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Petti Fong: Why are we spending so much money keeping Ebola out of Canada but so little on helping the people in West Africa who really need the resources?
Mark Tyndall: There hasn’t been one case in Canada — there will probably never be a case in Canada. Yet if we spent just a small proportion of our preparedness budget to help West Africa, there wouldn’t be an epidemic. We way overshot on our preparedness.
PF: Is it a political decision?
MT: If there is a transmission, people feel very accountable for that, and no health minister or provincial health officer wants to be the one in the one place where there’s a transmission.
PF: You lived and worked in Nairobi on HIV projects, and then in Ottawa and Vancouver on programs related to poverty, HIV, and drug use. What’s the difference?
MT: My four years in Kenya changed the way I think about health. We’re very complacent about our system. Here we have a great health structure: it’s socialized, centralized, and we should all feel great to be a part of that. But we’ve also lost our way as far as expecting that when we get sick, it will be free and everyone will take care of me.
PF: Shouldn’t we expect the health care system to look after us?
MT: The problem is we don’t take much responsibility for our own health. We need, as a country, to wake up. We won’t need to spend 25 percent of our budgets on health care if we get people to start taking on some more responsibility.
PF: It sounds like you, a medical doctor, have a problem with the tertiary care system.
MT: By being here at the B.C. Centre for Disease Control, I’ve joined the little team, and we’re going against a big tertiary care machine. I really hope the BCCDC can start to challenge things and start to change the dialogue. The sicker theperson is, the more the doctor gets paid. There’s not much incentive to prevent things.
PF: Are you saying, as a physician, “Patient, heal thyself”?
MT: There really needs to be much greater awareness in people where they take control over their health. Most diseases aren’t bad luck. We spend about three percent of our health care budget on prevention and 97 percent on sickness. A lot of chronic illnesses are predictable: if you smoke for 40 years, you’re going to get cancer. We don’t put much effort on prevention, but we will do anything it takes to prolong life.
Mark Tyndall, 56, received his medical degree in internal medicine at McMaster and has a doctorate in epidemiology from Harvard University. He is one of three Deputy Provincial Health Officers