American medicine, which is not very good to begin with, is under assault, as is that of the poorer nations of the world.

Having worked in both for all my professional life, I believe I am able to make some valid observations.

Let’s deal with America first. We can see some of the problems here in Lewiston-Auburn, where it is very difficult to find a primary care physician and, if ill, you are often directed to go to the emergency room with its long waits and exorbitant costs.

Measles, a devastating illness that can cause blindness, brain inflammation, pneumonia, deafness and chronic bronchial inflammation, is increasing as vaccine rates are falling. There is a tuberculosis outbreak in Kansas with 65 confirmed cases, as funding for public health services dwindles.

Robert F. Kennedy Jr., a man who has bizarre ideas about vaccination and other health issues, has been confirmed as the secretary of Health and Human Services.

Of all the richer nations, we have the lowest life expectancy, highest maternal/infant mortality (even Cuba is better), and the most insolvencies due to medical bills. The Affordable Care Act (Obamacare) allowed more people to get medical insurance. That, once again, is under assault by this administration as is Medicaid, the insurance for the indigent.

Trump has withdrawn America from the World Health Organization (WHO) and is dismantling the U.S. Agency for International Development (USAID). During my years working in refugee camps in Africa and other countries, I have watched and worked with both these organizations.

USAID, in one of its many functions, supplies food to the World Food Program and, for many, this is the refugees’ only source of calories. I have worked with USAID during an outbreak of measles in Sierra Leone, where we were fortunate to lose only one child in the more-than-150 cases until we were able to contain the outbreak through an extensive vaccination program coordinated with help of USAID. The measles vaccine is one of those under attack here in America.

I have seen USAID work to eradicate malaria, a disease that I saw and treated daily, through spraying, bed nets, medication and experimental vaccine programs. I received help from the agency in Sierra Leone during an outbreak of Lassa Fever. I cooperated with it in Uganda when we were receiving refugees from the Congo during and outbreak of Ebola. Now there is an outbreak of Ebola in Tanzania, and our expertise and help are not available due to Trump and Musk and their lies.

People should remember that, in 2014, Ebola came to America and two people died. Here in Maine, one nurse caused a furor. Returning to America after working in Sierra Leone, she was quarantined in New Jersey. After four days in a tent and two negative Ebola tests, she was returned to Maine and refused further isolation.

This is not a Republican nor Democratic endeavor. It is a humanitarian project. PEPFAR (President’s Emergency Plan for AIDS Relief), the global health initiative, was started in 2003 by President George W. Bush. As of now, the program has saved over 26 million lives. With the recent freeze on USAID, which took place on Jan. 24, the PEPFAR program stopped. It has been given a waiver, but there is widespread confusion and concern, particularly in light of the massive layoffs threatened.

Stopping these life-saving medications will allow the emergence of resistant forms of the virus and other diseases. They will find their way here.

Trump and his billionaire cronies are assaulting the poorest and most vulnerable. These actions — dismantling USAID and withdrawing from WHO — stop life-saving programs and limit the world’s ability to track and contain the next likely pandemic. People should remember that avian influenza has killed its first human and is spreading into cattle.

These actions are criminal and dangerous to our standing in the world. Who will trust our commitments in the future, not only in health care but in other endeavors?

This is a perfect place for our adversaries to step in, and they will. I have watched China take over and develop projects in Africa through its Belt and Road Initiative (Silk Road Project). Its terms are such that it will be there forever.

Stephen Sokol has lived and worked in Maine, predominately in Lewiston-Auburn since his arrival in 1970 with periods of volunteer assignments overseas. This work has been in refugee camps run by non-governmental organizations such as Doctors Without Borders and the International Rescue Committee. His last mission was in Uganda in 2019. He retired at age 84 from the University of New England as assistant professor of geriatrics.