BY PMA RASHEED
The Gulf Today, 21 June 2009
The Gulf Today, 21 June 2009
Staying away from family is not easy. Apart from the psychological impact, it also affects the physical health of individuals. It is all the more true in the case of expatriates living in the UAE.
A panel of doctors practising in the UAE in various specialisations discussed the host of health issues Ñ physical, mental and social ÑÊfacing expatriates in the country at a seminar organised by the Gulf Today.
They had a common advice to all: Follow the recommendations of your doctor, including taking prescribed medicines at prescribed time, llocate at least 30 minutes a day for exercises and have a social life wherever possible.
For those living in labour camps Ñ who carry high risk of contracting contagious diseases Ñ the doctors had a special advice. Maintain a high level of hygiene, starting with avoiding sharing of soaps, towels, blankets and utensils. Ideally, those who smoke should quit but the least they could do is to make sure they do not smoke indoors.
Most important is indeed washing hands. Even door knobs could carry bacteria that could lead to diseases.
The discussions got off with the general observation that healthy individual means health in its broader terms ÑÊ physical, mental and social. This state materialises only if the individuals are living in a health-promoting environment, the physical and social ones.
The physical environment includes the water, air and soil which might be subject to chemical, biological and physical contamination. The social environment is related to work stress and its associated risk factors and to the living conditions.
Most expatriates lack knowledge in helping them realise what a healthy lifestyle is. The public should be conscious on how to achieve good health.
Lifestyle diseases such as hypertension and diabetes are very common in this part of the world, due to an unhealthy way of life.
The doctors taking part in the debate also stressed that we should have simple and cost-effective ways of receiving medical services that will help a large number of people to receive medical check-ups and advices on the best attitudes of maintaining a healthy body and mind.
A balanced diet and regular physical activities are essential for good health. Today, however, residents of the UAE are consuming too much in calories and moving too little.
Children in the UAE are increasingly affected by overweight and obesity. "Many important risk factors for premature death such as blood pressure, cholesterol, body mass index and diabetes relate to how we eat, drink and move," said Dr T M Jaison, specialist cardiologist at Al Raffa Poly Clinic, Bur Dubai.
He strongly recommended that the major objectives to be achieved are increasing awareness and improving habits relating to nutrition and physical activity.
Health awareness messages should be passed to laymen, covering various topics and guidance about the ideal healthy nutrition for human body, and the importance of maintaining a balance between various food requirements such as sugar, starches, fats, proteins, and vitamins among others.
Health and Hygiene
Hygiene is extremely important. Maintaining a hygienic environment is the basic requirement to stay away from contagious diseases.
Dr Jayakumar B Kannan, specialist gastroenterologist, Dr Moopen's Poly Clinic in Deira, said: "Healthy living in all ways should be promoted, especially in places like labour camps and places where a lot of people are staying together.
"Gastroestinal diseases are very common in places where people are staying together like bachelors' accommodation and labour camps. Special care should be taken while preparing food together. Small measures such as processing of food in a hygienic way and washing your hands properly before cooking can stop the spreading of these contagious diseases."
Of all the factors, living condition is one of the most important social environments that have a powerful effect on the health of an individual. These factors include their living and working conditions, income level, educational background and the communities they are part of.
Big differences in social environments in the UAE contribute to wide disparities in health problems for people living here. There are big gaps in disease rates between the different communities staying here in the UAE.
Dr Mohammed Yousuf, psychiatrist at Dr Moopen's Poly Clinic in Deira, said: "The social environmental factors are like education and personal aspiration. A majority of people who come to the Gulf are quite ambitious and once they realise that attaining their goal is quite difficult they go into depression."
"The recent recession has also affected a great number of people. People who are losing their jobs are forced to go back to their home country and those who are staying back are going through a constant fear of losing theirs," he pointed out.
According to Dr. Yousuf, many are sending back their families in order to continue to stay here but as a as a bachelor.
Leading a lonely life is taking its toll and affecting them in many ways. For most people there is a complete lack of social life that pushes people to the brink. A majority of people go through depression and anxiety.
Apart from the damage that it causes to individual lives, mental illness ÑÊmost commonly anxiety and depression ÑÊ also carries significant social and economic costs, said Dr. Yousuf. "It is one of the main reasons for people taking sick leave or early retirement or even taking drastic measures such as suicide."
"In the UAE, we come across a lot of people staying away from their families. This leads to social isolation and affects their mental health," he added.
According to the World Health Organisation (WHO), both mental and physical well-being of a person are of equal importance. Leading an active social life is as important as eating healthy food and maintaining a healthy lifestyle."
"There are numerous social environmental factors that have an effect on the mental status of a person living here," said the specialist.
Sports and active physical activities bring great health benefits and also play a social and educational role.
The doctors participating in the debate stressed that that physical activity can help people improve their health. In particular, sports can play a key role in staying healthy, in preventing diseases and in getting rid of excess weight.
They also stressed on the fact that media has a very important role to play to spread the message and create awareness.
"A regular physical activity does not just keep the body fit but also keeps the mind fit," said Dr Jaison, the cardiologist.
He also stressed that a regular exercise of 45 minutes to one hour is the best way to keep all diseases at bay.
Diabetes has become a major lifestyle disease in the UAE. According to Dr Jaison, a majority of the population is being affected by the ailment.
About 24 per cent of the UAE population suffer from diabetes Ñ the country has the world's second largest prevalence of the slow-killer disease.
It is high time to declare war against diabetes and raise awareness among residents to fight the disease, he said.
The major reason is lack of exercise and the lifestyle that most people follow.
"No proper study has been done by anybody but data has shown that people early in their life (28 to early 30s) are getting affected by this disease," Dr Jaison said.
According to the medical specialists, there are a number of factors which cause diabetes. Some of the factors are diet, high stress level and lifestyle. The diet here is very rich with high content of fat. Majority of people also tend to go for junk food that is another major culprit.
Most of the diabetic patients do not go for a regular check up. Even after being confirmed of the disease they do not take up treatment with the fear of getting hooked to the medicine for the rest of their life.
Depression is another factor that many people are affected by when they suffer from diabetes.
Dr. Jaison pointed out that these two are inter-related. If a person has diabetes he/she generally gets affected by depression and vice-versa.
"People should be educated about the dangers of increased waist circumference due to an increased risk for type 2 diabetes and associated cardio metabolic risk factors and their link to cardiovascular disease," said Dr Jaison.
He advised those who regularly use insulin or tablets to control blood sugar to make a blood test before and starting any exercise. They might face a severe drop when exercising, if they are on insulin or tablets.
After the middle age, people should regularly go for checking high blood pressure, elevated blood glucose, body mass index (BMI) and increased waist circumference.
The second common lifestyle disease in the UAE is hypertension. High blood pressure sufferers in the country are mostly undiagnosed.
"As few as one in four high blood pressure sufferers UAE have been diagnosed with the deadly condition because they fail to regularly have their blood pressure checked," said Dr Rismon P Hakkim, another specialist.
"And only one in three individuals, diagnosed with high blood pressure, is properly treated for the high blood pressure condition which doctors refer to as hypertension," he added.
According to Dr Hakkim, anyone can suffer from hypertension, but certain factors like smoking, obesity, diabetes, kidney diseases, high alcohol intake, excessive salt intake and lack of exercise, can seriously aggravate hypertension and increase the risk of complications.
"Hypertension is a silent killer, so the middle-aged should know all their numbers ÑÊ weight, cholesterol level, haemoglobin and most importantly, their blood pressure," he said.
Those with high blood pressure should seek medical advice about the possibility of treatment including prescribed medicines for the chronic condition.
Proper medication can only reduce the risk of diabetes and chances of strokes for high blood pressure patients.
Dr Jaison said that the prevalence of cardiac disease is comparatively higher in the Middle East region than other parts of the world. High cholesterol is the basis of all kinds of cardiac diseases, and both male and female are in the risks fatal heart attack and stroke or other related complications.
The burden, management and disease registry of the prevalent cardiac condition have to be evaluated. "We currently do not have facts and figures on the prevalence of this disease, but we do know it has a high prevalence," commented Dr Jaison.
"We have to learn how to better manage and control the disease to find out the burden of this disease on our health system," he added.
Patients with hypertension, diabetes or other factors such as obesity, smoking and positive family history of heart diseases have an increased risk for coronary disease.
Effective lowering of cholesterol is the most important for those who experienced with cardiovascular disorders. To combat and find a way to ease the burden of this potentially fatal disease is the challenge.
Excess blood sugar, high blood pressure and obesity are the major indicators of serious cardio-vascular diseases and cerebral vascular diseases.
"The increase of blood sugar level and obesity may be a big problem which can lead to diseases of the heart and the blood arteries. So, continuous exercise is the best way to help in the management of diabetes and decrease sugar level in the blood," advised the cardiologist.
Obesity Among Children
Another factor is childhood obesity, which is a pressing factor in this part of the world. A big percentage of the UAE children are quite vulnerable to obesity.
"It causes development of further health hazards and psychological impacts among the future citizens of the country," warned Dr Yousaf.
"The socio-psychological consequences of obesity could have considerable impact on the self-confidence of the child, in addition to causing introverted behavior, excessive shyness and self-seclusion," he said.
According to Dr Yousaf, many of our social attitudes are relevant to note in this regard, as many tend to give children the impression that a fat child is healthier.
"Obesity, as a matter of fact, is more prevalent in families where there is an exaggerated focus on feeding the kids, regardless of their nutritional requirements," he said.
"The absence of a regulatory framework in tackling the perils of obesity among the tiny ones will result in the proliferation of the health hazards due to obesity," he added.
Hazards of Smoking
The public should be educated about the hazards of smoking and its negative impacts on the individual as well as the society.
Dr Jaison said that most of the smokers who really wish to stop smoking, but they fail in their efforts to escape from the world of cigars. Smokers should get appropriate assistance, tools and education to support long-term smoking cessation.
"The prevalence of lung cancer is on the rise in the region and there is very low awareness about the severe effects of smoking including shisha," he said. "There are not enough studies about the bad effects of shisha, but there is enough evidence that it can lead to lung cancer," he added.
Now most of the youth people start smoking at an early age. As more young people have started smoking, lung cancer can take alarming proportions in future.
The lung of a smoker cannot be expanded like that of an ordinary person. Tar collected in a jar showed the amount of tar goes to lungs if a person smokes 10 cigarettes a day for a period of one month. Anyone exposed to tobacco smoking are at the risk of lung cancer, which comes third among the most prevalent cancer incidents, Dr Jaison said.
According to the specialist, cases of lung cancer have been increasing at a fast pace both among locals and expatriates.
It is also very important to educate patients to make informed decisions. Lung cancer is often detected when it is at advanced stages.
Dr Jose K. Kurian, dental-care specialist at Dr. Mooppen's clinic, said that dental care involves taking good care of teeth, gums and the related structures of the mouth.
Oral hygiene affects a person's wellbeing and this is why it is important for people to follow proper oral hygiene practices before a problem arises. Many people fail to realise that healthy teeth and gum are extremely important to keeping them healthy and sound. Proper dental health is not only important to our healthy physical looks, it is essential to the well being of the entire body.
"In many cases people may suffer from dental diseases due to sheer laziness and lack of knowledge towards proper dental care, with mostly the children and at times adults who often do not pay enough attention to teeth care," said Dr Kurian.
Harmful bacteria residing on toothbrush can be transferred to the mouth as well as the body every time we brush and cause a host of illnesses and diseases.
"Millions of bacteria can breed on our toothbrush bristles. There are over 10,000,000 types of bacteria that can grow on our toothbrush. The bacteria increase in the warm, moist environment of a bathroom. Studies have shown that bacterium reproduces growth, which doubles every 20 minutes."
"The bathroom is the single most germ-ridden location in the house with the bathroom sink being first, followed by the floor and the toilet seat. When flushing, the toilet releases a spray of germ-infested toilet water that can settle on a toothbrush," he pointed out.
He strongly recommended people to brush their teeth twice a day, in the morning and evening, for two minutes and change their toothbrush every three months. Excess toothpaste left on your brush is an invitation to bacteria to join in.
Chronic viral Hepatitis is a serious health problem in the UAE and has a history of under diagnosis. This, coupled with the stigma associated with transmission of the disease, means that many individuals are afraid to get tested for fear of a positive diagnosis.
A greater awareness should be there about the risks of alarmingly spreading Hepatitis-B in the UAE, said Dr Jayakumar B. Kannan.
Residents should be given lessons on how to seek screening and learn how to protect them from the disease. Spread of the disease should be prevented through awareness, testing and prevention.
"Hepatitis is an inflammation of the liver, most commonly caused by viral infection," Dr Jayakumar said. "While there is no cure for Hepatitis-B, there are effective treatments that can manage the disease and allow patients to live a relatively normal life. The key to overcome the fear of a positive diagnosis will be realised though educating people about the treatments available and raising awareness," he pointed out
Hepatitis-B is the most common of the viruses and affects more people than any other form of hepatitis. The chronic Hepatitis-B can lead to serious liver damage and potentially liver cancer which can be fatal. Because patients often do not demonstrate symptoms until later stages, early detection can help save lives.
He warned: "Left untreated, it can progress to cirrhosis and even liver cancer. In fact, some 80 per cent of all primary liver cancers worldwide can be attributed to Hepatitis-B. There is no cure but there are medications available to treat the condition."