An old racing adage warns us to never change the name of a horse. I saw the result with perhaps the best colt we ever bred during our farming years. As befitted such a special fellow, we named him Roubini after the economist who predicted the Global Financial Crisis.
A sparkling future seemed assured. Until the fellows who bought him at auction rechristened our man Fathead Brownie. With predictable results. After a promising 5th on debut, the beautiful colt has run another 20 times without finding the placings.
But in other parts of our world, a name change can make a huge difference. As my Biznews colleague and medical specialist Chris Bateman discusses in today’s contribution where he looks at one of the saddest legacies of Apartheid.
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Chris writes: “Buried in South Africa’s colliding epidemics of HIV/AIDS, violence and trauma, and high maternal and child mortality is a behavioural time-bomb; lifestyle or non-communicable diseases – or NCD’s.
All are inextricably linked to current and past policies encouraging the annual migration across the country by hundreds of thousands of male miners with many of their desperate homeland women and children repelled from the urban fringes by apartheid enforcers.
The dawn of democracy opened the urban migration floodgates. Today it’s all reversed. Economically-destructive government policies are repelling ever-growing numbers of miners from their places of work through unavoidable lay-offs.
Poverty is the enduring constant – a factor which drives the quadruple burden of disease via an insatiable demand for healthcare and expertise as authorities battle to deliver against a policy outcome of dysfunctional cadre deployment and trade union hegemony.
This – and post 1994 ‘liberation’ – has Westernized the habits of millions of black people, creating the perfect NCD storm. Risk factors for cardiovascular disorders, driven by hypertension (high blood pressure), dyslipidemia (disordered blood fats), obesity and chronic renal disease, combine to generate a virtual tsunami.
Cheap, sugar-laden drinks and instant processed food or takeaways have become the staple daily diet of millions. On a continental scale, by 2030, half of all Africans will live in cities; the African Development Bank estimates that the continent has a consuming class of 300 million people. Global fast-food brands are pushing ever deeper into previously virgin markets.
Currently, lifestyle diseases are responsible for about 35% of mortality on the continent; The World Health Organisation forecasts a rise to 65% by 2020.
So, it’s a major boost for South Africa to have the Council for Medical Schemes extend its accreditation of the Centre for Diabetes and Endocrinology (CDE) as a Managed Care Organisation from its eponymous description to embrace the management of other cardiovascular disease factors.
Besides hugely enhancing research, this will allow medical aid schemes to contract with the CDE to manage additional disease conditions beyond Diabetes.
Out of the ten leading, underlying natural causes of death reported by Statistics South Africa, (2013–2015), diabetes mellitus ranks second, cerebrovascular diseases rank third, other forms of heart disease fourth, hypertensive diseases seventh and ischaemic heart diseases, tenth.
According to the CDE, 4 out of 10 men and 7 out of 10 SA women are overweight or obese. This adds to the potential burden of cardiovascular risk, particularly amongst youngsters.
Obese youths are also more likely to have type 2 diabetes or ‘prediabetes’, both conditions being major risk factors for cardiovascular disease.
We know that diabetes, hypertension, dyslipidemia and obesity are influenced by lifestyle behaviours involving high-energy, low nutritional value processed foods, high salt intakes, excessive alcohol use, smoking and lack of physical activity.
You may well ask what’s in a name change? In this case, when it comes to a more effective, holistic approach; absolutely everything.”
It has taken chemically-obsessed modern man a while to awaken to the wisdom of the ancients. This is one area where, at last, the penny is dropping.
