We work for people who find themselves trapped in a vicious circle of poverty and poor health.
Social and economic status are crucial for a person’s health. In Berlin, a metropolis of the so-called first world, people in the poorest city districts have a life expectancy almost six years shorter than those in the rich districts. In the megacities of the so-called third world, the wealthy have the same life expectancy as the people of Europe. The poor, however, die decades earlier. The daily struggle to exist, to combat hunger, lack of rights, poor education especially among women and girls, wretched living conditions, dirty drinking water and contaminated sewage, criminality, noise and environmental pollution make people ill.
Poor people are more frequently ill and often have no access to medical services. What is lacking is money and time because those who are ill are unable to work. Poor people live a hand-to-mouth existence: that which is acquired today, will be consumed today. Illness prevents them from working. And those who earn nothing are unable to eat. In this way, an illness rapidly becomes a catastrophe, not only for the sick person, but also for the entire family. "A minor illness costs a chicken, a serious one will be your ruination" as an Asian proverb has it.
"Everyone has the right to a standard of living adequate for the health and well-being of himself and of his family, including food, clothing, housing and medical care and necessary social services" (Article 25, United Nations Universal Declaration of Human Rights, 1948). The reality appears rather different: in the 21st century, 1.3 billion people are still living in abject poverty, that is to say on less than 1 USD per day, and 3 billion have to get by on less than 2 USD per day. Almost a billion of these people have no proper access to medical care.
Helpless, destitute, devoid of rights, without a steady income or reliable supply of food, at risk of being displaced at any time, treated with discourtesy and lack of respect in the event of sickness – that is the reality for the very poor. Among the billions of poor people, it is especially those who exist at the very edge of society who are also the very last to be able to take advantage of medical care.
For these people, any illness or accident poses a great danger: each pregnancy puts women’s lives at risk, their children die all too often of infections that could be prevented or treated with the simplest methods. These are the people who also suffer social exclusion because they come from the so-called primitive tribes such as the pygmy people in Africa or the "Tribal People" in India. Or those who are forced to live in the most run-down districts of the already dirty slums of the megacities, in the simplest huts that are regarded as illegal settlements and thus cut off from any infrastructural facilities. And they are also the people who are still frequently outcast on account of their disfigurements caused by leprosy, Buruli ulcer or other neglected diseases.
The poorest of the poor are the people on whom we have directed our attention for the past 50 years and for whom we want to be able to do even more in future. Our goal is the improvement of their health and their living conditions. The millennium development goals should apply for them, too (see left-hand column), and they too should be able to participate in their own development as described in the Ottawa Charter.