Friday, September 12, 2008

Ki Tetze 5768: What is Environmental Health?

At the end of a nonstop string of commandments this week we read two rather interesting and contradictory commandments. We are to remember Amalek did to us [Deut 25:17], and we are to erase the memory of Amalek [Deut 25:19]. How can we do both? I believe the answer is woven throughout this week’s Torah reading, but its key is rather simple:

8. When you build a new house, then you shall make a parapet for your roof, that you should not bring any blood upon your house, if any man falls from there. [22:8]

What does a biblical enemy have to do with a railing? First let’s look a little closer at Amalek, who first show up in the Book of Exodus not long after the Israelites cross the read Sea out of Egypt[17:8-16]. They begin their pattern of picking on the rear, on those who cannot defend themselves. We later read in I Samuel 30 of an Amalekite Attack in the settlement of Ziklag, where David had settled to keep out of Saul’s way. David and all his troops go to war, and while gone, Amalek raids Ziklag and takes all the women and children. Yet when David attacks the Amalekites, he makes easy work of them. The Amalek of the Bible attacks the weak and defenseless.

I interpret the modern Amalek as disease. Salmonella enteritis, Aspergillus flavius, Bacillus anthracis, E. coli STEC, Shigella sonnei, Mycobacterium tuberculosis, and Vibiro cholera are just some of the soldiers of Amalek, be they bacteria, viruses, parasites or fungi. Most often these soldiers attack the weak or when we leave ourselves defenseless. Like David, who forgot to leave a garrison, when we are not diligent they strike, often taking lives as easily as someone falling off a roof.

Like that rooftop terrace, the easiest, best way to keep people alive is to prevent them from falling off. According to Torah, it is preventative actions that are key to survival. We as Jews believe that preventative actions are so important, not only do we do things like put railing on roofs, but put fences around the Torah itself, preventative actions to prevent transgression. Prevention works. Had David left a few good men behind, Amalek would not have attacked. Even if they did they would have been easily defeated. We have such soldiers in the modern war against Amalek. They are called Environmental Health professionals. When I’m not writing Shlomo’s Drash, I happen to be one.

Many people get Environmental Health mixed up with environmental protection. Environmental protection I usually define as protecting the environment against us, while environmental health is protecting us from the environment. Environmental health professionals instruct people how to make what is contaminated into what is pure. We as EH professionals try to prevent contamination, so that the people will live and not die. We include indoor air quality experts, epidemiologists, and wastewater treatment specialists. Many of us, including myself are involved with food protection. If those soldiers of Amalek do get loose and start to cause trouble we find them and do our best to contain them. Much of this is reminiscent of a good chunk of the book of Leviticus in chapters 11-16 which talks about such contamination issues from bloodborne pathogens, mold infestations of homes, sexually transmitted diseases, and even what most biblical translations call leprosy, which more likely was fungal infections. Leprosy is once again mentioned in this week’s portion:

8. Take heed in the plague of leprosy, that you observe diligently, and do according to all that the priests the Levites shall teach you; as I commanded them, so you shall take care to do.

In a sense Environmental Health is the role of Levitical priests with a strong science background. Ancient peoples did learn important lessons in public health. There is one passage in this week’s portion which particularly interests me. When in military maneuvers against an enemy, there is a commandment to have latrines:

13. You shall have a place also outside the camp, where you shall go out to it; 14. And you shall have a spade among your weapons; and it shall be, when you will ease yourself outside, you shall dig with it, and shall turn back and cover your excrement; 15. For the Lord your God walks in the midst of your camp, to save you, and to give your enemies before you; therefore shall your camp be holy; that he should see no unclean thing in you, and turn away from you. [23:10-15]

The Talmudic Rabbis take this further:

R. Johanan also said: If one desires to accept upon himself the yoke of the kingdom of heaven in the most complete manner , he should consult nature then wash his hands and put on tefillin and recite the Shema’ and say the tefillah: this is the complete acknowledgment of the kingdom of heaven.[Berachot 15a]

Fecal contamination is a major cause of foodborne and waterborne illness. In these two passages from the Torah and Talmud, it is clear that cleanliness and good hygienic practices are holy acts. The rabbis elevate washing ones hands after defecation to the same level as the morning prayers. Interestingly, the spade is not a mere vessel or implement but specifically called a weapon. It is the weapon used against the modern and probably the ancient Amalek. Preventing disease by keeping away what causes disease is a mitzvah. Environmental health’s duty is to do exactly that.

What I do for a living may not be considered some holy job like a rabbi. But in teaching people to wash their hands, cook their food well, store their food below 41°F and wash everything in sight, I am doing something holy, and something sacred. By telling people not to store something on the floor, to close up holes that mice or rats can crawl through, I am installing that railing on the roof.

As I learned when I taught a session on kashrut at my national professional meetings, Jews are a tiny minority in Environmental Health. Yet I also learned that day the Torah has much to teach us about EH. For me, my life in Environmental Heath is not just a profession but a mitzvah handed down by God to Moses at Sinai.

To remove the memory of Amalek and to remember Amalek is not contradictory. It is the role of those of us who keep disease from ever striking. We can get to place where we forget the horrors that disease causes on us, because disease is no longer there. We must get there with constant diligence against disease, and the ever changing, mutating, evolving pathogens that make up the army of Amalek.

What is Environmental Health? It is a mission from God.

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