Perspectives in Public Health

With the increasing demand for food and raw materials due to increasing world population, there is a growing interest in the development of the tropics, as they cover most of that part of the world normally classified as under developed. To-day, as in the past, the principal barrier to the successful development of the tropics is the tropical environment. While we have now a great many new scientific techniques at our disposal for use in development, most of these are not directly applicable to the tropics. The special problems and special conditions of that area demand special consideration, and it is suggested that this can best be done by an "environmental "approach, the control of the environment for the health, comfort and convenience of man. The new definition of health, as accepted by the member countries of the World Health Organization, provides for this broad concept. Engineers have an important contribution to make, particularly in the field of sanitation and in a comprehensive consideration of the supply and utilization of water.

A brief history of plague in Hyderabad State during the present pandemic is given. It is shown that the epidemics on the whole are on the wane, and this experience coincides with the experience of other Indian states. This general decline cannot be attributed to any specific anti-plague measures adopted earlier. Earlier measures such as fumigation of rat burrows with Cyanogas were able to control epidemics to a large extent, but were not successful in eradicating infection, particularly from the endemic zones.

Recently DDT has been introduced as an anti-plague measure, relying on the assumption that control of transmitting agent alone may be able to check the epidemics and may ultimately succeed in eradicating the infection from the state.

Insufflation of rat burrows with DDT I0 per cent. powder and disinfection of houses with DDT suspension spray made by mixing water with 50 per cent. DDT wettable powder for the disinfection of huts, walls, roofs and windows, etc., are the main anti-plague measures now adopted. The measures have given very encouraging results ; the record of incidence and mortality from plague in the whole state during the last year has been the lowest recorded for the last fifty years.

Some statistics are given of the increases that have occurred in the proportion of elderly persons in the population in this and other countries, and some views are expressed as to reasons why associated problems have become intensified. The call to seek solutions and put them into practice is not only on social and ethical grounds, but also to form a model for other countries to copy. It is stressed that these problems are essentially the concern of public health and deserve more attention than they have yet received.

Senility is declared to be a preventable condition, being dependent on disease or disuse of faculties superimposed on the uncontrollable processes of aging. The claim is made that physical and mental exercise is a physiological need, but that many do not have the opportunity or incentive to take it otherwise than in employment. This must be to an extent described as beneficial capacity, which is constantly diminishing.

A pioneer scheme for providing part-time remunerative employment for the elderly in Finsbury is briefly described and its success is submitted as evidence of the conclusions reached.

Odours can either be masked or destroyed. Only destruction is really effective. Destruction is achieved by changing the molecular structure of the obnoxious substance, or its vapours, so that now chemical structures are formed which do not contain osmophoric radicals, and thus cannot act as a stimulant of the sense of smell.

Oxidation is the most elective means of altering the chemical structure of a substance, and of all oxidants, nascent oxygen and ozone are the most powerful. The physical method of generating nascent oxygen and ozone from the oxygen in the air by irradiating the latter with ultra-violet energy of certain well-defined wave lengths is the only method possessing acceptable technical and economical features.

The attempt has been made to consider the future rôle of the health visitor within the total context of the welfare state. The case for her redundancy has been examined and it has been suggested that her continuance is unlikely unless her rôle is envisaged in an entirely new way. It has been pointed out that the most serious problem facing the health and welfare services is not physical but psycho-social breakdowns. It has been suggested that the health visitor's new task should be to make herself redundant in the mental health field as she has already made herself redundant in the physical sphere. To this end her training requires to be reconsidered. The skills she will need will be primarily those of a family case-worker, and it is suggested that her training in future should be along lines similar to those of the almoner rather than the nurse.

This paper attempts to show, directly and by implication, that serious dust and fume nuisances are still problems which, in specific cases of steel-making and steel-melting, await a really satisfactory solution which is also an economic proposition. Particular attention is drawn to the increased nuisance caused by oxygen enrichment.

In such cases it suggests that the basic design of the buildings is a stumbling-block not easily overcome. An original building lay-out is given. It illustrates how some firms have tackled the problems involved and suggests where there is scope for further investigation and research in furnace design and fume and dust analysis.

By way of contrast it states that many small dust nuisances for which the cures are fairly well known are not dealt with efficiently. The broad scientific approach to this problem is outlined.

Finally, it calls attention to the dispersion aspect of pollutants, which is becoming of increasing importance, and suggests that recent scientific investigations, carried out primarily for marine application, may be adaptable to land practice.