By Kaboni Gondwe and Shaoqing Ge
The heart is an interesting organ in the body; it beats continuously even when asleep. Such a simple thing that signals the presence of life during embryonic period, signals the end of life at its cessation. While important to our survival, cardiovascular disease remains a silent killer. We have come through decades where heart disease was thought to be an issue for people who were overweight and obese or a problem for people with high socio-economic status. However, the burden of heart disease in global affecting people from all walks of life.
Heart disease has thus been described as the number one killer globally. And it is the 2nd leading cause of death in developing countries.
Dr. Bloomfield mentioned how developing
countries are challenged by the dual burden of communicable and non-communicable
diseases. The epidemic of non-communicable diseases such as cardiovascular/heart
diseases has dramatically increased in recent years. In countries where
resources are limited and are unaware of their risks for heart disease the
people die without understanding why someone who looked perfectly normal could
just collapse one day and die. In Malawi, most sudden deaths in the rural areas
are usually thought of as witchcraft and gaining weight was for a long time
viewed as a sign of wealth and peace. There was an incident where a man in the
urban area felt a sharp pain in his chest while driving, he rushed to the
hospital and he was in time to get the best treatment. This man was educated
and was aware of the signs and symptoms, thus he knew he needed to seek medical
attention and he survived. Other cases form the rural start with complaints of
chest pain and headaches. People eventually die in their sleep with blood
coming through their nose. “zitheka
bwanji munthu oti anali bwino bwino dzuro lero muziti watisiya, ufiti” (How
could someone who was fine yesterday die today, this is witchcraft). This lack
of sensitization of the signs and symptoms is bound to result into more deaths
that could have been prevented.
The problem of increasing cases of cardiovascular
disease has equally affected developed countries like China. In China, the
prevalence of diabetes among Chinese adult population has increased from less
than 1% in 1980 to 11.6% in 2010 (Xu, Wang, He,
& et al., 2013). China has the largest population in the world, with
an estimated 113.9 million diabetic adults (Yang
et al., 2010). Cardiovascular disease has also become a chronic problem
for Chinese population and a challenge for older adults whose health is already
diminishing. Shaoqing’s grandmother, an 80 year old Chinese lady, has lived
with hypertension for 30 years, had stroke around 20 years ago and developed
atrial fibrillation around 5 years ago. She now controls her situation with
medicines and exercise regularly. However this was not the case when she
initially diagnosed with hypertension, she was a regular smoker back then and
she absolutely had no idea of self-management. The only thing she knew was she
would not die soon only with hypertension. This situation was not changed until
she had that stroke tragedy; she then realized the importance of
self-management, such as diet, exercise and medicine. However, as age grows,
the situation kept deteriorates to arterial fibrillation but just slower.
These stories reveal that behavior change
will not happen suddenly; it is highly related to education and self-awareness.
Strengthening education is especially valuable for countries with limited
resources, which is the case for most developing countries. Back 30 or more
years, people were not aware of the relationship between smoking, salty diet
and cardiovascular diseases, now even though this can be a common sense to some
people but can still be unfamiliar to people in certain lower-income countries
and areas. We believe this is both a challenge
and opportunity for stakeholders, practitioners and global health researchers,
to provide information, technology, and treatment.
References
Xu, Y., Wang, L., He, J., & et al. (2013).
Prevalence and control of diabetes in chinese adults. JAMA, 310(9), 948-959. doi:10.1001/jama.2013.168118
Yang, W., Lu, J., Weng, J., Jia, W., Ji, L.,
Xiao, J., . . . He, J. (2010). Prevalence of Diabetes among Men and Women in
China. New England Journal of Medicine,
362(12), 1090-1101. doi:doi:10.1056/NEJMoa0908292
