Forest for the Trees

As found at

On December 14, 2012, 26 innocent people – 20 children and 6 adults – died at the hand of a mass shooter at Sandy Hook Elementary School in Newtown, Connecticut, United States. (1) This tragic incident, widely recognized as the second deadliest of its kind in the U.S., seems to many to be part of an increasingly widespread trend. (2) A movement has since begun to address the accumulating shootings, with demands for increased gun registration restrictions, tighter school security, and further restraints on firearm possession. These lobbyists – parents, administrators, and common citizens alike – have fought and continue to fight for the protection of themselves and one another against this recurring threat. (1)

But while, on December 14, 2012, approximately 3,000 other innocent children died to a remorseless killer, they passed with little recognition or advocacy for reform on their behalves. These children, living in sub-Saharan Africa, lost their lives to malaria, a disease barely present in the developed world, even less so a common cause of mortality. (3) The children lost in Connecticut, United States and those lost in Kinshasa, Congo or Luanda, Angola were not so very different from one another; they had dreams and aspirations for the future, did nothing to provoke their demise, and belonged to loving families who grieved at their needless deaths. Then why, might one ask, did the former incident claim headlines while the latter, far more devastating in numbers and frequency, pass un-hyped? That is, sadly, a rhetorical question, for we accept that the nature of news is to report on new and shocking occurrences, of which this manner of death is not one. We have become so inured to death by hunger or disease in underdeveloped countries that not only do we, as a general populace, take little heed of its enduring nature, but even concoct justifications and sweetened images to mask the inconceivable reality. While we may be able to empathize with a fear of guns, we can only loosely sympathize with fears of water contamination or lives of destitution. Just because the loss of young lives in Kinshasa or Luanda is not broadcast on the news does not make their demises any less pressing or tragic; in fact, it makes them more so because they pass under the public’s radar. If we can put aside our empathetic notions and remind ourselves that every innocent life, regardless of geographic affiliation, is equally worthy and, ideally, potentially savable, utilitarians will find that their sentiments are best fulfilled by focusing on medical attention in underdeveloped nations, instead of just on those threats that hit closer to home.

One should not be surprised to hear that in the high-income areas of Asia Pacific, Western and Central Europe, Australasia, and North America, the death toll of infants is so low as to be negligible by international standards. In these regions the top causes of adult mortality are cardio and circulatory diseases, (4) namely ischemic heart disease, the reduced blood supply caused by, to be unscientific, unhealthyl diets and old age. (5) These diseases account for about one-third of most-developed country (MDC) deaths, approximately twice the rate seen in less- and least-developed countries (LDCs). (4) Globally, deaths before the age of four are some of the most frequent, especially in South Asia and sub-Saharan Africa. Within the first month of life, over two million babies die each year to neonatal disorders like preterm births and Neonatal Encephalopathy. Treatable in a hospital with incubation and/or medication, (6) these disorders kill less than one percent of MDC babies, a small number compared to the near five percent statistic for LDC nations. If an infant manages to live past childhood, it again faces another serious threat in its young adult life: HIV/AIDS. Spiking in risk around an adult’s early- to mid-30s, the virus causes 40 to 50 percent of deaths in many areas of sub-Saharan Africa, and as many as three-fourths of deaths in the Southern region. (4)

Despite their truth, listing these somewhat expected statistics is pointless except for effect, for even the least service-minded among us seem to be familiar with the disparity between regions and nations on death tolls. As developed nation citizens, it is easy to undervalue the caustic impact of preterm births and HIV/AIDS in LDCs, for their implications there far from equal those of our relatively resource-abundant societies. Not only are these conditions lower risk where we live but they also have mitigated symptoms. Ischemic heart disease can be greatly prevented with a less-fatty diet and fought with aspirin. (7) Diarrhea, accounting for about 12,600 deaths daily elsewhere, (8) is a problem easily remedied with antibiotics, water, and time in a developed nation. (9) These and many other “annoyances” of our developed communities superficially pale in comparison to the publicized incidents of death via plane crash or bombing which, fairly protected against death as we are, make us fear for our own safety while we easily estrange ourselves from the seemingly innocuous issues that run rampant in poorer areas. (4)

We know and expect there to be a lot more deaths in LDCs, in numbers as well as in percentage of their populations, than in MDCs. We often hear about the benefits and cost-effectiveness of saving lives abroad – less than a dollar (64 pence) for a measles vaccination (10) or pneumonia antibiotic, about 50 cents (32 pence) for a Neonatal Tetanus vaccination, etc.; (11). The purpose here is not to belabour this point but to emphasize the need for the paradox of acting upon this highly sentience-based cause while separating ones emotions from the decisions made to do so, to keep the trees of local illness and gun violence from obscuring our view of the forest of international woes. While personal memories and animal nature guide us to “look out for our own,” our “own,” as recently redefined by a now-globalized society, reaches far beyond tangible boundaries, a change that should be reflected in the way in which we give.


  1. Fitzgerald, Jim, Pat Eaton-Robb, Samantha Henry, Pete Yost, and Michael Melia. “Sandy Hook Elementary School Shooting: Newtown, Connecticut Administrators, Students Among Victims, Reports Say.” Huff Post Crime. The Huffington Post, 14 Dec. 2012. Web. 18 Jan. 2013.
  2. Walker, Jesse. “Are Mass Shootings Becoming More Common in the United States?” Reason Foundation, 17 Dec. 2012. Web. 18 Jan. 2013.
  3. “About Malaria.” Johns Hopkins Malaria Research Institute. Johns Hopkins Bloomberg School of Public Health, n.d. Web. 20 Jan. 2013.
  4. Rogers, Simon. “How Do People Die? Global Mortality and Causes of Death Visualised.” The Guardian. Guardian News and Media, 13 Dec. 2012. Web. 20 Jan. 2013.
  5. “Ischaemic Heart Disease.” ScienceDaily. ScienceDaily, n.d. Web. 01 Feb. 2013.
  6. “Neonatal Encephalopathy.” Neonatal Handbook. The Royal Children’s Hospital Melbourne, n.d. Web. 01 Feb. 2013.
  7. “Ischemic Heart Disease : Treatment, Causes, Symptoms & Prevention.” SRS Pharmaceuticals Pvt. Ltd. SRS Pharmaceuticals Pvt. Ltd., n.d. Web. 25 Jan. 2013.
  8. Staff, Mayo Clinic. “Diarrhea.” Mayo Clinic. Mayo Foundation for Medical Education and Research, 26 June 2010. Web. 25 June 2013.
  9. Guerrant, R. L., J. M. Hughes, N. L. Lima, and J. Crane. “Diarrhea in Developed and Developing Countries: Magnitude, Special Settings, and Etiologies.” Diss. University of Virginia School of Medicine, 1990. Abstract. National Center for Biotechnology Information. U.S. National Library of Medicine, n.d. Web. 25 Jan. 2013.
  10. “Where Does My Donation Go?” American Red Cross. Central and Northern Michigan Region, 29 Nov. 2010. Web. 04 Feb. 2013.
  11. “AFRICA: 28 Days to save a Life.” IRIN. UN Office for the Coordination of Humanitarian Affairs, 16 June 2009. Web. 04 Feb. 2013.

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