“We know what works, we know what it costs and we know that all countries are at risk.We have an Action Plan to avert millions of premature deaths and help promote a better quality of life for millions more.” — World Health Organisation
World Heart Day is an occasion to spread the message that the leading cause of death in the world is heart disease and stroke and that most of the deaths — 17.1 million lives are lost each year — could be prevented. The day was started in 2000 and falls on the last Sunday in September. Starting in 2011, it will be celebrated on September 29 each year. The theme this year is One World, One Home, One Heart.
One World
World Heart Day presents a great opportunity to communicate messages about the importance of elevating non-communicable chronic diseases (NCDs) up the global health agenda. Of the 17.1 million lives claimed by the global burden of cardiovascular disease (CVD) every year, 82 per cent of the deaths occur in low and middle-income countries. This excessive number is particularly saddening, for, by eating a healthy diet, regular physical activity and avoiding tobacco, the majority of the deaths could be prevented.
Global leaders have recognised the urgency of prioritising the prevention and control of CVD together with the other non-communicable diseases (NCDs), which include cancers, chronic respiratory diseases and diabetes, by holding the first-ever United Nations High-Level Meeting on NCDs in September. However, efforts to fight CVD do not rest only with policymakers and global leaders. Individuals can also reduce the CVD burden by learning about the risk factors and taking vital steps to reduce them.
One Home
As the hub of family activities and focal point in everyone's life, the household is the perfect place to start taking action to improve heart health. That is why this year, the World Heart Federation and its members are focussing their efforts on the home.
One Heart
However, not all heart events are preventable. It is, therefore, important to know what action one should take in the event of heart attack or ischemic stroke occurring at home by learning about its symptoms and taking preventive steps.
The WHO reports that NCDs are responsible for about 70 per cent of all worldwide deaths. In India, mortality data from the Registrar-General of India prior to 1998 were obtained from predominantly rural populations, where vital registration varied from five to 15 per cent. Stroke is increasing in India with greater incidence in rural regions. Indians are succumbing to heart disease and stroke in their most productive years. And, workplace interventions in developing countries can reduce the CVD risk.
A study on industrial worksites highlights the great promise of working through organised workplaces, but we have to go beyond this sector. In India, over 85 per cent of the working population is in the informal sector — street vendors, self-employed farmers and those who work in their own or other people's homes. Most are underprivileged and very poorly served by systems of healthcare and social security. And there is an urgent need to find out how to reach them.
If we are to achieve a healthy, powerful and prosperous India, the government and non-government sectors, industries, policymakers, the media, city planners and economists all need to work together, along with the health sector, to engineer the country's growth through health.
As part of an awareness campaign, we, at the Kalra Hospital, have identified and advocated a ban on smoking tobacco, developing healthy food options, being active and making frequent visits to healthcare centres for check-up.
Our community outreach programme has covered more than three lakh people. Over 3000 volunteers have been created and trained all over the country who work as a watchdog to monitor people who are at high risk and take them for referrals. More than 45,000 critically ill patients have been given quality health care services either free of cost or at very nominal cost.
The burden of CVD and its risk factors in India calls for a sound public health approach to stem the epidemic. Efforts to put in place an intervention programme should be complemented with a robust surveillance mechanism so as to monitor, evaluate and guide policies and programmes. It has been demonstrated in pilot mode that it is feasible to establish surveillance for CVD risk factors at community levels. The future of surveillance systems lies in timeliness, systematic approach and enduring partnerships. Consolidating the gains should pave the path for the way forward.
(The writer is Medical Director & CEO, Kalra Hospital, Sri Ram Cardio Thoracic Neurosciences Centre, New Delhi. His email id is: dr_rnk@hotmail.com)
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