Editorial – Of paradoxes and words
Ian C. Ellul
As I attend the various initiatives of Puttinu Cares sprouting practically all over Malta I become increasingly aware of the prevalence of paediatric cancers. Indeed the incidence of cancer in the genral population in Malta has increased over the past few decades (Source: DHIR, Malta). Something which everyone knows, you may say. And with today’s medical advances, as our Health Minister, Dr Joe Cassar quoted last month, Cancer may indeed be a Word, Not a Sentence. However personally, I do not find any refuge whatsoever in these statements.
So I ponder on this. Many people have suggested different reasons why the incidence of cancer has increased (apart from better screening, that is). Chemicals used to maximize the yields of husbandry which ultimately end in our Sunday Roast, obesity, more workrelated stress affecting more people (including our female counterparts who are ever increasingly being successful at breaking the glass ceiling), changing life-styles such as increased sedentary work, smoking, promiscuity, radiation which enters our food chains including fish and crops, longevity, and the list goes on. It is also worth mentioning that the environment with its array of increasingly resistant viral infections certainly does not help. And obviously Malta is not immune to all this.
However I would like to add a couple of points with respect to the local scenario. The greatest disasters striking Malta in the last century were WWI & WWII. Obviously this entailed considerable loss of lives but not only. There was no hygiene, inadequate food, medicine was lacking, medical technology was almost non-existent and our medical resources were scarce. People (and children) survived because most probably they were able to overcome these hardships ie had a robust genetic makeup. So if a child was weak, it died. There was little or no hope for children to live if they suffered from acute respiratory distress, cardiac problems or acquired a severe infection. In fact it was common practice for parents at that time to have many children, even up to twenty, also to compensate for the loss of siblings. Some or many died, depending on where you lived and your income, which could buy you some comfort and food, relatively speaking.
On the other hand, babies born today including those born prematurely or with a life-threatening medical condition are offered an armamentarium of medicines together with cutting edge technology and medical expertise. Thus they have excellent chances to survive and live a normal so-to-speak life. Something which a child living during any war does not have. The achievements of today’s medicine could in fact be depicted in the 1940’s as real miracles.
And this is fair and just. Everyone wants his own child to live. But let us reflect on this. This means that most probable, that same child who was helped by modern medicine to survive an acute or chronic life-threatening condition or a severe congenital anomaly is on average, weaker than a normal healthy child.
Now, I ask, if that same weak child/ adoloscent is exposed to the factors mentioned previously, doesn’t this mean that ultimately this will not only translate into an increased susceptibility to illnesses like any normal healthy child/adoloscent but such transition will proably occur at an earlier stage since the genetic make-up is weaker? In such cases, ironically enough, medicine aided the survival of a child which otherwise would probably have died, but then that same child, during its life, is at its mercy!
And when these weaker subjects will eventually procreate (and the chances of them meeting other weaker partners will gradually increase with time, as more medical advances will help even more patients survive more childhood diseases) doesn’t this mean that the same weak genetic profile is propagated? And a vicious circle seems to emerge … ultimately it seems that by default, medicine is becoming increasingly self-sustaining…