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EcoHealth ONE
Chad Monfreda, 18 Nov 06
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There’s no denying modern medicine’s success. In wealthy countries, more people live longer, healthier lives than anytime in history. There’s been, however, plenty of denying its failures. Modern medicine’s obsession with the pathogen-in-the-patient does little about the conditions that make people sick in the first place. Fortunately, ecological approaches to health that treat both the patient and the ecosystem are taking off.

Links between ecology and health exist wherever you look. We now know that SARS emerged from bats in China and that the terrifying H5N1 avian influenza virus hitchhikes on major flyways and poultry trade routes. At the same time, we’re waking up to the ecology of cities. Clean air and access to fresh water and sanitation are major ecological challenges on a rapidly urbanizing planet where one in two people already live in cities. These realizations gained critical mass at the EcoHealth ONE conference in October, when 400 experts on ecology and health from 30 countries convened in Madison, WI.

Their refrain: cramped ideas about health must become spacious enough to encompass entire ecosystems. I heard this repeated over three days of talks covering topics like the effect of urban design on equity and health, the industrial livestock industry’s absurd cultivation of antibiotic resistance, and the ties between deforestation and malaria.

Rita Colwell, the banquet speaker and director of the US National Science Foundation from 1998 - 2004, made an especially compelling case for wedding ecology and health when she revealed surprising connections between climate and cholera (which we've covered before). In 1983, Colwell discovered that Vibrio cholerae, the bacterium that causes cholera, attaches itself to zooplankton, and in particular to tiny relatives of shrimp called copepods. Until her discovery, the vibrios’ hideout between cholera outbreaks was a mystery because the dormant bacteria are difficult to detect in the ocean. In the last few years, however, Colwell and her colleagues have used satellite remote-sensing to show that the warmer sea surface temperatures conducive to plankton blooms are tightly correlated with past cholera outbreaks in Peru and Bangladesh. The connection between climate and cholera is an ecohealth success made possible by collaboration between sociologists, statisticians, ecologists, geneticists, physicians, remote-sensing specialists, and field-extension agents. It also makes predicting epidemics a real possibility.

Unfortunately the ecology of disease is missing from mainstream medicine—but it’s far from a new idea. In one talk, historian Warwick Anderson outlined the field of disease ecology that flourished during the mid-twentieth century. René Dubos, the ardent environmentalist who coined ‘think globally and act locally’, was an early student of the ecology of infectious disease. Disease ecologists like Dubos somewhat pejoratively distinguished themselves from ‘microbe hunters’ and promoted a more dynamic, ecologically attuned perspective than the fields of medical geography or environmental health. The ecology of disease eventually faded with Dubos and its other founders, but it’s back in a big way.

Growing fears of global plagues and bioterrorism are reviving disease ecology—SARS and avian influenza being two of the more obvious examples. Topics like these are getting the academic attention they deserve in the journal EcoHealth (the namesake of the conference), where innovative approaches to ecology and health have a professional home. But are smart scientific connections enough?

If the EcoHealth ONE attendees are any indication, making professional connections between doctors and ecologists is as much of a challenge—and just as important—as making the scientific connections between disease and ecology. The conference had a good interdisciplinary showing, gathering veterinarians, social scientists, public health workers, and even organizations like NASA and Conservation International—although only a few physicians. The small group of physicians who were there described a medical community that was interested, open, and not at all hostile to ecohealth—but also overstretched, rigidly institutionalized, and missing the right incentives to become involved. Consider that none of the US National Institute for Health’s $28 billion budget funds ecological studies. It’s hard to do research on a budget of zero.

Physicians do get it though. And a few are even doing something about it. Physician John Howard of the University of Western Ontario described his work to introduce ecohealth into the medical school's curriculum through the innovative Ecosystem Health Program. Unlike the disease-centered curriculum that dominates most medical schools, and even unlike the more inclusive idea of patient centered health, Howard’s ecohealth epiphany recognizes that “Big systems are going to be the problem for the 21st century.?

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Comments

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So i also give a segation-
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Posted by: jansenkoe on 23 Nov 06

Along with an alert to the community re. environmental issues of health, it is also important to remind community members of their individual
responsibilities for maintaining a healthy personal environment. Community and personal responsibilities go and-in-hand. Preventive and public health
issues highlight most conferences for all but very narrow medical specialties.

We have enrironmental issues because it is assumed that we have little choice in where we live and work, but we can control our personal situation.
It is the patient's and clinician's responsibility to attempt (prescribe)life style changes before medications for chronic illness are prescribed.

Not smoking, exercise that one enjoys, eating a variety of foods in reasonable portions, drinking plenty of liquids, comsuming alcohol in moderation, washing before one eats each time, and never putting one's hands into his mouth, nose, or eyes will reduce chronic illness and all but airborne acute communicable diseases.


Posted by: Donna Brandmeyer on 25 Nov 06



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