Public Health - the 'black hole' in Indian Medical Services.

Consultant Physician and Director Medical Education, P.D. Hinduja National Hospital and MRC, Mumbai, Maharashtra Received: 18.03.2016; Accepted: 10.06.2016 class was quite the reverse. People flocked into towns and cities in search of jobs . Overcrowding followed, slums sprang up, garbage and filth accumulated, sickness with serious infectious diseases like tuberculosis escalated, cholera outbreaks added to misery, and hospitals were viewed as ‘pest houses’ only fit to die in.4 All this happened it should be remembered at a time when the principles of hygiene and sanitation were still to be defined. A full investigation followed by corrective action was required and that is indeed what followed. Edwin Chadwick (Figure 1) a lawyer by profession was the author of a famous report that urged the government to improve the housing and working conditions of the people and to recognize that filth was the greatest evil they faced.5 In response a great sanitary crusade was embarked upon to improve public health.6 The report also adopted a high moral tone by stating that government was responsible for the health of i t s people . Comprehensive legislation was brought into force with the Public Health Act of 1875. Other pioneers of the sanitary movement, were Peter Frank who introduced the concept of public health, John Snow who studied the epidemiology of cholera, and John Simon the first Medical Officer of London tasked with implementing the new leg is la t ion . F lorence Night ingale another towering Public Health – the ‘black hole’ in Indian Medical Services