Safar Banus death may be technically explained using concepts in Health Economics, one of which is to layout particular details coinciding with the topics under the framework for Health Economics. First in its structure are the influences on health, upon which the determinants of health could be used as template. Under this is the underlying socio-economic, demographic, and cultural factors which indirectly affect health outomes and for which include Safar Banus age, being 43 years old having to deliver her 10th child and her heavy work in the field; her husbands superstitious beliefs regarding the use of contraceptives, as well as his belief on Allahs will and constant providing; the familys poor state of living attributing to low income and resource from a lowly-paid job; the familys poor educational backgorund, relying on superstitious beliefs and hearsay; the transportation size and structure being inefficient and expensive; the social structure involving village healers with unreliable expertise and medicine. Next are the proximate factors which directly affect health outcomes, and which include the health care service utilization of Safar Banu, not being able to have her prenatal checkup; her occasional nutrient dietary intake being very low for eating very little; and the injury that she had incurred during and after pregnancy, involving a great deal of blood loss resulting to whole body swelling with profuse sweating but no fever, and registering an extremely low pulse with difficulty in breathing.

The healthcare practice which contributed to Safar Banus death has certain characteristics that can be related to the framework for health economics. Underlying factors No money, hospitals are very expensive Gopal daktar: tradiitional healer is every bit as capable to tend us as those doctors; charges less Transportation not even covered by the hospital Had to sell half a kani of land to get her to hospital Thinking that safar had not bled enough to drain the polluted from from womb and legs when safar had bled a great deal during and after the delivery Safar ate very little, worked very hard (always feeding husband and sons first) Husband not caring, went to the village healer instead Fake healers village healer only caring about the moneyProximate: Didnt go to prenatal checkup Ate very little Safar couldnt get up for 10 hours after the birth, whole body was swollen and sweating profusely but with no fever (injury) Unconscious on the 7th day Pulse extremely low and had difficutly breathing

Story(that(inspired(Travelers(Aid(for(the(sick(project( It! was! the! plight! of! a! young! child! who! moved! me! to! start! this! programme.! I! was! in! a! remote! village!when!a!young!boy!of!two!(Nagaraju)!was!brought!to!me!by!his!mother.!She!explained!that! the! boy! had! been! born! without! an! anus! and! that! her! husband! and! his! sister! took! child! to! the! district!hospital!for!help,!but!that!they!had!told!them!to!go!to!Hyderabad.!They!were!frightened! and!came!back!to!the!village.!Then!they!decided!that!he!would!die!and!went!to!Hyderabad!very,! very!reluctantly. In!the!bus!terminal!they!met!a!kindly!person!who!told!them!they!looked!worried!and!asked!if!he! could!help.!He!said!he!knew!a!hospital!where!the!doctor!just!loved!poor,!rural!people!and!that! he! would! charge! them! only! a! little.! He! took! them! to! a! private! nursing! home! where! someone! opened!the!anus!in!a!crude!manner.!(The!correct!treatment!is!to!leave!the!anus!as!it!is!and!put!a! colostomy!or!tube!connecting!directly!to!the!gut.)!He!then!said!that!the!hospital!needed!what!was! the!equivalent!of!a!years!wages!from!the!father.!He!returned!to!the!village!and!borrowed!money! from!everyone! and!even! sold! his!little! plot! of!land! and! his! hut.!When! he! realized! that! he! could! never!pay!off!the!debts,!he!never!returned!to!the!village.!When!I!saw!Nagaraju,!now!aged!2!years,! his! anus!was! a!mass! of! scar! tissue! and! fecal!material!was! coming! out! of! his! penis! and! he!was! nearly!dead.!I!took!the!boy!and!went!back!to!Hyderabad!with!the!abandoned!mother!and!child.!A! pediatric! surgeon! had! to! operate! three! times! to! save! the! little! boys! life.! I! vowed! to! start! our! programme!to!combat!the!touts!who!were!ruining!the!lives!of!innocent!village!people. Recently,!I!was!standing!outside!the!Mahbubnagar!District!Hospital!when!I!saw!a!woman!run! across!the!open!area!next!to!the!hospital.!She!threw!herself!into!my!arms!and!said,!Remember! me,!I!am!Nagarajus!mother.!He!is!now!10!years!old.!What!more!inspiration!can!one!ask!for?