Island News

Fighting the silent killers – NCDs

Written By : SUN FIJI NEWSROOM. FS: What is NCD? How can people differentiate what NCDs (non communicable disease) is? Dr Sharma: A non communicable disease or NCD is a
09 Apr 2011 12:00

image Written By : SUN FIJI NEWSROOM. FS: What is NCD? How can people differentiate what NCDs (non communicable disease) is?
Dr Sharma: A non communicable disease or NCD is a medical condition or disease which is non-infectious.
NCDs are diseases of long duration and generally slow progression. They include heart disease, stroke, cancer, asthma, diabetes, osteoporosis, Alzheimer’s disease, cataracts, and more. While often referred to as “chronic diseases”, NCDs are distinguished by their non-infectious cause.
In contrast, some chronic diseases such as HIV/AIDS, while also lasting medical conditions, are caused by transmissible infections. They are similar in that they also require chronic care management.
The World Health Organization (WHO) reports NCDs to be by far the leading cause of mortality in the world, representing 60 per cent of all deaths. Out of the 35 million people who died from NCDs in 2005, half were under age 70 and half were women.

FS: What are some of the risk factors?
Dr Sharma: Risk factors such as a person’s background, lifestyle and environment are known to increase the likelihood of certain non communicable diseases. They include age, sex, genetics, exposure to air pollution, and behaviours such as smoking, unhealthy diet and physical inactivity which can lead to hypertension and obesity, in turn leading to increased risk of many NCDs.
The WHO’s World Health Report 2002 identified five important risk factors for non communicable disease in the top 10 leading risks to health. These are raised blood pressure, raised cholesterol, tobacco use, alcohol consumption, and overweight.
Historically, many NCDs were associated with economic development and so-called “diseases of the rich”.
However, today an estimated 80 per centy of the four main types of NCDs – cardiovascular diseases, cancers, chronic respiratory diseases and diabetes – occur in low and middle-income countries.
In September 2011, the United Nations is hosting its first General Assembly Special Summit on the issue of non communicable diseases.
Noting that NCDs are the cause of some 35 million deaths each year, the international community is being increasingly called to take important measures for the prevention and control of non communicable diseases, and mitigate their impacts on the world population especially on women, who are usually the primary caregivers.
NCDs is the leading cause of death accounting for three out of every four (70 per cent-75 per cent) deaths. The majority of heart disease related deaths were due to ischaemic heart and cerebrovascular disease (stroke) – that is the result of changing diet and nutrition patterns inadequate intake of fruit and vegetables, declining physical activity levels, high levels of tobacco use raised blood pressure, high cholesterol and glucose levels in the region. Overweight and obesity rates in PICs including are among the highest in the world.
The region is facing major health challenges.

FS: So how can we tackle this problem? And what is the Ministry of Health doing about it?
Dr Sharma: The buzz words these days is; “Let’s walk the talk” and the Ministry is trying to do just that.
We have different programmes, targeting the different arms of the NCD programme. I will try and give you a running account of what we are doing.
n This includes the Healthy Settings programme, which involves working with the different arms of the community to help them be more healthy.
We have started this with our National Centre for Health Promotion and stakeholders.
It will demand political will from leaders and commitment by everyone to changing the mind sets and the norms in the community in order for everyone to reap the benefits of your programme. Since the launching of Healthy Islands Settings in Yanuca, Fiji, in 1995, a number of initiatives have been started including the various settings approach. While community and school settings have been progressed little progress has been recorded from workplaces.
There is widespread agreement in the literature that public health interventions, based on ecological model, can influence health behaviour including the intrapersonal factors like motivation, skills, knowledge, social support, social networks, and social norms.
The Fiji School of Medicine played a significant role in the development of the Healthy Islands concept in the Pacific and it must remain in the forefront not only in providing training but in initiating research projects, providing community services and playing other key roles in improving health services and programmes like this.
In 1998 the Government of Fiji endorsed and launched the policy framework for health promoting workplaces.
The physical health benefits of taking part in sports have been well documented. Belonging to a sporting club provides opportunities for people to develop friendships, interact with others from varying backgrounds, become part of a team and develop a strong sense of belonging and purpose.
Taking part in sports is linked to increased levels of self-esteem, lower levels of overweight and obesity, and decreased involvement in risky behaviours like taking drugs and crime.
n We are also targeting cardiovascular diseases. These are the world’s and Fiji Public Health Number one problem claiming 17.5 million lives a year globally and locally in Fiji and the Pacific.
On one hand we face the ravages of communicable and re-emerging diseases. On the other hand we are now fronting up with the realities of non communicable diseases like obesity, diabetes, hypertension and other cardiac diseases.
n Over 60 per cent of our population in Fiji is aged below 30 years old. Only 16 per cent reach 50 and only eight per cent live to 60 years; similar to other Pacific island territories and where the situation is even more precariously dangerous.
n The increasing gains of vaccinations, antibiotics and technology are being fast lost with the re-emerging of tuberculosis associated with HIV; poor sanitation and hygiene in our villages. Risk-taking behaviour by males results in great set-back to national development with leptospirosis, dengue and typhoid remaining endemic with periodic outbreaks.
n Increasing climate change will factor as a major concern to the people of the Pacific. The health risks could be disastrous.
n As responsible adults, the cream of your communities, society and nations you do need to re-align thinking; for yourself, your families, communities, nation and region during your stay at US. Being the centre of regional educational excellence you need to remain on course to make a difference.
Let us address some basic issues
Eating Healthy:
n You all must determine your ideal body weight and you BMI (Body Mass Index) and eat healthy. Failing all that a tape measure is really the answer to monitor your girth. For the majority of


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