Recent data, both from the Barbados National Registry (for the chronic diseases) and the Health Of The Nation (HotN) Survey, highlight the dire health situation here.
The National Registry has informed us that we currently have, on average, one heart attack and two strokes every day. Dispite the recent establishment of a Stroke Unit at the Queen Elizabeth Hospital, very few of the 60 strokes we generate monthly can get into the Stroke Unit. Very few of the 30 heart attacks we generate every month can get into the Intensive Care Unit at the hospital. None of the patients, their families, the hospital resources, or the national budget, can tolerate this.
Two in three of these heart attack victims, and one in three of the stroke victims, die every month. The survivors are often left with significant disabilities, many not able to work, and requiring support to do everyday activities like bathing and eating, many requiring lifelong medications. Changing the approach to preventing the event in the first place (disease prevention), as opposed to “attempting to patch the patient up” after the event, can save more lives and prevent significant disability. The need for change is urgent.
In 1981, in the report on the National Health And Nutrition Surveys 1969 And 1980, Dr Frank Ramsay, head of the National Nutrition Unit, noted that strategies for dealing with obesity should be urgently implemented. Thirty-four years later, at another Press conference this year, our Minister of Health basically reiterated this same message. If achieved, this can reduce the number of heart attacks and strokes.
In September 2007, Caricom ministers responsible for health signed on to the Declaration Of Port Of Spain – Uniting To Stop The Epidemic Of The Chronic Non-Communicable Diseases. One specific declaration coming out of this meeting was for Caricom countries, by mid-2008, to establish programmes for the screening and management of chronic diseases and risk factors so that by 2012, 80 per cent of people with NCDs would receive quality care and have access to preventive education. Even though these deadlines have passed with little sign of action in this regard, at least back then Caricom ministers thought this issue needed fairly immediate attention. It still does.
In 2011, in commenting on her annual reports for the years 2004 to 2006, Dr Joy St John, our Chief Medical Officer, wrote: “New evidence-based strategies for managing the chronic non-communicable diseases should be implemented with utmost urgency.”
Dr Kenneth George, the Senior Medical Officer of Health with special responsibility for the chronic non-communicable diseases, in the foreword to the Health HotN Survey noted that “the global target set by the United Nations for a 25 per cent reduction in premature mortality from NCDs by 2025 is achievable”.
Barbados is heading in the wrong direction, as the reports highlight that things are getting worse, not better. The summary statement of the HotN states “urgent action is required to address the low levels of healthy behavioural risk and high levels of biological risk present in the Barbadian adult population”. We need this urgent action.
The Minister of Health has noted that a programme to aggressively manage the chronic diseases has both the potential of saving limbs, lives, and money. We need to adopt and implement a new action plan today. If we are committed to evidence-based decisions, all the evidence points to the need for urgent action. It cannot be business as usual.
– Dr Colin V. Alert