CMA focuses on E-health next year

With both communicable and noncommunicable diseases being of concern to the “varied” countries spanning the Commonwealth group, next year (2014) will be declared ‘The Year of E-health’.

The Commonwealth Medical Association (CMA) has dedicated 2014 as ‘The Year of E-health’ with the theme ‘A path to a healthy life through the information superhighway’, its President Dr. Solaiman Juman told the Sunday Times.

E-health would help a doctor in a rural setting to seek advice using modern communication technology from a senior doctor in the city, according to Dr. Juman, who cited such a pilot project in India.

The CMA with its motto of ‘Champions of Health’ has a membership of 42 Medical Associations from among the 53 member countries.

Soon after participating in a meeting the Commonwealth Foreign Ministers had with civil society organisations at the Hilton Hotel on November 16, Dr. Juman who is from Trinidad and Tobago promised “lots of action” next year.

Having also been part of the People’s Forum at Hikkaduwa, he said the medical issues that came to the fore there were communicable disea- ses (CDs) such as HIV, malaria and tuberculosis as well as non-communicable diseases (NCDs) such as diabetes and cardiovascular disease.

Pointing out that the Commonwealth has a crosssection of nations and even now there are pockets in Africa where CDs are rampant, Dr. Juman reiterated that for both CDs and NCDs what is needed is preventative action.

The governments should be looking at people’s lifestyles, he said, adding that in one document prepared at the People’s Forum, governments and policymakers are urged to promote healthy lifestyles.

He cited two “simple” examples where government action would help. If a person is in his car for two hours while getting to work and two more hours getting home from work, not only has he wasted four hours but it is also “deleterious to his health – both physical and mental”. Here, the decentralization process should come in, so that this person can find work closer home, he pointed out.

The other is the need to plan a town or city with spaces and green areas for people to exercise, he said, adding that they also met the Commonwealth Association of Planners to discuss ways in which urban planning could promote healthy living. Treatment of chronic diseases creates a burden on the economy and it is simpler to change people’s lifestyles.

Another area of concern for the CMA is preventative and maintenance of dental care which has “big issues of morbidity”, the Sunday Times understands. “Dental illnesses are linked to cardiovascular disease too, Dr. Juman said.

Taking up the crucial issue of health and education, he was of the opinion that for sustainable development these two aspects are vital.

Migration was also discussed at length at the People’s Forum, it is learnt, with Dr. Juman pointing out that when doctors and nurses leave their home country there are many medical consequences. Sometimes as many as 50-60% leave for greener pastures and this depletes the resources in their home countries. A balance must be struck through trade, employment and immigration agreements as migration issues are multi-factorial.

Conceding that there are “no easy answers”, he said that training in a particular field should be followed by a requirement that those trained should work in the home country for a stipulated period of time. When they go for postgraduate studies there must be agreements for them to come back.

Referring to the one million migrants, mainly housemaids who have gone abroad from Sri Lanka, Dr. Juman asked, “who takes care of their children back home?” Research indicates that there is a higher incidence of depression in these families, he said also quoting a different study in the United Kingdom which has found that women-migrants are six times worse off than the local population when it comes to health issues.

“There may be different reasons for this such as cultural barriers and their reluctance to seek healthcare, but this is the reality,” he added.

Underscoring the fact that the Commonwealth meetings in Sri Lanka brought about the “big asset of networking”, Dr. Juman said the discussions at the People’s Forum covered a gamut of issues including universal access to health, minority

Pointing out that the Commonwealth has a cross-section of nations and even now there are pockets in Africa where CDs are rampant, Dr. Juman reiterated that for both CDs and NCDs what is needed is preventative action

The stigma surrounding HIV was dispelled in South Africa by leaders getting themselves tested for HIV in public view, said CMA Treasurer Dr. Phophi Ramathuba from South Africa.

The lead role in dispelling the stigma is played by our leaders, she said, explaining that the President, the Deputy President and the Health Minister get themselves tested for HIV every year in front of the cameras, although their status, whether negative or positive, is not made public.

“Before we go to the factory floor to test workers, the Chief Executive Officer will get himself tested, while celebrities who are on antiretrovirals (ARVs) talk about it openly,” she said.Urging the channelling of more resources for health, Dr. Ramathuba says that although her country is investing adequate resources, some African countries don’t have a similar mindset. For them health spending is not a priority and health is looked at as “social spending” not as an investment. rights, gender issues and reproductive rights, infant and maternal mortality rates and reconciliation.

With the index of human development being measured by the infant mortality rate (IMR) and the maternal mortality rate (MMR) and three of the Millennium Development Goals (MDGs) being these two as well as HIV, Dr. Juman was of the view that the CMA could influence the United Nations post-2015 agenda.

Reiterating the “silent danger” that most people face – the 90% chance of dying from cardiovascular

Economic development is a priority but not this. How can there be economic development if there is no health, she questions, stressing that health and education are overarching. There simply cannot be economic empowerment without health and education.

Adding her voice to issues with regard to complementary medicine, she is strident in her calls for such treatment to be evidencebased. Citing the example of a healer back home who gives water to those suffering from HIV, she pointed out that usually when a patient has been on ARVs for about five years, as the viral load is very low, the test comes out negative.

This is when the healer claims that he has cured them, by just giving them water. Then these patients stop ARVs and the consequences are terrible. “When they come back to us they are worse off, because their bodies have developed resistance to ARVs,” adds Dr. Ramathuba. disease or cancer which cannot be ignored, he said the document that emerged from the People’s Forum is “soft power”. A major element is the essential government-business-civil society link when implementing changes and also in governance. The power lies in the fact that the Commonwealth has endorsed it and we can demand its implementation from our respective Health Ministers.

“There was a space for all to interact and the interactions were fruitful,” Dr. Juman, added.