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... were starving, the Inuit residents of coastal Greenland ... The Norse disappeared from Greenland, but the Inuit remain today. Competition. Fragile Ecosystem ... – PowerPoint PPT presentation

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Title: Collapse


1
Collapse What the mute Statues of Easter
Island have to tell us about health care
Ian G Rawson, PhD The Trillium Centre
2
  • Many societies have disappeared from their
    original locations, leaving only traces of what
    their lives were like while they lived there.
  • The ancient Maya, Easter Islanders, Greenland
    Norse, Anasazi, and other cultures leave only
    subtle clues as to why they abandoned their
    traditional homes.
  • Jared Diamond, in his book, Collapse, chronicles
    the decline of these civilizations and finds that
    the causes were complex, but often shared several
    common themes.
  • Primary among these is the over-exploitation of
    resources in a fragile environment, and a failure
    to interpret the danger signals which the
    ecological environment sends.
  • The same may be said about health care in the US
    today.

3
Cooperation Fragile Ecosystem

Overexploitation
4
The Easter Islanders arrived from Polynesia and
found an island which looked very similar to the
ones they had left. Except it wasnt. The soil
was shallow and plants had a fragile
existence. The Easter Islanders built statues of
their ancestors, moai, near the coasts, rolling
them from the quarries over logs. The trees were
not replanted, and eventually the last one was
cut, and the deforestation affected the climate,
reducing crop production. As the residents
faced starvation, they abandoned their island
home. Diamond asks What was the Easter
Islander thinking when he cut the last tree on
the Island? How could the residents commit
ecocide, in which ecological collapse leads to a
threat to the population? Is there an analogy
with health care, with a limited resource base
(insurance) and continuing assaults on the
ecology (reimbursement, malpractice)?
5
Competition Ecocide Depopulation
6
  • Much of the stress on the environment came from
    competition among the social groups to build
    larger and more complex statues, hoping to
    appease the spirits and return the islands
    productivity.
  • The expenditure of caloric resources in
    unproductive activities only exacerbated the
    imbalance between the population and the
    environment.
  • The pursuit of a miraculous salvation also
    impeded the development of more appropriate
    exploitation techniques.

7
Competition Edifice Complex
8
  • The Maya also competed by building large temple
    complexes, and requiring the production of
    foodstuffs for economically unproductive workers.
  • Eventually, food production in the peninsula
    declined so it did not support the needs of the
    residents, and competition for food increased,
    turning into violence.

9
Fragile Ecosystem Climate Cycles
10
  • Instead of attempting to adapt to changing
    environments, the Maya attempted to control the
    environment through spiritual means.
  • As the climate cycles in the Yucatan region
    passed through a series of droughts, more temples
    were built and ceremonies were conducted to
    change the course of nature.
  • Can we see some similar trends in health care,
    in which a failure to interpret trends leads to
    unproductive and competitive strategies, rather
    than adapting to the changes?

11
Competition Conflict
Ecocide
12
  • Ceremonial games were held between neighboring
    groups, and as the skulls on the wall of the ball
    court show, losing could be a dangerous
    proposition.

13
Fragile Ecosystems Climate Cycles
14
  • The Norse came to Greenland seeking new lands,
    and thought that they had found a familiar
    environment.
  • Greenland was not similar to their homeland it
    is a harsh and unforgiving environment, and the
    Norse lived through a number of climate cycles of
    increasing cold.
  • This affected their food production, and
    eventually those who could not leave the island
    starved, or possibly reverted to cannibalism.

15
Imported Culture Overexploitation Class
Conflict
16
  • The leaders of each settlement group controlled
    the resources, keeping much of them for
    themselves, and leaving the other residents with
    little to live with.
  • In trying to maintain a traditional way of life
    with herds of cattle, which destroyed the shallow
    soil, the Norse changed the ecology and sowed the
    seeds of their own destruction.
  • Is health care pursuing traditional strategies
    to exploit the environment, instead of adapting
    to the cycles of change? And what impact might
    this have on the populations we serve, especially
    the most vulnerable?

17
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18
  • While the Norse and their cows were starving,
    the Inuit residents of coastal Greenland pursued
    their traditional food production techniques, and
    maintained a balance between their population and
    the ecology. The Norse disappeared from
    Greenland, but the Inuit remain today.

19
Competition Fragile Ecosystem Over-Exploitation
Ecocide?
20
  • Health systems continue to build dramatic new
    buildings, competing with other systems for
    control over services to populations, usually
    with adequate health insurance.
  • Is this a productive use of scarce resources?
    What impact does this have on the environment of
    a diminishing economic resource base?

21
ISEP Its Someone Elses Problem
Suppression of doubt and critical thinking
Refusal to draw inferences from negative
signs Persistence in error
22
  • Several tendencies guided the Maya, the Easter
    Islanders, the Greenland Norse and others toward
    self-destruction.
  • Each individual told themselves that whatever
    was happening was not their problem, but someone
    elses.
  • As the climate cycles became more extreme, the
    populations and their leaders continued to
    persist in their belief that the trend was not
    increasingly dangerous.
  • Instead of shifting their exploitative
    techniques to methods which adapt to the
    environment, they continued their pursuit of
    traditional, and destructive, techniques.
  • Are there analogies in health care today?
    A suppression of doubt? A
    persistence in error?
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