Lifestyle change effort necessary, but culture is a major impediment

19Jan 2021
The Guardian
Lifestyle change effort necessary, but culture is a major impediment

NEW appeals are being issued to the public as well as to health sector authorities to intensify awareness campaigns on regular medical checkups and change of lifestyle following a sharp rise in deaths arising from non communicable diseases (NCDs).

Current statistics show that such diseases account for 33 per cent of acute sickness and death countrywide, with urban areas more acutely affected. It is a disturbing situation which requires effort to be impacted in a positive direction, but it is daunting if it will be so.

An exposition on the situation was made at a year-end free screening event to commemorate the role of nurses and midwives in healthcare provision, where the Acting Executive Director for the Muhimbili National Hospital (MNH) Dr Julieth Magandi appealed for changes of lifestyle so that many avoidable deaths do not occur as projected at present. In the past the problem of non-communicable diseases had a clear cultural image, either it was a problem of Europe and America rather than developing countries, or it was a problem of rich people generally, whether living abroad or in poor countries. That changed later.

The trouble with non-communicable diseases is that these ailments arise from the very things that make life either livable of appreciable, like sweet foods and drinks, not to speak of social ranking embedded in having meals with copious amounts of meat. In developed countries the habit still prevalent here that a meal is basically grain and meat or other comes up as an accessory has largely disappeared, with meat being the basis meal and vegetables as an accessory. At times the situation is worse: it is wine that is an accessory, or an invigorating liquor especially spirits; this was for long embedded in high class culture.

Expecting that the world turns around from these habits that really are the hallmarks of culture at an advanced level, such that meals like legumes (beans of all sorts) or tubers (other than fried potatoes) make their way to tables across rich homes or restaurants around the world looks somewhat comic. It is like advocating for a meal of whole grain and legumes on a festival in Tanzania, as it is a non-starter even if that is standard food in ordinary people’s homes. People have different levels of access to protein-rich foods but scarcely different attitudes to the consumption of such foods, as it is an issue of opportunity.

There is all the same a kind of silver lining in some of the research especially in Western countries, as data from the World Health Organisation and activist organizations suggest that more educated people are more aware of the dangers of excessive protein and sugar intake in diet, or in lifestyle generally. The crisis of NCD exposure has two distinctive parts, one relating to diet at a home/family or restaurant level, and the other relating to what is consumed at leisure, what it is made of and amounts to which one is exposed. Some people get diseases from family diets basically, but many risk disease from entertainment.

That is why the current ministerial initiative is important, in the idea that ‘herd immunity’ from NCD exposure will be limited to an educated and persuaded section of society, for a while. But many more will see examples of disease, the suffering and could adjust. It is vital to impart such awareness.

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