Some people may have missed the recent revelations that the spiralling epidemic of non-communicable diseases is driving the vexing delays experienced by patients seeking emergency care at the Queen Elizabeth Hospital. We did not.
This newspaper has observed that despite renovated facilities and some new processes, the treatment rooms of the Accident and Emergency Department remain badly overcrowded. Patients remain there for more than 24 hours waiting for placement on scarce beds on wards. The best bedside manners of dedicated nurses and doctors on one shift wear out hour by hour.
Acting Director of Medical Services Dr Chaynie Williams blames the overcrowding on the epidemic of chronic non-communicable diseases.
“The Emergency Department’s challenges are a health system challenge as it represents one geographic location,” she said. “We have many complications of non-communicable diseases – kidney, heart, and others – that patients need inpatient care [for] and many times persons spend days in the Accident and Emergency Department trying to access in-patient care because they are very ill or in hospital and can’t get out of hospital because they are not well enough.”
Critics have questioned Dr Williams’ rationale, but the underlying message is clear: this NCD crisis will continue to overwhelm not just the A&E, but every facet of our society If we don’t face it and fix it.
A leading medical consultant, Dr Kenneth Connell, believes our NCD situation is understated and even more dire than we think.
He explained: “What has happened post-COVID, is an increase in the NCD emergencies – stroke, heart attack and heart failure. COVID has been the propellent for a lot of this. So patients admitted with emergencies can sometimes remain in the A&E department for two, three days waiting to be placed on the ward.”
“Expanding the A&E Department, which there has been a lot of talk about, I am not sure is the actual solution. What would happen, the beds from the expanded department would just be basically holding more patients with NCD emergencies.”
Dr Connell has proposed a serious conversation involving the Ministry of Health and Wellness, civil society organisations, patient advocate groups and other interested parties to help those who already have NCDs to better manage themselves and to ensure more people remain NCD-free.
The statistics must force us to respond.
According to the World Health Organisation’s (WHO) 2022 Non-communicable Disease Progress Monitor report, the percentage of deaths from NCDs in Barbados in 2019 stood at 83 per cent or 2,800 total NCD deaths, which is above the world average of 74 per cent.
Need anymore be said?
We already have a blueprint after two years of weathering the coronavirus pandemic.
It was only months ago that all hands came on deck to tackle that deadly virus.
Legislation, the introduction of protocols, public education programmes and other sweeping changes were quickly enacted to protect the public.
Now the NCD problem deserves the same urgency.
Lest we forget, NCDs, largely lifestyle diseases, can be prevented. This fight is not about wearing masks, sanitizing and physical distancing but we know the risk factors, including poor diet, lack of exercise, smoking, and alcohol.
The current NCD crisis requires not only a whole-of-government approach from nutrition and trade policy to preventative health care to education and social welfare.
Major fiscal measures beyond the occasional piecemeal fiat and electioneering crumb are now badly needed to widen access to healthy, affordable foods, discourage consumption of cheap, processed foods, and facilitate mass exercise.
We have seen positive steps in this direction with the increase in the tax on sugar sweetened beverages and the introduction of the School Nutrition Policy.
But there is so much more to be done. Our nation’s health is on the line. The administration needs to take decisive action on front-of-package warning labels, reinforcing national dietary guidelines and encouraging government departments and private sector companies to develop employee wellness programmes.
The greatest onus still lies on all of us.
Most of us think wellness is expensive, but illness is the poor alternative.
Barbadians young and old have the power to lead healthier lives. Our health is our responsibility. We consume way too much processed meat, and salty, sugary food and drinks,.. We need to consume more plants and be more active.
A century ago, communicable diseases made life in Barbados nasty, brutish and short. It is now up to today’s government and governed to work together to make the sham, drudgery and misery of emergency health care into yet another faded picture of a dim and distant past.
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