PUBLIC HEALTH

• Introduction:

“Clinical / treatment” is contrast with “public health”. “Clinical / treatment” refers to the medical treatment and treatment at the town doctors and hospitals that we usually visit for illness. It means that a medical professional examines and diagnoses an “individual” who has an illness, provides appropriate treatment for it, and cures the illness. On the other hand, public health “Public Health” is said to be “collectively responding to problems related to the health of human society” and regards people as a group, at the city level, town level, and in some cases at the national level. It can be said to be organized hygiene activities carried out by public and private health institutions and regional / occupational organizations to maintain and improve the health of the people. It may include maternal and child health, prevention of infectious diseases, measures against lifestyle-related diseases, mental health, food hygiene, housing hygiene, water and sewage, human waste disposal, pollution control, and occupational health.

• Background:

The first public health activity in history said to be the planned urban development of the Mohenjo-Daro archaeological site, the birthplace of the Indus Valley Civilization in 2000 BC. It is said that stone roads were built in the city and waterways for citizens were systematically built. Since then, many infectious diseases have afflicted civilized societies as a collective public health issue rather than as an individual issue. The outbreak of smallpox, allegedly occurring in 1000 BC, has been evidenced by the mummies of the pyramids, and in Greek times Hippocrates described epidemics such as plague, diphtheria, and malaria, along with their symptoms.

During the Renaissance period in Italy in the 14th century, it is said that the systems such as food hygiene monitoring, environmental hygiene monitoring, and customs business monitoring, which can be said to be the public health systems that are already being implemented at health centers, were completed. A major public health problem has emerged in Britain around 1800, the time of the Industrial Revolution. In other words, it is a large movement of a large number of farmers to the city due to the industrial era.

The city did not have a saucer to receive these people. Housing, water and sewage, waste disposal and manure disposal are overwhelmingly inadequate, these people are in poor health, cholera and tuberculosis are widespread, and statistics around 1840 show the average number of workers in London. Lifespan is stated to be 18 years. Regarding these hygiene issues, the world’s first public health law, the Liverpool Sanitary Act (1846), was issued. It was the first time that public institutions systematically practiced that “the government has an obligation to protect the property of the people, including health,” and after that, public health laws were issued one after another.

• International Health and Public Health:

Medical professionals working in International hospitals may be the first to be confused in the field of international medical cooperation. In developed countries, under the insurance system, it was possible to use all kinds of drugs to save one patient, but in developing countries it should not be done.

Lifestyle diseases such as heart disease, cancer, and cerebral tuberculosis occupy the top causes of death in the world, but in developing countries, diarrhea is still 3.3 million, AIDS is 3.2 million, and pneumonia is 3.1 million every year. Two million people have died of malaria, one million people with tuberculosis, and 750,000 people with measles. In addition, 500,000 people have died in connection with pregnancy. Deaths from this preventable or known cure account for more than half of all deaths worldwide, with 95% of these being said to occur in developing countries.
In 2000 AD, the Millennium Development Goals, an international goal, was set as an urgent task to be tackled now under the agreement of all UN member states (191 countries). The goals to be achieved by 2015 include (1) Goal 4: Reduction of infant mortality, (2) Goal 5: Reduction of maternal mortality, and (3) Goal 6: HIV. It contains three health-related goals: / AIDS, TB, and prevention of malaria epidemics, which the world is currently working on. However, in reality, it is thought that about 20% of developing countries can reach these goals, and it is said that they cannot be achieved in Sub-Saharan Africa and South Asia.

• New era of public health:

Various new infectious diseases have emerged, and as a new definition of public health in the dizzying era of the information age, “continuous and collective (cooperative and organized) for improving the health of local residents. “Activities” were advocated. What can be done for developing countries where people, goods and money are not enough is also a big issue. Even if you teach technical things such as mere medical care and nursing, you cannot use it if the necessary environment is not in place. Even if you know how to diagnose and treat malaria, you can’t do anything without medicine. And what about those who can’t get there? 

In that sense, public health cannot be achieved by healthcare professionals simply by technology transfer. It is necessary to look at all the environments surrounding health care and solve them comprehensively. In addition, it is a big issue to find means and methods to deliver such medical care to the necessary residents and to create the system. Also, these systems are not possible by health professionals alone, nor can humans be created from the outside. It is important for people in that country who have good values ​​and who know the country or region best to take the lead, and it is correct to share wisdom with them and create a really good system.