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It’s politicians, engineers, town planners, architects and such like who have advanced public health and social well being. Not the medical fraternity in cahoots with big pharma

17/10/2011

In the early 19th century, the growing towns of Britain were characterised by overcrowding, dirt, poor housing, poverty, bad water and disease. Public health provision was transformed as the 19th century progressed and by the 1900s social reformers had comprehensively turned things round.

  • In 1842, Edwin Chadwick argued that disease was the main reason for poverty, and that preventing disease would reduce the poor rates.
  • In 1848, a cholera epidemic terrified the government into doing something about prevention of disease – through both public and individual health measures.

In some slums people weren’t even lucky enough to have communal toilets and had to make do with open drains. As cholera spread through London, people called for action. As some 54 citizens cried to the editor of the Times:

THE EDITUR OF THE TIMES PAPER

Sur, -May we beg and beeseech your protection your proteckshion and power. We are Sur, as it may be, livin in a Wilderniss, so far as the rest of London knows anything of us, or as the rich and great people care about. We live in muck and filthe. We aint got no privies, no dust bins, no drains, no water splies, and no drain or suer in the hole place. The Suer Company in Greek Street, Soho Square, all great rich and powerful men, take no notice watsotnedever of our complaints. The Stenche of a Gully-hole is disgustin. We all of us suffur, and numbers are ill, and if the Colera comes Lord help us…
                                                Teusday, Juley 3, 1849.

Public measures
Florence Nightingale, English hospital reformer, who publicised the ‘miasma’ theory of disease while campaigning for cleaner hospitals. At first the government tried – as the Romans had done – to prevent illness among the population by public sanitation measures.

The first public health measures were based upon the idea that miasmas (bad smells) caused disease. Although the idea was wrong, the measures against the miasmas involved a greater focus on cleanliness, and this improved public health. And allowed Joseph Bazalgette to build the London sewers, replacing the antiquated systems that allowed sewage to accumulate and pollute the Thames, cholera to spread and people to die.

Further measures included:

  • In 1848 the first Public Health Act caused the setting up of a Board of Health, and gave towns the right to appoint a Medical Officer of Health.
  • In 1853 vaccination against smallpox was made compulsory.
  • In 1854 improvements in hospital hygiene were introduced.
  • In 1875 a Public Health Act enforced laws about slum clearance, provision of sewers and clean water, and the removal of nuisances.

The benefits of these measures soon became clear, and by the late 19th century local councils were competing with each other to provide the best public health.

Individual measures
When the Boer War revealed that half the population were unfit for military service, the government accepted that it had to pass laws to improve the situation of the individual poor:

  • In 1906 local councils were told to provide free school meals for poor children.
  • In 1907 school medical examinations were ordered for all children (among these examinations were those of the ‘nitty nurse’).
  • In 1908 Old-age pensions were introduced.
  • In 1911 National Insurance (free medical treatment for workers who fell ill) was introduced.

I view this 19th century British timeline important to highlight that public health and social well being is not a function of the medical fraternity in cahoots with big pharma. Rather it’s politicians, engineers, town planners, architects and such like who have advanced public health, and continue to do so. Put simply that includes all except the medical fraternity in cahoots with big pharma, and these people are imposters and should be shown the door. Yet, and this is unfortunate, most people associate public health foremost with medicine and ignore these milestones in infrastructure building and the making of decent societies. The propaganda industry has a significant role in this assumption and thus the increasing medicalization of society. People certainly are aware of the need for potable water, sanitation and the other factors but they are blind to these as key factors for public health.

The post war Australian governments of Prime Ministers Ben Chifley and John Curtin embarked on massive public infrastructure projects and introduced social benefit and social security reforms that had the affect of enhancing public health and general well being and lifted the people out of their misery. These great men’s views were shaped by the events of two world wars and the linking great depression that had caused enormous harms and misery to the people of Australia.

IIvan Illich argued that the medical profession harms people in a process known as iatrogenesis, where there is an increase in illness and social problems as a result of medical intervention. He saw this occurring on three levels:

1) The clinical, which involves serious side-effects that are often worse than the original condition. Medical tests can trigger unnecessary further tests, like biopsies, that can create extreme anxiety. Mammograms can find cancers that grow so slowly that they would never be noticed in a woman’s lifetime, resulting in unnecessary treatment. Tests are often conducted with no scientific basis for their supposed effectiveness. Certain tests do not save lives over all and may lead to more tests and treatments that needlessly harm people. These tests are invasive, expensive, dangerous and irrelevant.

2) The social, whereby the general public is made docile and reliant on the medical profession to help them cope with their life in their society.

3) The structural, whereby Western medicine’s notion of issues of healing, aging and dying as medical illnesses effectively “medicalised” human life, rendering individuals and societies less able to deal with these “natural” processes.

Thus it’s critical thinking coupled with scepticism that’s lacking. It is thinking critically about claims and issues by medicine and big pharma. So why not take a close, sceptical look before buying someone else’s opinion, to ensure that it is worth it and holds up under scrutiny? This is scepticism and critical thinking – believing only those claims for which there is good hard evidence. Scepticism should be widely applied in one’s life to all the claims heard on a daily basis and that applies foremost to those by medicine and big pharma.

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