Health and wellness – how serious are we?
Much has been written and said about the importance of physical exercise to a meaningful life. In the past few years there has been a significant increase globally in people’s recognition of the importance of being fit and eating healthy.
Everywhere we have witnessed the immense growth in the numbers engage din waking, jogging, yoga, martial arts, and other forms of exercise in an effort to stem the tide of the sedentary lifestyle associated with development.
It is no secret that there has been a close association between obesity and development. Wherever people have attained a higher standard of living there is a tendency towards diets that are high in fat and cholesterol. Small wonder then that associated with development has been an increase in heart diseases, hypertension and diabetes.
St Vincent and the Grenadines recently played host to a session on chronic non-communicable diseases (CNCDs). During the session participants were treated to a diet of life-style changes that are perhaps the best means of sustaining the fight against non-communicable diseases generally and more so those that are chronic in nature.
It was most interesting to hear the feature speaker at the opening ceremony identify the important role that physical exercise plays in the fight against such diseases. The organisers and participants must have been shocked by the information presented by the featured speaker. The Minister of Health, Wellness and the Environment, Cecil McKie, must also have been shocked at the presentation. That is the only conclusion one can come to because neither the Minister nor the organisers seemed to have had it in their plans to invite persons and organisations involved on a daily basis in the promotion of physical exercise in St Vincent and the Grenadines.
No invitations were extended to sporting organisations, the Physical Education and Sports Teachers Association (PESTA) or any of the owners and operators of the gyms or their physical trainers.
The foregoing fact clearly illustrates the extent to which the Ministry of Health, Wellness and the Environment is doing little more than paying lip service to the fight against non-communicable diseases.
Non-communicable diseases
One important research project yielded a paper that addressed the major challenges confronting those keen on waging war on chronic non-communicable diseases. It was first published 22 November 2007 in Nature.
The statement, Chronic non-communicable diseases constitute the major burdens of illness and disability in almost all countries of the world… Inaction is costing millions of premature deaths throughout the world, resonates with us all and is cause for concern. It also defined for its purposes, CNCDs as diseases or conditions that occur in, or are known to affect, individuals over an extensive period of time and for which there are no known causative agents that are transmitted from one affected individual to another
The paper notes that Chronic non-communicable diseases (CNCDs) are reaching epidemic proportions worldwide. These diseases — which include cardiovascular conditions (mainly heart disease and stroke), some cancers, chronic respiratory conditions and type 2 diabetes — affect people of all ages, nationalities and classes.
Particularly important for us in St Vincent and the Grenadines is the fact that The conditions cause the greatest global share of death and disability, accounting for around 60% of all deaths worldwide. Some 80% of chronic-disease deaths occur in low- and middle-income countries. They account for 44% of premature deaths worldwide. The number of deaths from these diseases is double the number of deaths that result from a combination of infectious diseases (including HIV/AIDS, tuberculosis and malaria), maternal and perinatal conditions, and nutritional deficiencies.
It should be noted that we are dealing with a paper dating back to 2007. Globally the situation has worsened rather than improve. And the forecast is for a sustained worsening scenario unless concerted action is taken.
CNCDs place a severe economic burden on countries, especially those with already slender resources available to their populations. They impact all countries but the economically weak are also the most vulnerable and the most difficult in which to effect change.
Of major concern where CNCDs are concerned is the fact that they are preventable if we commit to lifestyle changes. Therein however lies the problem. The paper states, Several factors are implicated in this increasing burden, including longer average lifespan, tobacco use, decreasing physical activity, and increasing consumption of unhealthy foods. Fortunately, CNCDs are largely preventable. Up to 80% of premature deaths from heart disease, stroke and diabetes can be averted with known behavioural and pharmaceutical interventions2.
People become so set in their ways that they do not wish to effect changes even if it means their own survival.
In the Caribbean the CARICOM Summit identified the following facts, among others, on CNCDs. In the Caribbean the chronic diseases of concern are heart disease, stroke, cancer, diabetes and chronic respiratory diseases. These are caused by biological factors such as high blood pressure, obesity, high blood sugar, and high blood cholesterol.
… In Latin America and the Caribbean (LAC), chronic diseases are now the leading cause of premature mortality, accounting for nearly half of deaths of persons under 70 years, and for two out of three deaths overall.
It was also stated, The Caribbean is the Region of the Americas worst affected by the epidemic of chronic disease. The human and economic cost burden of these conditions is not sustainable and could undermine the development of these small, fragile countries.
Here at home we seem to pay little attention to obesity. Few people take into consideration the Body Mass Index (BMI), globally used as an indicator of obesity in individuals.
Should our Ministry of Health, Wellness and the Environment ever reach the point of taking the health of our population seriously they would certainly engage in studies(R & D) aimed at discerning the extent of obesity in this country, especially amongst children.
Apart from the Health Word, there seems little to suggest that we are educating Vincentians about their lifestyles and how these impact their general well being.
Wellness revolution
The Prime Minister of this country was the one who, while attending a Caricom Summit on CNCDs at the Crowne Plaza Hotel, Port of Spain, Trinidad and Tobago, 17 September 2007, eagerly called for the region to engage itself in a wellness revolution. Of course, since taking the reins of government in this country the Prime Minister has been seemingly anxious to push for the creation of revolutions. He proclaimed what should otherwise be the systematic development of an education system an education revolution. He is probably the only leader in the region who has proclaimed this normal educational development process as some sort of revolution without recognising that others around the Caribbean have gone ahead and implement many of the components that he is now putting in place or are themselves engage din doing likewise yet none have found it necessary to proclaim their approach revolutionary
Given the modus operandi of the Prime Minister however it came as no surprise to anyone following his politics that he so eagerly advocated that the Caribbean’s approach to fighting for better health and wellness in the region be deemed a wellness revolution.
Interestingly, when Fidel Castro sought to lead his people into the adoption of healthier lifestyles he publicly declared that he would desist from smoking. In other words he recognised that it was Unfortunately we cannot say the same for our Prime Minister and hence this country has seen an absence of leadership in the so-called wellness revolution.
One would have thought that with Cecil McKie having had a very strong athletics background and a proud history of sporting involvement, he would have been not just an advocate for wellness but a fine example to others in Vincentian society important for him not to simply ‘talk the talk’ but to lead by example. This is not the case.
Here we are then in St Vincent and the Grenadines with a Prime Minister who gave the concept of a wellness revolution to the Caricom leaders yet whose physical features suggest a fine example of obesity. At the same time we have a Minister of Health, Wellness and the Environment who may also well be bordering on obesity.
The Vincentian scenario
Some years ago the Division of Sports began a programme called, Fitness in the Park. There is hardly any evidence that this has led to anyone really taking the project seriously enough to have engaged in sustainable exercise to be fit for life.
The initial idea behind the programme of the Division of Sports while being good did not in any way link with other pertinent ministries and institutions around St Vincent and the Grenadines and hence failed to make an impact. The programme itself was not sustained.
While here in St Vincent and the Grenadines we have introduced PE in the education system the emphasis has been more on it being an examinable subject and therefore one to be added to one’s curriculum vitae when applying for a job, instead of it being a route to a sustainable healthy lifestyle.
There has been little attention paid by PE teachers to establish the link between their subject and sport in this country thereby leaving a major gap in the education process. It
While the PE results at the Caribbean Examinations have been good no attempt has ever been made to evaluate whether the teachers are somehow able to influence students of this subject to an appreciation of what it can do for them in their personal lives and how they in turn can impact the lifestyles adopted by family and friends. Thus it is that we could come to an understanding of why the organisers of the recent session on chronic non-communicable diseases would have thought it necessary to involve PE teachers and physical trainers from around the country. The concept may well still be very alien to them even though at the theoretical level they spout the relationship between a healthy lifestyle underscored by regular physical exercise, involvement in sport and the avoidance of chronic non-communicable diseases.
Conclusion
There has been much talk about CNCDs in St Vincent and the Grenadines with little action aimed at a sustainable approach to addressing them. We remain essentially preventive rather than curative in our approach to CNCDs.
There needs to be a clearly enunciated national policy in respect of this country’s approach to redressing the state of affairs in respect of CNCDs.
There must also be on-going research regarding the success/failure of the approach adopted.
International and regional collaboration must be deemed essential to attaining success in our approach and we must ensure that we bring on board all stakeholders.
Combatting CNCDs cannot be left to the Ministry of Health and the Environment. It cannot be left only to the government. Lip service gets us nowhere neither does the hosting of national, regional and internal conferences/seminars.
We must get serious and forge a broad-based approach of committed individuals and organisations. The time is now since we are already very late.