HSE West director of public health Dr Diarmuid O'Donovan has just won several British Medical Awards
EVERY DAY, nearly 6,000 children die from waterborne diseases, and nearly two million young people die annually from diarrhoea and other diseases contracted from contaminated water. It is a sobering statistic, and that gives a context to renewed concern about the quality of drinking water here.
Ireland may be ranked fourth most developed state by GDP per capita in the most recent United Nations Development Programme statistics, but water quality is still a constant challenge.
Last month's confirmation of lead contamination in parts of Galway city has shaken public confidence just 18 months after the outbreak of the city and county's cryptosporidium parasite "crisis".
HSE West director of public health Dr Diarmuid O'Donovan was the public face for the official response to the cryptosporidium issue, and he estimates that some 2,000 people contracted gastrointestinal illness in Galway city and county at that time. Fortunately, there were no fatalities, but a small number of people affected have continuing complications.
The latest water quality issue in Galway came to light as a result of additional testing for lead levels in August by HSE West. The results have prompted medical screening for residents of 12 houses in four areas of the city, and an action programme undertaken by Galway City Council at the behest of the Environmental Protection Agency (EPA).
Coincidentally, wearing his NUI Galway (NUIG) hat, O'Donovan has just won several British Medical Awards (BMA) - one of which singles out his communication skills in contributing to public understanding of science. The awards were conferred by the BMA for a new health atlas he has compiled, which charts recent and emerging trends to highlight how health, poverty and human rights are, as he notes, "inextricably linked".
BMA chairman Sir Charles George has described the compendium as "superbly accessible, beautifully produced and highly informative". The work should "grace the bookshelf of everyone who cares about human health", he has said.
"Brilliant and original, this vividly informative book gives an incredibly holistic account of how our planet is divided by health and wealth," Channel 4 broadcaster Jon Snow has also noted in a recent review.
O'Donovan, who is also senior lecturer at NUIG's social and preventive medicine, says the publication was driven by a desire to inform his students - but was then transformed into a textbook for the general reader. He emphasises the contribution of the book's designers, Isabelle Lewis and Corinne Pearlman, who drew up the extensive set of maps and graphics.
NUIG is the first medical school in the State to provide an undergraduate course in global health and development, which he contributes to, and he is also chairman of the Irish Forum for Global Health (see panel). In endeavouring to present sets of information which are already in the public domain, he noted that there was a need for a more global approach.
Having worked in sub-Saharan Africa, O'Donovan believes poverty is the "central determinant" of health. As his atlas notes, malnutrition is still the most important cause worldwide of ill-health and death. The probability of dying between the ages of 15 and 55 in many southern African states has doubled since 1990, it records.
The atlas charts how more than 30 million children are slaves or bonded workers, how more than one-fifth of the global workforce works more than 48 hours a week and how cancers are projected to be the leading single cause of death worldwide by 2010. By 2020, some 70 per cent of cancer deaths will be in developing countries, due to extended life expectancy and changes in diets.
It describes as a "global crisis" the enormous shortage of health workers, estimated at four million, and how each year of a girl's education reduces by 10 per cent the risk of her own children dying before the age of five.
"People everywhere are more interconnected than ever before. Yet, as life expectancy and quality of life improve for the rich, millions are still dying for want of food, clean water, and affordable medicines," O'Donovan says.
He quotes 19th century Russian doctor and public health advocate Rudolf Virchow: "Do we not always find the diseases of the populace traceable to defects in society?"
Virchow's observation was made long before globalisation was to have such a dramatic impact, both positively and negatively, on health.
As public health specialists, O'Donovan and his colleagues are exposed to the harsh side of health politics - and are accustomed to working with tight budgets, while dealing with crisis management issues that are often complicated by particular political agendas.
"Historically, public health has been under-funded in Ireland - and we are talking about much more than water quality," he says. "Under the current reform programme in the HSE, it is not clear where public health is going to be within the new structures."
Global health
A conference on hunger, environment and health is due to be held by the Irish Forum for Global Health, which Dr O'Donovan chairs, in University College Cork (UCC) on October 17th and 18th. The conference is being held in collaboration with UCC's Centre for Sustainable Livelihoods. More information is available on www.globalhealth.ie
•The Atlas of Human Health: Mapping the Challenges and Causes of Disease by Dr Diarmuid O'Donovan is published by Earthscan
