Healthy people, healthy animals, and a healthy environment: One Health
BMJ 2018; 362 doi: https://doi.org/10.1136/bmj.k3020 (Published 12 July 2018) Cite this as: BMJ 2018;362:k3020All rapid responses
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The Hindu, a newspaper, reports ( 6 October) more than 20 deaths from Diphtheria, in a hospital in New Delhi, the capital of India.
Dr Kumar, a rapid responder from the Indian Council of Medical Research promotes ancient Vedic Wisdom . Would she agree that in acute infections like Diphtheria, modern medicines such as anti-serum might be more useful for children who are dying?
It is frightening that in Delhi, in 2018, children in a HOSPITAL, can not be treated.
Competing interests: No competing interests
Indian scripture has echoed the same facts and sentiments for more than 5000 years; I hope modern science takes note and benefits from vedic wisdom.
Ref.
Salutogenesis and Ayurveda: indications for public health management. EPMA J. 2011 Dec; 2(4): 459–465.
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Thank you for your recent thought provoking article on the One Health concept. It’s interesting isn’t it that our economy, our welfare, our very lives depend entirely on healthy ecosystem services and yet at a strategic level in health we barely pay them lip service. I believe part of the reason for this is that as a society we have become disconnected from the natural world. We see nature as a peripheral to our lives perhaps as a middle class lifestyle add on rather than something we are intrinsically part of. Somehow we forget there is no health and well being on a dead planet.
This has led to a collective indifference to the catastrophic demise of our natural environment. We think the world is so large we can never run out of resources. Indeed our entire economic model is based on converting more of nature into money to keep alive the fairy-tale of infinite growth. If we step back and look at changes that have occurred in a generation it really helps to give a context and urgency to the problem
Since the 1950s (when, with the onset of consumer capitalism, we really started maxing out nature's credit card) we have removed at least half of the fish, wild mammals, invertebrates, birds and insects from our planet. In 1976, the year I was born, an oceanographer called Charlie Veron took the first known photograph of coral bleaching. Since then at least 50% of the world’s reefs have bleached. Over a billion people reply on these reefs for their main source of protein. If the trends in environmental degradation coupled with population growth continue it would be an understatement to say our children are going to have a problem!!
Humans are said to have the gift of reason. What more knowledge do we need to recognise that we need to change? As doctors we are in a position of trust and trust is a cognitive shortcut. When information is complex people make decisions based on values and trust. We are in a position to speak out, to be seen as leaders on this agenda, and challenge the status quo. This is not contentious, it is common sense and I struggle to see why it is not more of a priority.
We need to use our influence to embed sustainability in every level of politics and healthcare. We need honest debate around population and discuss whether the essence of consumer capitalism is good for us or our planet. We need to help our patients recognise the value of the natural world for their health and wellbeing and, where appropriate, use it as a therapeutic tool. You mention links with Defra. The 25 Year Environmental plan published this year has a whole chapter on connecting people with the environment for the benefit of health. There is now a wealth of evidence that demonstrates efficacy and cost effectiveness of “green interventions” and we should be embedding the naturally healthy approach in all health strategies. I would love to see a clear strategic steer from NHS England regarding this.
Through Health and Nature partnerships we are moving forward with a number of work streams here in Devon. The beauty of it all is that as well as being evidence based it is just common sense. If we can help our population connect with the natural world they will value it and their health and wellbeing improves. Once they value it they will want to protect it.
I gave a presentation recently to my GP colleagues about the Naturally Healthy program and sustainability. The feedback was very positive. The main theme was - why as this is common sense are we not doing more of it – the answer is simple, short term boom + bust funding cycles do not allow us to look at the bigger picture.
The One Health Concept allows us to begin to see our place in the world again. We need to look at our values and priorities and really think about what matters to us. We are running out of time. Action not more words is what is needed. Our predecessors might be forgiven for taking the Mammoths, the Dodo and the last living Monk seal for lack of understanding of the consequence of their actions. Who will forgive us – do we have any excuse?
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In SRILANKA, " An ELEPHANTINE TASK ."
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Srilanka is an island located in the Indian Ocean . It has an area of 25,000 square miles , has a human
population of 20 million and has an elephant population of 3,000 . The human numbers are increasing while
the elephant numbers are decreasing . Following an excruciating 30 year civil war , the economy is sliding down .
What prevails within the 600 mile perimeter is a delicate status that poses multi-dimensional challenges .
In a global perspective , Srilanka is an example of the human beings , non-human beings and the milieu that
not only has to successfully encounter the contemporary difficulties but also assure future tranquility. Under these
circumstances , to observe that concepts as , " One Health " are seriously considered is much appreciated and most
welcome.
Competing interests: No competing interests
The global media today are focusing on a visitor to London called Donald who has contempt for the environment and healthcare and who is happy for dead animal "trophies" to be imported to the USA. However, a much more admirable representative of America is also visiting London. He has just given this interview about healthy animals in a healthy environment:
https://www.bbc.co.uk/news/entertainment-arts-44620186
Welcome, Kermit !
Competing interests: Burls A, Caan W. Human health within ecology: positive well-being through nature conservation. BMJ 2005; 331: 1221-1222.
Re: Healthy people, healthy animals, and a healthy environment: One Health. A further question, about DIPHTHERIA in Delhi
I was under the impression that in Delhi and around, Dip, Tet, Pertussis immunisation had long been “ buttoned up”.
Yet, there are so many deaths. In my previous response I have bemoaned the reported shortage of anti-serum.
May I ask further questions :
1, IS THERE A SHORTAGE OF VACCINE AS WELL?
2.Or, has there been a change of VACCINE?
A continuing affliction of C diphtheriae is of importance not only to Indians but also to the rest of the world for obvious reasons. We, the residents of other parts of the world could be affected by diphtheria originating from Delhi.
3.Is the prevailing strain of Corynebacterium diphtheriae different from the strains currently used in the manufacture of vaccine?
Competing interests: No competing interests