Prevention over cure – changing the NCD narrative

Barbados faces a staggering health challenge: a spiralling epidemic of non-communicable diseases (NCDs). With 80 per cent of deaths on the island attributed to these illnesses, we must act now to address the problem.  

Minister of State in the Ministry of Health, Davidson Ishmael, has announced a crucial step in this fight: a new Health of the Nation Survey, set to be conducted this year. This initiative is long overdue. It is not merely an exercise in data collection but a critical step in safeguarding the health of our nation.

The last such survey was conducted a decade ago, in 2015. Since then, dietary habits, lifestyles, and the prevalence of NCDs have undoubtedly changed. To effectively address the worrying trends, our health workers and other key persons will need current and accurate data. 

The survey, to be conducted by the George Alleyne Chronic Disease Research Centre (GA-CDRC), will help authorities develop targeted interventions and policies. Minister Ishmael emphasised the importance of tracking “trends in obesity and NCDs” to identify key risk factors and formulate effective strategies.

The stark reality is that NCDs are not just a health concern—they place a significant burden on our healthcare system.

Notably, Minister Ishmael’s announcement coincided with a grim warning from Dr Michael Krimholtz, the leading endocrinologist at the Queen Elizabeth Hospital (QEH) for more than two decades. He described diabetes as a “scourge plaguing our nation” and crippling the healthcare system.

Speaking on the QEH’s Pulse Radio Show this week, Dr Krimholtz revealed that the last time diabetes hospitalisation data was reviewed—about a decade ago—between a third and half of the hospital’s patients were there for diabetes-related complications. While he had no up-to-date figures, it’s not unreasonable to expect the situation has deteriorated further

According to Dr Krimholtz, diabetes dominates the hospital’s workload, with conditions such as diabetic foot complications, kidney disease, strokes, heart attacks, and heart failure overwhelming healthcare resources.

We have been repeatedly warned about the devastating impact of diabetes and the urgent need to reverse this trend.

Dr Krimholtz identified several root causes of this crisis. Unhealthy eating habits and sedentary lifestyles are major contributors, but economic constraints also play a role. As he pointed out, telling someone to “eat healthy” is meaningless if they are struggling to afford basic necessities like rent and food.

However, Barbadians must take charge of their health. Dr Krimholtz recommended simple lifestyle changes, such as reducing meat consumption, increasing the intake of beans and pulses, and incorporating regular exercise—such as a daily ten-minute walk—to significantly reduce the risk of diabetes and its complications. For diabetics, taking medication as prescribed by doctors is critical.

Above all, as a nation, we must emphasise that prevention is paramount. The focus must shift from treating complications to preventing them in the first place. Achieving this requires a collaborative effort involving healthcare professionals, policymakers, and the public. We need to promote healthy eating, encourage regular exercise, and ensure access to affordable medication and healthcare services.

The fight against diabetes is a battle we can win, but it demands collective commitment. We must heed the warnings of our healthcare experts, embrace healthier lifestyles, and work together to create a society where diabetes is no longer a crippling scourge.