April 7, 2019

World Health Day 2019: getting health care to the other half

Today is the global health day. Each year, April 7 is when the world celebrates its Health Day. Every year the World Health Organisation draws our attention to a weakness in our health systems as a wake up call towards health. This year it’s that nagging issue of the still dire lack of health care coverage for much of the world. Half the world's population even in this day and age lack the resources to do so. Not because they can’t but because their health systems have not been planned to do so.

Forty years ago in Alma Ata in Kazakhstan, WHO and UNICEF got together at a historic meeting to introduce Primary Health Care to the world as an approach for attaining Health for All by the year 2000. It was about affordable and culturally acceptable appropriate technology spearheading the access to health care into a movement. And it did wonders to demystify medical care and provide an alternative that was a less costly, yet effective care that revolutionised the movement for health all over the world.

Maldives was a clear beneficiary of this and our present national health situation could be unequivocally attributed to the dedicated application of the principles of primary health care in their essence. The community health workers and their dedicated effort on prevention rather than cure pushed down an outrageous national IMR of 150 per 1000 in 1975 to just about 30 per 1000 in the next 20 years in a context of no doctor present. These PHC’s unsung heroes gave their life for this cause and a nation benefited. No more childhood diseases, no scary diarrheas, no leprosy or malaria and even TB was driven to a level that was no more a public health problem.

Today however the NCDs have taken over and instead of the health centres of yore we now have gleaming hospitals to take care of the sick. It is time for us to give another lease to the idea of prevention. The young people now succumbing to cancers and heart diseases and diabetes can’t be addressed by treating these when they show up as disease but before they have a chance to show themselves as diseases. And that is through prevention. 

But this can only happen when we ride our motorcycles a bit less each day, desist from eating all that junk food and crushing out those nasty cigarette packs that fool the youth generation after generation. I tell them it’s not cool to smoke and not exercise and gorge on these fast foods. But one voice is not enough; we need a resurgent voice in unison and attendant rules and regulations that are enforced; we need schools and homes that nurture healthy habits and a community that pulls together for the perpetuation of thee good habits. All this requires effort at the community level. Simple yet effective prevention and advocacy that is the essence of primary health care.

Yet again it’s time for PHC to be revived and reapplied. It’s truly a timeless concept and kudos to WHO for bringing this into view again. Yet,  blessed as we are with universal coverage in Maldives, we need to be mindful of not being wasteful in using this blessing and supplement it with the good habits that will make our body smile and say “if you look after me for the first 50 years, I will look after you for the next 50”.

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