At present we are in a vicious circle. Diseases diminishes our work output, which in turn diminishes the production of food. Deficient nutrition is one of the main causes of insufficiency, ill health and general backwardness in tropical countries. The control of malaria will be definitely a great step forward in increasing the food production of our country. Other things which will help us, are, safe water supply, a programme for maternal and child health and campaign against tuberculosis and venereal diseases.
One main task of the public health service is to adapt mans environment to his needs, so that disease may be avoided; this adaptation includes public health measures viz., control of water, food, housing etc. Success in eradication has been achieved by alternation of environment, by eliminating the causative agent or the transmitting agent of the disease. For instance, cholera has been eliminated from Britain where there were epidemics in the nineteenth century, and louse-borne typhus ceased to be a serious problem in a several countries during the last war when means were found of controlling lice. Success has also been achieved by inoculations, by vaccines, as in smallpox, typhoid fever and other diseases.
Apart from other public health measures it is also important to maintain the health of the people by ensuring proper nourishment and facilities for rest, exercise, and fresh air. In these matters the public health services are intimately related to the agricultural, veterinary, and educational services. Another function of the medical departments is to provide the means for cure of disease – hospitals, dispensaries, clinics, travelling team – and to train the staff to administer them. In this work the Government can be effectively aided by the voluntary organisations.
These facts indicate the directions in which the activities of public health departments are turned. The diseases due to contagion, in so far as they can be controlled, are controlled by regulations affecting isolation and treatment of patients. But in relation to venereal diseases, isolation is not practicable. The air-borne diseases are controlled by regulations affecting isolation of the patients, and by general rules of living conditions.
But no amount of legislation can prevent the scattering in public, of bacteria or viruses from the throats of infected persons; yet many diseases are in this way, either before the patient becomes ill enough to be seen by a doctor, or because a person may carry the infecting agent without suffering from the disease, or after recovery from it. The water-borne and food-borne diseases are controlled by supervision of water supplies and foodstuff, and by the careful disposal of faeces and refuse. They are also controlled by vaccination where this is appropriate (as in typhoid and cholera).
The insect-borne diseases like malaria are controlled largely by measures directed against the insects concerned, and by drug treatment of the people diseased or exposed to infection. All these however clearly indicate how important it is for medical men of the tropics to know “Tropical Medicine” well. This refers to special study of diseases, viz., malaria, Kala-azar, dysenteries, cholera, plague, filariasis, hookworm disease, leprosy, certain skin diseases etc., which are particularly prevalent in the tropics and sub-tropics. They are mostly of infective origin and are therefore preventible.
