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Medicine's unsung heroes: helping health before we need miracles

By Fiona Stanley - posted Tuesday, 30 December 2003

Every day it seems that we hear about another modern day medical miracle - the wonders of transplant surgery or premature babies who live when, just a few years ago, there would have been little hope. Indeed, the medical skills that preserve life against these types of odds is extraordinary.

But when I see these stories, I ask the question which patients and their families ask over and over again. What could have been done to prevent these near tragedies - what factors led to a mother delivering her child too early or caused a transplant recipient's heart or lungs or kidneys to fail? In other words, before the need for medical miracles, what actions could we take?

As an epidemiologist - someone who studies the patterns and causes of disease in our community - I know that many of our most effective health solutions are not in the realms of high-tech equipment or newly formulated drugs, but at the community level. And let's get real - even if we were to double the health budget, there would still be problems in keeping pace with the spiralling demands on services.


The fact is that while death rates have fallen, we're seeing increases in major problems for children and an increase in disease in adults. These problems are at unprecedented levels - there is no way that medical care and particularly mental health services can cope.

What's happening in our society that is leading to a decline in our health and wellbeing at a time of relative economic prosperity and the stunning developments in science and technology? The answers are complex and multi-faceted. Take, for example, the increased rates of behavioural problems in children.

To help these children we need to support their families and we need to identify their problems early - probably even before they start school. That requires really strong community health programs. But if we fail to offer early intervention support, then we'll pay far more dearly as that child risks falling into the juvenile justice system or becoming dependent on welfare. Of course the loss of human potential is the greatest price that never gets factored into these economic equations.

A dietitian who provides quality nutrition advice to families is helping to cut the obesity epidemic and reduce the risk of cancer and heart disease - that's saving lives. Providing sexual health information saves lives. Encouraging regular exercise saves lives. Counsellors who help drug addicts to reconcile the reasons that are driving their addictions are saving lives. Child health nurses who support new mums to tackle the biggest challenges of raising children are saving lives.

The innovations that have been shown in these less-dramatic areas of medicine are to be commended. And many of them demonstrate the benefits of two powerful factors - a focus on prevention and on community-based solutions.

All this should take nothing away from the highly skilled professionals who save lives in extraordinary ways. It's just to say that the people who can help us to improve our lifestyle, provide early-detection screening services, and those who support us in our community before we reach crisis point - either mentally or physically - deserve to share the plaudits.


Prevention is certainly cheaper, more effective and far less painful than a cure.

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This article was first published in The Sydney Morning Herald on 9 December, 2003.

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About the Author

Professor Fiona Stanley, Australian of the Year, is the chief executive officer of the Australian Research Alliance for Children and Youth.

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