Sustaining development

Canadian Medical Association Journal 1996; 154: 755-764

[Letters]

Dr. Robert Woollard's editorial "Ecosystem and population health: the role of Canadian physicians at home and abroad" (CMAJ 1995; 153: 1117-1120) catches the excitement of the challenges of general practice in Third World countries such as Vietnam and Sri Lanka. His description of small successes by disadvantaged people is a real antidote to the despair forced upon us by exposure to the mainstream media. Whether the goal is smaller families, cleaner indoor air, improved soil fertility and conservation or a clean water supply, much self-help is required to reach permanent solutions.

What I find disturbing is his observation that, if all the people in the world consumed resources at the rate of the typical North American, we would need two extra planet Earths to support us. Is it not fraudulent to raise the expectations of people in the deprived parts of the world if we are not, at the same time, prepared to reduce our consumption of the Earth's resources?

Joseph M. Dubé, MD
Nanaimo, BC

[The author responds:]

Dr. Dubé states with remarkable clarity and precision a fundamental ethical dilemma for all of us. In 1987 the United Nations World Commission on Environment and Development under the chairmanship of Gro Haarlen Bruntlund, prime minister of Norway, produced a report[1] that led to a more civil dialogue about the balance between development and environmental degradation. Although this dialogue has been useful, some of the assumptions it is based on do not bear close scrutiny. The increases in productivity and consumption required for developing countries to achieve levels comparable to the industrialized world are quite simply impossible. Whereas policymakers place a touching faith in the potential for technological innovation, studies at the University of British Columbia[2,3] and elsewhere[4] show that the amount of carrying capacity now supporting human activity is already at the edge of, if not beyond, the amount that will lead to massive biosystem collapse. The fisheries in both of our oceans are telling us the same thing.

Therefore, the answer to Dubé's thoughtful question is Yes. The humbling fact is that we have far more to learn about living sustainably from the Third World than we have to teach it about consumption. My editorial sought to make this connection. I thank Dubé for holding our collective feet to the fire to make a commitment to reduce our own resource consumption. The expectations that we should raise in the Third World are those of sufficient resources to nurture a civil society and a healthy community. The expectations that we should raise at home are that we can cut back drastically on our collective resource consumption in a way that also nurtures civil society and healthy communities. To put such a belief into operation will require all the help we can get from our "less fortunate" neighbours.

Robert Woollard, MD, CCFP, FCFP
Assistant head
Associate professor
Department of Family Practice
University of British Columbia
Vancouver, BC

References

  1. World Commission on Environment and Development: Our Common Future, Oxford University Press, Oxford, England, 1967
  2. Tools for sustainability: iteration and implementation. In Chu CM, Simpson R (eds): Ecological Public Health: from Vision to Practice, Centre for Health Promotion, University of Toronto, Toronto, 1994
  3. Wackernagel M, Rees W: Our Ecological Footprint: Reducing Human Impact on Earth, New Society Publishers, Philadelphia, 1995
  4. Vitousek PM, Ehrlich PR, Ehrlich AH et al: Human appropriation of the products of photosynthesis. Bioscience 1986; 34: 368-373
| CMAJ March 15, 1996 (vol 154, no 6) |