Hospital waiting rooms are glum places pretty much everywhere. People, sick or injured, wait and wait and wait. Nowhere are the huge gaps between rich and poor so graphically in evidence. That's the essence of the American health reform challenge, however deeply it gets submerged in the passionate debates now raging: to bridge those gaps so that the misery of illness is not compounded by inability to pay.
The issues are not just American, they are global. And they have many faith dimensions.
The waiting room at the Sihanouk Hospital of Hope in Phnom Penh, Cambodia, is full of sick people. It's hot and they wait outside. Faces are resigned, many show obvious pain, and worried relatives cluster nearby. But the hospital's name is apt -- Hope -- because this is a well-run facility, bustling with doctors from many countries. And a central principle is that care is free of charge and available to anyone. Cambodians sell their last bullock and travel for days to get here. They call it the hospital of God or the hospital of angels.
The hospital's story is unique, but there are many stories like it: a facility built because of a deep and faith-inspired determination to care for people. The Sihanouk Hospital came about through an alliance among a Jewish journalist and stubborn activist, a remarkable Japanese Shinto leader and philanthropist, an American Christian nongovernmental organization, and a Buddhist nation.
The principles of all these faiths can be read in the hospital's operations. The Jewish principle of "healing the world" (tikkun olam), plus a dose of chutzpah, led Bernie Krisher to drive to build it. Dr. Haruhisa Handa is an intuitive and creative leader and philanthropist who guarantees half the operating costs (he also financed most buildings) and, drawing on his religious beliefs, presses the philosophy and policy of generosity (no payments). Bob and Pat Gempel head HOPE worldwide, a Christian organization dedicated to responding to the needs and wishes of poor countries across the world, which provides excellent management of the hospital. For their team, the healing mission of Jesus is the inspiration. And Cambodia, whose constitution defines it as a Buddhist nation, prides itself on the core Buddhist principles of loving kindness and compassion.
So, in Cambodia, one of the world's poorest countries, the very poorest citizens can hope to receive compassionate and excellent care at no charge. It's an inspiring example.
There's another inspirational story about overcoming the huge gulfs in health care. An unusual pressure group has come together across boundaries of social group, political affiliation, and nationality to support people living with HIV and AIDS. They are demanding more active financing and aggressive research on the disease. And they have taken the extraordinary position that it is unacceptable for people to die because they do not have access to treatment and care, no matter what the cost of medicines or the difficulty of delivering complex treatment regimens in poor countries.
Their pressure and solidarity has truly moved mountains and played a major part in recent sharp increases in funding for HIV and AIDS programs. They are pressing hard to extend these benefits to the millions who need care in very poor and remote areas.
Likewise, the Catholic lay community of Sant'Egidio has pioneered treatment programs grounded in the conviction that people everywhere are entitled to the highest standard of care. That means the poorest women of Mozambique and other African countries, places "experts" said could not handle sophisticated regimens. Sant'Egidio has proved them wrong, quite wrong, and their adherence and results are as good as any anywhere. They see equity in health care as the most basic of human rights, the sign of a decent and caring society.
There are messages here that those debating American health care should heed. First, where there's a will there's a way (and political will is what may be in shortest supply at present). If complex HIV/AIDS regimens can be delivered in rural Mozambique, surely the U.S. can manage to deliver care to all its people. Second, many ethical and religious approaches would conclude that health care is part of what our modern society, with all its knowledge, skills, and resources, owes every human being. And third, health care is not just an American issue. H1N1 fears are a reminder that diseases know no boundaries.
The HIV and AIDS activists and Sant'Egidio believe that equity means that what is available to us should also be available to others. Surely it is time to make common cause for decent care for everyone.
Katherine Marshall is a senior fellow at Georgetown's Berkley Center for Religion, Peace and World Affairs, a visiting professor, and a senior advisor for the World Bank.