Before entering into post-graduate studies the term ‘health’ just meant to me ‘not having the disease’ and ‘disease’ was just an unusual experience of life and if got sick the target was to get treated, seek a physician, follow advices and finally get cured that’s it! But now when I chose to study the vast field of public health I came to know that health is not merely targeted for an individual but collectively when considering health of a nation, entire population devoid of cast, creed, borders, wealth, and gender, political or religious views, focusing on the complete physical, biological, mental & social well-being of public in aggregate and emphasizing on preventive measures unlike medicine which deals with the curative measures and focuses on the health on an individual level.
I find there are many of the challenges globally which need to be addressed, get fixed whether its related to people living in developed or developing country, whether the sufferers are rich or poor, female or male, they may follow any religion, whether they are victims of any disease or a disaster, without any discrimination I feel it’s the born right of every human being on this earth to get proper, efficient & effective health care services and therefore I call public health as an humanitarian discipline dealing with disease prevention, prolonging life, promoting health or in simple words dealing with the betterment of mankind.
On the whole world is getting urbanized there is a great shift from communicable diseases to non-communicable or chronic diseases. Until 19th century, in United States and other developed countries the leading cause of death reported to be was pneumonia and influenza. But by the end of century, heart diseases were ranked top among the leading causes of death in developed countries. Though our living standards are getting better and better but our lifestyles are modified to the worst. Yet in all urban cities industrialization is causing opportunity cost.
There is an increased use of tobacco, alcohol, drugs, unhealthy diets, physical inactivity and lack of exercise, careless attitudes towards health seeking behavior, delays in getting diagnosed, all these are risk factors leading us the so called ‘civilized people of modern era’ towards cardiovascular diseases, diabetes mellitus, cancers, neurological disorders, obesity, suicide, accidental injuries etc. These non-communicable diseases (NCD) have become a major health problem both in developed and developing countries and have accounted for 70% of the deaths worldwide in 2005. The gap left by popular communicable or infectious diseases is now been filled by the non- communicable diseases, which run long chronic and result either in death or disability.
But what’s more important is to take into account the established risk factors and minimize exposure to them in order to prevent these diseases later in life; for example the famous we know- ‘Smoking is a risk factor for Lung Cancer.’ If one is diagnosed with any of such diseases then prompt treatment as advised by the physician should be followed at an earlier stage so as to prevent further complications and further worsening of the disease and making it difficult to get treated. Unlike the third world population, people living in developed countries enjoy good civil rights and social justice; they have better health structure and facilities, proper system for water supply and sanitation, adequate nutrition then I may ask what is that which drives them towards drinking alcohol which is one of the major causes of liver and pancreatic cancers? Or what makes them getting addicted to drugs?
Despite of improved living standards, better environment and health services, in addition their social aspects of life and impact of social behaviors onto their lives should be considered and studied that will surely clue to deviating from normal behavior and fostering them towards such unsafe attitudes like unhealthy diet and stuff. Call it fashion or whether it’s because of peer-pressure, frustration in life or whether it’s a personal or community behavior it has a major impact on health. In this regard, public health can intercede through behavioral interventions including promotion of good health habits and avoidance of smoking, use of excess alcohol and other dependency disorders. On the contrary, the situation of health in developing countries is at a burning stake. The middle and low income countries are facing the major burden of diseases both infectious and chronic at the cost of their environment.
WHO estimates that 80% of deaths due to NCD occur in developing countries, over 7.5 million children under age of 5 die from malnutrition. Every year 11 million children are dying from preventable deaths, 15% of child deaths in developing countries are because of diarrhea. An important underlying cause of all deaths due to infectious diseases is ‘poverty’. International organizations are greatly focusing on issues of high infant and child mortality and maternal mortality rates, the spread of infectious diseases (malaria, TB-MDR, measles, polio, HIV etc), inadequate sanitation, lack to access safe drinking water, occupational diseases and pollution related health problems which are more common in developing countries than in developed countries.
WHO initiatives in conducting intensive immunization against the major preventable diseases of childhood in developing countries are praiseworthy but there are several significant barriers to complete coverage including poverty, low level of education, geographical obstacles, civil unrest and wars, government mistrust, corruption and misuse of funds have considerably prevented the control of disease vectors. On the other hand, rapid growth in transportation has also contributed in the spread of infectious diseases through one continent to the other continent of the world while remaining asymptomatic! SARS outbreak is such an example which took over South Asia and as far as Canada within weeks of appearance of index cases in Hong Kong.
Pakistan at present is still unable to kick many of the infectious diseases particularly ‘polio’ off the country. Poverty, overcrowding, poor water supply and sanitation, ineffective immunization coverage are the factors but in addition the poor law and order situation have worsened it. In Karachi recently on July 20th ’2012, Mr. Ishaq who was working on Pakistan’s polio eradication efforts supported by WHO, was shot dead. In such dreadful situations when the lifesavers are at risk of protecting their own lives, I ask the leaders of my country, how they could be able to sustain health care provision, their effective and efficient delivery and their maximal utilization in the country? I would conclude that addressing these challenges goes beyond the medical interventions and require social integrity and political will so as to bring incredible success in achieving the Millennium Development Goals by 2015.
Currently, total world’s population is over 6.5 billion people and half of the world’s population lives below the internationally defined poverty line and it’s estimated that up to 2050 the total world’s population will grow to 9 billion people. It is therefore important to make future oriented policies and approaches combating through emerging of new agents, re-emerging of diseases, fighting bio terrorism, working for vulnerable groups, effective utilization of resources with equity and fairness along with protecting our environment. In last I would quote Roger Detels: “We have been successful at adding ‘years to life’ but have reduced the quality of the years of life added. We must now concentrate on adding ‘life to years’, helping people to continue to be productive.