Poland has a population of 38 millions people, what means an eighth rank among 43 European countries. When 5 million (13% of total population) suffer from chronic rheumatic problems and rheumatic diseases constitute the first cause of disability, arthritis should be defined as public health problem at the national and prehaps European level too. Unfortunately, public opinion is under the pressure of clinical, individual approach to health care.
Individualisation of health issues produces invisible social dramas, id est: social isolation of disabled, enormous bureaucratic disfunctions of care system and also shifting out cost of treatment to patients’ family. Rheumatic patients have serious troubles to maintain satisfying personal relations and to participate in religious or social/political life. Those results of chronic rheumatic diseases are usually neglected in public dispute on health priorities.
Three “curtains” exist in public health theatre making difficult to perceive rheumatic problems:
social attitudes towards disability
self marginalisation of arthritis patients
family support instead of systemic resolutions.
Governmental agencies, using a traditional model of public activity are highly bureaucratic: centralised, impersonal, hierarchical and specialised. Self-help groups are quite opposite: locally centred, personal, non-hierarchical and non-specialised. The two actors of public health performance act in different ways and their political influence changes. As governmental agencies failed so far to remove all three courtains, it is time for NGOs to play a crucial role.