Bell tolls for career in public health

Honoured: Derek Bell was presented with this touch stone by Public Health South staff at his farewell function last month

He calls the role unglamorous, but recently-retired medical officer of health, doctor Derek Bell, has confronted several serious public health challenges over the past 19 years. He discusses these, along with his next move, with Philip Chandler

Though he’s modest, a Queenstowner can take credit for the resort coming unscathed through a raft of potentially deadly public health scares over the years.

Doctor Derek Bell, 58, retired last month after 19 years in the role of medical officer of health for Southland and Otago.

You name it, he’s dealt with it – from epidemics like SARS and bird flu to meningococcal and whooping cough outbreaks, to bed bugs and bus-loads of tourists coming down with gastro.

“The highlights have probably been what I regard as the reasonably swift and efficient manner in which we’ve confronted the big things that have occurred such as the outbreaks and the international health issues.

“I was the only medical officer of health in New Zealand working outside of a main centre.

“Queenstown is tiny, but it actually, as we all know, punches above its weight in terms of the issues that arise.

“In all of Southland and Otago, Queenstown has often thrown up the curliest public health issues because of the nature of the town.”

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Because the resort has one of NZ’s busiest airports, during threats like SARS “we had to really step up and provide a city-level response in a town with a tiny public health workforce”.

“When we had the SARS outbreak, we had to pull a lot of resources together, very quickly.”

Teams of people were deployed at the airport, for example.

Bell says not many people realise that the water that inundated the Queenstown CBD during the record flood of 1999 had the same E. coli reading as raw sewage.

“People were walking past turds and tampons and all sorts of other things floating in the water.

“We did a lot of work in terms of advice to GPs and the public, and established hand-washing stations.

“The fact we got through that without a significant outbreak was magnificent.”

Raised in Auckland, Bell originally graduated as a doctor in 1981.

After travelling and working overseas and around NZ, he settled in Queenstown in ’86 “because I met my wife and I was very into ski touring and skiing in those early days”.

Starting with locum work, he then ran his own practice for a few years.

“By that stage I was starting to look for something different, connected with medicine.”

He became aware of a public health medicine training programme in Christchurch and moved there to do a masters degree.

“It was very eye-opening to see medicine as just part of a much bigger health sector.”

Graduating in 1998, he took a long-vacant medical officer of health position in Southland on condition he could base himself in Queenstown.

Bell says it’s not well known that while medical officers of health have “immense powers” during public health crises, “that’s not mirrored by any sort of powers or influence to do work proactively”.

“If you take a regional issue that I’ve worked on a lot over the years, water quality in the lakes and rivers, we really have to sit by and watch things get worse and worse with toxic algae and algal blooms, trying to convince the various government agencies to do stuff.

“Really, we have no power to do anything until it gets so bad that everyone’s dropping dead or getting sick.”

A classic example, he says, was the norovirus outbreaks at Cardrona – at the skifield, in 2006, and in the village six years later.

“After we dealt with the skifield one, I wrote to the council explaining my concern about Cardrona village, where there were numerous septic fields and water courses for drinking water mixed up in a small area.

“It was a recipe for disaster but I couldn’t actually influence anything until we got the inevitable outcome.

“The water supply did get contaminated, and we had a massive outbreak which has pretty much tainted the reputation of Cardrona for time to come.”

Reflecting on his years in public health, Bell says: “There’s so much more that I would like to have achieved, proactively.”

Now he’s pulled stumps, Arrow Junction will still be home, however he intends spending a lot of time on a conservation/ecological project on remote Great Barrier Island, near Auckland.

“I’ve got a block of bush land where I’ve set up a predator-control programme.

“I’m doing a sort of an eco-sanctuary, developing some bush walks and may also move into what we are now calling astro-tourism.

“I’m just hoping it will avoid the tourism boom that other places in NZ are experiencing.

“It’s not a paid career – I’m just very lucky to be in a position where I can do this, but it does require some significant lifestyle changes.”

Far from retiring, he says: “I’m probably going to be as busy, if not busier”.