Author: Shusmita Khan

When Profit Trumps Health

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 obser2013_05_16_21_3_bvations 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!

news_image_2012-03-08_12129Another 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

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NCDs as a Barrier to Social and Economic Development in Asia

NCDFREE is a global social movement, by, for and about young people – against the world’s leading cause of deaths: Non-Communicable Disease. Launched in 2013 at Harvard University and the University of Melbourne’s Festival of Ideas, NCDFREE brings young, local change-makers from around the world to tell their stories and their visions for a world free from preventable NCDs. To engage their peers and inspire global action.

This is the first in a series of articles from our change-makers. Bangladeshi nutritional epidemiologist Shusmita Khan tells us her vision as a young leader in NCDs.

 

I come from a small country with large population and larger challenges – Bangladesh. At the same time it’s also a land of potential, prosperity and possibilities. Often times there will be multiple challenges to manage and all would need similar attention. And also often times by giving attention to something we tend to forget things with similar urgent need of attention. And I suppose it’s like any other developing country on this world.

The NCDFREE Melbourne LaunchOn 5 October this year in Melbourne, a group of young professionals gathered with a dream – the Melbourne launch of NCDFREE. A dream of having a NCDFREE world – a world FREE of preventable NCDs. As a part of this huge but humble initiative, my idea of dream always starts with stories. Stories of happiness and stories of helplessness and stories of hope! Stories of the human face of NCDs. Of real people, living, dying and surviving.

I was born cancer. As a star sign of course! This made me funny, creative and emotional! But lets say the word cancer again! Cancer. What do you think of when you hear this word? Something that comes to your life, uninvited! Something that tries to stop your course of life and make you count your days! Something that gives you the courage to fight back, to see the end of this legacy of death! Ever wondered how this six-letter word changes our life and affects a whole family? Lets hear a story!

Masuda and ChhondaJust like any other 23 year-old, life for Masuda was beautiful. She had a loving husband, and a baby girl – Chhonda. Suddenly, without warning, Masuda’s chronic stomach-ache turned out to be colon cancer. Without wasting a single moment, the young couple came to Dhaka – the capital – for better treatment where her doctors decided to operate. Surgery meant removal of her intestine followed by rounds of chemo. Surgery also meant a huge financial burden to this young couple and they put their whole future at stake. Months of intensive care with her doctors, Masuda came back to Chhonda. The couple started getting better mentally and financially as well – with some struggles of course. But this was not happiness ever after! The six-letter came back like a déjà vu! The worries and struggles all are back again. Again surgery. Doctors. Hospital corridors. Late night. Anxious moments. Prayers. Debt, loans, more mortgages and borrowing! Three months of all this and at the end this time Masuda doesn’t make it! Now all Masuda’s family has is a lifetime worth of worries of how to give Chhonda a better life with so much of debt! For many, life is beautiful, but for this young couple and lovely Chhonda, life is beautifully cruel . . .

Bangladesh Cancer Support GroupHow do I come across these stories? From 2011 our organization Eminence with a group of volunteers are trying to change the story lines through Bangladesh Cancer Support Group – by raising funds. By making innovative approaches to match cancer patients from wealthy family to donate cost for one round of chemotherapy or radiotherapy to a cancer patient from a resource poor family. Baby steps that are always in need of support from all ordinary person like you and me. Does these baby steps solves the whole problem? No it does not. Because when you are talking about Cancer there is no magic solution that can save lives. For families living in resource poor settings, cancer is just another way of spiraling back below the poverty line, right back in the struggling phase. This is just another example of how a NCD can change the storyline of a happy family. This is also an opportunity for people like you and me to change the storyline through initiatives like our cancer support group.

In 2011, when the United Nations high-level meeting on NCDs was taking place, I wrote a blog called the “three letters”. The basic idea about the blog was how we missed the train back in 2000 by not having three letters in there. The letters were “N, C and D”. These missing alphabets costed us 15 years backlog from getting into the global development agenda of Millennium Development Goals, the MDGs. Today, we are at the verge of replacing those global development goals with new ones and life has given us a second chance as a global community. A chance to have those letters in the next focus agenda and changing the course of tomorrow. A chance to recognize that in my country, your country and all countries – NCDs are a barrier to development!

In September 2013 during the 68th UN-GA Secretary General Ban Ki-moon spoke about the post 2015 agenda – sustainable development goals – and in his speech there was only one line on NCDs. Just one line for the highest cause of deaths and disabilities. Just one line for the issues that will ensure breaking the sustainability of any development.

As a young professional, I believe we can and must do better – for the millions around the world who face or will face NCDs. For people like Masuda and little Chhonda! We must keep the conversation going. We must demand that our leaders see these are issues of poverty everywhere – and ensure they are no longer the forgotten burden anywhere.

Let’s keep being engaged and let’s keep trying to change the course of tomorrow – toward an NCDFREE world!

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This article was commissioned by NCDFREE, in collaboration with Remedy Healthcare and Local Peoples.

Shusmita Khan is a Senior Associate Coordinator in a Bangladesh based NGO – Eminence (www.eminence-bd.org). Ms. Khan was trained as a nutritionist in Dhaka, Bangladesh.  

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