I traveled to Central America during the dirty little wars of the 1980’s, when mercenaries (today they are called “private contractors”) were maiming and killing impoverished workers, farmers, and Indians to protect local dictators and their wealthiest cronies and families that held virtual all of the society’s assets.   One mid day I sat on a café veranda in a small city with several co-workers when I noticed that one of the women at my table was very studiously wiping the rim of her drinking glass with a handkerchief.  Marta (real person, fictional name) was from Mexico City, and was attending graduate school at the University of Wisconsin in Madison for her doctorate when she decided to travel with us.

“What are you doing, Marta?” I asked.  I was taken with the peculiarity of such a gesture.

“I am trying to not get sick,” she replied.

Being the medical officer for our little band of co-workers and visitors, I pointed out the futility of her efforts.   “You are just moving germs around the glass, Marta.  Plus our beverages and food will be hopelessly contaminated.”  We were also guests in workers’ homes, and not residing in multi-starred hotels with clean food and water provided for other tourists.  I had dispensed anti-biotic pills to my troupe, to be taken each day “preventively,” of undetermined effectiveness.

We both recalled having sat with a writer from Boston on the flight to San Jose, who informed us of her nearly dying at a local hospital from food poisoning on a previous trip to the region.

Marta had elaborated, “When I moved to Madison, I could not believe it.  Within a week, I was well.  In Mexico City, I was sick all the time.  All my life, my parents, my siblings, none of us really well a single day of our lives.”

Marta was pointing to vital societal differences between North America and Central America and Mexico.  At that time, US taxpayers were still adequately funding a very critical segment of public health for citizens to “be well (most) all the time.”   The municipal provisions and laws and money guaranteeing clean water, with its consistent and reliable separation from sewage, will always constitute one of the most important measures of a modern and healthy standard of living.  If coli-form water flows out of a residential or commercial faucet, no one can clean his own hands, or properly cleanse fresh fruits and vegetables.  For a very long while, that has been an assumed basic social provision in the United States.

On a Sunday some weeks ago, the New York Times published a long article about the defunding of this feature of our modern lives, and the resulting breakdown of public health.  Over forty large cities were sighted in the article, including New York, with profoundly antiquated water and sewer systems.  Public health officials have been tracking the flooding of sewer facilities during heavy rains, and the visits to emergency rooms for gastrointestinal illnesses by the city’s residents.   It turns out there is a surge in use of health facilities, coincident with the rains, occurring in NYC at least once a month.

With the breakdown of funding for infrastructure in America, I have been wondering if I will see other “Marta’s” making the futile gestures of trying to wipe away the source of illnesses in the era of a shredded social contract.

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