While everyday rural life in Third World countries implies twelve or more hours of hard physical work for nearly every member of the community, regardless of age, the vitality of most residents is severely sapped by chronic infestation of such common parasites as hook worm, round worm and pin worms. The causes of these debilitating infestations are unpaved streets, open wells, unstructured sewage disposal, insanitary kitchen procedures and shared housing with livestock. In addition, the subsistence level diets lack necessary vegetable or animal protein to ensure minimum vitality, even under conditions of good health; and continued productivity in such conditions is due only to the great persistence of the will to survive. Despite this pervasive need, the image of health care is of action in the case of emergency to be called on only when accidents occur or when disease finally threatens life. While such emergency facilities are urgently required, they would be of no use in eradicating the causes of general ill-health in a community. Although villagers see the vitality and good health of persons from urban areas, they do not perceive that they have the option of good health in their own villages.
In developing countries, health care is often a low priority, although good health is a prerequisite for economic development. Problems exist but are not tackled in: provision of safe water; sanitary disposal; balanced diets; rudimentary knowledge of hygienic practices; dirt floors. Villages are often without water purification methods, and standing taps and bathing and sewage disposal methods present a constant health hazard. Even when there is an abundance of available food, a well balanced diet may not be consistently available. Health information is often a combination of traditional beliefs and popular images created by advertising. Parasitical and bacterial infestations result in chronic illnesses and subsequent lost of vitality. The scarcity of trained medical personnel, the high cost of treatment, and the remoteness of medical facilities block preventive efforts and lead to care only in extreme emergencies.
Locally-based health care can be postponed only at the expense of decisive economic and social development.