Deadly NCDs

ALMOST 4,500 people have reportedly died of covid19 in this country to date.

But many didn’t die because of covid19 alone. A vast number suffered from chronic non-communicable diseases (NCDs) such as diabetes, heart disease and cancer.

In December 2021, when 37 additional deaths were reported over one day, 26 of these had at least one comorbidity. The covid19 pandemic was a crisis within a crisis: one relating to the virus; one relating to NCDs.

Wednesday’s parliamentary committee hearing, chaired by Paul Richards, on the management of NCDs, amounted to yet another dire warning about the need for action. The questions posed by the independent senator and the members of the committee, as well as the responses of Dr Roshan Parasram, the Chief Medical Officer, and other officials of the Ministry of Health, underscored why it is now critical for focus to turn to this issue.

According to Minister of Health Terrence Deyalsingh, diabetes alone affects approximately 150,000 people here. Those numbers could well rise, and there are some projections that suggest NCDs might one day overwhelm the healthcare system, even with the ongoing addition of hundreds of new beds costing billions.

The Ministry of Health has been focusing on things like the TT Moves marketing campaign, staging “health and wellness” walks, and even launching digital applications to encourage people to track their fitness journey. There has been consistent messaging, which was evident at Wednesday’s hearing, which focuses on getting people to change their “lifestyles.”

All of this is well and good, but the challenge is far more formidable than just telling people to move.

Historical and genetic factors play a silent yet significant role in NCDs. For example, as it relates to diabetes, links have been drawn between colonialism and famine in decades past and the predisposition of some populations to this disease today.

Which is not to say we must ignore the choices people make and blame the past. Rather, we need to inform and target groups more at risk and have complex conversations, instead of opting for simplistic approaches bordering on hectoring. If more people are aware that they are at risk and why, they are more likely to act proactively.

A good example of the need for nuance: the ministry, rightly, wants people to address stress. At the same time, it is trying to discourage people who drink alcohol and smoke.

Missing is acknowledgement that one reason why many people adopt unhealthy habits – including the regular consumption of fatty, carbohydrate-rich, “comfort” foods – is stress. Habits die hard. It is a vicious circle. Only education can break it.

If the approach is not holistic, the next pandemic will be worse.