The Need for a System of Health Rather than a Health Care System in Jamaica

It is difficult to imagine that with all the sunshine, ocean, open spaces, and such a strong sports tradition, 20% of our children are overweight. All aesthetics aside, being fat ought not to be perceived as anything other than unhealthy. Obese children become obese adults.

As has been noted in The Gleaner, obesity has reached troubling proportions in Jamaica. Since 1980, we have seen a 50% increase in the incidence of obesity every decade. This dramatic rise in obesity is inevitably accompanied by an equally critical rise in diabetes, resulting in over 20% of Jamaican adults suffering from this awful disease. Diabetes is particularly nasty as it impairs eyesight, causes impotence, and may result in the amputation of toes and legs. How did a society where people walked miles each day, succumb to this plague of inactivity, diabetes and obesity? An unhealthy country is a country without a future.

The United States has taught the world that there isn’t enough money to pay for all the disease caused by obesity, lack of exercise, cholesterol, smoking and diabetes. However, the United States spends 20 cents of each dollar collected as revenue on health care. Still, the life expectancy of an average African American men is less than Jamaican men. The United States has a so-called ‘state-of-the-art’ healthcare system, yet they are way behind the rest of the world in promoting health and well-being. When a patient has a disease, treat the disease; similarly, when a large segment of a population has a disease, treat the country. If you want to reduce violence, crime and unwanted pregnancies in Jamaica, let children have the opportunity to know their grandparents.

Jamaica needs a system that promotes health and not an expensive “healthcare system” that only treats disease. In a country where the average household income is less than US$1,000 per year, Jamaica can ill afford to provide invasive and expensive medical services to treat illnesses that should have been prevented. A “System of Health” emphasizes prevention, while a “health care system” places emphasis on the treatment. By being proactive instead of reactive, we can inspire people to take health promotion and disease prevention seriously.

Jamaicans live on an island of sunshine and cool breeze and most of us must live and eat by the sweat of our brow. Europeans and Americans come to our island to lose weight through exercise and heart healthy eating, so why can’t we take advantage of these home grown remedies? If we consider the fact that most of the disease that plague us and cost so much can be prevented, it becomes apparent that promotion of heart health and exercise would allow enormous savings for the health care system. In fact, just about all the heart attacks, heart failure, strokes, diabetes, kidney failure (diseases that kill 50% of us) could be prevented by making simple adjustments to our lifestyles. Being proactive in health can add 10 more years to enjoy the company of our grandchildren and guide them to a happy, healthy and productive life. I grew up reciting the nursery rhyme about Humpty Dumpty who was lazily sitting on a wall, had a great fall and nothing could put him together again. If Humpty was not sitting on the wall, his risk of falling would be far less. We can take an important message from this nursery rhyme by understanding that no matter how good our reactive plans in medicine and surgery may be, it will never be as good as prevention. An ounce of prevention is always going to be worth more than a pound of cure.

At the Heart Institute of the Caribbean, I am fortunate to work for a private entity that excels in the gamut of these services. In the hopes of implementing a “System of Health” we are eager to share our secrets and methods for prevention with readers of the Gleaner. We also offer executive physicals that may help determine the risk of a premature heart attack, using state of the art diagnostic equipment and Board Certified Cardiologists. If you are already aware of your condition, there is absolutely no better place to receive treatment for a wide range of cardiovascular related diseases. We realize that treating disease in an expensive undertaking and so, we offer our services for less than 20% of the cost for the same services in the United States. Again, preferring that you didn’t have the disease in the first place, we counsel family members who come to the Institute to be treated for heart disease, encouraging prevention. If you are sick, you are not making money, you are spending it. The best place to put your money is in your health. Healthy people are likely to be wealthy people and at the end of the day, we want a System of Health, not just a healthcare system

While our government struggles daily with how to allocate our limited resources, it should be recognized that it would be a good investment to spend more on prevention. At present, the Government spends less than 5% on prevention of diseases and we need to increase our spending here to at least 25%. In a Gleaner article dated 13/8/2008, Prime Minister Bruce Golding, in identifying this problem addressed 750 delegates from 80 countries at the opening ceremony of the 57th August General Assembly of the International Federation of Medical Students’ Associations disclosing the fact that the Government is planning to launch an island wide program aimed at getting people to adopt healthy lifestyle practices. In outlining the Government’s plan, Prime Minister Golding emphasized the need to sensitize the public of the benefits of a healthy lifestyle, letting them know that “you can eat yourself to death in the same way that you can smoke yourself to death.” However, other than this speech, no much has been done in this arena.

Comparable to the above mentioned program, The Heart Institute of the Caribbean has developed a plan which involves an island wide tour aimed at training “Community Health Advocates” in various parishes. This plan also involves cardiac screening and group counseling thus effectively identifying the healthiest and most at risk communities in Jamaica. This way, we can educate and motivate our citizens to maintain good health.

Just as it would be unconscionable not to have an infectious disease program, it is unacceptable not to have a cardiovascular disease prevention program. Every citizen must recognize that if they do not take time to exercise and eat well, they will prematurely succumb to disease. God made us to be strong and physically fit, and by choosing to be “fat and lazy”, we will have to pay the price.