A first world city inside every third world one

Darryl and I are sitting in our hotel in Orlando, Fl. We spent Christmas with my mom & cousins in Roseburg and Bend, Oregon. Then flew here for some R&R on our way to Africa. As we contemplate the idea of "luxury vacation" our thoughts turn to the socioeconomic divide in Malawi. We are grateful to our parents, who shared their timeshare points with us for this lovely luxury hotel. The kitchen in this hotel suite is nicer than the kitchens in the first three apartments we lived in after we were married! Imagine!! And two TV's... we haven't even had that in our nearly 6 years of married life.

Today while searching the internet for a cell phone in Malawi, I stubbled across a very interesting article by Martin Lucas on this website: http://www.mobileactive.org/one-laptop-child-v-cellphones-view-malawi. He writes an interesting opinion of Malawi as one who is there to help. And he touches on some excellent points. It is a long read...I actually read the whole thing out loud to Darryl while he made lunch...but worth the time. One of the things that stands out is his reference to the "post-globalization dictum" that there is a first world city inside every third world one and a third world city inside every first world one! Darryl and I have been talking about this concept for a while, but didn't realize someone else had put a name to it.

I will be moving to Africa as a physician ... but I don't think it will be like the stories we've heard of mission doctors to Africa from the last century. I will be living in a city. In a normal looking house. Probably on the row of elitist hilltop homes Mr. Lucas references. I will have internet access and a trip back home to the United States every year. And I'll have a computer at work. And one of my goals is to be able to provide care to a city that has both "first world" and "third world" inhabitants in the backdrop of one of the poorest countries in the world.

The need is so great...Malawi is said to have the lowest doctor-to-patient ratio in the world. One physician for every 60,000 Malawians! How do you even begin to care for 60,000 people as a single person? Blantyre, where we will be living, has over 700,000 people and I will be the only cardiologist. There must be a balance between seeing the middle & upper class who have health insurance or pay cash; and seeing the very poor who cannot afford even the free health care provided at Queen Elizabeth Hospital because of time and travel costs to get there.

Food for thought, a Gedanken experiment if you will, for those following along...think about which parts of your own current city of residence are "third world" versus "first world." As I think of the two places we lived most recently,  Salt Lake City, Utah and the Inland Empire, California, I think there are definitely parts that qualify as third world. I hope as the US pulls out of the recent economic downturn, those places are addressed.

Tiffany