Health and development in the Maltese Islands

Abstract

After analysing the major theoretical contributions to health and development, the author develops a dialectical materialist approach. Health, both physical and mental, is defined as a movement of energy that is simultaneously conserved and expanded. It is reality in movement. It is the vital ingredient of labour power and the capacity to create. Fundamental to humanity's health, both on a personal and public level, is productive activity. The relations and forces of production are the main determinants of public health. The relative power of the oppressed and the contemporary means of production affect both the type and spread of disease. In the specific historic investigation of health and development in the Maltese Islands, the prevalence of contemporary diseases is appraised with reference to the balance of forces between nations, classes and the sexes. The particular significance of imperialism, merchant capital and religion is discussed. Examination of three major diseases, cholera, undulant fever and cancer, between 1837 and 1987, is the empirical basis of the thesis. The transition from high mortality rate to high morbidity rates in the past forty years reflects Malta's late and uneven development. Health policy to overcome disease is limited because health and disease are manifestations of the mode of production. Health in developing countries is placed in the dialectic of imperialism and development, chauvinism and development and, essentially, the dialectic of capitalism and development.