Ethical Dermatology

There has been much to celebrate in the dermatology community over the last few decades – the introduction of isotretinoin has provided us with a treatment that can limit the scarring affects of acne, the use of the topical agents tacrolimus and pimecrolimus has helped patients with eczema and lessens the risks of steroid induced skin atrophy, and most recently the biologics have brought new hope for patients with severe psoriasis. Through the good work of the British Skin Foundation and other such organisations more success will follow.

If we look beyond our own shores however, there is much that should be of concern to us. Over three billion people in 127 developing countries lack basic care for their skin diseases. If left untreated some of these diseases, such as leprosy cause major functional disability and disfigurement.

This inequality in healthcare is only the tip of the iceberg - in 1854 John Snow removed the handle from the pump on London’s Broad Street, which resulted in the discovery of the mode of transmission of Cholera. Yet more than 150 years later, and in a time when so much money is invested in healthcare, there are still over 2 million children worldwide who die a year from preventable diarrhoeal disease such as Cholera. With climate change upon us the discrepancy in health between the wealthy and the poor nations is only going to increase as the most severe weather events are predicted to affect the developing world.

And what about the future? As we continue to look to the natural world in search of new treatments, the possibilities are diminishing as we destroy the environment of which we are a part - an area of rainforest the size of a football pitch is destroyed every two seconds.

Who is responsible for climate change, deforestation and the exploitation of the developing world? It is not the 90% of the world’s population that live in the developing world, but instead the unsustainable lifestyle of those living in the developed world.

Working in the medical professional many of us are afforded a comfortable standard if living, which in turn means we have a greater capacity to impact on the problems referred to above. Although the very nature of our work often means that we don’t have much spare time it doesn’t take a lot to make a difference:

• As you are sitting looking at this website have a think about what energy is used to power your computer and heat your house – could you use less damaging energy? Click here to compare those companies supplying renewable energies.

• Do you really need to print anything from this website or can you store the information electronically?

• If you need to print anything off please use scrap paper, recycled paper or products that are FSC (Forest Stewardship Council) certified.

• When you have finished using your computer don’t leave it on stand by, turn it off.

• How many medical journals and GP magazines do you receive and not read? Contact the relevant companies to cancel the delivery. You can go further than this by contacting the Mailing Preference Service to stop receiving most of the unwanted junk that lands through your letterbox.

If you are interested in helping improve dermatological resources to those regions of the world in most need, the International Foundation for Dermatology (IFD) is a non-profit organization whose principal mission is to improve dermatological care in rural areas of developing countries.