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European Journal of Epidemiology (2005) 20: 813814 Springer 2005
DOI 10.1007/s10654-005-3211-0COMMENTARYPostmodernism versus idealism in public healthHans-Werner HenseInstitute of Epidemiology and Social Medicine, University of Mu
nster, Munster, GermanyI can vividly recall myself standing in front of a group
of nurse practitioners, public health nurses, public
health inspectors, and community health aides. The
scene was West Jamaica in the early 1980s and I, a
young doctor dispatched by German Foreign Aid,
was at that time a District Medical Ocer under
contract with the local Ministry of Health. The public
health team of the parish had assembled for its Annual Conference. They had reason to be proud of
their achievements because outbreaks of polio and
dengue fever on the island had mostly spared the
parish, new health centre buildings had been completed or were under construction in various locations under PAHO patronage and most indicators of
the maternal and child health program demonstrated
clear improvements over the past years. It was my
task that day to give a talk for which the senior nurse
had picked the topic: the implications and prospects
of the WHO Alma Ata Conference and the new
campaign, Health for All by the Year 2000...In my preparation I had encountered two problems. One was giving my rst talk in English in front
of a larger group, and I had gone through some
simulation exercises at home with my wife acting as
an attentive and critical audience. The second problem, however, was far more substantial. It was related
to the very topic of my statement. How was I to
approach the demanding message of this motto?
Clearly, Health for All was (and still is) rightly
reinforcing the role of health as a principal human
right. But how about that queer appendix by the
Year 2000 was this utopian and visionary, perhaps
with a little blend of provocation and pugnacity, or
was it a serious objective that, fuelled by impatience,
had got out of touch with reality? Was it meant to
rhetorically underline the urgency for instantaneous
reaction to global health challenges, or was it rather
an idealistic conjecture, a dream close to illusion? I
decided for the rhetoric and refrained from outlining
any idealistic projections...