Garth George: Need to get through to underclass

You'd think you were living in New Zealand 50 years ago when you read in the press that a Bay of Plenty medical officer of health has to warn of an outbreak of whooping cough.

But that's just what Dr Neil de Wet had to do this week, as winter approaches, in view of a steady increase in the number of cases reported in the Bay of Plenty and Lakes districts so far this year.

He said there tended to be outbreaks of the highly infectious disease every three to four years and "our rise in cases could be the beginning of a local outbreak".

Yet we have known for years that this disease has been preventable for generations simply by having children immunised against it at 6 weeks, 3 and 5 months, with boosters at 4 and 11 years.

And it is the first immunisation that is absolutely crucial because babies in their first year are most at risk of serious complications.

That's where the problem really lies - too many children are not being immunised because their parents are either ignorant of the necessity or just can't be bothered taking time to have the simple job done, even though it costs nothing.

Leave out the anti-immunisation brigade, who are at about the same level of evolution as the anti-fluoridationists, and what we are left with is the parental ignorance, incompetence or carelessness that is the bane of our society.

Health authorities tell us that symptoms start with a runny nose, fever and dry cough which develops into attacks that can sometimes cause vomiting and that the disease is spread by coughing and sneezing.

They say people who work with young children need to be especially vigilant and that parents should contact their family medical practice for more information or to make an appointment for immunisation.

That's not going to happen. You can guarantee that thousands of parents will simply shrug the symptoms off as a cold - if they even notice.

This is something that the Maori Party's Whanau Ora programme, and other social services, must aim at - and quickly. It is no use the Government providing the answers to health problems if they are not being used by those most in need of them.

And it is known that most of the really serious health afflictions that continue to dog this country occur among Maori and Pasifika people and the poverty-stricken in general.

We have plenty of them all in the Bay.

So bad has the situation become that it has led the editors of the international medical magazine, The Lancet, to call on New Zealand to address inequalities in the provision of health services.

They write: "The apparent widening of longstanding health disparities based on economic position and ethnicity in a country that has repeatedly tried to narrow differences is disappointing, and prompts questions about the effectiveness of current policies for health equity.

"Disparities have changed little for either the Maori or for Pacific peoples (who together constitute a fifth of the population in New Zealand) in the past two decades. More effective solutions are needed."

That's all very well for outsiders to say, but perhaps they fail to understand that in a democracy you can rarely force people to do what is best for them, you can merely suggest it.

And when such a large proportion of the indigenous population is poorly educated, often illiterate and innumerate, those suggestions are likely to be misunderstood or simply ignored.

We have to devise effective ways of getting through to our ever-increasing underclass, over whom the agonies of infectious diseases lie heavily.

garth.george@hotmail.com