Public Health
Volume 124, Issue 3 , Pages 123-124, March 2010

Quiet heroes after the quake

Royal Society for Public Health, 3rd Floor Market Towers, 1 Nine Elms Lane, London SW8 5NQ, UK

published online 22 March 2010.

Article Outline

 

This editorial is dedicated to the memory of the estimated hundreds of thousands of Haitians who lost their lives as a result of the massively destructive earthquake that struck the western part of the Island of Hispaniola on 12th January 2010. Although some weeks have passed since this catastrophe, and the immediate tasks of rescue and the provision of emergency medical care to survivors have been completed, there is still much to do. Now tasks such as burying the dead, clearing the debris to provide a relatively safe environment on which to rebuild the most affected urban areas and trying to minimise the scourges that accompany such disasters – infectious diseases, under nutrition, and all the other sequelae of an almost total loss of infrastructure – are the ongoing priorities.1 The magnitude of these tasks was outlined by the UN Office for the Co-ordination of Humanitarian Affairs at the end of January when they estimated that at least two million people were in need of food, a million needed shelter and some 500,000 were in need of water and sanitation through combined effort of international aid agencies.2

Managing the public health consequences is the subject of continuing efforts of experts from around the globe, tending to proceed away from the spotlight of international media. As we know from other severe natural and manmade disasters, the public health response is central to the relief effort and to longer term recovery,3, 4, 5 but, perhaps mercifully for those concerned, these activities are only occasionally considered newsworthy. The downside of this is that the public – all over the world – has little idea what public health does or how indispensable it is to the retrieval and maintenance of health and wellbeing among populations in post-disaster situations. The public understands the importance of dealing with outbreaks of infection to minimise their impact, for example, but the holistic role of public health in ensuring equity of health opportunity and tackling inequalities in health, does not lend itself to easily understood sound-bites or newspaper headlines.

Perhaps it is timely to mention here Sir Donald Acheson, who died this January. He brought to public attention the meaning of public health in his report published in 1988, while England's Chief Medical Officer (1983-91): “the science and art of preventing disease, prolonging life and promoting health through the organised efforts of society”.6 Later, in 1998,7 Sir Donald informed the public of the meaning of health inequalities, in the report of the independent inquiry he chaired on the subject. Despite these publications and the limited media attention they elicited, public health and health inequalities are continuously ‘rediscovered’ and their relevance to the general public poorly appreciated.

The immense response of charitable giving that followed the Haiti earthquake was in response to pictures and stories of children left homeless and orphaned, not stories of disease prevention by ensuring access to clean water and wholesome food. Yet again, we are reminded of the former US Surgeon General (1993-4), Joycelyn Elders' comment that, when effective, public health is often invisible, which contributes to it being poorly understood.

By way of illustrating the breadth of public health endeavour, how exciting that this month's issue alone covers topics as diverse as smoke-free legislation8 and domestic violence9, 10; or regeneration11 and low birth weight12: we are a very broad church and proud of it.

So, while we remember those who have died or suffered as a result of the Haiti earthquake, we also salute the efforts of everyone involved in the public health response – the largely unsung heroes, sometimes doubtless working in significant personal danger in order to help restore some kind of normality for survivors in a ravaged living environment.

In this issue

 

We are reminded this month of how some scourges affect all societies, often hidden from view by stigma and prejudice. For example, two papers from India and Hong Kong, respectively, examine the prevalence and factors associated with domestic violence in two very different societies. Some might question whether domestic violence is a public health issue – of course it is, but this again serves to illustrate how complex our definition and inclusivity of public health is. Another relatively ‘new’ area of public health is the study of the environment in which we live, and so a paper seeking to understand the health impact of area regeneration is most welcome. Policies such as regeneration are seldom led by health (in the UK, at least), and so evidence that the actions of others outside the health sector can contribute meaningfully to the health and wellbeing of communities should serve to inspire all concerned to continue the hard work of partnership working for the long term benefits of the communities we serve. From a European perspective, a comparison of Hungarian and Scottish ways of tackling communicable disease control provides insight into a Europe of diversity and at the same time with much potential for shared learning.

Back to Article Outline

References 

  1. Haiti earthquake. Available at: http://edition.cnn.com/SPECIALS/2010/haiti.quake/(accessed 31/01/10)
  2. UCHA . Haiti – situation Update 31st January 2010. Available at: http://www.reliefweb.int/rw/fullmaps_am.nsf/luFullMap/0A59D310168011E5C12576BD00507B52/$File/map.pdf?OpenElement(accessed 04/02/10)
  3. Matsuoka T, Toshioka T, Oda J, Tanaka H, Kuwagata Y, et al. The impact of a catastrophic earthquake on morbidity rates for various illnesses. Public Health. 2000;114(4):249–253
  4. Akbari ME, Farshad AA, Asadi-Lari M. The devastation of Bam: an overview of health issues one month after the earthquake. Public Health. 2004;118(6):403–408
  5. Murray V, Goodfellow F. Mass casualty chemical incidents – towards guidance for public health management. Public Health. 2002;116(1):2–14
  6. Public health in England. vol. 289. Dept of Health; 1988;Cmnd
  7. Independent inquiry into inequalities in health. Available at: www.archive.official-documents.co.uk/document/doh/ih/ih.htm(accessed 31/01/10)
  8. Nimpitakpong P, Dhippayom T, Chaiyakunapruk N, Aromdee J, Chotbunyong S, Charnnarong S. Compliance of drugstores with a national smoke-free law: A pilot survey. Public Health. 2010;124(3):131–135
  9. Babu BV, Kar SK. Domestic violence in Eastern India: factors associated with victimization and perpetration. Public Health. 2010;124(3):136–148
  10. Mak WWS, Chong ESK, Kwong MMF. Prevalence of same-sex intimate partner violence in Hong Kong. Public Health. 2010;124(3):149–152
  11. Beck SA, Hanlon PW, Tannahill CE, Crawford FA, Ogilvie RM, et al. How will area regeneration impact on health? Learning from the GoWell study. Public Health. 2010;124(3):125–130
  12. Jafari F, Eftekhar H, Pourreza A, Mousavi J. Socio-economic and medical determinants of low birth weight in Iran: 20 years after establishment of a primary healthcare network. Public Health. 2010;124(3):153–158

PII: S0033-3506(10)00044-2

doi:10.1016/j.puhe.2010.02.008

Public Health
Volume 124, Issue 3 , Pages 123-124, March 2010

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