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unsorted data and besieged by requests for information. Nosystematic mechanism existed for the exchange of informa-tion ; and the measures taken, though adequate to preventany short-term risk to public health, were uneven andinconsistent. Public confidence suffered a serious blow, yetthe number 4 reactor at Chernobyl had lost only 3-5% of itsradioactivity content.As Ian Waddington, the director of the European region’s

environmental health service pointed out, 25 countries, atvarious stages of socioeconomic development, now pro-duced nuclear power commercially. Yet the philosophy ofradiation protection and the fixing of exposure levels had beenderived from studies of evidence from the Hiroshima and

Nagasaki explosions. It was time for a review. Environ-mental monitoring had not been well integrated: it wasuneven and the data were inconsistent. There was con-siderable confusion in the scientific units used and inmethods of expressing radiation doses. Epidemiology had avital role to play in relation to residential areas adjoiningnuclear installations. The importance of negative findingsshould not be overlooked. An early meeting of expertswould review priorities for a thorough epidemiologicalfollow-up and establish guideline protocols. There wouldalso be a detailed study of trends in relation to food chainsand their potential impact on public health.

JILL TURNER

Medical Association for Preventionof War

The Medical Needs of Africa

AT the Association’s conference in London on Sept 28, organisedjointly with the United Nations Association, Dr Maurice King,formerly professor of social medicine in Zambia and now seniorlecturer in community medicine at the University of Leeds, quotedthe Archbishop of Sao Paulo: "The problem is not between

capitalism and communism. We are not in an ideological strugglebetween East and West. We are hungry, we are ill, we are homeless,we are illiterate. We want our children to be nourished in mind and

body." Dr King went on to pose several questions. Was UNICEF’soptimistic view on progress in child health care justified? Whatwould be the outcome of its child survival revolution? Would it leadto an acceptable quality of life for the survivors or would it condemnthem to poverty and malnutrition? He predicted a population crashas a result of the destruction of the ecosystem and an inability tosupport the rapid population expansion. Child survival by itselfwould not lead to a tolerable life, but, possibly, to an increase in thesum of misery. We needed a broader vision than any so far provided.Prof David Morley, head of the tropical child health unit at the

Institute of Child Health, London, spoke of the needs of Africanchildren. Whereas 75 % of the world lived in the South, theyreceived only 6 % of the world’s health expenditure. The South hasfive times as many children, yet only 11 % of what the world spendson education is available to them. An experiment in Cali, Colombia,had convinced him that to attain full development, physical andmental, the child needed not only health care but also adequatenutrition and educational stimulation. He made no confident

predictions on the attainment of WHO’s aim of Health for All by2000, but he suggested that much improvement could spring fromwise policies and a change in political will. Politicians needed to beinformed, preferably with the help of fewer words and more copiousillustrations of suffering children.Dr George Cumper, senior lecturer in health economics, London

School of Hygiene and Tropical Medicine, discussed the resourcesneeded for basic health care, including basic hygiene, education,and the provision of safe water. He chose a modest target of healthcare, aimed to achieve a minimum level of health, as also envisaged

in WHO’s proposals for Health for All by 2000. That target was aninfant mortality rate of 50 per thousand. He calculated that, as aminimum, recurrent spending on health, sanitation, and educationwill need to increase by US$38 billion a year by the year 2000; andadditional capital expenditure of US$75 billion would be neededduring the period to 2000. In relation to the aggregate nationalincome of the developed countries, these sums were not vast. Theshortfall in hospital beds, physicians, and health workers insouthern Africa was very great and the resource gap could becalculated. As for international assistance of all kinds, Dr Cumperthought that short-term emergency aid had been reasonablyeffective; medium-term aid was largely insufficient and poorlyorganised; and long-term assistance had so far been inadequate,erratic, and inconsistent. A rational integrated system might seem aremote prospect, but it could lead to a better distributed, morepredictable, and higher level of world economic activity, whichmight do more for the improvement of health than any specificintervention.

Miss Margaret Pollock, principal nursing and health servicesadviser, Overseas Development Administration, describedassistance provided by the UK. It was clear that the principlesguiding her department were progressive and constructive and inline with recent thinking in WHO and UNICEF. Many usefulprojects had been supported and the presence at the meeting ofseveral nurses from Charing Cross Hospital, London, who hadtaken part in work in Africa funded by the ODA, testified to thisprogress. Spending by the ODA had been wisely directed, but theconference questioned the volume of aid. Did it match the vastneed?A paper written by Dr Saadet Deger, economic and social

research fellow, Birkbeck College, London, and read in her

absence, due to illness, by Dr Sumnath Sen, a colleague andcollaborator in her academic work, dealt with the possible transfersfrom military expenditures to health care. She emphasised the nowaccepted link between disarmament and development. Althoughdefence spending may result in some economic benefits in somecountries, it could be shown that on average it had a negative effect.But disarmament, by itself, will not necessarily mean that resourceswill be channelled to useful purposes, such as health care.

Institutions and mechanisms had to be fashioned to achieve thatend. She believed it was wishful thinking to plan the totalsatisfaction of minimal health needs, but a partial approach wasrealistic and could be achieved by modest transfers. The Frenchproposal for an International Disarmament and DevelopmentFund was discussed. A 1 % tax on defence expenditure would raiseabout$10 billion a year, sufficient to fund the partial approach tohealth care.The conference supplied valuable information and original ideas

for anyone interested in pursuing the discussion and planningaction. Copies of the papers will be available from the MAPW office(16B Prince Arthur Road, London NW3 6AY).

International Diary1987

Conference on Immunology and the Clinical Practice of Allergy:San Diego, California, Feb 11-14 (Dr R. N. Hamburger, UCSD/M009D,La Jolla, California 92093, USA).

International conference on Childbearing and Perinatal CarImplications for Childbirth Education: Jerusalem, Israel, March 22-26(Atzeret Ltd, 29B Keren Hayesod Street, PO Box 3888, Jerusalem 91037).

1 lth meeting of the International Association of Forensic Sciences:Vancouver, British Columbia, Aug 2-7 (International Association ofForensic Sciences, Suite 801, 750 Jervis Street, Vancouver, BC, Canada V6E2A9).

4th European Conference on Clinical Oncology and Cancer Nursing:Madrid, Spain, Nov 1--4 (4th European Conference on Clinical Oncologyand Cancer Nursing, Siasai Congresos, Paseo de la Habana 134, 28036,Madrid, Spain).

International symposium on Toxic Shock Syndrome: Atlanta, Georgia,Nov 16-17 (TSS Program Committee, Joan B. Daniels, 180 LongwoodAvenue, Boston, Massachusetts, 02115, USA).