Choose to live well

Health Today-blockWorldwide, non-communicable diseases (NCDs) take the lives of over 38 million people annually, and, according to the World Health Organization (WHO), they represent the greatest public health threat ever known to man. In fact, according to the WHO, millions are dying prematurely –– in their 30s 40 and 50s.

Barbadians are among that vast number, and, this week, the point man at the island’s main hospital urged citizens to choose to live and avoid surrendering their health and quality of life to these devastating diseases.

Chief executive officer of the Queen Elizabeth Hospital (QEH), Dr Dexter James
Dr Dexter James

“We have some big problems to solve,” warned Dr Dexter James, chief executive officer of the Queen Elizabeth Hospital (QEH), as he unveiled alarming data on the impact of these diseases, while delivering the 22nd Annual Louis Lynch Memorial Lecture on Universal Health Care And Sustainability at the Grande Salle.

The silent killers –– diabetes, cancer, heart disease, hypertension, chronic respiratory diseases and kidney disorders –– are crippling the island’s main health care facility, and Dr James is adamant that the most effective remedy is for Barbadians to take charge and adopt healthier lifestyles.

He revealed on Monday night that the QEH, which admits 22,000 patients a year, and treats an additional 90,000 outpatients, was “bleeding” as it tried to cope with the ever-increasing NCD crisis.


“This trend will continue in the next five years unless we find a way to stop the bleeding with respect to the NCDs. This is a very disturbing trend, which is going to consume a tremendous amount of the financial resources of our
health system.”

According to Dr James “the vexing area” was patients with renal problems. From just three patients on haemodialysis in 1979, the hospital now has to provide care for 241 at a substantial cost.

“Today we dialyzed patients at the QEH at $62,400 per patient per year . . . . We outsource at $46,800 per patient for haemodialysis, and peritoneal dialysis is $50,000 per patient, per year.

“The most disturbing trend is that we add four new patients on haemodialysis per month and two to three new patients in terms of peritoneal dialysis, which is really home dialysis, per month.

“This is going to be a tremendous burden on our health system in the next ten years,” he added, warning that the trend was unlikely to reverse itself in the short term.

Dr James continued with an equally troubling picture of the diabetes epidemic; and the data was not comforting.

“Forty-two point five per cent of all the inpatients that come through the hospital are diabetics and it is the highest documented in the English Medical Literature to date. Of diabetic related admissions, 89 per cent are for active diabetic foot disease; but look at the length of stay
–– 19 days.

“The hospital is like a revolving door. These are people who come into the hospital –– some may require in-hospital care, but, for the most part, most of them require just stabilizing their condition, and then they are discharged.

“And we wonder why the QEH is always short of funds.”

The grim picture continued to unfold as Dr James reported on strokes and cancer.

“If we look at strokes today, there are 53 strokes per month in Barbados. Again, the common thread you would see is that the NCDs are prevalent as it relates to strokes. Seventy-five per cent of stroke patients have diabetes, and another 90 per cent of them have hypertension.”

With respect to cancer, the QEH provides over 1,130 treatments for patients on radiation and chemotherapy, and the Haematology Department sees about 150 patients a week.

“Prostate cancer is the leading cause of cancer in men; then colon, lung, stomach and rectum. In women –– breast, colon, cervical cancer and the rectum,” says Dr James.

“In terms of prostate cancer, we have the second highest incidence of prostate cancer in the world on per capita basis but perhaps the most serious issue is that our mortality rate is the highest in the world again based on per capita.

The QEH head stressed the situation was more than enough evidence that the population must take greater responsibility for its health, insisting there was enough information for people to make the right changes.

“Some fixes require personal responsibility; it has nothing to do with education or information.”

Unhealthy habits like consuming too much fat, salt and sugar, smoking and alcohol are driving the NCDs epidemic. Health care professionals continue to press home the message of daily exercise, the consumption of well balanced meals and adequate rest.

“It is about behaviour modification,” says Dr James. That is an easy fix. Just take care of yourself and this would not place pressure [on] . . . the services.”

WHO estimates that if the NCD epidemic is not reversed, deaths from these lifestyle diseases will drain $US7.0 trillion out of the global economy over the next decade.

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