By Vivek Pattanayak*
The central theme of public health is about community health which includes prevention of ailment, sickness, disease among the people, prophylactic action against epidemic, pandemic, and global scourge of deadly virus, promotion of hygiene and sanitation, looking after maternal, child, and adolescent health and in recent times health of the aging population.
When the mention is made of public health it invariably relates to health of the community. The word public is used as distinct from private. At the same time health of individual and health of the community are inter-connected. One affects the other. Health can be viewed in the immediate period, and also on a long-term perspective.
Disease, ailment, and sickness in individual mean one thing but when it affects a large number of people in the geographic vicinity at the same time it is yet another thing.
Sanitation and hygiene have their effect on health both public and private. Swachh Bharat designed to construct public toilets is a public health programme meant to improve sanitation and prevention of spread of air and water born diseases.
Some diseases are infectious, and they spread rapidly among the people in close proximity. It can be epidemic or even pandemic.
In the Middle Ages, plague claimed lives in Europe almost decimating population in various parts. Smallpox was a dreadful disease. Its rapid spread brought deaths to large number of people. Prevention of this disease could be done through vaccination. Similarly, cholera was claiming human lives in substantial number. Prevention of this ailment was done through inoculation.
Similarly, people carrying diseases were coming on ships from different countries and places. They could affect the people living inland. Isolating people who had been affected by infectious disease was attempted by keeping them on the ship or certain designated place. To take these actions state and its agency were required to be armed with legal power.
The compulsory vaccination and inoculation had to be done on people which required legislation. Similarly, isolating affected people from spreading infectious disease needed a law of quarantine.
Sometimes adulteration of food could cause large scale ailment causing deaths. Therefore, to prevent adulteration of food law was needed. Public health officials were empowered to inspect food processing industries, hotels, and restaurants.
Production of vaccines, medicines, drugs etc. had to be regulated for safety of patients. Inspection of the premises where the production was going on was necessary to ensure they are free from pollution and the production of drugs had to meet the prescribed medical standards. For these purposes, laws had to be enacted.
The medical doctors and health officials were required to have certain qualification and they had to maintain a certain code of conduct with regard to the patients and their clients. Hence, there was need of law to regulate them.
Wars, hostilities, and armed struggles have caused migrations. Temporary accommodation of refugees also by itself has enormous public health hazards and challenges.
Forecast of outbreak of unknown ailment based on study of medical doctors, researchers, and public health experts is one area which is part of public health discipline.
In terms of economic and social cost and benefit to the nation, public health plays a significant role. The relevance of oft repeated cliché “prevention is better than cure” need not be underplayed.
In long-term infant mortality, death during pregnancy and childbirth, stunted growth has consequences on demography. It is the demographic dividend which propels the development and prosperity of the nation. Thus, one can visualize the extent of cost to the country in absence of well-designed community health programme.
In 20th and the 21st century, the world has experienced several types of epidemics like Spanish flu, SARS, Ebola, Zika virus, Swine flu, Camel flu etc. becoming pandemic starting from one country moving to other countries because of modern transportation system like inter-continental railway and road transport but more specifically due to trans-oceanic air transport with large aircraft.
Since the end of 2019 and beginning of 2020, the most dreadful pandemic of the recorded history was experienced across the world with rapid spread of Covid 19. No country escaped this devastating disease.
According to World Health Organization, globally as of 3 May 2022, there have been 511,965,711 confirmed cases of COVID-19, including 6,240,619 deaths. As of 1 May 2022, a total of 11,532,661,625 vaccine doses have been administered. Drug industry, after two years of intensive research, conscious and determined effort has started finding medicines to cure the disease.
From these information and reports of IMF and World Bank, one can imagine what is the extent of damage the global population has suffered and its consequences on global economy and the impact it has made on life in general. Decline in global GDP, sickness of industries, disruption of supply chain and largescale unemployment and increased poverty have been the sequel to lockdowns, quarantine, and disruption of transport system.
The world, therefore, has now woken up to new reality that community health has to be given top priority. While study of medicine had been given importance in the past which included community health for those joined medical colleges for MBBS degree, public health has now become a specialized field of study. It is a discipline by itself. The subject includes epidemiology, child and maternal health, public health regulations and ethics, biostatistics, population science, health systems, health policy, health economics, environmental health and sustainable development, strategic management in public health etc.
Need for having professionals in public health is being increasingly felt not only in governments whether at the level of Central, State Governments, and also at local self-governments like Municipalities, Zilla Parishad and Panchayat Samitis, and but also by corporate bodies under their CSR programme and NGOs. The employment opportunities of public health professionals have increased after the pandemic. Not only the demand exists in India, but it is growing in emerging markets, developing and under-developed countries.
In the recent years public health as a specialized study has gained popularity in India. Interestingly, a dedicated University in public health called Asian Institute of Public Health has been set up in Odisha since few years. Time is now most appropriate for policy makers in public domain to focus on public health education.
*The author is a former bureaucrat and held important positions in aviation and power regulatory body. He can be reached through e-mail at [email protected]
DISCLAIMER: The views expressed in the article are solely those of the author and do not in any way represent the views of Sambad English.