Getting ready for a tsunami of health problems.
On an official visit to Dominica last week, Dr Carissa Etienne, the Director of the Pan American Health Organisation (PAHO) used very picturesque language to describe the potentially alarming health situation facing her home country.
Referring to the high rate of non-communicable diseases here Dr. Etienne warned that Dominica is sitting on an "erupting volcano" and warned authorities to move quickly to deal with a possible "tsunami of chronic diseases".
The PAHO director said she told the Cabinet of Prime Minister Roosevelt Skerrit that Dominica has some startling statistics to contend with. For example, for every three persons one has high blood pressure; for every five persons one has diabetes; for every four persons one has high cholesterol; for every two persons one is overweight or obese. Startling indeed!
To avoid the tsunami that she sees coming, Dr Etienne stressed that Dominicans must change their lifestyles but the authorities have the greater responsibility to ensure the nation's food do not contain "high salt levels or high sugar levels or high trans-fat levels, that we have possibility for physical activities in our communities and our schools."
She said that she urged Government to enacted legislation and taxation measures that seek to limit or stop the use of tobacco and the excessive use of alcohol. Cabinet was learning nothing new about that subject, we are sure, but hearing it from the PAHO director should goad the Government into quick action.
But as we said in an earlier editorial, generally the average Dominican rarely monitors his blood pressure, does not eat a balanced diet with a permissible amount of salt, does not engage in regular physical activity and consumes much too much alcohol. In other words, few people care enough to make the necessary life-style changes that are required that Dr. Etienne referred to, to reduce levels of high blood pressure. And Dominica is paying the price. Maybe Government needs to make these changes mandatory to reverse the tsunami of NCDs that Dr. Etienne predicted.
One of the major NCDs that the PAHO director identified is high blood pressure. Medical practitioners tell us that if left uncontrolled, high blood pressure causes blindness, irregularities of the heart beat and heart failure and the risk of suffering from these conditions increases when one is affected by diabetes, one of the most common diseases in Dominica. In fact, one in three adults worldwide has high blood pressure and that proportion increases with age, from one in ten people in their twenties and thirties to fifty percent of people in their fifties. Additionally, persons who live in low income countries or are of African descent are more likely to be affected by hypertension and diabetes.
Hence, there has never been a better time for you to take stock of your diet and levels of physical activity. Each year on World Diabetes Day the International Diabetes Association (IDA) makes us aware of some alarming statistics.
For example, we now know that diabetes is a silent killer that sends one person to his grave every seven seconds. Today, more than 382 million people worldwide are living with diabetes and by 2035 this figure is expected to increase to over 600 million. Each year more seven million people develop diabetes. This a growing epidemic which is threatening to overwhelm global healthcare services, wipe out some indigenous populations and undermine economies worldwide, especially in developing countries. In 2012 more than 1.5 million people died from diabetes-related causes, more lives annually than from HIV/AIDS. The world spends more than US$550 billion per year treating diabetes. These are rather frightening figures. But there's more.
The IDA has estimated that 11.29 percent of the Dominican population have been affected by the disease and 1.29 percent of Dominicans do not know that they already have the disease. There were 5180 cases of diabetes in Dominica in 2013. Diabetes, as you may know, is a chronic disease marked by elevated blood glucose levels.
Though the Caribbean region has generally taken the diabetes epidemic quite lightly, health officials have persistently warned of the problem. Many years before Dr. Etienne made her dire prediction, Sir George Alleyne of the Commission on Health and Development in CARICOM concluded that the problem of obesity in Dominica and the rest of the Caribbean poses "a major threat" to the economic survival of the region and that efforts at curtailing this problem must be pursued "with vigor".
Dr. Alleyne reiterated the point that Dominica has its fair share of cases of diabetes in addition to high risk factors which are known to contribute to the disease.
According to Dr. Alleyne, "approximately 12% of females are diabetic and surprisingly the figure in males is twice as high. The first four causes of death here are consistently hypertensive heart disease, diabetes, coronary heart disease and strokes. About 15% of the adult population smokes and almost twice that number are exposed to smoke in the workplace. About 30% of males are overweight or obese and females show twice that figure. About two out of every three Dominican women are overweight or obese. About 16% of males had low levels of physical activity and the figure for females was twice as high".
But financing health care is the key to avoid an explosion of health related problems due to the NDCs. And that issue will increasingly become a challenge for poor and vulnerable people in Dominica. During a press conference Dr Etienne suggested that the Government of Dominica has been consulting PAHO in finding an equitable system for financing health care here.
As we stated in an earlier editorial, the rising cost of health-care, the increasing prevalence of non-communicable diseases such as diabetes and hypertension, and changes in the structure of the population will eventually force Governments in the region to consider alternative and sustainable ways of funding health care because the current system is ineffective. Here's a real problem for CARICOM to solve together. But can CARICOM come together on anything?