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Wednesday, 6 July 2011

The dilemmia of rurality, misplaced priorities and public perception

The day approaches when I will tell friends, family and colleagues of the impending switch.  It does weight on my mind as any change has major implications, and the current setting is very unstable and less than productive.

I was struck by two public health issues today, one planned one inadvertant.

In the first is the challenge faced in providing a basic service like clean safe water.   We all assume when we turn on the tap that it comes with some sense of a guarantee.  For over a 1000 communities/systems in Canada that is not the case, these communities/systems openly state the water is not good enough so use another form of safety.   Often referred to as a boil water advisory, few users boil the water, most buy bottle water or get their own personal treatment system.   More fundamentally is the question why would a local government or health agency allow for a system to be built that doesn't meet safety expectations?   For that matter why do we continue to make decisions at a local government level, that knowingly have financial consequences to "fix" later, but perhaps provide an immediate benefit through growth.   The cost of the fix to all concerned is much higher than the cost of doing it right the first time.   This was in rural Canada, and one local councilperson noted that we lack a rural growth strategy - our focus is on sustaining the ever increasing bulky urban structures.   The domination of urban issues has overridden the need to have concerted discussion on how to diversify our population.  On the other hand, the small p politics of rural areas has a pettiness that precludes the rich level of discussion needed.

On to the second issue.  It was a 2 hour drive to the water system.  I was delayed in arriving by the second major public health issue.  Two vehicles had collided.   In rural Canada that may mean that there is no detour around the block.  The highway was closed for several hours, and I was fortunate to arrive as the carnage was being cleaned.   Perhaps I will learn that the occupants of these vehicles survived, their vehicles are not salvagable based on my cursary and uninformed observation.   Put simply, there was a lot of damage to both vehicles.   The tragedy is that we continue to lose so many of our neighbours to motor vehicle collisions each year, and for rural residents the risk is double or more where "depopulation" is already a crisis.   The most effective prevention strategy has been the continuously escalating price of gasoline (and I do remember gas at 16 cents a litre).  

Both events reminded me of how far we have to go to protect ourselves, our families and our communities.  

The headlines were about infants (and dogs) left unattended in vehicles when temperatures soar.   Another tragedy that is simply prevented.   No doubt we tragically loose a handful of infants each year to heat exposure in cars.   We lost close to 3000 to motor vehicle collisions and that is nearly half of what it was 2 decades ago.   There are an estimated 90000 illnesses and 90 deaths each year in Canada from waterborne disease. 

There is irony in the dilemmia of what causes public outcry, where we are spending massive amounts of dollars, and what is killing us.  

Dr P

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