- Email: [email protected]
Swaziland AFRICAN REGIONAL CONFERENCE OF INTERNATIONAL BABY FOOD ACTION NETWORK
1230
Embryonic and Fetal Development The recent development of new techniques, notably the culture of human gametes and early embyros and the development of probes to explore the genome, has opened a very large field for investigation. 7.
7.1Chromosomal abnormalities. -40-60% of oocytes fertilised in vivo never develop into a clinical pregnancy. Likewise, with in-vitro
fertilisation and embryo transfer, only about 30% of patients become pregnant. Chromosomal abnormalities in these early human embryos may be a major cause for this degree of embryonic wastage. Human embryos should be karyotyped to evaluate the incidence and nature of chromosomal abnormalities occurring at fertilisation or shortly thereafter. 7.2 Genetic analysis.-Specific cDNA probes provide a new method for the early prenatal diagnosis of genetic disorders from trophoblastic biopsy specimens. These could also be used effectively as markers of differentiation during early development. 7.3 Placenta as a normal human tissue.=The trophoblast, which expresses most of the human synthetic capabilities, could be used as a human model for the study of the mechanisms regulating gene expression, and as a source of hormones, enzymes, and receptors for the preparation of monoclonal antibodies. 7.4 Fetal growth-Many factors are responsible for fetal growth but these need to be studied specifically in man by the use of non-
Round the World From
our
Correspondents
Swaziland AFRICAN REGIONAL CONFERENCE OF INTERNATIONAL BABY FOOD
ACTION NETWORK
THE first African regional conference of the International Baby Food Action Network, held in Mbabane, Swaziland, on May 1-5, heard much about the monitoring of the international code on marketing of breast-milk substitutes. In a practical demonstration of monitoring, participants visited a local clinic, a hospital, and retail shops and chemists in Mbabane. They found that while staff at the clinic and hospital had a policy of encouraging breast-feeding for newborn infants, some of the practices interfered with the establishment of good breast-feeding. At the clinic, for example, mothers were not given their babies until four to five hours after birth. Infants were first given bottle feeds containing a glucose solution. In the hospital, although mothers were given their babies to breast feed immediately after birth, nurses were putting away feeding bottles as conference participants toured the wards. Apparently, whenever difficulties arose, staff used baby milks as the answer, rather than working with the mothers to support them in
breast-feeding. Infringements of the international code were observed in both clinic and hospital. A Nestle poster was displayed in the clinic; and formula supplies in the hospital failed to conform with the provisions of the code. In the shops a Nestle breast-feeding poster in one store gave incorrect advice on preparation for breast feeding, while advertising stickers promoted feeding bottles. Several products also caused concern. A Gerber yellow plastic feeding bottle was found, designed in the shape of a smiling dog. The bottle was impossible to keep clean because of its many recesses. The Swaziland Ministry of Commerce has agreed that such bottles should be banned. A wide range of so-called weaning foods were also to be found, such as Ouma Meelbol, distributed by a South African firm, Norwood Coaker. It is a combination of wheat flour, salt, iron, and calcium, which the company recommends as a feed for infants from two weeks, an age at which such a food is unsuitable. An equally questionable product, Holle Baby Food, distributed by Pharma-Natura of South Africa, was made from wheat, oats, and barley, and was recommended by the company for use from the second day of life. The label claimed that babies using the product "will excel in health, joy of life, vitality", while parents would have "happy babies, low feeding expenses and eight hours sleep". 1 Breast
feeding and health
for all. Lancet 1981; i: 1254.
isotopes, or in in-vitro models. The relation between genetic, immunological and nutritional factors, and chronic and acute infections on fetal growth retardation require more intensive
radioactive
research. EMRC Advisory Subgroup.-Prof E. Nieschlag (chanman), Max Planck Clinical Research Unit for Reproductive Medicine, Munster, F.R. Germany; Prof B. Bacetti, Istituto di Zoologia, Universita di Siena, Siena, Italy; Dr L. Cedard, Maternites Cochin, Paris, France; Dr Ph.A. Corfman, National Institute of Child Health and Human Development, Bethesda, Maryland, USA; Dr A. Kessler, World Health Organisation, Human Reproduction Programme, Geneva, Switzerland; Prof E. D. B. Johansson, Department of Obstetrics and Gynecology, University of Uppsala, Sweden; Dr D. W. Lincoln, MRC Reproductive Biology Unit, Edinburgh, Scotland; Dr C. Robyn, Hopital Umversitaire St. Pierre, Brussels, Belgium; Prof R. Vthko, Department of Clinical Chemistry, University of Oulu, Finland; Prof G. H. Zeilmaker, Department of Endocrinology, Growth and Reproduction, Erasmus University, Rotterdam, Netherlands. REFERENCES
European Medical Research Councils’ Advisory Subgroup on Human Reproduction: Recommendations on priority areas in reproduction research. EndocrinologieInformation 1979, 3: 99-108. 2. Nieschlag E, Wickings EJ, Breuer H Chemical methods for male fertility control. Expert Consultation of the European Medical Research Councils’ Advisory Subgroup in Human Reproduction Contraception 1981; 23: 1-10. 3. European Medical Research Councils’ Advisory Subgroup on Human Reproduction Recommendations on human in-vitro fertilisation and embryo transfer. Lancet 1983; ii: 1187. 1.
Speakers at the conference recommended that such products should be removed from the market immediately. Other countries reported examples, collected in the last half of April, of practices which infringed the international code. Many breaches were attributed to the Swiss-based Nestle company, the world market leader in breast-milk substitutes. In January this year, Nestle formally agreed that it would follow the provisions of the international code in all developing countries. IBFAN’s Africa regional coordinator, Margaret Kyenkya, said: "This evidence shows that Nestle has not taken the situation in Africa seriously enough. We are not impressed with idle promises". Representatives from Mauritius noted that Nestle was regularly breaking the code by making a weekly delivery of free samples of baby milk for staff at the three main hospitals to pass on to mothers. Posters were found in doctors’ clinics advertising infant milks; and baby-care booklets provided incorrect advice on breast-feeding. The labels of Nestle’s baby milks in Ethiopia, Uganda, Kenya, Zimbabwe, Zambia, Mauritius, Swaziland, and South Africa were found to be in violation of the code, despite the company’s efforts to change labels which began more than two years ago. Other companies faced strong criticism. Both Wyeth Laboratories and Cow & Gate had posters or leaflets on display in Mauritius clinics advertising their products. Wyeth was also distributing free samples in hospitals in South Africa, as well as supplying its baby book, with a front cover portraying a mother bottle feeding her baby, and inside several promotional pages for baby milks. These findings call into question a report by WHO for the 1984 World Health Assembly which evaluates the progress of efforts to implement the international code. Some 130 countries are said to have taken steps to give effect to the principles and aim of the code. The WHO report, however, fails to provide any monitoring information on actual practices within these countries. Even the relatively superficial IBFAN monitoring suggests that the situation is not as satisfactory as WHO indicates. In a nine-point statement-the Mbabane memorandum-the conference called for the minimum requirements of the code to be "strengthened, made law, and be fully implemented and enforced at the national level". The memorandum emphasised the need for governments to enact and enforce legislation to provide women in paid employment with adequate paid maternity leave, job security, creche facilities, and nursing breaks. It recommended that governments and health care systems should, as a matter of priority, emphasise the improvement of the health and nutritional status of pregnant and lactating women, and that all Ministries of Health should take account of new knowledge about lactation management, both in the practices permitted in health-care facilities and in the basic and continuing training of health and community workers. ’
1231
United States
_
BEHIND THE EVENT. FARMERS IN TROUBLE
THE murder of two bank officials by a young man on a remote farm would not of itself attract much interest in this country if behind the incident did not lie great trouble and discontent in a wide part of the land. This is the heartland of the US from which much of the cereal food crops come, either for human or animal consumption. Over a vast area many farmers are in serious difficulties, with implications for the consumers in this country and other countries which import, and even may rely on, US
agricultural surpluses. A small-town bank had loaned money to the father of the young his 10-acre plot, but it had foreclosed and repossessed the land and had since been trying to recover some of the money by reselling. A telephoned offer of resale drew the two bank officials to the farm where they became the victims of some accurate shooting which the jury did not believe had been the action of the father, a diabetic, with poor sight, while the young man was a known marksman. Neither of the bankers had anything to do with the foreclosure. The plight of the small farmers is now a serious economic, social, and political problem. Faced with stable or falling prices for farm products, they have to endure the increasing cost of supplies for farming, the very high price of farm machinery, and mounting interest rates. All of which reflect the Administration’s policies and the recession. Some of those affected’ are fast operators who speculated on the high prices for land a decade ago, over-extended, and are now in difficulties. But if there is not too much concern about the land speculators there is deep sympathy for the owners of middle-sized farms (180-500 acres), some held for generations by man on
In
England Now
ELECTION TIME FOR THE GENERAL MEDICAL COUNCIL
THAT select band of electors, the registered medical practitioners of the United Kingdom, are now, I hope, facing up to a double responsibility in voting. Not only should they be striving to discover the names of the candidates they might support in the election on June 14 for the European Parliament but also they ought to be grappling with the voting papers now being circulated in the 1984 election for the General Medical Council. It is the English doctors who have the most exhausting choice: the voting paper (due for return by June 29) is loaded with 169 names and there are 39 places to be filled by the perplexingly unBritish system of the single transferrable vote. The Scots have a modest choice of 6 out of 16 candidates, the Welsh 3 out of 9, and the Northern Irish simply 2 out of 5. In the preceding GMC election in 1979 the "turnout" in England was a feeble 34 - 3%; Wales managed 44 - 4%, Scotland 43 - 3%, and Northern Ireland an almost respectable 55. 9%. At a time when many questions are being asked about the GMC’s achievements in upholding the repute of the profession, a repeat this year of these low percentages could be interpreted as a sign of disgraceful apathy among the electorate. The new GMC must readdress itself to several challenges, including: is enough being done to limit damage to patients by incompetent practitioners?; does the impact of private consultant practice on NHS waiting lists merit the attention of the Council?; and are doctors too susceptible to incriminatory contacts with the pharmaceutical industry? Whatever the difficulties of making even a moderately informed choice from the 169 English candidates, few voters should find it
impossible to name women they would
first
preferences one (or even two) men or guardians of ethics and protectors of patients. There is no need to choose dozens of names: one is enough and certainly preferable to none. After primary BMA elections, the Association is sponsoring candidates in numbers corresponding to the seats available in the four constituencies, so there will be as usual a simplifying invitation to choose names from the straight BMA ticket. Many voters may wonder, however, whether a BMA landslide is likely to create the kind of alert and innovative Council the profession and the public should have.
as
trust as
are now being dispossessed by banks trying to and realise some return on loans while there is something to sell. So as many farmers run into trouble, large areas of land are for sale in some of the once most productive farming areas. The social consequences are harsh. For every seven farmers who fail, it is estimated that one local business closes, and the small Middle West farming towns are badly hit, and so are the manufacturers of farm machinery. Two trends are visible: towards the development of large, or very large, farms owned by the Agribusinesses, which may be subsidiaries of large corporations with widespread interests; and an increase in the number of small farms run by part-timers, as a secondary enterprise to other paid employment in the family. But small farming towns may wither away and local employment in non-farming jobs may disappear. We have mining "ghost towns" in the west, we have distressed towns dependent on one industry which folds up, and now we have distressed small farming towns. If farming, large or small scale, becomes subsidiary to other interests, the effects on food production may be severe. The immense surpluses of recent years depressed prices for farm products and big corporations may not care to expand or even maintain past production levels. Some contend that the farming practices responsible for such surpluses are mining the soil to future detriment, while the widespread use of herbicides and pesticides are causing great concern to environmentalists. In recent years criticism has been directed at poor food production policies and neglect of agriculture in many Third World countries. But it is clear that in the US agricultural and production policies need rethinking, perhaps particularly so in an election year. At a time of budget deficits, calls for farming aid may not get the generous responses they have had in the past.
pioneer stock, who protect their
assets
’
As the atmosphere of the hustings sharpens, one of the BMA candidates, Dr Brian Lewis, a consultant anaesthetist in Ashford, Kent, may have done his prospects a disservice by the campaigning zeal he displays in addressing general practitioners in his part of the country in the April issue ofa quarterly journal from the Kent Local Medical Committee. His appeal for votes includes this passage: "If you want to be represented by the Overseas Doctors Association, the
Medical Women’s Federation or any other pressure group including a sizable wodge of professors, then all you have to do is to forget to return your form, or fail to put Jim [Dr W. J. Appleyard, a paediatrician in Canterbury, another BMA candidate] or myself as your first choice". Well I suppose we should not be too dismayed by jibes of that kind. Election fever is a familiar cause of distasteful symptoms. *
*
*
"IT was the indignity of it all," said Giles, propping himselfon his pillows. "You mean, clinging to the top of the tree in your front garden yelling for help?" I asked, as I ate one of his grapes. "Well, that too," said Giles, a trifle defensively. "Or was it when you slipped through the fireman’s grasp and landed on top of the ambulance?" I inquired. "I mean, you did go on
bit." "Well, I admit I did lose my self-control for an instant," said Giles, "but, no, it wasn’t that." "Was it the way the boy scouts cheered as the ambulance, the police cars, and the fire brigade left your house, then?" "Not at all," said Giles. "If you must know, it was that crowd of ladies from the Red Cross. I had just given them a a
talk on accident prevention a few days ago. It did make me feel a fool." "Why were you on the roof in the first place?" I asked, chewing one of his chocolates. "That was simple enough. I wanted to see how many tiles we had lost in the gales before I called in the builder." "But you always said you had no head for heights," I reminded him. "That was the trouble," said Giles. "I tied a rope round my waist to give me confidence." "Seems reasonable," I said, nibbling a biscuit. "I also tied the other end to something solid," Giles continued. "Very sensible," I agreed. "Unfortunately," said Giles, "I tied it to the bumper of my wife’s car." "Oh!" I said. "Yes, indeed," he concluded, sadly. "How was I to know she would get a phone call from her mother, rush out into her car, and take off like a thing possessed. I mean it was all so undignified." "
Embryonic and Fetal Development The recent development of new techniques, notably the culture of human gametes and early embyros and the development of probes to explore the genome, has opened a very large field for investigation. 7.
7.1Chromosomal abnormalities. -40-60% of oocytes fertilised in vivo never develop into a clinical pregnancy. Likewise, with in-vitro
fertilisation and embryo transfer, only about 30% of patients become pregnant. Chromosomal abnormalities in these early human embryos may be a major cause for this degree of embryonic wastage. Human embryos should be karyotyped to evaluate the incidence and nature of chromosomal abnormalities occurring at fertilisation or shortly thereafter. 7.2 Genetic analysis.-Specific cDNA probes provide a new method for the early prenatal diagnosis of genetic disorders from trophoblastic biopsy specimens. These could also be used effectively as markers of differentiation during early development. 7.3 Placenta as a normal human tissue.=The trophoblast, which expresses most of the human synthetic capabilities, could be used as a human model for the study of the mechanisms regulating gene expression, and as a source of hormones, enzymes, and receptors for the preparation of monoclonal antibodies. 7.4 Fetal growth-Many factors are responsible for fetal growth but these need to be studied specifically in man by the use of non-
Round the World From
our
Correspondents
Swaziland AFRICAN REGIONAL CONFERENCE OF INTERNATIONAL BABY FOOD
ACTION NETWORK
THE first African regional conference of the International Baby Food Action Network, held in Mbabane, Swaziland, on May 1-5, heard much about the monitoring of the international code on marketing of breast-milk substitutes. In a practical demonstration of monitoring, participants visited a local clinic, a hospital, and retail shops and chemists in Mbabane. They found that while staff at the clinic and hospital had a policy of encouraging breast-feeding for newborn infants, some of the practices interfered with the establishment of good breast-feeding. At the clinic, for example, mothers were not given their babies until four to five hours after birth. Infants were first given bottle feeds containing a glucose solution. In the hospital, although mothers were given their babies to breast feed immediately after birth, nurses were putting away feeding bottles as conference participants toured the wards. Apparently, whenever difficulties arose, staff used baby milks as the answer, rather than working with the mothers to support them in
breast-feeding. Infringements of the international code were observed in both clinic and hospital. A Nestle poster was displayed in the clinic; and formula supplies in the hospital failed to conform with the provisions of the code. In the shops a Nestle breast-feeding poster in one store gave incorrect advice on preparation for breast feeding, while advertising stickers promoted feeding bottles. Several products also caused concern. A Gerber yellow plastic feeding bottle was found, designed in the shape of a smiling dog. The bottle was impossible to keep clean because of its many recesses. The Swaziland Ministry of Commerce has agreed that such bottles should be banned. A wide range of so-called weaning foods were also to be found, such as Ouma Meelbol, distributed by a South African firm, Norwood Coaker. It is a combination of wheat flour, salt, iron, and calcium, which the company recommends as a feed for infants from two weeks, an age at which such a food is unsuitable. An equally questionable product, Holle Baby Food, distributed by Pharma-Natura of South Africa, was made from wheat, oats, and barley, and was recommended by the company for use from the second day of life. The label claimed that babies using the product "will excel in health, joy of life, vitality", while parents would have "happy babies, low feeding expenses and eight hours sleep". 1 Breast
feeding and health
for all. Lancet 1981; i: 1254.
isotopes, or in in-vitro models. The relation between genetic, immunological and nutritional factors, and chronic and acute infections on fetal growth retardation require more intensive
radioactive
research. EMRC Advisory Subgroup.-Prof E. Nieschlag (chanman), Max Planck Clinical Research Unit for Reproductive Medicine, Munster, F.R. Germany; Prof B. Bacetti, Istituto di Zoologia, Universita di Siena, Siena, Italy; Dr L. Cedard, Maternites Cochin, Paris, France; Dr Ph.A. Corfman, National Institute of Child Health and Human Development, Bethesda, Maryland, USA; Dr A. Kessler, World Health Organisation, Human Reproduction Programme, Geneva, Switzerland; Prof E. D. B. Johansson, Department of Obstetrics and Gynecology, University of Uppsala, Sweden; Dr D. W. Lincoln, MRC Reproductive Biology Unit, Edinburgh, Scotland; Dr C. Robyn, Hopital Umversitaire St. Pierre, Brussels, Belgium; Prof R. Vthko, Department of Clinical Chemistry, University of Oulu, Finland; Prof G. H. Zeilmaker, Department of Endocrinology, Growth and Reproduction, Erasmus University, Rotterdam, Netherlands. REFERENCES
European Medical Research Councils’ Advisory Subgroup on Human Reproduction: Recommendations on priority areas in reproduction research. EndocrinologieInformation 1979, 3: 99-108. 2. Nieschlag E, Wickings EJ, Breuer H Chemical methods for male fertility control. Expert Consultation of the European Medical Research Councils’ Advisory Subgroup in Human Reproduction Contraception 1981; 23: 1-10. 3. European Medical Research Councils’ Advisory Subgroup on Human Reproduction Recommendations on human in-vitro fertilisation and embryo transfer. Lancet 1983; ii: 1187. 1.
Speakers at the conference recommended that such products should be removed from the market immediately. Other countries reported examples, collected in the last half of April, of practices which infringed the international code. Many breaches were attributed to the Swiss-based Nestle company, the world market leader in breast-milk substitutes. In January this year, Nestle formally agreed that it would follow the provisions of the international code in all developing countries. IBFAN’s Africa regional coordinator, Margaret Kyenkya, said: "This evidence shows that Nestle has not taken the situation in Africa seriously enough. We are not impressed with idle promises". Representatives from Mauritius noted that Nestle was regularly breaking the code by making a weekly delivery of free samples of baby milk for staff at the three main hospitals to pass on to mothers. Posters were found in doctors’ clinics advertising infant milks; and baby-care booklets provided incorrect advice on breast-feeding. The labels of Nestle’s baby milks in Ethiopia, Uganda, Kenya, Zimbabwe, Zambia, Mauritius, Swaziland, and South Africa were found to be in violation of the code, despite the company’s efforts to change labels which began more than two years ago. Other companies faced strong criticism. Both Wyeth Laboratories and Cow & Gate had posters or leaflets on display in Mauritius clinics advertising their products. Wyeth was also distributing free samples in hospitals in South Africa, as well as supplying its baby book, with a front cover portraying a mother bottle feeding her baby, and inside several promotional pages for baby milks. These findings call into question a report by WHO for the 1984 World Health Assembly which evaluates the progress of efforts to implement the international code. Some 130 countries are said to have taken steps to give effect to the principles and aim of the code. The WHO report, however, fails to provide any monitoring information on actual practices within these countries. Even the relatively superficial IBFAN monitoring suggests that the situation is not as satisfactory as WHO indicates. In a nine-point statement-the Mbabane memorandum-the conference called for the minimum requirements of the code to be "strengthened, made law, and be fully implemented and enforced at the national level". The memorandum emphasised the need for governments to enact and enforce legislation to provide women in paid employment with adequate paid maternity leave, job security, creche facilities, and nursing breaks. It recommended that governments and health care systems should, as a matter of priority, emphasise the improvement of the health and nutritional status of pregnant and lactating women, and that all Ministries of Health should take account of new knowledge about lactation management, both in the practices permitted in health-care facilities and in the basic and continuing training of health and community workers. ’
1231
United States
_
BEHIND THE EVENT. FARMERS IN TROUBLE
THE murder of two bank officials by a young man on a remote farm would not of itself attract much interest in this country if behind the incident did not lie great trouble and discontent in a wide part of the land. This is the heartland of the US from which much of the cereal food crops come, either for human or animal consumption. Over a vast area many farmers are in serious difficulties, with implications for the consumers in this country and other countries which import, and even may rely on, US
agricultural surpluses. A small-town bank had loaned money to the father of the young his 10-acre plot, but it had foreclosed and repossessed the land and had since been trying to recover some of the money by reselling. A telephoned offer of resale drew the two bank officials to the farm where they became the victims of some accurate shooting which the jury did not believe had been the action of the father, a diabetic, with poor sight, while the young man was a known marksman. Neither of the bankers had anything to do with the foreclosure. The plight of the small farmers is now a serious economic, social, and political problem. Faced with stable or falling prices for farm products, they have to endure the increasing cost of supplies for farming, the very high price of farm machinery, and mounting interest rates. All of which reflect the Administration’s policies and the recession. Some of those affected’ are fast operators who speculated on the high prices for land a decade ago, over-extended, and are now in difficulties. But if there is not too much concern about the land speculators there is deep sympathy for the owners of middle-sized farms (180-500 acres), some held for generations by man on
In
England Now
ELECTION TIME FOR THE GENERAL MEDICAL COUNCIL
THAT select band of electors, the registered medical practitioners of the United Kingdom, are now, I hope, facing up to a double responsibility in voting. Not only should they be striving to discover the names of the candidates they might support in the election on June 14 for the European Parliament but also they ought to be grappling with the voting papers now being circulated in the 1984 election for the General Medical Council. It is the English doctors who have the most exhausting choice: the voting paper (due for return by June 29) is loaded with 169 names and there are 39 places to be filled by the perplexingly unBritish system of the single transferrable vote. The Scots have a modest choice of 6 out of 16 candidates, the Welsh 3 out of 9, and the Northern Irish simply 2 out of 5. In the preceding GMC election in 1979 the "turnout" in England was a feeble 34 - 3%; Wales managed 44 - 4%, Scotland 43 - 3%, and Northern Ireland an almost respectable 55. 9%. At a time when many questions are being asked about the GMC’s achievements in upholding the repute of the profession, a repeat this year of these low percentages could be interpreted as a sign of disgraceful apathy among the electorate. The new GMC must readdress itself to several challenges, including: is enough being done to limit damage to patients by incompetent practitioners?; does the impact of private consultant practice on NHS waiting lists merit the attention of the Council?; and are doctors too susceptible to incriminatory contacts with the pharmaceutical industry? Whatever the difficulties of making even a moderately informed choice from the 169 English candidates, few voters should find it
impossible to name women they would
first
preferences one (or even two) men or guardians of ethics and protectors of patients. There is no need to choose dozens of names: one is enough and certainly preferable to none. After primary BMA elections, the Association is sponsoring candidates in numbers corresponding to the seats available in the four constituencies, so there will be as usual a simplifying invitation to choose names from the straight BMA ticket. Many voters may wonder, however, whether a BMA landslide is likely to create the kind of alert and innovative Council the profession and the public should have.
as
trust as
are now being dispossessed by banks trying to and realise some return on loans while there is something to sell. So as many farmers run into trouble, large areas of land are for sale in some of the once most productive farming areas. The social consequences are harsh. For every seven farmers who fail, it is estimated that one local business closes, and the small Middle West farming towns are badly hit, and so are the manufacturers of farm machinery. Two trends are visible: towards the development of large, or very large, farms owned by the Agribusinesses, which may be subsidiaries of large corporations with widespread interests; and an increase in the number of small farms run by part-timers, as a secondary enterprise to other paid employment in the family. But small farming towns may wither away and local employment in non-farming jobs may disappear. We have mining "ghost towns" in the west, we have distressed towns dependent on one industry which folds up, and now we have distressed small farming towns. If farming, large or small scale, becomes subsidiary to other interests, the effects on food production may be severe. The immense surpluses of recent years depressed prices for farm products and big corporations may not care to expand or even maintain past production levels. Some contend that the farming practices responsible for such surpluses are mining the soil to future detriment, while the widespread use of herbicides and pesticides are causing great concern to environmentalists. In recent years criticism has been directed at poor food production policies and neglect of agriculture in many Third World countries. But it is clear that in the US agricultural and production policies need rethinking, perhaps particularly so in an election year. At a time of budget deficits, calls for farming aid may not get the generous responses they have had in the past.
pioneer stock, who protect their
assets
’
As the atmosphere of the hustings sharpens, one of the BMA candidates, Dr Brian Lewis, a consultant anaesthetist in Ashford, Kent, may have done his prospects a disservice by the campaigning zeal he displays in addressing general practitioners in his part of the country in the April issue ofa quarterly journal from the Kent Local Medical Committee. His appeal for votes includes this passage: "If you want to be represented by the Overseas Doctors Association, the
Medical Women’s Federation or any other pressure group including a sizable wodge of professors, then all you have to do is to forget to return your form, or fail to put Jim [Dr W. J. Appleyard, a paediatrician in Canterbury, another BMA candidate] or myself as your first choice". Well I suppose we should not be too dismayed by jibes of that kind. Election fever is a familiar cause of distasteful symptoms. *
*
*
"IT was the indignity of it all," said Giles, propping himselfon his pillows. "You mean, clinging to the top of the tree in your front garden yelling for help?" I asked, as I ate one of his grapes. "Well, that too," said Giles, a trifle defensively. "Or was it when you slipped through the fireman’s grasp and landed on top of the ambulance?" I inquired. "I mean, you did go on
bit." "Well, I admit I did lose my self-control for an instant," said Giles, "but, no, it wasn’t that." "Was it the way the boy scouts cheered as the ambulance, the police cars, and the fire brigade left your house, then?" "Not at all," said Giles. "If you must know, it was that crowd of ladies from the Red Cross. I had just given them a a
talk on accident prevention a few days ago. It did make me feel a fool." "Why were you on the roof in the first place?" I asked, chewing one of his chocolates. "That was simple enough. I wanted to see how many tiles we had lost in the gales before I called in the builder." "But you always said you had no head for heights," I reminded him. "That was the trouble," said Giles. "I tied a rope round my waist to give me confidence." "Seems reasonable," I said, nibbling a biscuit. "I also tied the other end to something solid," Giles continued. "Very sensible," I agreed. "Unfortunately," said Giles, "I tied it to the bumper of my wife’s car." "Oh!" I said. "Yes, indeed," he concluded, sadly. "How was I to know she would get a phone call from her mother, rush out into her car, and take off like a thing possessed. I mean it was all so undignified." "