Once upon a time, when disease prevention's primary focus was on environmental protection and its management, it was quite a hassle for us to individually maintain clean sanitation, safe water and dispose our garbage. We did so through a mix of individual approaches that lacked a collective clout. However, it was a daily chore that had to be carried out if we wanted to enjoy a healthy household keeping at bay, communicable diseases such as diarrheas, skin infections, fevers, and various forms of insect borne infections. As our towns and our cities grew, and even in our small islands in Maldives, we soon gave up this job to our elected municipal officials to handle with the hope of a coordinated and consistent approach. Later, in addition to water and sanitation and solid wastes, we added healthy housing also to the responsibilities of these elected officials. Crowded and ill-ventilated housing brought in the dangers of all kinds of respiratory infections, and tuberculosis, a particularly dangerous one. Unlike in a homogenous community of a village or a small island community, city life meant all kinds of people inevitably coming to live in proximity to each other and so, as the saying goes, “everyone’s responsibility becomes nobody’s responsibility”. So it was fitting that the municipality included this into its work list.
However, again, the time has come for us to be responsible individually, for it is the era of non-communicable diseases now. It is estimated that 60 percent of all deaths in this world are from NCDs. The prevalence of heart disease, hypertension, cancers, diabetes Alzheimers, dementia, and the like are on the rise even in developing countries. For example, even today, two-thirds of the world’s type-2 diabetes is in the developing world, Obviously, as the world grays, the burden will increase. Population projections indicate that in a couple of decades, those over 60 years of age will out-number those under the age of 15, and this is indeed a cause for concern.
Keeping from these afflictions requires prevention, but our municipal authorities can provide only limited help in this case The onus is on us again to be wise and selective in using the scores of enticements we have in this modern era. The expanding feast of the taste-buds in the marketplace that holds the potential for those added calories, all types of stimulants that keep you dazed half the day, video-based entertainment and social media that keep you physically inactive for hours, fast cars and motor-cycles that thrill and injure and not infrequently kill, and those ever present cigarettes which Mr Bernard Shaw defined as “white long cylindrical objects with a fire at one end, and a fool at the other” are the noteworthy. Truly, we should not be fooled by the companies that produce these. Their well researched and wily adverts are made to fool the customer every time. So the onus is on us to eat wisely, exercise regularly, shun those seemingly lovable bad habits of smoking and drinking, and take time periodically each day to meditate away from the busy chatter of our mind. Being wise to the crafty callings of the ego, and eschewing those momentary pleasures, will bring you a world of benefit in the many years you have left in your life. Those of us who can take up this challenge will reap the success of good health.
Its a comprehensive and a precise write up. NCDs pose a very real threat to developing nations, particularly to those which are not prepared to address it. Curative medicine alone will not be able to absorb the burden.Preventive aspect need to be emphasized more than ever.
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