Term Paper: Ibsen / Public Health Write

Pages: 10 (2934 words)  ·  Bibliography Sources: 10  ·  Level: Master's  ·  Topic: Healthcare  ·  Buy This Paper

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[. . .] Again, to use the contemporary application of the Health Behavior Model in HIV transmission prevention, the greater susceptibility of various groups (such as homosexuals or African-Americans or intravenous drug users) to HIV infection is an established fact (although education and outreach are always required to ensure the public knows the fact); the severity of death from AIDS is also an established fact, and education will certainly not depict it as a minor health issue; and then the benefits and barriers to the correct behavior analyze what the positive gain, or reasons militating against, an activity such as condom use would be. As the Health Behavior Model ends up formulating it, this is what must be accounted for by the public health professional in assessing the "readiness to act" on behalf of their own best health interests of the general population.

We can see how Dr. Stockmann becomes a disastrously bad public health advocate when he has his little breakdown at the public meeting, and begins casting blame at the assembled crowd:

Dr. Stockmann. You may depend upon it -- I shall name them! That is precisely the great discovery I made yester- day. (Raises his voice.) The most dangerous enemy of truth and freedom amongst us is the compact majority -- yes, the damned compact Liberal majority -- that is it! Now you know! (Tremendous uproar. Most of the crowd are shouting, stamping and hissing. Some of the older men among them exchange stolen glances and seem to be en- joying themselves. MRS. STOCKMANN gets up, looking anxious. EJLIF and MORTEN advance threateningly upon some schoolboys who are playing pranks. ASLAKSEN rings his bell and begs for silence. HOVSTAD and BILLING both talk at once, but are inaudible. At last quiet is restored.)

Aslaksen. As Chairman, I call upon the speaker to with- draw the ill-considered expressions he has just used.

Dr. Stockmann. Never, Mr. Aslaksen! It is the majority in our community that denies me my freedom and seeks to prevent my speaking the truth. (Ibsen 71)

The apportionment of shame and blame that Stockmann in his frustration is casting at the majority is a terrible maneuver for any doctor to make. One of the greatest problems with public response to health policy is the perception of paternalism, condescension or anything that indicates a disconnect between policy makers and the public at large. Ibsen is of course a masterful dramatist, so we can understand perfectly how Dr. Stockmann reaches this point: his gradual discovery of the vested interests of so many of the most prominent members of the town, up to and including his own brother the mayor, has left him absolutely frustrated. But if Stockmann had employed the Health Belief Model with his brother the mayor earlier in the play, he might have had a more favorable result. The mayor's response to Stockmann hinges upon the fact that he thinks the threat greatly exaggerated:

Dr. Stockmann. But what do you think ought to be done, then?

Peter Stockmann. Your report has not convinced me that the condition of the water at the Baths is as bad as you represent it to be.

Dr. Stockmann. I tell you it is even worse! -- or at all events it will be in summer, when the warm weather comes.

Peter Stockmann. As I said, I believe you exaggerate the matter considerably. A capable physician ought to know what measures to take -- he ought to be capable of pre- venting injurious influences or of remedying them if they become obviously persistent. (Ibsen 34)

If Stockmann had been able to trace out the direct cause and specify the threat, and make clear what the health benefits and costs of making the fix he proposes would be, he would have been a far more effective advocate.

Present a current Public Health dilemma that has a theme(s) similar to those in the play

Steven Zaillian's film of A Civil Action -- adapted from the non-fiction book by Jonathan Harr and thus genuinely "based on a true story" as the film promises in its opening frames -- provides us with a precisely similar incident to the fictional one depicted in An Enemy of the People. A Civil Action tells the story of Jan Schlichtmann, who represented plaintiffs in Woburn, Massachussetts whose drinking water had been contaminated by trichloroethylene or "TCE," an industrial chemical that had been used and illegally dumped. The seepage of the toxic chemicals would eventually kill several small children in the town, who developed various forms of leukaemia and other ultimately terminal conditions from the chemicals. As with the book upon which it is based, the film depicts more or less accurately the process of filing a civil complaint and seeking damages from large corporate defendants -- W.R. Grace, a manufacturer of industrial chemicals and building supplies, and Beatrice Foods, a conglomerate with a host of well-known brand names in its holdings -- ranging from Tropicana orange juice to the Riley Leather Company, ultimately shown to be the source of the contaminants. In other words, just as in Ibsen's play, a local tannery was discovered to be poisoning an entire community's water supply -- and Zaillian's film depicts how in Woburn, Massachusetts, there was an actual "wall of silence" built up on the part of the residents, who were collectively unwilling to openly blame Riley Leather or its parent companies when the factory was the only source of employment in a region where most manufacturing had long since abandoned the communities. James Gandolfini plays the one factory worker who is finally willing to break the silence and confess that Riley's tannery had been dumping the TCE into the water supply. Dan Kennedy, who covered the Woburn case as a local journalist, concluded in retrospect -- when interviewed about the release of the Hollywood film of Harr's book on the case -- came to a conclusion that might equally apply to Ibsen's An Enemy of the People:

Eventually, investigators would report that the 28 leukemia cases diagnosed in Woburn between 1964 and the mid-1980s were four times more than should be expected for a community of its size. Anderson's tenacity -- and that of other Woburn activists -- led to a new understanding of the environment, to new laws, to stricter standards of accountability for companies that handle toxic chemicals….No one deserves more blame for what happened in Woburn than its city government. (Kennedy 2002)

The difference between the Woburn case and Ibsen's drama is fairly obvious, though. In Woburn, it was the mother of a dead child who had to do all the work herself -- and discovered the empty barrels which may have indicated the presence of the toxins -- then presented it to a lawyer in the hopes that he would take up the case as a lawsuit. A Civil Action also presents the cost of doing the sort of chemical analysis that Stockmann has performed is now fairly astronomical, and to be able to prove liability in a case of groundwater contamination in order to make the sort of changes that Stockmann proposes in the play requires virtually months of efforts by teams of geologists and chemists.

Bibliography

Becker, M.H.,Radius, S.M., & Rosenstock, I.M. (1978). Compliance with a medical regimen for asthma: a test of the health belief model, Public Health Reports, 93, 268-77.

Conner, M. & Norman, P. (1996). Predicting Health Behavior. Search and Practice with Social Cognition Models. Open University Press: Ballmore: Buckingham.

Glanz, K., Rimer, B.K. & Lewis, F.M. (2002). Health Behavior and Health Education. Theory, Research and Practice. San Fransisco: Wiley & Sons.

Glanz, K., Marcus Lewis, F. & Rimer, B.K. (1997). Theory at a Glance: A Guide for Health Promotion Practice. National Institute of Health.

Harr, Jonathan. (1996). A Civil Action. New York: Vintage.

Kennedy, Dan. (2002). "Toxic Legacy: Hazardous Waste and the Lessons of Woburn Massachusetts." Web. 14 June 2002, accessed 21 March 2011 online at: http://home.comcast.net/~dkennedy56/woburn.html

Ibsen, Henrik. An Enemy of the People. Translated by Farquahrson Sharp. Acceessed 21 March 2011 online at: http://www2.hn.psu.edu/faculty/jmanis/h-ibsen/enemy-people.pdf

Rosenstock, I. (1974). Historical Origins of the Health Belief Model. Health Education Monographs. Vol. 2 No. 4.

Zaillian, Steve. A Civil Action. Based on the book by Jonathan Harr. With John Travolta, James Gandolfini, William H. Macy. 1998. [END OF PREVIEW]

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