for National Geographic News
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Impact: From the Front Lines of Global Health, an in-depth look at global health issues from AIDS to obesity, is the latest book (details) issued by photojournalist Karen Kasmauski. National Geographic News spoke with the National Geographic Contributing Photographer-in-Residence about the insights she's gained documenting human health crises around the world.
A range of health problemsAIDS, obesity, SARSare addressed in Impact. Which one do you feel requires the most attention?
The reason why I wanted to do a book like Impact was not to emphasize any disease but to emphasize change in geography and the repercussions of those changes, whether it's disappearing borders, increase in population, or destruction of our natural environment. Unhealthy conditions, which give rise to disease, are usually the end products of these disruptions.
How does globalization affect these health issues?
I think globalization is a two-edged sword. In one way, it's great to be connected to everybody, but the reality is that there is unfairness in how wealth is distributed. We're not really paying the true price of what it costs to produce items and that's sort of the unfairness of globalization.
How did you get interested in health issues?
There are things that you observe in the course of your job. My first story on health, I was wondering why everywhere I went to cover an epidemic there was disruption going on, whether it was environmental or political. This was back in the early '90s, and it made me think about the whole ecology of disease. That story was sort of my jumpstart to thinking about health in a much more global way. If you're aware of itif you're an observeryou do notice these things along the way. And that got me thinking about how interesting it would be to look at how changes in geography can affect our health. Of course, working for National Geographic, geography is a major part of our mission.
How does it affect you when you're photographing people with health afflictions, or people who are starving?
I'm as guilty as the next person of enjoying a comfortable lifestyle. But one of the hardest things I face is coming back in from a developing country. I was shocked when I realized how overwhelmingly soft we live, how consumer oriented we are, how spoiled and how wasteful we are as a population. That is very hard to deal with. When [you hear that] to eliminate AIDS in Africa it would take so many billions of dollars, it sounds like a lot of money, but when you think about the fact that this war in Iraq will cost $400 billion, then you realize it's not really a lot of money, and that is a major issue that we could solve if we put our minds to it.
Do you see the biggest present-day problem as AIDS?
No, I don't. The biggest problem in health is not one particular disease; it's the lack of empowerment of women, the mistreatment of children, and poverty. AIDS is a big diseaseit's affecting a lot of peoplebut the reason why it's spreading so rapidly is women have no control over their own lives and they are afraid, or they're being told to follow arcane practices. I don't want to say women should be running the world, but they should have the right to be healthy and have healthy children. There are a lot of cultures that don't allow that, in some ways certain elements of our own culture. Those are the things that are the biggest threat to health in our world, as well as not having clean water and nutrition. It's really not any one disease that is the biggest threat, it is the conditions that are causing diseases to take hold.
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