Only few years’ back, if you would ask any public health professional from Bangladesh, what is the most challenging experience they face! They would say communicable diseases, water borne diseases, child and maternal mortality and malnutrition – referring to under nutrition. Now this situation is slowly but steadily being replaced with new challenges like rapid urbanization, climate change, disaster, migration and raising prevalence of non-communicable diseases and its risk factors – obesity/over weight, tobacco use, unhealthy diet, physical inactivity and substance abuse! Unfortunately women and children, once the main victim of under nutrition, are becoming over weight and obese – especially in urban areas.
So why this shift? I have some theories and again these are just my personal thoughts based on observations and evidences. Lets look into the raise of having sugary beverages and junk foods in Bangladesh. Each year the world-renowned food chains are opening new outlets, giving attractive promotions during each of the festivals. Why? Because the market scope for such “in fashion” foods are rising by each day, if not each hour. What about the sugary drinks! During the last one decade a new raise in “Energy Drinks” is being observed. All these products has very effective and attractive marketing strategy which will “make” you believe that these gives you nothing but “Energy” and makes you a “Man”! And we all know that sugar-sweetened beverages are linked to more than 180,000 obesity-related deaths worldwide each year, according to new research presented at the American Heart Association conference. And what about processed food? This silent beast is also on raise as well as within the form of “Entrepreneurship”!
Few years back while doing a school based awareness campaign on anti-tobacco issues one 13-year-old boy asked me “if tobacco is so bad for health then why doesn’t the government shuts down the industry”? The only answer I had was “by showing that they pay tax and do less harm”. This is the dilemma we all – people working for the prevention and control of NCDs face. From public health arena we also have numbers – both for deaths and disabilities. But those numbers are not as attractive as the “revenue” numbers! According to the a report by Centre for Policy Dialogue food beverage and tobacco industries give the highest share for annual inflation in the country for the year of 2013. And sadly this is the “Number” what policy makers and bureaucrats like to hear!
Another issue that is being discussed almost everyday and by everyone! Safe food! Because unfortunately food can just as easily kill as it keeps people alive, where excessive use of pesticide, unregulated street food and lack of awareness about food safety sicken millions annually. Since the country still depends on agriculture, with decreasing land and increasing population farmers look forward for getting more yielding in each of crops they harvest. And while doing so many farmers in the country use an excessive amount of pesticide in agricultural products and ignores the serious health impacts on consumers.
Unfortunately the “philosophy of making profit at any cost” puts consumers at risk. A common practice among food vendors is to spray fish, fruits and vegetables with chemical preservatives including formalin – a commercial solution of formaldehyde and water – to boost food’s lifespan and appearance. The chemical’s short-term effects include: a burning sensation in the eyes, nose and throat; coughing; wheezing; nausea; and skin irritation. As for potential long-term health consequences, formaldehyde has been identified as a human carcinogen. Almost all diet related NCDs renal failure, cancer and liver damage – all potentially fatal – can be linked to the consumption of unsafe food, but the “extent of food-borne illness is yet unknown.
We all know that tobacco makes a lot of people a lot of money. Both forms of tobacco use – smoking and smokeless – are on the rise in Bangladesh. Two in five people aged 15 years or more use tobacco in one way or another. A WHO study estimated that, annually around 57000 people lost their life prematurely as a result of tobacco use and 382000 people becomes disabled.
What is the way out? Honestly I don’t know! As of yet I don’t know but one thing I know that until we show the correct numbers to the people who makes the decision “Profit” will always trump “Health”!
Shusmita Khan works in Eminence as senior associate coordinator and can be reached at Shusmita@eminence-bd.org