One in every 12 people in the Americas, 62 million and counting, are currently living with diabetes. And as the World Health Organisation (WHO) celebrates its sixty-eighth year of existence today on World Health Day, it issues a serious warning on the worrying progression of diabetes around the world – up to 422 million adults in 2014 from 347 million in 2008 and from 108 million in 1980.
A chronic non-communicable disease (CNCD) for which there is no cure, diabetes is spreading rapidly in middle and lower-income countries and is affecting poorer people – a dramatic shift from its earlier/historical perception as a disease afflicting the more affluent.
Today, diabetes is the fourth leading cause of death in this part of the world; cardiovascular disease tops the list, followed by stroke and dementia, according to WHO. This is great cause for concern as not only has diabetes climbed the cause-of-death ladder, but poor control of the disease leads to complications that affect quality of life, such as blindness, kidney failure and leg amputations.
Genetics predispose some people to diabetes, but even among those susceptible because of heredity it is both preventable and treatable particularly type 2, which is linked to an unhealthy lifestyle. Nutrition and exercise play huge roles in delaying or preventing altogether the onset of type 2 diabetes and are far less costly to the individual, both financially and emotionally, than the medicines that have to be used constantly to keep blood sugar levels in check. They would also be much less of a drain on countries’ health systems and should therefore be embraced and advocated by governments. Sadly, this is far from the case.
In Guyana, for example, there is more talk around diabetes as well as other CNCDs than there is about its treatment and prevention and this is more likely to occur when there is a global focus, like today. It is still typical in hospitals and clinics around the country for doctors to write prescriptions and send patients to a pharmacy than to refer them to nutritionists and wellness experts who could advise them on diet and exercise.
The importance of a daily diet which involves fresh fruits and vegetables is well known, but we still have government and private sector functionaries cutting ribbons at fast food joints and calling them sound investments. While on the other hand, we often hear stories from farmers in far flung areas who face extreme difficulties in getting their produce to market. Usually, transportation is the issue and the lack of this means they have to choose between being undercut by unscrupulous middlemen or letting their produce rot; some choose the latter. Why is it that the promotion of what is locally grown and produced is left to annual occasions like World Food Day or GuyExpo? Why is there a lack of emphasis on the prevention of a disease that can cripple or kill citizens and the glorification of habits that can lead to it, in the name of so-called investment? It would seem that there is a link between insanity and the accumulation of wealth at any cost.
There is a sad misconception that the task of ensuring the nation’s health and wellness lies solely with the Ministry of Public Health and its two ministers. The truth is that while that is the primary role assigned to them, unless there is a holistic approach by the government on one part and the individual citizens on the other, nothing will happen.
A case in point is the approach to HIV, a communicable disease. At one point its prevalence was very high in Guyana. While there was/is tremendous financial assistance from the global community, it eventually became known that every individual had a responsibility in halting the spread of the disease and the government had its role to play as well. The result is that there has been a decrease in the rate of infection and with medication available, along with knowledge of how to prolong their lives, those infected have been living longer and better quality lives. If this is achievable with HIV, a disease to which much stigma and discrimination has been attached, then it is definitely doable with diabetes as well as any other CNCD.
Unfortunately, there is a dearth of impetus in the case of CNCDs, which has nothing to do with the lack of finances. An ongoing blitz promotion of local foods through social media for example is just one of the things that could be done here immediately to help reduce the spread of diabetes. Timely messages addressing health issues could be easily spread via Twitter, Facebook, Whatsapp and the like – all of which cost virtually nothing and could in many cases help save lives.
