He was a top muscleman, she runs 17 kilometres a week, and they now are both working to stem the local onslaught of non communicable diseases (NCDs).
Dr Ian Ho A Shu is health specialist at the Inter American Development Bank (IDB) which is loaning US$48.4 million to the Ministry of Health’s Health Services Support Programme (HSSP) run by fellow medic Dr Maryam Abdool-Richards.
The duo in a recent interview at the IDB's St Clair office told Sunday Newsday how they hoped the money would help save the nation from the health and financial costs of the current upsurge in NCDs.
For this loan, NCDs are listed as cancer, cardio-vascular diseases and diabetes, although elsewhere can also be defined to include the likes of mental illness, said Abdool-Richards.
Briefing notes supplied by Dr Ho A Shu suggest that 80 per cent of all deaths in TT are due to NCDs, whose associated risks are poor diet, alcohol abuse, tobacco use and physical inactivity. Half the adult population of TT are overweight, and TT now has four times as many overweight kids as a decade ago. Childhood obesity is a precursor to adult obesity and poses a heightened risk for cardiovascular diseases, cancers, diabetes, bone and joint problems, sleep apnoea and social problems.
Since 1980 the prevalence of diabetes has increased by 350 per cent, and for each patient on dialysis the health system is paying an extra $136,000 per year. The annual economic burden of all NCDs is $6 billion, or three percent of TT’s GDP.
Ho A Shu said the project will aim to change personal behaviour as early as primary school level. The Healthy Schools TT initiative will encourage more physical activity, plus food preparation guidelines. “We’ll measure BMI from the First Year for a five year period,” he said. Students, parents and teachers will all be involved, effused Ho A Shu.
NCD status is largely related to such as diet, exercise, tobacco and alcohol use, he remarked. “We need to get this message out and measure if it is having an impact. “Traditionally, these programmes are very good at getting the information out, but a gap exists in collecting the results and data.”
Noting the four-fold increase in child obesity, Ho A Shu lamented, “This is the first time in history that the younger generation are unhealthier than the older generation.” He said NCD awareness must constantly be kept in the public eye.
Abdool-Richards said the IDB loan will aim to improve both self-management of NCDs and hospital delivery of care. It will boost the capacity of health providers such as dieticians plus the use of ICT to monitor patients. The loan will fund the screening of pregnant women for diabetes, she added.
Ho A Shu said the loan can help in the upgrade of existing recreation parks and other facilities by the likes of gym equipment to encourage people to exercise more. This funding will be by capital expenditure, but with the Government otherwise to be responsible for recurrent costs such as salaries of sports coaches, he added. Abdool-Richards was glad that the IDB will also be offering its technical expertise to implement aspects of the programme. Even as the programme will enact health ideals espoused by both the United Nations and the Government, she hoped it will become a model of best practice for emulation throughout the Caribbean, where it is the first ever project of this magnitude.
IDB documents show the main allocations of the loan, chiefly US$30 million to the NCDs Prevention and Control Plan, US$8.4 million to the Human Resources for Health Plan, US$5 million for the Health Facilities Investment Management and US$2.1 million for Project Administration. A US$3.5 million counterpart from the Government will fund an e-Health Information Management System.