The facilities we use as well as the places in which patients are treated are often overlooked as ways of improving the uptake of skin care and the betterment of our work. Yet it’s poor conditions of a general nature than can prolong suffering and open us to disease and infection beyond the simple fact that a bright, clean and airy environment is a positive atmosphere to be in.
Warning Bad Housing at home or in the health service encourages skin disease and discourages attendance at such facilities. Gregory Karelas writes from Nepal:
“We [the staff] care so much about this hospital, because it is ours. If we see dust on the equipment, we wipe it. We do not do it because it is our duty, or in our job description. We do it because this is our home.”
When addressing the question of access it is clear that diagnosis and treatment depend on attendance which is enhanced by a homely and inviting room rather than by the decor of a police cell.
Action Reducing the hazards of climate change can be addressed by improvements to our immediate locations, reducing freezing, overheating and risks from storm and flooding. Investment against biting insects goes well beyond just mosquito nets and managing waste is a key intervention. Like-wise, contact dermatitis from Parthenium or Oak Procession Moth is in some places very common and its skin irritancy can be easily remedied. In basic terms alone, the open air and the presence of natural sun light under which to examine the skin as well as having sufficient space within which to treat people, is a major advantage of any facility.
Basic therapeutic advantages are access to outdoor areas, ensuring qualitative palliative care, especially when dealing with odorous cancers. Issues such as privacy are also highly important, concerns of overcrowding and single sex wards with many environments having insufficient safe storage facilities against theft, animals, flies and other insects. Fundamental quality care extends further than the medicine and advice we impart, it also concerns the conditions in which we allow our patients to survive and thrive.