The Greek physician, Hippocrates wisely said: “The physician must be able to tell the antecedents, know the present, and foretell the future — must mediate these things, and have two special objects in view with regard to disease, namely, to do good or to do no harm.”

As one of the physicians practicing on the west side of Kauai, who has witnessed a troubling rise in the number of complex congenital birth defects, I would like to live up to this expectation. To do that I must have information that will allow me and my patients to make good decisions about the health of their families. But just as importantly, the community and our regulatory bodies need good data on which to base licensing decisions and to oversee the behavior of those who are applying restricted use pesticides in large quantities on Kauai.

I don’t know if Kauai westside families bear the burden of more birth defects because of pesticides, and I am sure no one else knows either. But I do know that in other locations with larger populations, good studies have shown a correlation between birth defects and neurobehavioral problems with pesticides.

We need to know what the companies are spraying on our fields, often close to schools and residential areas. We need to know in what quantities, and how often they are conducting the spraying in order to determine if, in fact, they are doing no harm.

Yes, the Joint Fact Finding Report in regards to birth defects and neurodevelopment problems on the westside carefully states that there is not accurate data to answer the question of whether the pesticides are causing birth defects.

But the claim by some that the data show no evidence of increased incidence of birth defects or health problems is just not true.

The state Department of Health’s Birth Defects Registry has not been updated since 2005. There are efforts underway now to rectify that but the challenge of gathering data is real. Many birth defects are not diagnosed at birth but are discovered later after leaving the birth hospital. Some serious cardiac defects result in first- and second-trimester spontaneous abortions.

Our electronic health records systems are designed to support billing and are inadequate for epidemiology studies. There simply do not exist any well-designed epidemiologic studies on Kauai to determine if there has been an increase or not in birth defects in the last 12 years.

Whose responsibility is it to disclose and take precautionary measures?

It is a fact that the chemicals being used on open fields on Kauai have potential toxicities.

It is a fact that studies elsewhere have demonstrated these same chemicals can cause an increase in birth defects and neurobehavioral problems. We need to know if these chemicals are making their way into our drinking water, into our bodies, into our unborn babies and into our mother’s breast milk.

Why do we as citizens — why do our government agencies — have to bear the burden of proving these pesticides are harmful? Why don’t we demand that the companies applying these restricted use pesticides follow the Fact Finding Report and pay for good studies, pay for biologic sampling and prove to us that they are safe?

I do understand the importance of jobs and a healthy economy for the health of families.

But I know many Kauai westside families and none would trade the health of their treasured children for a job if they knew a risk existed.

It’s time we told corporations who want to do business on Kauai that they, too, must do good and prove that they do no harm.