitary practices have been responsible for more lives saved than millions of doctors ( something to keep in mind as you curse health inspectors or the building codes for septic tanks ). Yes, vaccines have played a huge role. But sanitary waste elimination and safe food storage was a huge step forward in quality of life and even longevity. As long as these standards are continued in practice disease and illness will not be the huge killers they once were. That said, no more antibiotics mean certain modern inconveniences turn deadly. No more vaccines will see a return of pandemics. And the lack of public services such as mosquito spraying will reintroduce malaria and such. The last item alone is reason to be leery of living in hot and humid regions. Much to do has been made of air conditioning opening up the South and southwest for colonizing by the swarming hoards of Yankees. But I would think that deep well irrigation and damming the Colorado opened up the lower west, and insecticides allowed the South to be safely inhabited. Air conditioning made them comfortable, but that didn’t allow water to be piped long distances or fetid swamps to become less threatening. The end to cheap energy and centralized control will turn those two areas in to unhealthy homes again.
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Now, having made the case that sanitary practices prevent diseases and that safe food storage contain illnesses, you also have to keep in mind that certain things are going to happen during and after the collapse. The breakdown of infrastructure means sewer mains leak. Private efforts at waste disposal are ineffective. The accumulation of trash, uncollected, harbors flies and rats. Water is treated badly or not at all. Even intentional contamination of reservoirs might occur ( for instance, as blackmail against a community ). Electricity supply becomes erratic and causes refrigeration malfunctions. And the lost knowledge of old school food preservation does not help matters. And don’t forget famine or at least malnutrition will weaken peoples immune system. So it really does become a crap shoot if disease does get uncontrollable or not.
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One thing we can count on is a complete breakdown of modern medical care. There are simply not enough facilities to accommodate any significant increase in required care and the extreme cost of education and malpractice insurance make sure that the supply of doctors stays limited. Medical professionals are said to be the next growth industry, but given that over half that field is government funded, and in light of the current financial health of the government itself, any wave of students going mercenary will be short lived. Health care is a luxury for most of the population. Costs have become too high. During a collapse, that will get much worse. Fewer patients will mean higher costs. An aging doctor population and decreasing medical students will see less personnel. Unless a collapse happens very quickly and you will see a lot of latent talent available. But even then, how many doctors could practice without their high tech tools and the pharmaceutical industry? How many could become general practitioners with little or no modern medicine, with only herbs or opiate based pain killers or less than ideal chemicals for operating? Perhaps we have raised the bar in knowledge enough that even with such a setback medical care will still be an improvement over that of a century ago. But as with most transitions being hampered with lack of trade, lack of energy and lack of low tech infrastructure, don’t count on it.
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The return to a pre-vaccine/antibiotic era doesn’t necessarily mean we are all going to keel over on the street as soon as someone coughs bloody droplets into the air. It does mean a return to early, random death for some. Decreased life spans for the poor. The return to the norm of death during child birth, of young widows and widowers, of once again treating death as a natural occurrence rather than a thing to be feared and fought with unending treasure. Remember, our present society mimics the wealth of kings of old. The poorest ghetto dweller of today lives better than a king several hundred years ago. Due to oil. Remove the oil and things go back the way they were. Which includes all but the wealthy unable to afford doctors or battling death with money.