Wednesday, November 15, 2006

The new group of students have arrived. The joy of teaching postgraduates is that they all bring with them a wealth of experience and, in most cases, a real enthusiasm to learn and to apply their knowledge to real life situations. The challenge we face is how to maintain and even enhance that enthusiasm.
Each autumn term I teach a course entitled “Issues in Public Health”. It is designed to give students an idea of the broad scope of public health as well as some of the basic concepts, such as what we mean by inequalities in health and what we can do about it. The first lecture gives me the opportunity to indulge my conviction that we must learn from history if we are not to repeat our mistakes. Almost all the contemporary debates in public health have been rehearsed before. Take the role of the state – Thomas Hobbes, writing in the aftermath of the English Civil War warned how, in the absence of effective government, life was “solitary, poor, nasty, brutish, and short”. Then there is free trade and public health. The Venetian Republic introduced quarantine (keeping ships at anchor outside the port for 40 days) to prevent the spread of plague, yet as Shakespeare’s Merchant of Venice reminds us, a delay in a ship returning to port can also have adverse consequences for health!
It is an opportunity to recall that public health practitioners have not always been on the side of the angels, too easily lapsing into a role as agents of social control. For example, many public health professionals played an enthusiastic role in the Nazi Holocaust. Even today, there is a real danger that, in the “war against terrorism”, public health professionals become complicit in the growing tide of authoritarian legislation in the UK and the USA, a point I expanded on in my DARE lecture at the conference of the UK Faculty of Public Health in June, which is now published in the Journal of Public Health as “A crisis of governance”.