252
Letters to the Editor
Polish man who is one of t:he few survivors of the notorious medical experiments in Dachau. Whatever other inhumanities were practised on him, he had been robbed of his right to health. Department o f C~rnmuniO, 3tedicine, Htpa¢ FRANCIS The Uni*'ersit),, Manchester References 1. Garratt, F. N. (1978). Public Healtli 92, 106. 2. Stein, E & Shand, J. (1974). Legal Values in HZestern Society. Pp. 8-14. Edinburgh: The University Press. 3. Lord Lloyd o f Hampstead (1972). Introduction to Jurisprudence. 3rd Ed. pp. 74-78. London: Stevens. 4. Copleston, F. C. (1955). Aquinas. lqarmondsworlh: Penguin Books. 5. Rook, A. (1964). The Origins and Growth of Biology, p. 42. Harrrloi~dsworth: Penguin Books. 6. Hart, H. L. A. (1961). Tile Idea o f Law, (Reprinted 1975), p. 194. Oxford: Clarendon Press. 7. ibid. p. 187. 8. ibid. pp. 189-93. 9. Association of District C o m m u n h y Physicians (1977). Evidence to the Royal Comm£~sion on the National Health Service Health and Hygiene 1, 27. 10. Flathman, R. (1976). The Practice o f Rights. Cambridge: The University Press. I 1. Alexander, L. (1949). New l:'nglandJournal o f Medicine 241, 39.
Editor's note Surely the D.C.P.'s are right. To raise public expectations by promoting the idea that (good) health is a basic human right would be most unwise. Unrealistic expectations merely lead to .dissatisfaction, unhappiness and sometimes to litigation. We should not make promises which we cannot keep. We cannot guar~.ntee for every individual a genetic constitution Which enables him t o enjoy good health. We cannot prevent many degenerative or metabolic diseases. We do not know the causes of mental illness, a n d cannot at present prevent it. Employees in an asbestos, o r any other kind of factory have a right to be protected from avoidable harm to their health. A right not to have one's health impaired by the activities ,of one's neighbour is, howex~'r, a very different concept from a right to health, particularly if the W.H:O. definition o f health is used. There is enough dissatisfaction and unhappiness in the world without adding to it.
An Atypical Case of Malaria .Sir, In recent years, in the face of increasing morbidity and mortality from malaria, the Government of India has reverted her National Malaria Eradication Programme to Malaria Control .Programme. The reasons for the failure o f N.M,,E.P. :are many but important a m o n g them are administrative and geographical factors a n d the development of drug and insecticidal resistance by parasite and vector respectively, together with the emergence of malaria due to P. falciparum, a Apart from the above reasons, the change in symptomatology o f malaria is also an important reason for the failure o f eradication measures, since it results in a continuous source o f unrecognized infection t o the community. The male patient, aged 26 years, o n whom I am reporting, came .to the outpatient department of the Rural Health Training Centre, Jawan, Aligarh (U.P.), India, with the complaints of loss o f appetite, gradually developing weakness and feeling o f heaviness in the upper abdomen for the last three months. This patient had no history of fever with rigor or o f dysentery. Clinically, he showed no abnormality except severe anaemiawithhepat°'spleen°megaly'This type of presentation
Letters to the Editor
253
ted to the investigation o f the case with Hb. estimation, peripheral blood smear for TLC, DLC. GBP and blood parasites. Surprisingly, his, peripheral blood smear was found 1o be positive for malaria, showing signet and schizont stages` o f P. ,.ivax, which explained the cause of anaemia and hepa~o-spleenomegaly. In my opinion this type of c a ~ in whom the characteristic features of rnalalia are not present needs thorough medical screening for malaria, particularly in developing countries where the malaria is an endemic public health problem. Commonwealth Medical Fellow, Dr M. Y. KH/,.~ Community Medicine, U.C.H.M.S., London, Vr'CIE dJJ
Reference I. Park, J. E. & Park, K. (1975). Text Book of Preventire and Social Medicbte. India" Banarsi Das Bhanot.
Letters to the Editor
Polish man who is one of t:he few survivors of the notorious medical experiments in Dachau. Whatever other inhumanities were practised on him, he had been robbed of his right to health. Department o f C~rnmuniO, 3tedicine, Htpa¢ FRANCIS The Uni*'ersit),, Manchester References 1. Garratt, F. N. (1978). Public Healtli 92, 106. 2. Stein, E & Shand, J. (1974). Legal Values in HZestern Society. Pp. 8-14. Edinburgh: The University Press. 3. Lord Lloyd o f Hampstead (1972). Introduction to Jurisprudence. 3rd Ed. pp. 74-78. London: Stevens. 4. Copleston, F. C. (1955). Aquinas. lqarmondsworlh: Penguin Books. 5. Rook, A. (1964). The Origins and Growth of Biology, p. 42. Harrrloi~dsworth: Penguin Books. 6. Hart, H. L. A. (1961). Tile Idea o f Law, (Reprinted 1975), p. 194. Oxford: Clarendon Press. 7. ibid. p. 187. 8. ibid. pp. 189-93. 9. Association of District C o m m u n h y Physicians (1977). Evidence to the Royal Comm£~sion on the National Health Service Health and Hygiene 1, 27. 10. Flathman, R. (1976). The Practice o f Rights. Cambridge: The University Press. I 1. Alexander, L. (1949). New l:'nglandJournal o f Medicine 241, 39.
Editor's note Surely the D.C.P.'s are right. To raise public expectations by promoting the idea that (good) health is a basic human right would be most unwise. Unrealistic expectations merely lead to .dissatisfaction, unhappiness and sometimes to litigation. We should not make promises which we cannot keep. We cannot guar~.ntee for every individual a genetic constitution Which enables him t o enjoy good health. We cannot prevent many degenerative or metabolic diseases. We do not know the causes of mental illness, a n d cannot at present prevent it. Employees in an asbestos, o r any other kind of factory have a right to be protected from avoidable harm to their health. A right not to have one's health impaired by the activities ,of one's neighbour is, howex~'r, a very different concept from a right to health, particularly if the W.H:O. definition o f health is used. There is enough dissatisfaction and unhappiness in the world without adding to it.
An Atypical Case of Malaria .Sir, In recent years, in the face of increasing morbidity and mortality from malaria, the Government of India has reverted her National Malaria Eradication Programme to Malaria Control .Programme. The reasons for the failure o f N.M,,E.P. :are many but important a m o n g them are administrative and geographical factors a n d the development of drug and insecticidal resistance by parasite and vector respectively, together with the emergence of malaria due to P. falciparum, a Apart from the above reasons, the change in symptomatology o f malaria is also an important reason for the failure o f eradication measures, since it results in a continuous source o f unrecognized infection t o the community. The male patient, aged 26 years, o n whom I am reporting, came .to the outpatient department of the Rural Health Training Centre, Jawan, Aligarh (U.P.), India, with the complaints of loss o f appetite, gradually developing weakness and feeling o f heaviness in the upper abdomen for the last three months. This patient had no history of fever with rigor or o f dysentery. Clinically, he showed no abnormality except severe anaemiawithhepat°'spleen°megaly'This type of presentation
Letters to the Editor
253
ted to the investigation o f the case with Hb. estimation, peripheral blood smear for TLC, DLC. GBP and blood parasites. Surprisingly, his, peripheral blood smear was found 1o be positive for malaria, showing signet and schizont stages` o f P. ,.ivax, which explained the cause of anaemia and hepa~o-spleenomegaly. In my opinion this type of c a ~ in whom the characteristic features of rnalalia are not present needs thorough medical screening for malaria, particularly in developing countries where the malaria is an endemic public health problem. Commonwealth Medical Fellow, Dr M. Y. KH/,.~ Community Medicine, U.C.H.M.S., London, Vr'CIE dJJ
Reference I. Park, J. E. & Park, K. (1975). Text Book of Preventire and Social Medicbte. India" Banarsi Das Bhanot.
