How will humans civilize Mars

Mars colony: how good is the medical care?

On the use and misuse of language as a means of communication

Elon Musk wants to establish an autonomous colony on Mars in case the earth becomes uninhabitable or humans die out in a nuclear war. A million people should live and work there. Given these prerequisites, could medical care at the usual level of the 21st century be established? Let's see.

A doctor today needs much more than a stethoscope and reflex hammer. A hospital has become a high-tech facility that can no longer do without computers. X-ray devices work digitally, complex analysis devices are buzzing in the laboratories. Nothing works without magnetic resonance imaging and CT, and robots are finding their way into operating theaters. All of these components and of course the consumables, medicines, medical devices, disinfectants, gowns and scalpels would have to be produced on Mars.

But of course doctors are still needed. Around 4,000 doctors work per million inhabitants in Germany. In the Martian colony there would probably be a thousand, because initially only healthy young people would make the long journey.

Assuming half of the doctors are still in training when they emigrate, you would have about five hundred specialists. The model further training regulations of the German Medical Association list 33 specialist areas in which 50 different specialist titles can be acquired. 43 additional training courses (e.g. aviation medicine, infectious diseases or emergency medicine) allow additional specialization.

Today's medicine is so complex that in a Martian colony of one million people it is certain that not all disciplines will be represented. AI systems will be able to partially compensate for the deficiencies. Mars colonists can therefore rely on finding a competent doctor for most (but not all) ailments.

Medication

Here the colonists will have to do without a lot. In Europe today we have thousands of active ingredients to choose from. They cannot all be produced on Mars. However, some important drugs, such as insulin, do not cause a problem. Today they are produced by genetically modified bacteria and yeasts. In the past, pharmaceutical companies used tons of frozen pancreases from cattle and pigs to make insulin. Today one bacterial culture is enough. This also applies to many other proteins, such as erythropoietin or interferon. In July 2017, 231 pharmaceuticals with 178 active ingredients from genetic engineering were approved in Germany (source: VfA - Association of researching pharmaceutical manufacturers).

Even a comparatively small laboratory on Mars should be able to supply most of them. The full range will probably not be available, however, and many resources will be much more expensive than on earth because they are only needed in small quantities.

A Martian autonomous colony will be able to produce many of the most important drugs on its own. An almost complete supply of medication will probably only be available after many decades.

Medical equipment

The word “device medicine” actually describes a cold type of modern medical treatment in which technical monitoring replaces human attention. But even with optimal support, there is no avoiding an extensive range of equipment. Nothing works without ultrasound, digital X-ray machines, computer-aided EKGs and EEGs, ventilators, magnetic resonance tomographs, laboratory machines, etc.

The only thing is that it is simply not worthwhile to set up your own production facility for the small requirements of perhaps four or five hospitals. The supply chain for components and consumables is very long.

So most medical devices will have to come from Earth. If the Martian colonists absolutely want to be autonomous, they shouldn't rely too heavily on high-tech medicine in the first few decades.

Infrastructure

In our world, plants and animals naturally provide a lot of what we need for life. And we produce plastics from crude oil, the remains of perished living beings. The colonists found no building material on Mars, only dust and stones. The air is too thin and consists of a lot of carbon dioxide and little nitrogen, and there is no oxygen at all. When the colonists need wood, they have to pull trees up. All ore deposits have yet to be found and developed, none are known to date. So how do you build an infrastructure if you only have water, CO2, Nitrogen and stones?

This is probably the main problem. Even on earth there is not a single metropolis in the inhospitable zone north of the Arctic Circle. The largest city is Murmansk on the Russian Kola Peninsula with around 310,000 inhabitants. However, it is in no way self-sufficient. The Arctic Circle does not contain a single large settlement. For example, if one wanted to settle a million people in Antarctica, no one would assume that they would be able to supply themselves with all essential goods within 50 years.

The doctors of the colony brought their knowledge with them from the earth and would have to import other things in the first decades. Laboratories and chemical factories will likely produce the most important medicines, but the equipment for doing so will have to come from Earth, as will almost all of the replacement parts. If you want to produce medical devices or even just individual assemblies on Mars, all important metals and rare earths would have to be mined and processed on Mars. This will take a while. 50 years? No, that's probably unrealistic. More like 100 years or more. Even a country like Germany or a continent like Europe are by no means autonomous. We have to import many raw materials or finished products.

Conclusion

Surely enough doctors could be brought to Mars to adequately care for a million people. The most important drugs could also be produced if the equipment had to be imported from the earth. There would hardly be any large medical equipment, and it would not be possible to build them on Mars for the time being. The biggest problem would be the provision of the basic infrastructure. Until this problem is resolved, there is really no need to discuss the rest of it.

Martina Grüter is a doctor and has been dealing with congenital prosopagnosia, a hereditary deficit in facial recognition and processing, since 2001. The topic showed her how complex the processing of information in the brain is and how little knowledge is really secured. She has always been fascinated by words and languages.