Tuesday, May 27, 2014

Memorial Day 2014

May 26, 2014

Even though he was 25 years old when the United States entered World War II, my dad never served in the military. Instead, he used his machinist skills to help build tanks for the war effort. He was proud of his contributions but, like most men of his generation, he seldom talked about the war. “I did my part but the soldiers should get the attention and praise because they risked their lives” was about the extent of his conversation on the topic.

The wartime actions of my father resurfaced today (Memorial Day) when I paused to reflect on the lives lost in war in defense of our country and the values on which it is based. My dad won’t be honored in speeches today, but that’s OK. He would want it that way. He did the best with the skills and talents that he had and he was secure in the knowledge that he was a vital part of the war effort. That was recognition enough.

My mom was less reticent to talk about those war years. “Winning the war was truly a national effort. All of us contributed in whatever way we could. Your father had some unique skills that were best used here at home. Few people could do what he did. He certainly did his part in winning the war.” She would frequently use the occasion of these conversations with her children to reinforce her belief that any really big accomplishment is usually the result of a community effort and that the “behind the scenes” efforts are oftentimes the most important. It was in those chats that she would often quote a couple of verses from the poem Be the Best of Whatever You Are by Douglas Malloch:

We can't all be captains, we've got to be crew,
There's something for all of us here,
There's big work to do, and there's lesser to do,
And the task you must do is the near.

If you can't be a highway then just be a trail,
If you can't be the sun be a star;
It isn't by size that you win or you fail —
Be the best of whatever you are!

People in the public health field understand the importance of behind the scenes work. Like my dad’s behind the scenes efforts in winning the war, most people don’t recognize the behind the scenes reasons for losing most wars. Throughout history, the greatest number of casualties in wars has not been due to the conflict but infectious diseases. Over two-thirds of the deaths in the U.S. Civil War were due to infectious diseases – cholera, dysentery, yellow fever, etc.  And despite the homage given to cannons in Tchaikovsky’s 1812 Overture, Napoleon’s advance into Russia was not stopped by artillery but by typhus. As Charles Hewitt, the founder of the Minnesota Department of Health learned during the Civil War, the armies with the best public health infrastructure are usually victorious.  

Another “behind the scenes” fact is that civilians also suffer casualties because of war. And, as with troops, infectious diseases have been the major cause. It is estimated that one-fourth of the 4 million freed slaves died from infectious diseases in the wake of the Civil War. War disrupts the public health infrastructure that helps keep people safe and alive. That’s why the World Health Organization places “peace” at the top of the list of determinants of health.   

As my Memorial Day thoughts evolved, I began to more fully appreciate the fact that war and peace are public health issues. I also began to better understand what my mom meant when she stated during our war conversations that any really big accomplishment is usually the result of a community effort. Certainly the outcomes of the 20th century wars in which the U. S. participated – whether military victory, negotiated settlement, or withdrawal – were determined by community engagement and support (or lack thereof).  Getting into wars is often not a community decision, but getting out of wars, one way or another, most often is.  

But what about peace? Is that also a community effort? There is growing recognition that investing in public health is one way to assure peace. One example is that the State Department's Strategic Plan for International Affairs lists protecting human health and reducing the spread of infectious diseases as strategic U. S. goals. This doesn’t get much attention but, if accomplished, could dramatically change the war/peace dynamic in the world. It is this kind of “behind the scenes” efforts of public health that could really make the world a more peaceful and healthy place. But this will happen only if the community comes together to support local, state, national, and international public health efforts.  

Public health may never get the public accolades it deserves but that’s not the goal. The ultimate goal is to protect and improve health and create the conditions for peace. We can do that by following the poetic advice quoted by my mother:  

There's something for all of us here,
There's big work to do, and there's lesser to do,
And the task you must do is the near. 

If you can't be the sun be a star;
It isn't by size that you win or you fail —
Be the best of whatever you are!

On this Memorial Day I honor our soldiers and all the people behind the scenes in our many war efforts. I also honor all public health workers because they are doing some of the most important work in creating a peaceful world and they are doing it the best way that they can from behind the scenes.  

Ed