Responsibility for Health

Nov 23, 2012 Editorial

One of the unfortunate consequences from the amazing growth of the medical sciences has been the unbridled emphasis by modern governments on treating ill health as purely one for medical intervention. This has resulted in the creation of an increasingly unsupportable infrastructure in the developed countries as witnessed by the contentious debate on health care insurance in the US.
To ensure that we do not end up in the same fix very soon, our policymakers must take cognisance of what is only now belatedly accepted in the ‘developed’ countries: lifestyle choices by citizens are highly correlated with many diseases. Our nation’s health can be better secured and improved if it is more widely recognised that there is a dual responsibility for bringing about that eventuality: the individual as well as the state; the private as well as the public.
Improving health means addressing the causes of poor health. These causes, of course are myriad –arising out of a complex interaction between personal, social, economic and environmental factors. One of the debilitating legacies of a colonial past, however, is while rightfully blaming the then government for much of our predicament, after independence we refused to extend our newly-won agency to so many areas of our lives – including health. We forgot the “personal”.
This is not to propose an “either/or” situation, where we have to point fingers at each other, but to recognise that there will have to be a partnership between the health authorities and us the ordinary citizens if we want to develop a healthier nation. Take for example the case of cancer of the lungs, which is a significant cause of death in our country and is defined as a “public health” problem. It is universally known that smoking is a major factor in the development of lung cancer.
The authorities of most jurisdictions, including Guyana, have banned commercials for cigarettes on TV; have banned smoking in confined public places and have even gone so far as placing graphic warnings about the causation link between smoking and lung cancer on each pack of cigarettes. Yet smoking continues unabated and the programs to deal with the consequences then fall on the rest of society via the government coffers. The analogous argument can be made for diabetes, HIV/Aids and so many other “lifestyle- conducive” illnesses.
We are suggesting that in the public-private partnership necessary for a viable health sector, a balance must be struck in the allocation of responsibilities for dealing with certain health problems.
Greater responsibility ought to be placed on individuals than presently prevails, which can be in the end only be enforced by other individuals – in the collective as a society – who develop and practice the healthy alternatives as social mores and norms. We recognise that this is a sensitive subject and we hope that there will be some public discussion on the issue.
Better health is everyone’s business. Many of us complain about our economic underdevelopment, but do not appreciate that better health can improve economic productivity significantly. We wonder if the Ministry of Labour computes the number of working days lost through work-related ill-health. Ill-health is expensive in both economic and human terms. Cutting the cost of sickness at work will help to decrease burdens on business.
While people are responsible for their own actions in health as in other areas, there is always the question of whether the individuals are aware of the nexus between their lifestyle choices and their subsequent illnesses. The decisions people take over their health are more likely to result in better health and a healthier life, if they have the opportunity to make informed decisions. And this has to be the responsibility of officialdom.
We can do no worse than begin in our schools – starting from the lowest grades – where it appears that our officials have forgotten about the old aphorism of the benefits of “a sound mind in a sound body”. Physical education must be a part and parcel of the curriculum of every school – from nursery to university.

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Responsibility for Health

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