By Dr Miguel Goede
The health of the citizens in the Caribbean differs by island. There are several indicators to indicate public health of a society. One of them is life-expectancy. According to the data collected by the World Bank, Cuba has the best results in this policy area and Haiti is the lowest in ranking. Cuba beats even the richest OECD countries.
A few weeks ago a very concerned reader sent me an email, asking me to write an article on the fact that a lot of citizens in Dominica have to amputate a limb, because of complications with DIABETES. Several studies indicate that the indices of diabetes and hypertension are high on some the islands of the Caribbean. These diseases correlate to obesity. Obesity is sometimes inherited but mostly it is a consequence of a lifestyle. It is a consequence of an unhealthy diet and not enough exercise. Some Caribbean islands are among the highest in the world regarding obesity.
Still it seems that we are living longer but not healthier and the population is aging. With high youth unemployment and aging societies the Caribbean healthcare systems face the challenge of future financial deficits. Because a working young population has to pay for premiums while the aging population demands more healthcare services. Revenues are projected to go down while expenditures go up. These facts make the current healthcare system unsustainable and must be reformed.
Caribbean people being overweight was not always the case. If one studies pictures of some twenty years ago, you notice that the people on the island used to be slim, just like in Cuba, for example. Combating and preventing these diseases have become or should be a national public health priority. Fact is that most islands dealing with this crisis have no policy in place.
For years, the World Health Organization has been promoting the healthcare system as a best practice. The essence is the focus on a strong primary healthcare system. The family doctor knows his patients. The emphasis is on prevention and a healthy lifestyle.
The government and the healthcare sector don’t inform and educate the citizens regarding a healthy lifestyle. We cannot transform the health care policy from cure-based to prevention-based. Another aspect of the policy should be to create infrastructure for exercise, recreation and sports, as a condition for a healthy lifestyle and a preventive healthcare system. New neighbourhoods are built without these facilities.
One other aspect of the policy is the position on fast-food. There is a correlation between fast-food and obesity. Some countries have restricted advertisement by these chains. Others have limited these chains and others, like Bolivia and Bonaire, have banned them.
The government, especially the minister, fulfils an important role. They should not only facilitate and formulate the healthcare policy, but also lead by example. I know ministers responsible for healthcare who are overweight. A better example is the First Lady of the United States, who is heading the campaign to inspire America to change their lifestyle. Now she is promoting dancing as a form of exercise.
Another strange fact is that many healthcare professionals do not address these issues. This article should have been written by a healthcare professional and not by a strategist. Are healthcare professionals too caught up in the neo-liberal game of MAKING? How are we going to change this?
(Miguel Goede is a strategist and trend watcher in the Caribbean. He is based in Curacao and works for governments, corporations and NGO in the region. You can find out more onwww.miguelgoede.com. Join the discussion on Facebook Caribbean 3.0)
