Florence Nightingales’ graph that documented her data of disease being the majority cause of death in the Crimea War, which 900,000 people died. Image provided by London Sotheby in the Smithsonian Magazine article “The Defiance of Florence Nightingale.”

Community focused

Madison County Public Health

Devastating realities in history have prompted and propelled the role of public health in societies. The induction of the Federal Emergency Management Agency after 9/11 drove Madison County to create a public health board for the first time in 2001.

The county put together a group of locals with a variety of medical experience. Some of those original members like Nurse Practitioner Margaret Bortko and Veterinarian Doug Young are on the board today. The span of public health is vast, reaching into elements of environmental health, water treatment, weed spraying, disease control, natural disasters and more.

“I love public health because it’s everything,” Bortko said.

Madison County’s Board of Health is stacked with experts. Montana has five certified pediatric nurse practitioners and Madison County has one of them, Dayna Thergesen. Each board member brings a specialty to the MCBH.

“The community is the patient,” Bortko said. “Public health has to take care of the herd.”

Today amid the COVID-19 pandemic, America’s death toll is quickly approaching 200,000 and has already tripled the number of casualties in the Vietnam War.

Public health departments and governments around the country are strategizing to combat COIVD-19. From its beginnings, public health has been challenged with skepticism and scrutiny.

A perceived founder of public health, Florence Nightingale, began collecting data on the causes of deaths and recoveries in soldiers during the Crimean War. As early as 1854 she connected disease to the majority of deaths. According to some Nightingale scholars, Nightingale linked disease and improper sanitation, but military doctors initially rejected her ideas of cleaning areas.

The Hungarian doctor, Ignaz Semmelweis, who demanded medical staff to disinfect their hands and medical instruments between using them on patients died in an insane asylum. He discovered that using chlorine to disinfect hands and instruments lead to less disease spread and deaths. Doctors resented Semmelweis discovery because it faulted them to be the cause of spreading disease.

Public health has always been data driven and remains to be today. The political backlash on public health during the COVID-19 pandemic is not new to public health. The 1918 influenza pandemic had protestors against the requirement of wearing masks in public. They called themselves the Anti-Mask League. That year cities closed dance halls, theaters, schools and large gatherings.

The masks that were being used in 1918 were made of gauze and were not as effective as the Centers of Disease Control and Prevention recommended cloth masks recognized today. The California Public Health Boards even argued about the effectiveness of the gauze masks, according to the Forbes publication, Protesting During A Pandemic Isn’t New: Meet the Anti-Mask League of 1918.

Education is the path to public health success. Public health is an ethical profession and its departments and boards are often made up of nurses and doctors. The information on COVID-19 is constantly changing and it is frustrating. Technology has provided thousands of sources for information, but it can be tricky to navigate and know who to trust. But Madison County has a board of experts with the health of the county in the forefront of concern.

“We don’t want to be punitive,” Bortko said. “We want to be encouraging.”

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65 N. MT Hwy 287
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