Preventive Medicine

Press, Volume CVI, Issue 31206, 2 November 1966, Page 2

Preventive Medicine

Any preventive medicine project was more complex than merely providing food. Changing the attitudes and behaviour of people towards a more healthy way of life presented a more difficult challenge, Dr. N. C. Begg told a Plunket Society conference in Dunedin last evening. Dr. Begg outlined three stages of preventive medicine. Scientists and doctors should devise a practical method of prevention. Doctors and health educators should disseminate knowledge of the disease and the methods of its prevention. The people themselves should apply this knowledge. “Stage three pertains to the masses, whose behaviour depends on local customs and the culture of the nation, who are reluctant to change their

habits because of some hypothetical diseases which they do not think will threaten them, and whose behaviour frequently depends on conforming to the actions of a neighbour and on the natural conservatism and human inertia which affects us all,” said Dr. Begg. Dr. Begg said that each year hundreds of Indonesians went blind, although a local food which would prevent xerophthalmia was plentiful, but fed only to animals. The problem of getting people to change food habits was not confined to Asians. A survey among a group of London women showed that they believed fresh fruit was healthier than canned, wholemeal br&ad was nutritionally better than refined white bread, and that sweets encouraged dental decay. However, this same group brought large quantities of canned fruit, 92 per cent of their bread was white, and they averaged weekly half a pound of sweets. “It is as useless to advocate pork to a starving Jew or Muslin, as it is to suggest beef to a Hindu. In our efforts to change nutritional habits we have had some notable problems.” Fluoride was one example of the reluctance of New Zealanders to accept that which was good for them. “How much more difficult it is to break into the eating habits of overseas people, about whose cultural and a superficial knowledge, and who have economic and social pressures beyond our comprehension,” said Dr. Begg. “We have to win over the active support of the Indian mother, who at present sells her child’s ration of dried milk to the baker, so that she can have money to buy a cereal. This is no easier or more difficult than to change the behaviour of the Western mother who encourages dental decay in her children by providing them with sweets, although she knows that it is unwise. “If good citizens are prepired to work for the better health of their own children, and the children of their community, then the battle is half won.

“If the people themselves can be involved in this work by asking for advice, by making decisions, by planning policies then a subtle but fundamental change comes into their way of thinking.”

“What was before—this is what they are trying to make us do,’ became ‘this is what we are aiming to do.’ Each person who participated in this community effort became a teacher of others as well as a learner.

“The change in thought spreads from one person to another as people tend to behave as their friends and neighbours do. “This technique of ‘citizens’ planning groups,’ pioneered by the Plunket Society, is even more important in the international sphere. National pride and the impact of various ideologies, as well as local customs and cultures, make advice given from afar less compelling. The required changes are much more likely to be wrought by local people,” said Dr. Begg. To try to exploit this powerful weapon of change, the Plunket Society was cooperating with Bombay citizens—doctors, nurses, a biochemist and a group of businessmen, who were training girls as infant welfare nurses. “We have supplied all the teaching material about the practical things of mothercraft, the proper nutritional requirements of babies, methods of preventing infection—all the simplest and most effective practical things of infant welfare,” he said. The citizens, working with their own child health scheme, might be able to improve maternal and child health techniques in their own country.

“To back up this programme of health education and by the people themselves, we advocate the proper use of dairy products. Not only are we advocating dried milk powders as an admirable source of essential protein for infants, but we also have the milk protein biscuits devised by the Dairy Research Institute ” said Dr. Begg.

Each biscuit contained all the proteins required for growth found in a quarter of a pint of milk, and could be eaten by the young child under supervision. “Success breeds success and people who see healthier children as a result of these methods are likely to accept the changes advocated. By this method we can establish in overseas countries not merely a change in the fashion of foods; we can build into these people a permanent change towards better health,” he said. Outlining other overseas projects of the Plunket Society, Dr. Begg spoke of the pilot scheme for protein biscuits in Samoa. A further biscuit campaign was planned for Fiji, other pilot schemes were working in Malaysia and schemes in Thailand and the Philippines were being prepared. Mrs Jacqueline Baker had prepared a health education booklet, “Practical Mothercraft,” which the society hoped to have printed in English, Fijian and Hindi.