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Photo: A person lying in a hospital bed (photo: Fotolia)
Not caring about patients in the early phase of their live only leads to taking care of them for their whole lives.Image: Fotolia/Direk Takmatcha

The cost of not caring

Gianna Grün
January 29, 2015

You make people sick - by not taking action. It’s hard to put it like that, but it’s the truth. 1.3 million young people alone could still be alive, if somebody had cared.


Too often our world reacts upon incentives as triggers for action. And if that direct incentive is missing, then nothing happens. But one way of getting society to act might be to put a price tag on doing nothing.

The most macabre way of doing this is by looking at the number of deaths that occur when we do nothing. So here’s a number - 1.3 million adolescents died in 2012, mostly from preventable or treatable causes.

It is in this second decade of life - from 10 to 19 years old -, the most crucial time for overall development, that these young people were left to fight for themselves and succumbed to sickness. Among those illnesses that most severely affect that age group are respiratory tract infections and mental health conditions.

With that in mind, the Life Links reporters went out to meet three young people around the world struggling with such health problems to see what holds them back.

Life Links on the go to meet young people struggling with health issues

One of the causes for lung diseases is air pollution, so Life Links reporter Carolina Machhaus traveled to Mongolia’s capital Ulan Bator, one of the most polluted cities in the world.

There she met Tsegi, a young Mongolian woman with severe lung problems, caught in a vicious circle: to avoid damaging her lungs further, she needs to keep warm in Mongolia’s below-freezing temperatures. But to warm the yurt she calls her home, she must burn coal - all other fuels are unaffordable for her. However, the smoke from burning coal further damages her respiratory system.

Photo: A young woman holds out her hand - “polluted lungs” written on the palm of her hand (photo: DW/Robert Richter)
We asked Tsegi: what holds you back? She loves hiking up mountains, but can barely breathe.Image: DW/R.Richter

If you think Tsegi’s is a one-off case: far from it. Air pollution levels are even higher in cities including Delhi, Dhaka, Dakar, Karachi, Doha and Abu Dhabi - the WHO estimates that around half of the world’s urban population is exposed to air pollution that is at least two times higher than the recommended thresholds. This puts them at risk of developing respiratory infections and chronic lung diseases.

In 2012, seven million people died as a result of exposure to ambient and household air pollution. And it’s estimated that within the next 20 years, chronic obstructive pulmonary disease, resulting from re-occurring lung problems, will become the world’s third-leading cause of death.

"One of the biggest public health threats in Mongolia"

As the causal connections are pretty indisputable, one would think that government agencies should combine forces to improve air quality. But for Mongolia the opposite is reported: efforts fail due to a lack of coordination - it comes down to people not knowing whether to invest in better stoves or better fuels, as they don't have enough money to afford both.

With examples like this, it’s no wonder air pollution has risen even further, by an average of six percent, in these cities over the past three years.

From regional to individual responsibility

Still, while it’s difficult for an individual to have an impact when it comes to air pollution, there are other means of tackling preventable deaths where every single person can make a difference: organ donation.

Life Links reporter Aaron Tilton met a young man waiting for a donor organ in Germany: twenty-year-old Alexander is in need of a new heart.

Photo: A young man holds out his hand - “my heart” written on the palm of his hand (photo: DW/Aaron Tilton)
We asked Alexander: what holds you back? He would love to work in the voluntary fire brigade to help people in danger, but isn’t able to do so anymore.Image: DW/A.Tilton

Living in one of the wealthiest and healthiest countries in the world, one would think he would have more access to help for such a condition. But a crisis in Germany’s organ donor system born out of manipulation and corruption has left people sceptical and reluctant to register. In 2014, just 780 organs were donated, while there are about 11,000 people waiting to receive one, be it a heart, lung or kidney.

This means that every person could make a difference - but does not. Although there are surveys showing that around 68 percent of Germans would be willing to donate their own organs, it is only in theory. In reality, only 28 percent were registered as donors.

Still, despite the large gap between theory and reality, Germany is not even close to being the country with the least number of donations when you compare the numbers internationally.

Where there are higher transplantation rates in other European countries, such as in Spain, they are most likely due to the different systems in place. In Germany, you have to declare that you wish to donate your organs, for example by carrying a donor card - making it the responsibility of each individual. In Spain, however, you must declare your wish not to donate your organs, otherwise it is presumed that you want to donate your organs - with the state taking responsibility for making sure there are sufficient donors.

From the individual to everyone’s responsibility

Where state and society are also relied on to recognize and properly deal with health is with mental conditions - one of the major health issues among young people.

One of them is ex-soldier David. Life Links reporter Constantin Stüve met the young war veteran in the United Kingdom: the 27-year-old served in Iraq and Afghanistan. There he lost a leg. And also friends.

But what remains with him all the time is memories. Every night he is blown up by a bomb in his dreams.

Photo: A young man holds out his hand - “memories” written on the palm of hand (photo: DW/Axel Warnstedt)
We asked David: what holds you back? After being a soldier, he has tried to return to normal life, but he’s caught in his past - and has to deal with it alone.Image: DW/A.Warnstedt

David has been suffering from a mental illness called PTSD, post traumatic stress disorder. PTSD is a serious mental condition caused by a very stressful or frightening event. Even years after the traumatic event has been witnessed, one can develop this disorder - characterized by symptoms like anxiety, flashbacks and nightmares, as well as sleeplessness and feelings of guilt and isolation.

For David, the condition not only caused his nightmares, but also made him experience fits of anger.

Now, he has found ways to manage the condition.

But not everyone with a mental illness finds a way to deal with the effects. Though acceptance in society for depression or anxiety disorders is growing, many people still don’t dare to speak out for fear of being stigmatized.

And even worse: if they do speak out, they may still not get the help they need. Of the 45.9 million adults diagnosed as having a mental illness in the US, more than 60 percent had not received treatment, according to 2010 figures. One reason is said to be budget cuts in the US health care system.

Experts, however, say that not caring and leaving mental illnesses untreated in early stages only results in patients needing life-long care.

But if the sake of the patient itself is not a strong enough incentive, then perhaps economic terms will help: experts estimate that the global cost of mental illness was nearly $2.5 trillion for 2011, with one third going directly into medical care for mental health, and two thirds accounting for indirect costs such as disability payments and compensation for productivity loss.

In the end, when thinking about health and human life it comes down to this most perverse of triggers: Caring would not only be morally better - but also financially cheaper.

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