Lifestyle, culture and disease interface

By Eleanor Lambert

Today, more than ever before health, culture and lifestyles interface and as we strive to strengthen our commitment to nation building, it is instructive to consider the words of a distinguished endocrinologist Jean Claude Mbanya of Cameroon as he addressed a massive crowd at a World Diabetes Congress in Montreal. He said: "There is a raging battle out here, one we cannot afford to lose as we confront the diabetes epidemic". To this I will add "together", hence, "come ye forward sons and daughters".

Past lessons to be learnt

I vividly remember the efforts made in the region in the 70's to deal with the protein energy malnutrition plague. At a meeting which focused on "Health for all by the year 2000" in Montego Bay, the CARICOM Heads of Government gave full support to recognizing that the health of the region is the wealth of the region." At that time also, a great outpouring of assistance came from PAHO, FAO, and CFNI enabling our divisions of agriculture, health and community programmes to take heed and address the following issues:

-Nutrition education in schools

-Agricultural programmes in schools

-Education to improve breast feeding and weaning practices

-Airing of regular radio programmes in nutrition and health related issues

-Training of professionals in all sectors

-Water and sewage improvement programmes.

In fact the school feeding programmes in progress today was born from the initiative taken by the Food and Nutrition Council.

Present Situation

Today, a new insidious culture has evolved which is threatening to damage our status quo. The essential ingredient that we now lack is the natural community spirit of helping one another. In fact, some years ago, Bishop Gabriel Malzaire alluded to "a kinder and gentler spirit which is needed."

Another observation which is apparent among our people is the "reluctance to taking responsibility for our actions." Our family structures have collapsed, dismantling the very fabric of our society. Thus, respect, discipline and self-control are fading away. Teachers are no longer in control for fear of criticism from the very ones they are trying to protect. Similarly, there is no time to exercise because the television is in control and "fast foods" whatever their nutritive values are the norms rather than the occasional snack. However, when we become ill, it is the responsibility of the doctors and nurses. And we have no part to play!

New scenario – dire health consequences

At a recent gathering of diabetic patients of the Portsmouth Health District, there was a reasonably good turnout but it was striking that there were few men and very limited attendance in the 30-40 year group. Are we to assume that men do not get sick? I doubt it! I can vividly remember in my youth that "Sulas" were easily identifiable in the communities. Today every gathering has a "jam" and we must be careful that our saints are not turned off at the "bacchanal" at some village feasts become the "norm". However, from the health perspective, too many calories from whatever source, even alcohol, leads to obesity. I must also emphasize that obesity, especially belly fat, is a precursor to Type II Diabetes because the fat prevents the insulin from the pancreas from doing a proper job.

Let us now consider HYPERTENSION which also runs in families. Many years when there was a SUDDEN DEATH people would say "la morte sibit" or it may have been attributed to "draft he catch" or even "mal yo faire". Today, we know better. We know that high blood pressure can cause an artery in the brain to rupture, also high blood cholesterol and high blood pressure can cause a clot to form in the heart or blood vessels and also the brain and there is no mystery about it. We know also that bathing in the sea is not forbidden by hypertensive individuals. Why then, with so much knowledge in our times we are treating, not teaching more about these diseases, why are there so many people on dialysis at the hospital due to kidney damage caused by diabetes and hypertension.

Many of our nutrition surveys have shown "a shift away from local foods" and the 2008 steps survey identified that the intake of vegetables and fruits were low among individuals.

Nutritional superiority of our local foods

Let me remind you that our yams, sweet potatoes and other root crops and bananas are high in an essential ingredient called potassium and in fiber, which protect against hypertension and high blood cholesterol. We have no excuse to abandon our leafy green vegetables example, zowemilat, zepina, sweet potato leaves, kale, Chinese cabbage that are readily available at the market and affordable. What about beans? "Pwa angol" seems to be going out of style and it is good for both hypertension and diabetes. Coconut water is very high in potassium. Our children ought to be involved in inventing their own local recipes; example, banana and coconut bread and many more, but to cut back on sugary juices. Presently, many people pay little attention to portion sizes and caloric value of foods and therefore should seek clarification or they may be frustrated when efforts at losing weight fail.

Exercise

Congratulations to the new emerging gyms on the island. Walk more, swim more! I envisage a bright and healthy future for those involved in sports. Keep it up! I am also hoping that the Youth Division will encourage sporting activities. We cannot afford to be complacent. Remember dancing and swimming are also alternatives.

Screening Services

It is amazing that with so many opportunities for screening that people do not take advantage of this to inquire about their health status.

Finally, let us evaluate ourselves honestly and endeavor to take action at every level of society in the coming year. Let us be a disciplined people and let our Christmas be a giving of ourselves to our communities and families, thus following the example of our Master.