I very much enjoyed the 2013 Special Issue of Johns Hopkins Public Health. Of special interest to me was the article “Speak and Save” on verbal autopsies by Richard Byrne. The Department of International Health, at the time chaired by Carl Taylor, was very much involved in the development and, I believe, first use of the method back in 1971. That information was missing in the story, and I think it should have been part of it, if only to give credit to Dr. Carl Taylor, under whose guidance highly motivating working and research conditions were provided in the Narangwal Rural Health Research Centre in 25 villages in rural Punjab, North India.
Ardy Kielmann, MDCM, DrPH
To assert that the practice of surgery equals the practice of public health [“Operation Health,” Spring 2013] brings the meaning of the words “public health” even closer to oblivion. The cover artwork and cover story blur distinctions that need to be made in order to keep the public aware of what the practice of public health is and what it has done for them.
A surgeon saved my life once and I thanked him. Public health practitioners save my life every single day and I don’t know whom to thank. The growth of public spending on clinical care while public health budgets stagnate suggests that our fellow citizens are only capable of thanking the life-savers they can see. Promoting the image of the heroic surgeon as the face of public health worsens confusion over what it means to create health at the population level. A circumcision program is public health, a circumcision is a surgery.
Words matter. Your magazine is one of few places where one expects to find clear words about what is involved in the practice of public health. Equating surgery and public health was a setback.
David Bishai, MD, PhD, MPH,
Professor, Population, Family and Reproductive Health, Bloomberg School
I enjoyed the article “Operation Health” in the recent magazine, but I wanted to comment on the photo of the two surgeons. The purpose of the surgical mask is to cover both the nose and the mouth. In the photo one of the surgeons has his nose exposed. I doubt this is a lesson Hopkins wishes to exemplify.
N. Lynn Eckhert, MD, DrPH, MPH
Partners HealthCare International
[Adam L. Kushner, MD, MPH, associate, International Health, and faculty, Center for Refugee and Disaster Response, responds: I agree that this is certainly not behavior to condone; the photo in fact demonstrates not only a lack of proper procedure, but also shows that the nurse is not wearing appropriate eye protection. Studies have shown that as few as 18 percent of hospitals in developing countries have proper eye protection. The photo was meant to highlight that there are many deficiencies in operating rooms in developing countries [ranging] from knowledge and use of proper techniques to proper safety precautions and resources. It is hoped that by bringing attention to the need for improving surgical care, additional resources can be devoted to the safety of patients and providers.]
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