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Dr Mike Fitzpatrick

Ireland imports health panics

I was on holiday in Ireland in June when Tony Blair issued his guarded apology for the role of the British government in the famine of the 1840s. The sympathetic response to Blair from all sections of the Dublin elite indicated the growing role of cultural manifestations like the famine commemorations in strengthening the bonds between Ireland and Britain. In addition to emigrants, Ireland is now exporting traditional Irish commodities like victimhood (Sinead O'Connor), sentimentality (Ballykissangel, mock Irish pubs) and sanctimoniousness (Bob Geldof, Bono). These find a ready market in a Western world that seeks to compensate for its loss of confidence with self-indulgence and moralism. In turn, Ireland imports the cultural dross of Britain - notably its misanthropic preoccupations with issues like child abuse, drug addiction - and health scares.

One example illustrates the trend for last year's panic in Britain to turn up this year in Ireland. My visit coincided, not only with the most sustained period of good weather - six days - I can ever remember in Ireland, but also with the launch of the Sunsmart Campaign. Promoted jointly by the Irish Cancer Society and the Irish Farmers Association, this campaign aims to alert Irish people, particularly 'farming families', to the risk of skin cancer from ultra-violet radiation.

Now as somebody of typically Irish complexion, with potato white skin which turns lobster red after the briefest exposure to sunlight, and then slowly peels and returns to whiteness flecked with freckles, I have always scorned suntans and thought sunbathing an overrated activity. Yet even I cannot believe that sunshine is really a major threat to public health in Ireland.

For a start, though farming families may spend much time outdoors, they do so in a country where the sun generally appears only in brief intervals between showers, and then only in any intensity on occasional days in the three months between May and September. For the rest of the time it rains, which is tiresome if you are on holiday, but if you're a farmer worried about skin cancer, highly reassuring.

Another reason why Irish farming families are unlikely to be at much risk of skin cancer is that, even when the sun comes out, they rarely remove enough clothes to get sunburned. As a child I vividly remember on the hottest days of summer when 'the men' sat down to tea in the field and cautiously loosened the top button or two of their shirts. This revealed a sharp border between a leathery, weather-beaten, V-neck and the pale skin of the rest of the chest, skin that seemed rarely to be exposed to the sun, or indeed to any other form of light. As I recollect, most Irish farmers were reluctant to remove their jackets and their caps in any circumstances, never mind risking more intimate exposure.

I was reminded of Irish reticence about the body during my recent holiday. On one particular sunny day I went to a wonderful sandy beach in County Wicklow and on another to an Irish water sports theme park in the nearby mountains. In both locations I noticed a strange habit of local youth of clowning around in the water fully dressed. It seems that they come equipped with a change of clothes and instead of getting into swimming gear just jump into the water. At first I wondered whether the Sunsmart propaganda had got to them, but then I saw them changing back into their dry clothes with the sort of scrupulous modesty - and physical contortions - that have long disappeared from the beaches of Europe. The fact that not even infants are allowed to wander naked in Ireland must make it one of the lowest risk countries in the world for sun-related skin cancers.

Yet the evening weather report on Irish television is now accompanied by warnings about the dangers of sunburn and recommendations about the maximum period of safe exposure. The Sunsmart campaign's guidelines on clothing and headgear, on using sunblocking creams and on the particular importance of protecting children were faithfully reported in all newspapers. Information leaflets are being distributed through schools and doctors' surgeries and special meetings are planned during the summer to raise awareness of skin cancer.

All this is, of course, depressingly familiar. Over the past few years we have had similar campaigns in Britain which exploit people's fears of rare but terrifying diseases to justify interfering in their leisure activities and regulating their behaviour. As a result I have spent much time either reassuring people that their minor skin blemishes are quite harmless or, having failed, cutting them out and sending them off to the lab. The result of what one expert has dubbed 'disaster dermatology' has been the flooding of skin clinics with the 'worried well' and an inevitable increase in the diagnosis of malignancy. However, in the vast majority of cases these are lesions which grow only slowly and are easily treated - and many may regress spontaneously.

The fear of the sun in countries that rarely see it is one of the more bizarre of the numerous health panics that have gripped the popular imagination over the past decade. The delayed appearance in Ireland of this - and other equally irrational scares about radon gas, nuclear waste and the 'heroin epidemic' - confirm that, despite all the hype about the Celtic tiger, Ireland remains captive to the anxieties and fears of the wider Western world.

The fact that it takes longer for health panics to reach Ireland reminds us that it is a backwater. The general election, which took place in early June, confirmed that, despite Ireland's affinity for the European and indeed global stage, the country's politics are not so much local as parochial. Even the supposedly extremist candidates were cringingly conservative. Thus Sinn Fein campaigned largely as a group of community activists with a strong law and order line against drugs and crime. The Socialist Party (ex-Militant) took a revolutionary stand against water rates. Even the Greens seemed to be led, like all the other parties, by a bunch of grey men in suits.

In the 1930s some Irish leftists won distinction, if not much popular support, in the League of Militant Atheists. Perhaps now is the time for the launch of a similarly principled campaign, provisionally titled League of Sun-Loving Irish Farming Families.

Reproduced from LM issue 102, July/August 1997

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