Considerations to Improve Public Health in Today’s World

Rafael Corona

Department of General Hygiene, Villa Clara University of Medical Sciences, Cuba

*Correspondence to: Dr. Rafael Corona, Department of General Hygiene, Villa Clara University of Medical Sciences, Cuba.

Copyright © 2018 Dr. Rafael Corona. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

It is a privilege to be able to write my ideas about the situation that public health is facing nowadays, for which I express my greatest gratitude to the management of the CPQ Women and Child Health magazine.

Humanity faces a very difficult moment, with a prognosis that is practically impossible to appreciate given the deterioration of sanitary hygiene, uncontrolled industrial production and the development of military actions in different parts of the world.

The hygienic and sanitary situation deteriorates more and more due to the lack of economic and financial resources for its control and the irrational action for the final treatment of the solid and liquid residuals of the population and of the industries.

The industrial production is constantly increasing in function of the profit of the companies without taking into account the contamination and the environmental damage that is produced by the emission of greenhouse gases and the liberation of toxic chemical, biological and radioactive substances to the medium adding in currently genetic manipulations with a very unsafe prognosis.

Wars, regardless of their political or economic objectives, are illegal, according to international humanitarian law. They only cause suffering among innocent civilians, especially the most vulnerable such as children, women and the elderly. They only cause great destruction of values created by humanity while leaving environmental damage sometimes irreparable.

Sanitary-chemical, biological and radioactive contamination, often caused by major accidents, generates climatic and environmental changes that seriously affect the biology of the planet.

In my 45 years as a professor of Medicine, in particular of Disaster Medicine and especially as a member of the Cuban Medical Brigade “Henry Reeve”, I have provided medical assistance during extraordinary situations in Cuba, Suriname, Haiti, Ecuador, San Cristobal and Nevis, and in Sierra Leone. In these countries I participated in the confrontation to cyclones, floods, intense droughts, mass transit and railway accidents, volcanic eruptions, chemical accidents, serious health disorders due to exaggerated consumption of alcohol and drugs and bad lifestyles and serious epidemics such as Dengue, Malaria, Cholera, and Ebola Virus Fever.

The lack of risk perception of the population and local authorities was a constant in our evaluation and therefore there were no plans to face the danger or threat, not even plans to work on the vulnerabilities to reduce or eliminate the risks. This situation is repeated in many countries, which limits the local and state projections for the forecasting, preparation and control of emergencies that may arise.

When considering a disaster as a serious unexpected situation, which does not allow confrontation with the available local resources and requires urgent help from outside the disaster site to resist and achieve the subsequent recovery, we use a very limited concept. Actually, the risk of disasters includes a diversity of phenomena based on the danger and vulnerability to its effect. The deficiencies in the political, economic, legal and ethical conduction, with the important positive or negative influence of the religions, condition a progressive aggravation of the situation on concepts and opinions that are far from the real situation that they face.

The diversity of thoughts in the community or nation is materialized in ideology that often does not consider the phenomena that develop over time, sometimes slowly, producing very destructive disasters. Disasters that are formed slowly demand actions for long periods of time and a high expenditure of resources much higher than those required, for example, recovery after a major earthquake, considered one of the disasters with the greatest capacity for destruction.

An example of what we affirmed is the emergence of outbreaks of Ebola Virus Disease in Africa that put all humanity at risk of a deadly disease and their appearances are unpredictable and uncontrollable until an international cooperation plan is decided organized and directed by the United Nations.

The environmental changes and the poor perception of risk have led to the re-emergence of infectious diseases such as Tuberculosis, Yellow fever, Cholera, Dengue, Chicungunya and Zika, in a very dangerous and aggressive variant because of the neurological consequences that they produce the mutations of the virus considered to be of little aggressiveness until a few years ago.

The appearance of AIDS, with its consequent immune suppression, conditions very aggressive forms of Tuberculosis and many diseases.

Other infectious pathologies emerge, such as the Severe Acute Respiratory Syndrome, the one produced by Hantaviruses and others transmitted by vectors or by infectious agents that attack by different routes. Respiratory, digestive, mucous skin or sanguineous transmission makes these diseases a permanent challenge for health services in all latitudes.

Life has shown that microorganisms are protected and quickly manage to resist antibiotics and chemotherapy causing them to lose their action in a short time and its harmful consequences to the human organism is evident, which forces the study and use of preparations of biological origin for its control, especially those that stimulate and modulate the immune system.

A not less important chapter is composed of chronic diseases non-transmissible derivatives of social stress, mainly due to poverty, political struggles and excessive economic ambition.

The psychological disorders that produce social inequalities, misery, the inadequate and irrational use of medicines, the environmental pollution of the air and water, the disordered and criminal use of chemical products in the production, conservation and preparation of food are the cause of much serious pathology.

The most important affectations are in the circulatory, blood, urogenital, digestive and nervous systems, giving rise to the phenomenon of epidemiological transition currently characterized by the shift in the prevalence of communicable diseases through non-communicable diseases, where, unfortunately, cancer is notable for its high incidence.

In my opinion, the social determinants of health are the most important aspects to take into account in order to achieve an efficient public health by considering both the aspects related to the economic and social development policies that determine the population lifestyle, such as equity and organization of health services, generally conditioned by the economic situation and education of the population.

For the reasons presented, it is necessary to work to achieve a universal unity of thought and action, of international collaboration, widely employing all means of social communication and adequate propaganda to awaken interests in these elementary aspects for the continuity of life on the planet, always convinced that a better world is possible.