Opinion - Letters to the Editor   

On public health

This has reference to the article “Errors of the public health movement” (Dec. 6) by Dr. K.S. Jacob. The concept of public health is often misunderstood and misinterpreted by the government and NGOs. They continue to emphasise curative or medical services as major part of public health activity, while what we need are health promotion and disease prevention activities through an integrated approach. Public health should strive to prevent, control and eliminate the commonly occurring communicable and non-communicable diseases.

For more than half-a-century, the public health department has been struggling to prevent and control typhoid, gastroenteritis, cholera, hepatitis A, and vector borne diseases such as malaria, dengue, Japanese encephalitis and so on. Even though appropriate vaccination programme is in place to prevent these diseases, they affect the people due to the lack of proper health services like good sanitation, quality drinking water, drainage system, etc.

Dr. S. Gopalakrishnan,

Chennai

If only we can provide clean drinking water, those compelled to suffer from diarrhoea will not need antibiotics. The irony of having to buy oral re-hydration solution (ORS) reinforces our lack of self-confidence. Trying to put in place a lavish public health system for people deprived of their basic rights of clean air, water and nutrition is like putting the cart before the horse. The need of the hour is revival of preventive medicine. The present system of forcing people to fall sick and then trying in vain to cure them is not humanitarian and makes no economic sense for a country of our size and diversity.

Dinkar Sahal,

New Delhi

The crucial question of who is responsible for the state of affairs was left unanswered in the article. While discussing the challenge of pharmaceutical industry, the author limited himself to the production and forced selling of medicines. The industry has a wider role in creating medical models of illnesses and creating an illusion of curative medicine. With the advent of neo-liberalism, the new hospital industry is trying hard to exclude the government from the field of healthcare. If the professionals in the field continue to remain unaware of the new developments, the bio-psycho-social models of health and ill-health will be erased from their minds and they will be under the total control of the illusion of curative medicine.

Dr. N.M. Mohammed Ali,

Thiruvananthapuram

The spotlight on the need to review our approach to public health could not have been timelier. As rightly pointed out in the article, our approach to health has been compartmentalised.

We have had very few significant policy decisions in other departments, which actually influence health. Rather, we have had governments taking many decisions, which have introduced public health problems. The neglect of rural economics and the agriculture sector is an apt example. The greatest public health tragedy that awaits us is the massive migration to urban areas from villages. Urban infrastructure is hardly sufficient to accommodate villagers who migrate. They end up living in congested, disease-prone conditions.

Jeevan Kuruvilla,

Vellore

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