What is public health?

Uganda, November 11, 2009

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  <span class="field-credit">
    Mercy Corps Uganda  </span>
    Mercy Corps Youth Program Intern Kate Dilley (standing on pile of dirt, digging) lends a hand to build a road in northern Uganda. Photo: Mercy Corps Uganda

One of the things that people often ask is "What is public health?" I used to say, "everything," without much conviction.

As a public health professional I have always been interested by issues that directly affect people's health. In my graduate coursework, this often meant talking about vaccination campaigns for polio and measles, vitamin and micro-nutrient supplementation including iodized salt and vitamin A, and of course access to clean drinking water and primary health care services. Coming to northern Uganda, I thought that I would be most intrigued by these topics.

Yesterday on a trip to the field, we stopped and inspected school latrines and road construction. While at the school (constructed out of tree branches and a thatched roof with UN tarps over it), I heard a little bit about the very successful child to child education campaign that Mercy Corps conducted along with the latrines. It seems to have provided the children — and, through them, their families — with impressive sanitation knowledge. As we stood at the handwashing stand, two children came to use the latrines and both washed their hands thoroughly, without being reminded. They also had to push through a big group of adults to get to the stand, which they did.

We moved on to look at the road that is being built by the livelihoods team. As we stood on one of the bridges, I was told that this road had been completely constructed by Mercy Corps — it had previously just been bush. The road is just about two cars wide, raised with channels running along the sides to drain water in the rainy season, and constructed out of murrum (gravel like soil selected for its stability). As we drove down a (mostly) smooth road for almost 20 kilometers, I kept thinking about the potential for this road — increased opportunity for jobs and trading of goods, making it easier for students to get to school, and easier to transport people and supplies for improved medical care in the area.

For people to be in good health, so many things must be in place. Without access to proper water and sanitation there is no good health. No roads means no access to medical care. Poor agriculture means no food, let alone a balanced diet including fruit and vegetables. And conflict and disaster means a drastic lifestyle change which can lead to poor mental health.

Mercy Corps is working to address all of these issues, in addition to others in its work around the world.

My view of improving people's health used to be so narrow. Like any good learning experience, my time in Uganda has helped me better understand the complexities of life and the issues and challenges that must be addressed in order to "alleviate suffering, poverty and oppression by helping people build secure, productive and just communities."

In northern Uganda, Mercy Corps is achieving their mission, and I am now further convinced that public health is, in fact, EVERYTHING.