22nd October 2010
Conventionally we battle in healthy opposition, be it in football, netball and cricket. But the unconventional fight South Africa and Australia share is against health epidemics of paralleled prevalence.The question of the epidemics we both are fighting is one that continues to shock even medical practitioners.
Dr. John Schwarz was a doctor at a mission hospital in South Africa for almost a decade. But in 1985 he returned home to establish a humble general practice in Camden, NSW.
“Initially when I came back to Australia, all those years ago, I thought this was going to be dead boring,” Dr Schwarz recalls.
South Africa is a nation plagued with high infant mortality, low life expectancy, political instability and rampant HIV/AIDS.
Australia is a plentiful country. We enjoy political stability. We are educated in a world-leading education system. We should live almost the longest out of all the developed nations and comfortably in safe houses, cars and communities.
Africa’s epidemic? HIV/AIDS.
Ours? Depression.
Human Immunodeficiency Virus affects more than 15% of South Africans. In the region of Dr. Schwarz’s work, Okhahlamba, more than 20% of adults, and 35% of pregnant mothers test positive. The region is home to 150 000 people including 12 000 orphans.
“I find it really fascinating that my practice in Australia, the epidemic, the problem most numerous is depression. When we compare our lives we have in Australia, we have phenomenal lives. The South African’s work to get a pension of $25 a week.” Dr. Schwarz explains. “Depression is an extraordinarily destructive problem.”
Last year, up to 1million Australian adults, and 100 000 young people suffered from depression related illnesses. It is estimated that 1 in 5 Australians will suffer from depression during their lifetime.
Depression is the black dog hidden from public view and HIV/AIDS is the often-ignored global pandemic. But their commonality lies in the helplessness, hopelessness and lack of self-worth of their sufferers.Dr. Schwarz tells of a story on his last visit to South Africa. “We came across a 13 year old girl sitting absolutely desolate beside a hut. She had a swollen face with blisters that covered it,” he said, “We discovered she had been raped as an 8 year old, contracted HIV, but also suffered from Tuberculosis and Shingles. She had been unable to access treatment.”
Although seemingly less harsh conditions in Australia, stories of depression linger.
“The 20 year old university student with a loving family and regularly visiting friends. Her hidden diminishing self-confidence developed into a heightening sensitivity to personal criticism,” he said. “The social embarrassment to seek help led to its spiral out of control.”
The social stigma surrounding depression often prevents suffers from seeking treatment. Depression is a leading cause in suicide, the largest single cause of injury related death in Australia.
Is it disfavourable to position depression beside HIV/AIDS in a list of health pandemics?
The World Health Organisation predicts depression to become the second largest contributor to the global burden of disease in the next decade.
Dr. Schwarz explains that often the provision of treatment is the key in helping others.
“When you’re a doctor you really just help one person at a time. When someone comes into the surgery you look at their problems. As a doctor you cannot solve everybody’s health problems but you can provide high quality care for each of your patients,” he said.
Depression in Australia is as common as HIV/AIDS in Africa yet the stigma surrounding its diagnosis and treatment is debilitating for sufferers.
In South Africa, “the people that [my mission hospital are] helping have the most pristine view and surprisingly they appear to be mostly happy despite living in the most difficult circumstances,” Dr. Schwarz notes. “Yet it’s Australian’s suffering in the same degree from lack of self-worth, confidence and hope.”
Perhaps the solution for both pandemics lies in the hands of Australians? Would giving more to help those living with HIV/AIDS fill the void of self-worth for all current and future depression suffers?
October is the Australian Government’s depression initiative, Beyond Blue’s Anxiety and Depression Awareness Month. Visit beyondblue.org.au