The danger of prayer revisited

A follow-up to yesterday's entry, addressing a couple of comments.

First of all, thanks to all of you who left thoughtful comments and understand where I'm coming from about this topic. For anyone who found my remarks disagreeable, I am not against prayer, by any means. Hey, knock yourself out. My point is that it doesn't work. Show me proof that it works. Show me an amputee that grows a new leg because of prayer. Then we'll talk.

My goal is not to get anyone to stop praying if that brings you comfort; I know many people that feel that way, and I would never take that away from them. But I would love it if my words made someone stop and think—critically think—about their actions and the results. Think about the inconsistencies in your god answering some prayers but ignoring others. Ask yourself how much sense it makes to believe that a "merciful" god would let one child be saved while another dies.

I had an exchange with someone who said that I was an idiot and that I didn't know what I was writing about. Gee, really? I write something that is my opinion, based on my experiences, and is something that I've pondered for decades, eventually coming to the philosophy that I hold today (a constantly evolving philosophy, by the way), and I don't know what I'm talking about? I would think that I would know, since I was there as I had all these experiences, I was there as family members prayed futilely for a miracle, I was there doing the work as I saw patients succumb to overwhelming infections, I was there as I watched as thousands of soldiers were killed and wounded and brain damaged in wars. I'm willing to bet that those people all had loved ones praying for them. What sort of psychotic god allows one person to live and another to have half of his head blown off? What god deems some worthy and others unworthy? If I sound angry, I am. Don't tell me about the power of prayer.

The only thing that prayer works for is your own comfort. I won't take that away from anyone who needs it. But for actually making a difference, actually resulting in a miracle...like I said: show me that regenerated limb, and then we'll talk.

Another comment (and I am not picking on this person or intending any sort of ridicule...they have the right to their opinion, but I also have the right to refute it) stated that my attitudes expressed here are more scary and saddening than any legislator trying to solve problems through prayer. What exactly is so scary about it? My encouraging everyone to think for themselves, rather than succumb to blind faith and dogma? I suppose that would be kind of scary, especially for women like I wrote about yesterday, who was so happy to have her god making decisions for her so she wouldn't have to make them on her own. That is what I find pathetic, that anyone would willingly give up control of their own destiny and the ability to make their own path through life based upon their decisions, their abilities, their strength, and their fortitude. Freedom in religion? The only real freedom I ever felt in religion is when I got away from it. There is no freedom in dogma, there is no freedom in indoctrination, there is no freedom in being subjected to archaic laws that discriminate and subjugate women and so many others.

You know what scares me? Politicians and others who would force their religion on everyone else. I've written about this several times before, but it bears repeating. Our government cannot constitutionally mandate or promote any religion. Just because you believe that your religion is the "correct" one doesn't make it so, and doesn't mean that the government is under any obligation to force your religion upon others; quite the opposite. If you feel the need to condemn me because I don't subscribe to your particular brand, I have to wonder at your willingness to judge. I have the right to tell you exactly why I disagree with you. I also have the right to demand that my legislators actually DO something to solve a problem rather than declaring some ridiculous day of prayer. I don't want to hear about pleas to their god, I want to see active work on solving the problem, I want to see ideas, I want to see results. Get off your knees and do something!

If anyone feels the need to pray for me, don't waste your time. Instead of my salvation, I'd much rather you thought about all the misery and woe that is happening in our world, and then realize that praying isn't doing one goddamn bit of good. Maybe then you'll take a few moments and consider contributing to organizations like Nothing But Nets, Malaria No More, Doctors Without Borders, or the Gates Foundation. Malaria killed 863,000 people worldwide in 2008, 91% of them in Africa; 1 in 5 of those deaths was in children. It costs ten dollars to buy an insecticide-treated malaria net for a family, and that ten dollars will save lives. The Gates Foundation is run by Bill and Melinda Gates. You might have heard of Bill...among other things, he's an atheist who has given millions in efforts to help alleviate suffering worldwide. One of the Gates Foundation's biggest donors is Warren Buffett, another atheist.

I would say that in about 15 years of existence, the Gates Foundation, funded primarily by two godless heathens, has saved more people—and has signed on to keep developing and funding ways in which to help people in the future—than prayer has in centuries. They don’t pray. They DO. Actions speak louder than words.

This seems like an appropriate time for a classic Devo song: "Praying Hands."

You got your left hand
You got your right hand
The left hand's diddling
While the right hand goes to work
You got both hands
You got praying hands
They pray for no man
(roll over, play dead, get spiritual-minded)
Okay, relax
And assume the position
Go into doggie submission
Wash your hands three times a day
Always do what your mom and dad say
Brush your teeth in the following way
Wash your hands three times a day

Infection Connection: Is there malaria in here, or is it just me?

Although it's not an infection that many of us take notice of, malaria is still a huge problem worldwide. In 2006, there were 247 million cases worldwide, and 881,000 died from the infection. In Africa, 2,000 children die from malaria every day. It may be eradicated from North America, Europe, Russian, and Australia, but this is a disease endemic to Africa, South America, and Asia, and it continues to cause pervasive problems in those countries.

The name malaria comes from the Latin, mal meaning bad, and aria meaning airs. It was believed to be contracted by breathing the miasma that arose from swampy areas. While the ancients didn't know the real cause, a protozoan parasite, they had the location correct, because of course mosquitoes breed in swampy areas or stagnant water.

Since the beginning of history, malaria has killed half of the people that have died on the planet, more than all wars, famines, and other epidemics combined. It is believed to have contributed to the fall of the Roman Empire as much as any other disease. A malaria epidemic in the year 79 laid waste to the Campagna area, where crops were grown. Its fields were untended and its villages were deserted; the area retained a low population for most of the next several centuries, and malaria wasn't eradicated from the region until the late 1930's.

Because of the prevalence of the parasite in Africa and the surrounding areas, genetic mutations developed that conferred immunity to some or all of the different strains. Sickle cell in those of African descent and thalassemia in those of Mediterranean descent cause a malformation in red blood cells that leave the cells impervious to infection. Other genetic mutations arose that confer resistance, and while these abnormalities may have protected against the infection, they certainly have their own serious consequences.

Malaria was a major problem in U.S. until the early 20th century. Presidents Washington and Lincoln had it; hundreds of thousands of Civil War soldiers contracted it; the infection traveled to California with the Gold Rush of 1849; and it killed many American Indians. The pesticide DDT proved effective in killing the mosquito that transmits the parasite, but the insects quickly developed resistance. It was also eventually found that DDT interrupted the ecological balance, resulting in other diseases like plague and typhus, and it was finally found to poison birds, fish, and mothers' milk. DDT was banned in the U.S. in 1972, but is still used in some tropical regions.

The protozoan is transmitted by the bite of the female Anopheles mosquito. Symptoms include fever and chills occurring in regular cycles, flu-like symptoms, sweating, and an enlarged spleen. Treatment of choice is chloroquine, although one strain is usually resistant and treated with quinine. When traveling to areas where malaria is endemic, prophylactic treatment with mefloquine is recommended. While generally only one strain can result in rapid death, part of malaria's covert danger is chronic anemia, which weakens the patient and makes them more susceptible to other diseases.

Most cases in the U.S. are in those who have traveled to endemic areas. While it's usually a rarity in U.S. laboratories, I was fortunate to work for the past ten years in a lab located in a city with several colleges that send students and/or missionaries abroad. We had a much higher rate of seeing malarial infections than in other places I worked, and it was a wonderful chance to learn. There are four species of Plasmodium that cause human malaria: falciparum, malariae, vivax, and ovale. It's important to speciate, because P. falciparum is by far the most deadly of the species, and causes the most deaths, and is also the one that is most resistant to treatment. We look at blood smears to see the parasites infecting the red blood cells, and many things have to be taken into account to identify the species: whether the red blood cells are enlarged or not; the presence of stippling, or dots within the cells; fimbriation, or feathered edges on the cells; whether there are multiple parasites in one cell; the various stages of parasite development; and the percentage of cells affected. Obtaining a patient's travel history is vital, because certain species are more common in certain areas--southeast Asia versus the west coast of Africa, for example.

As soon as I saw this picture, I said, “That’s falciparum.” Why? See those crescent-shaped purple structures in the middle? Those are the banana-shaped gametocytes of P. falciparum, and no other species has them. There are also cells that have more than one parasite in them, and that’s typical of falciparum.

Early diagnosis is crucial and can mean the difference between whether a patient lives or dies. Doctors in non-endemic areas don't necessarily think of malaria when a patient presents with flu-like symptoms. That's why a travel history is so important. We witnessed it a few years ago when a local family traveled to their African homeland. Although they took prophylactic drugs, they all contracted a resistant form of the infection. Not all of them survived, I'm sad to say.

While still a devastating and prevalent infection and still a terrible problem in Africa and other developing areas (where people cannot afford the expensive treatments), there is progress and hope. Groups like Nothing But Nets distribute mosquito nets treated with insecticides to African families to prevent the infection; The Gates Foundation provides grants for researchers attempting to find treatments and cures and is committed to eventually eradicating the disease; the drug company Novartis is providing Coartem, a very effective antimalarial drug, at a loss in order to treat patients in the developing world. Despite the monetary loss, the CEO of Novartis, Dr. Daniel Vasella, says, "We had the drug and the knowledge to help. It was our responsibility to be engaged."

I think most of us, with our multiple vaccinations, easy access to antibiotics, and increasing emphasis on preventive care, can't comprehend the effect that an endemic infection like malaria can have on a population and country. A populace weakened by hunger and disease has a much greater struggle in trying to make lives for themselves and improve their country. I applaud all of these companies and organizations, and those who contribute to them, for trying to make a difference in the lives of those who many find all too easy to ignore.

Sources:

Cartwright, Frederick F. Disease and History. New York: Dorset Press; 1972

Karlen, Arno. Man and Microbes. New York: Touchstone; 1996

Nikiforuk, Andrew. The Fourth Horseman. London: Phoenix; 1993

Kingsbury, Kathleen. "A Better Deal on Malaria." Time, March 9, 2009

Malaria. (2009, March 2). In Wikipedia, The Free Encyclopedia. Retrieved 23:21, March 9, 2009, from http://en.wikipedia.org/w/index.php?title=Malaria&oldid=274383494