Betrayal Of Trust [Paperback]

What do Russia, Zaire, Los Angeles, and--most likely--your community have in common? Each is woefully unprepared to deal with a major epidemic, whether it's caused by bioterrorism or by new or reemerging diseases resistant to antibiotics. After the publication of her critically acclaimed The Coming Plague, which looked at the reemergence of infectious diseases, Laurie Garrett decided to turn her highly honed reportorial skills to what she saw as the only solution--not medical technology, but public health. However, what she found in her travels was the collapse of public-health systems around the world, no comfort to a species purportedly sitting on a powder keg of disease. In Betrayal of Trust, Garrett exposes the shocking weaknesses in our medical system and the ramifications of a world suddenly much smaller, yet still far apart when it comes to wealth and attention to health.

With globalization, humans are more vulnerable to outbreaks from any part of the world; increasingly, the health of each nation depends on the health of all. Yet public health has been pushed down the list of priorities. In India, an outbreak of bubonic plague created international hysteria, ridiculous in an age when the plague can easily be treated with antibiotics--that is, if you have a public-health system in place. India, busy putting its newfound wealth elsewhere, didn't. In Zaire, the deadly Ebola virus broke out in a filthy and completely unequipped hospital, and would have kept up its rampage if the organization Doctors Without Borders hadn't stepped in, not with high-tech equipment or drugs, but with soap, protective gear, and clean water. Most of the world still doesn't have access to these basic public-health necessities. The 15 states of the former Soviet Union have seen the most astounding collapse in public health in the industrialized world. But during a cholera epidemic, officials refused to use the simple cure public-health workers have long relied on--oral rehydration therapy. Many of the problems in these nations can also be found in one degree or another in the U.S., where medical cures using expensive technology and drugs have been emphasized to the detriment of protecting human health. The result? More than 100,000 Americans die each year from infections caught in hospitals, and America has a disease safety net full of holes.

A Pulitzer Prize-winning journalist (for Newsday and others), Garrett has deftly turned what could have been a very dry subject into dramatic reportage, beginning with the eerie silence on the streets of Surat, India, where half the city's population (including doctors) fled the plague, while a thick white layer of DDT powdered the ground. Fascinating, frightening, and well-documented, Betrayal of Trust should be read not only by medical professionals and policymakers but the general public, and should galvanize a change in thinking and priorities. --Lesley Reed --This text refers to the Hardcover edition.

On a par with Rachel Carson's Silent Spring, this chilling exploration of the decline of public health should be taken seriously by leaders and policymakers around the world. Garrett, a Pulitzer Prize-winning journalist for Newsday (The Coming Plague: Newly Emerging Diseases in a World Out of Balance), has written an accessible and prodigiously researched analysis of disaster in the making in a world with no functioning public health infrastructure. In India in 1994, neglect of public health for the poor led to an outbreak of pneumonic plague; the once-dreaded disease is now easily treatable with antibiotics, but the failure of Indian authorities to quickly reach a diagnosis and provide accurate information resulted in a worldwide panic. The former Soviet Union, for all its flaws, according to Garrett, assured every citizen access to health care. After the U.S.S.R.'s breakup, the Russian economy collapsed. With no funding left for health care, Russia was overwhelmed by a tuberculosis epidemic. Even the U.S., historically a pioneer in public health (this commitment was demonstrated by New York City's quick and successful response to an 1888 cholera epidemic, as well as the tenement reform movement of the early 1900s that helped eliminate diphtheria), is lagging today. During the Reagan administration, Garrett says, budget cuts dramatically weakened public health while also denying poor Americans access to medical care. The author believes that the medical challenges posed by the epidemic spread of AIDS in Africa, by drug-resistant microbes carried from one country to another and by the danger of biological warfare can be met only by a cooperative global movement dedicated to strengthening public health infrastructures. Garrett sounds the alarm with an articulate and carefully reasoned account. Author tour; NBC Today appearance. (Aug.)
Copyright 2000 Reed Business Information, Inc. --This text refers to the Hardcover edition.

Turning her attention to the frightening condition of public health throughout the world, Pulitzer Prize-winning science reporter Garrett repeats the call for action she initiated in her tremendously successful The Coming Plague. Re-emerging diseases, antibiotic-resistant superbugs, and biological terrorism are increasing threats that can only be conquered through significant attention to worldwide public health. Garrett provides an in-depth look at public health programs in several different geographic areas and analyzes their successes and failures. The author shows clearly that successful public health programs require a fragile bond of trust between the people and their government, and she details the critical effects of politics and economics on public health infrastructures. Her endnotes, which might constitute a book in themselves, offer a tremendous resource for additional research. Completely readable for general readers and experts alike, this reasonably priced book is highly recommended for all libraries.DTina Neville, Univ. of South Florida Lib., St. Petersburg
Copyright 2000 Reed Business Information, Inc. --This text refers to the Hardcover edition.

In her surprise best-seller The Coming Plague (1994), Pulitzer Prize^-winning Newsday reporter and former NPR science correspondent Garrett drew readers' attention to emerging, antibiotic-resistant diseases. Her primary recommendations were more (and more effective) public-health fieldwork, research, and preventive medicine. In Betrayal of Trust, Garrett's subject is public health itself: the desperate inadequacy of public-health infrastructure in much of the developing world and the shocking neglect of that infrastructure in "developed" nations. Garrett moves from the relatively simple inadequacies revealed by the 1994 pneumonic plague outbreak in India and the 1994 Ebola epidemic in Zaire to a nuanced analysis of the issues involved in the near-total collapse of public health in the former USSR and the years-long underfunding and lack of respect for this key government responsibility in the U.S. (Her U.S. chapter pays special attention to public health in New York City, Los Angeles County, and the state of Minnesota.) Garrett's "biowar" chapter makes clear that the threat of biological terrorism has gained the attention of world (and U.S.) leaders, but their responses to date have been dominated by a military (rather than public-health) mind-set. Dramatic changes in attitudes as well as resource allocation will be needed to construct a public-health infrastructure capable of coping with the myriad challenges of globalization. Mary Carroll
Copyright © American Library Association. All rights reserved --This text refers to the Hardcover edition.

". . . Laurie Garrett has toured the world to share with us her vision of public health in action and in failure . . ." -- Professor Joshua Lederberg, winner of the Nobel Peace Prize

". . . traces public health through an engaging series of events and personal experiences -- her own and others' . . ." -- USA Today

"Bravo to Garrett for a diagnosis and wake-up call that is both brilliant and prescient." -- Dr. James Orbinski, president, Médecins Sans Frontières, winner of the Nobel Peace Prize

What do Russia, Zaire, Los Angeles, and--most likely--your community have in common? Each is woefully unprepared to deal with a major epidemic, whether it's caused by bioterrorism or by new or reemerging diseases resistant to antibiotics. After the publication of her critically acclaimed The Coming Plague, which looked at the reemergence of infectious diseases, Laurie Garrett decided to turn her highly honed reportorial skills to what she saw as the only solution--not medical technology, but public health. However, what she found in her travels was the collapse of public-health systems around the world, no comfort to a species purportedly sitting on a powder keg of disease. In Betrayal of Trust, Garrett exposes the shocking weaknesses in our medical system and the ramifications of a world suddenly much smaller, yet still far apart when it comes to wealth and attention to health.With globalization, humans are more vulnerable to outbreaks from any part of the world; increasingly, the health of each nation depends on the health of all. Yet public health has been pushed down the list of priorities. In India, an outbreak of bubonic plague created international hysteria, ridiculous in an age when the plague can easily be treated with antibiotics--that is, if you have a public-health system in place. India, busy putting its newfound wealth elsewhere, didn't. In Zaire, the deadly Ebola virus broke out in a filthy and completely unequipped hospital, and would have kept up its rampage if the organization Doctors Without Borders hadn't stepped in, not with high-tech equipment or drugs, but with soap, protective gear, and clean water. Most of the world still doesn't have access to these basic public-health necessities. The 15 states of the former Soviet Union have seen the most astounding collapse in public health in the industrialized world. But during a cholera epidemic, officials refused to use the simple cure public-health workers have long relied on--oral rehydration therapy. Many of the problems in these nations can also be found in one degree or another in the U.S., where medical cures using expensive technology and drugs have been emphasized to the detriment of protecting human health. The result? More than 100,000 Americans die each year from infections caught in hospitals, and America has a disease safety net full of holes.A Pulitzer Prize-winning journalist (for Newsday and others), Garrett has deftly turned what could have been a very dry subject into dramatic reportage, beginning with the eerie silence on the streets of Surat, India, where half the city's population (including doctors) fled the plague, while a thick white layer of DDT powdered the ground. Fascinating, frightening, and well-documented, Betrayal of Trust should be read not only by medical professionals and policymakers but the general public, and should galvanize a change in thinking and priorities. --Lesley Reed

Laurie Garrett is a Pulitzer Prize-winning reporter who has been a health and science writer for Newsday since 1988, and a contributor to such publications as Vanity Fair, Esquire, The Los Angeles Times, and Foreign Affairs. Previously, she was science correspondent for NPR. She is the only person to have received all of the top four awards in American journalism: the Pulitzer Prize (for which she has three times been a finalist); the George Foster Peabody Broadcasting Award; the George C. Polk Award; and three times honored by the Overseas Press Club of America. Her book The Coming Plague (1994) was named "One of the Best Books of 1994" by both The New York Times Book Review and Library Journal, and was a national bestseller in 1995. Garrett lives in Brooklyn, New York.

From bubonic plague to AIDS, this concise public health treatise is a bird's-eye view of how badly we are doing at providing medical and preventive care for the people of the world. Fran Tunno's cheerful voice brings a message that is not cheerful, although her delivery is vital and suitable for the evidence at hand. Tunno's pronunciation of medical terms falters occassionally, when she puts the emphasis on the wrong syllable, but her delivery of the author's substance is clear and crisp. The presentation skillfully holds our attention to a well-researched account of a developing crisis written by a Pulitzer Prize-winning health and science reporter. J.A.H. © AudioFile 2001, Portland, Maine-- Copyright © AudioFile, Portland, Maine --This text refers to an out of print or unavailable edition of this title.