Afterword
Oceania and Australia have been spared many of the major scourges of the tropical Third World: schistosomiasis, trypanosomiasis, onchocerciasis, and leishmaniasis. Yet they have coexisted for millennia with malaria, filariasis, and other troublesome diseases.
Through contact with Asia and the New World in the past several centuries, they were exposed to all of the major epidemic diseases, which have largely become preventable childhood illnesses. The continued lack of comprehensive public health programs for basic sanitation, hygiene, and home screening in the region means that the threat of fatal epidemics as in the past still remains. Lack of refrigeration and transportation problems make it difficult to deliver antibiotics and vaccines to those in need.In the more affluent areas, decreasing infant mortality rates, a sedentary life-style, and a change in diet have permitted an increasing number of people who reach adulthood, and who may be particularly genetically susceptible, to experience chronic diseases generally more common in industrialized areas. Although the recreational drugs of the West became available only after first contact and were often prohibited to indigenes until recently, substance abuse has become a major problem. In recent years the islanders and Australian aborigines exposed to experimental radioactive fallout have shown the world some of the minor health complications of nuclear warfare, which would be - for all - the final epidemic.
Leslie B. Marshall
The author is deeply grateful to M. Marshall, D. Denoon, H. Hethcote, and G. Rushton for providing essential bibliographic resources. The author also wishes to thank J. Armstrong, J. Boutilier, L. Carrucci, J. Fitzpatrick, D. Hrdy1 B. Lambert, D. Lewis, M. Maifield, C. Murry, K. Nero, N. Pollock, U. Prasad, M. Scott, B. Zzferio, and a Hawaii public health representative for providing valuable information.