PUBLIC HEALTH AND EDUCATION

Dominion, Volume 11, Issue 288, 24 August 1918, Page 10

PUBLIC HEALTH AND EDUCATION

ONE AND THE SAME PROBLEM

fßy Dr. Edgar Whitakcr, l'almorston North.]

Put the question to a man in tho street as to whether ho is intwestcd in public health, and ho will answer "No" —unless he has a recent grievance against a sanitary officer. Ask him what ho Ihinks of national education and ho will say "Rotten!" Ito will not worry, beraiuso he does not realise that public health and education nro so closely mingled as to bo inseparable; that they are one and indivisible, tho same problem, and affect him equally as to the chances of a fair future. Let him havo patience, and we will show how his welfare, his children's and his country's depend largely upon tho ready adoption .of this point of view. A statement of tho Minister of Public Health was recently published that his Ministry was far and away more important to tho country than the Ministry of Education. Let us prick that bubble al once. Theire is no more tru.th in it than that tho bristles of a brush aro more important than thei wire that fixes them, or the hands than the head which directs them. Public health and national education ai:e indissoluble, and tho cement that binds them is the plain fact that a country depends entirely, as to the future, upon what sort of children it is bringing mp now. Public Health Ministers and every other sort of Ministers depend upon a constant stream to suffer them. It was shown in an articlo recently published in The Dominion how the present incomplete system of health control allowed an unheard-of number of infectious diseases to break through the meshes of a too-wide net, oast haphazard upon tho waters of an unprepared and confiding public opinion; and that the public expenditure of bricks and mortar in the hospitals (destined to grow within the next two years to still larger proportions) ought to be checked at the fence, built inoiro strongly along the top of the Precipice of Sickness, rather than at tho bottom. That is only half the problem. Tho puWie docs not yet grasp the essentials of this matter. The Schools. Tho present position is that the public health authority cannot touch the schools or the children in tho schools until infection has broken out. It can then make recommendations, vital to the correction and prevention, of tho disease, to another authority. Which, for want of public funds or reasons of apathy, does not carry them oui. Photographs, monographs, biographs, and pantographs prove to the public the overcrowded state of our public schools; 11,000 yearly cases of 1 infectious disoaso show the results of it and testify to tho want of education, not of the people, but of tho two authorities in control. ' Tho two Ministries—Public Health and Education—aro neither of them superfluously endowed with personality nor emoluments. Ono of them has its own doctors in tho schools to prove that some of the children are diseased when they come in, 'and the other has them to show how infectious they can bo when they are out; each trying to seize for its own what rightly belongs to the two of t.hem, and both of them making the doctor their heir for a decado in spite of good intentions. i , Maternity Homes. There is another grave problem, inseparably associated with these Departments, which is exercising tho minds of hospital boards throughout the country, viz., the advisability of erecting maternity homes either in or attached to hospitals. The public, keenly sensitive and alive to the fact that something must be done, desires to remedy an ovil, without clearly appreciating its significance. Let us here lay out the matter, for it is a very intriguing one. All hospital boards have to find accommodation and treatment for diseases and ill-health occurring under their own direct control, which would not be otherwise provided for. But there is nothing in tho Act to compel them to erect maternity hom'es, at least until the chief medical officer certifies to its being absolutely necessary. Philanthropy, openhearted and benevolent, lias in many cases made its own arrangements for such cases, but public opinion now makes an energetic demand for action, basing, and wrongly basing, that demand on national grounds. Wo say wrongly because, if tho demand is national, the remedy is national. It does not become tho business of hospital boards unless local conditions demand it, or tho national authority deputes the national business to them. AVo dwell upon this because tho argument differentiates once for ail —it ( is as good an example as any—of the fundamental difference in the duties of tho State and that of local bodies. The conditions of tin; country and the local conditions concerning hospital boards and this maternity question are at tho present moment these:— 1. Tho birth-rate has fallen off from 271 per 1000 in 1913 to less than 25 per 1000, and will continue downwards. 2. Marriages are falling off. i .'i. The most physically fit have for the ! best part left the country, and the others j will follow. ! i. Local fusing homes of all kinds | which jr.ot i V: 2T>' rate must logically be ! sufficient to meet' the 25-or-less rate. .I. Women are. in the majority, are doing more work, getting higher pay, and having tess babies. _ _ Therefore, unless the local conditions [ were hitherto £o outrageous, either in I their financial or medical aspect, as to bo intolerable, there is no. call whatever upon boards, as boards,_ to move locally for the immediate erection of maternity homes. Significant Facts. But these very conditions (falling births, marriages, and tho fit populace giving up their lives for their successors ami tiieir country), which will make less and lcfip call on boards for additional local araommodation literally compriso a national problem of the deepest significance and magnitude. It entails the luigost national factors, which the nation here and now must find time to deal with. Hospital boards may indeed have less ti do, but this groat little country, all of ns think rightly the best in tho wido world, is faced with a problem which with our present-day device of an illogical and divided control of two essentials predicates our ruin. Tho key lo tho whole position is tho New Zealand child. '-We aro not getting them. Wo aro not safeguarding those we have. Lisfea to this. If the war by some horrible misfortune lasts five uioro years, and the present falling ratio is undiminished, there will not be 10,000 infants born yearly in the country. If it ends then, and the immense tide of immigration which is confidently 'anticipated occurs, Micro will hardly be, lil'teeiu,years later, a New Zealander between 20 and 30 in the Dominion. That is tho age when things happen to men and women. Tho country will be at tho disposal of the immigrants. Other countries, of course, will be in similar condition, indeed, not so fortunately situated as ourselves in many ways, but they arc all comparatively well populated and moro fooundant. What to them may ]>o a detriment will bo to us a calamity.

Public opinion ought to look upon, and ! be roused to look upon, tho Health Department (which comprises the birth of children and thoir early upbringing), and the Education Board (which undertakes their growth to adoleeence) as ono and the. same problem. It is no use now to suggest energetic aphrodisiacal propositions to bring about intensification of those not of the best physique, but it is essential to ensure from now on that all children, high or low, rich or poor, one with another, shall have ft healthy initiation into the myslerics of this muchobliged Dominion. The place in which these national assets are burn must; bo tho most healthy possible, their nurturing must lie assured by remitting substantially the taxes of a parent during the next few years, and, last, but noi; least, the sanitary regulations of the homes, the schools, such playgrounds as the picture shows and theatres, must no longer suffer the nfglent and torpor of divided sanitary control. The children of the Dominion, sound, healthy, vigorous bonds of betterment well when they enter school, should be not less so when they leave. The Minishrj <t Public Health and that

of Education should be under one strong hand. Younger, liioro confident of his own powers and moro sure of his high aim. If ho cannot bo found, if lie canliot. when found make the nation uncover the means, money, nnd the will (o win this through-thc history of our nation need not occupy his time.