Debate

I think the main debate for the Public Health Promotion is whether or not Education brings changes to Behavior, in promoting Health.

Harry: I think Education is indeed the foundation of promoting health in relative poor regions! Because it takes effect at the root cause in that region. That is the bottom-up effect!

Roseline: Yeah, I think so.

Harry: Legislation is the fastest way to see a cause-relation effect in promotion of public health, but the basic needs of the people should be met. They should have the fundamental education, free of worries of daily needs in life. Legislation is an up-down approach. Neither one should be set aside.

Roseline: Do you mean that both approaches should be implemented simultaneously?

Harry: That's right! But it seems to me that the government only concentrate in one type of approach.

Roseline: Maybe so, maybe not. It depends on how they look at the problems, and how much budget that they are ready to set aside to promote health, or make a change. But why do you have that impression that the government can only focus on one, do you mean "education without legislation" and "legislation without education"?

Harry: I think it is relative. Relative "focused" or relative "ignored".

Roseline: ???

Harry: It's hard to explain though...... I think no government would say that they will completely focus on one, and ignore another. So, I term it "relative". You know? There are some health education courses in school, primary or secondary, but always there would be such phenomena, where the teachers prefer to fill the time with preparing the students towards exam rather than utilize the time to install public health knowledge to the students, presuming that these are not important, for health is viewed to be 2nd, or 4th or 5th important. I know it is weird in saying so, but it seems to me that is the problem.

Roseline: Hmm... I remember that in secondary school, the Education Ministry did implemented a public health time slot into our weekly schedule. Only 45minutes a week. But we had always use that as a revision slot, or play at the field. Honestly, I had never viewed that as important. I didn't even know what it exist? To me, it was perhaps for leisure. It was a useless class to me. I didn't remember anything that I learned from it.

So, education if it was not properly introduced, and not properly being implemented, it's a waste of effort.

Harry: So, what's the problem here? Why the teachers do that?

Roseline: Well, I think they themselves do not know why the system needs to be implemented! Perhaps they just don't know what does it mean public health! And perhaps when it comes to weighting science subjects, mathematics classes with public health classes, they think public health is a much easy subject, and the students should grab by themselves.

Harry: Easy? Do they think that public health is an easy subject? I think it is just that they have not see the what tragics can be brought by disease! And the major problem is, many people think that they have health when they have not! Many people think that disease will not "catch" them.

So, how can we change this opinion? Should we have another SARS? How? How can we change?

Roseline: So, it is about the naive of people. I remembered the tragic of SARS in the hospital was caused by poor hygiene awareness among the hospital staffs. I am aware that the more knowledge that we have about hygiene, the more ignorance we become.

Harry: Well, many hospitals have the legislation or rules for certain procedures. However not many people follow procedures in terms of hygiene or health care methods. That is because of convenience and laziness.

Roseline: So, knowledge does not really bring changes to behavior, isn't it?


Notes: Harry worked for the Center for Disease Prevention and Control ( CDC).

A Tale:
While I was doing my undergraduate course, my secondary school friends invited me out for supper. We used to sit at the mamak store (Indian stores at the road side, with tables and stools on the road, normally with poor hygiene manner). As I sat down and ordered my meal, I found them looking at me suspiciously. Of course then I was uneasy, what happened to you guys? I asked. One smiled, seemed embarrassed," I thought you will never sit and eat with us in the mamak again. You are studying microbiology, aren't you?"