“WORKING FOR A HEALTHIER TOMORROW” by Humphrey Metzgen, President of the Heart and Stroke Foundation of Barbados

The Cardiovascular Disease Prevention and Rehabilitation unit is a programme designed for those persons who have had heart surgery, a heart attack, heart failure, a stroke or are at risk of these events.

This department, by the way, is accredited with certification from the American Association of Cardiovascular and Pulmonary Rehabilitation. Outside of the USA and Mexico, we are the only other country in the region with this certification. This is no small thing and Barbados should be very proud of this achievement.

(ECC)

The Emergency Cardiac Care Department runs a number of courses ranging from first aid for the general public to advance cardiac life support for medical practitioners and other healthcare professionals.

(Screening)

Our screening programme provides affordable cardiovascular testing. Launched in Feb 2014, this is the first of its kind with the help of grants from the European Union and the Goddard Group.

Overall these three departments’ primary role is to reduce the mortality rate among patients who suffer from heart disease and stroke, as well as help improve their quality of life. The problems we face however are two-fold: high patient numbers and high operating and service costs. This is made more difficult as the Foundation does not enjoy a subvention and is dependent entirely on its own commercial activities and charitable giving, which in the current economic climate has been difficult. The added burden of having to pay VAT charges on our charity fund raising activities has not helped.

Our turnover is just over $1 mil. On the trading front, although our CDP&R and ECC business accounted for some 88% of our total revenue, the corresponding salaries and related expenses were high and these have affected the margins for the two services. This is something we plan to look further into in the coming weeks.

Our turnover is just over $1 mil. On the trading front, although our CDP&R and ECC business accounted for some 88% of our total revenue, the corresponding salaries and related expenses were high and these have affected the margins for the two services. This is something we plan to look further into in the coming weeks. (FILE IMAGE)

Against this financial backdrop, the latest statistics from the National Non Communicable Disease Commission from the Ministry of Health in Barbados has indicated worrying trends among our community:

15% of the adult population is engaged in binge drinking
90% of adults do not consume the recommended five servings of fruit and vegetables per day
50% are physically inactive, accounting for two in three women and one in three men
Not surprisingly, 43% of the population is overweight or obese.

Clearly this situation will have an impact on the work of the Foundation and raises a number of questions at every level. Are we geared up to meet the new challenges? Should the role of government be limited to providing advice and information, or should legislation be used to enforce changes in food composition and its availability as we have done for Tobacco? And where do we stand on labelling of food products?

But I must point out that Barbados has not been idle and is the first in the Caribbean with the development of the NCD Commission itself to introduce a tax on sugar and a tax on sugar sweetened beverages.

Time is however against us: diseases in most cases involve a delay. By the time a condition is diagnosed, the pattern of behaviour that contributed to it is firmly established. Missing in this equation is a capacity to act quickly because of the sheer nature of the mechanics and the processes that are needed to assess the situation. There is clearly a time lag that needs to be filled and perhaps the key might be in the form of “preventative medicine” targeted at different members of the public at high risk.

Some 12 months ago, we introduced a screening test programme and although the outcome was not conclusive, those who participated appreciated our facility and thought that we should aim to reach out to a wider population and adopt a more aggressive marketing policy. Sadly we were not able to do this because of our limited funds.

There are very good reasons why the Foundation should carry out the screening:

  • We have the resources and experience
  • We can reach wide audiences of different demographics, including obese children and the staff of local companies
  • It is an untapped market for us.

Let me remind you that obese is taken from the Latin obesus – meaning having eaten oneself fat. In other words obesity comes directly from eating too much of the wrong foods. In certain jobs (the armed forces being one) obesity was once considered a self-inflicted injury that might lead to a disciplinary hearing, depending on the circumstances. We also know from medical statisticians that unless something is done soon, obesity in the next 25 years will become the biggest threat to health services, and not dementia.

We clearly need to take these warnings on board and come up with a master plan aimed at changing public attitudes towards better eating habits, and encourage the wider population to recognise that eating healthy food is the smart thing to do. The alternative will be longer waiting lists of patients with diabetes, cardiovascular problems, high blood pressure and cancer.

Given this scenario, the Heart and Stroke Foundation is looking at a number of different options, including launching Barbados’s first healthy food and drink outlet. We have identified a suitable building with a good customer potential, which also offers easy access to a gym.

The area around this outlet houses a large number of offices, clinics and educational establishments. Currently the area is serviced by a number of small mobile outlets providing sweetened drinks and a variety of fast food mostly high in calories. There is no evidence to indicate the availability of low fat or high fibre products, fruit, whole grains, vegetables or lean meat.

Occasionally I do ask myself questions about the future and what it might hold for us. If my crystal ball is not too cloudy:

I see a world where more patients are likely be treated at home, while hospitals continue to focus on serious illness and emergencies.

I see a greater number of NGOs working alongside hospital patients and their resulting convalescences.

I see a greater use of technology complementing health care service in hospitals and in the home.

I forecast better lifestyle choices, behaviour and medical care for our community. So let’s start building tomorrow now…

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