The World Health Organization’s (WHO) defines health as “A state of complete physical, mental and social well-being and not merely the absence of disease or infirmity”. This definition suggests that we need to focus not only on curative health for diseases that we have
identified, but also on preventative health for those that we cannot see, and we haven’t identified.
A culture of health is the conscious appreciation of one’s health and the purposeful actions towards achieving optimal health. Unfortunately, in many countries around the world we are yet to fully embrace a culture of health. Instead, we have a sick care culture; when you are sick or fear death, that’s when you go to the hospital. What is most beneficial is a “culture of health”; when you take care of your health even when you are not visibly ill or symptomatic.
The days when medical doctors were demi-gods are long gone. In this
century, healthcare has become a collective responsibility of several members of the healthcare system alongside the active participation of patients. This suggests that as individuals we need to make a conscious effort to be in tune with our bodies and live the very best lifestyle possible. Members of the health care team need to be more patient centric and guide patients into being more responsible for their health and work with them as partners with the aim of achieving the same goals.
There is an adage that says, “prevention is better than cure” and in this embodies how we should manage our health.
One of the issues we have with embracing a culture of health has to do with our lack of understanding of what it entails or how beneficial it is to our existence. I will use a case study to explain.
There was a young professional man who lived a busy life in an African country, like most people around the world. He was 45 years old, with a wife and three children. He ate well but not
excessively, he was not a smoker, he drank alcohol socially, and appeared to be in a general state of good health. He worked for approximately nine hours a day, his commute to and from work took another three hours of his day. His weekends were leisurely, catching up on sleep, going to events and spending time with his family. He began having constant headaches, which he attributed to stress at work, which always got better after taking some form of pain relief. He noticed some slight warming of his body and the usual telltale sign of body aches associated with malaria. Fortunately, this was on a Friday and so first thing on Saturday morning he went to
a nearby hospital and within a few minutes following consultation was diagnosed with malaria and treated according. By Monday morning, all his symptoms had subsided, and he felt
he was well enough for work, and he went in. On Wednesday, his headaches returned but he couldn’t get to the doctors until Saturday and so he continued on his pain relief, on Friday at work he collapsed and he was pronounced dead that night.
This case is unfortunately a true-life event and has been replicated with various degrees of similarity repeatedly around the world. This scenario can and should be prevented. There are various interventions that could have led to a better outcome.
For starters, the idea that we are healthy because we do not have any obvious disease needs to be thrown out because it gives us a false sense of safety and complacency. This inhibits us from being proactive about our health and lets us take our health for granted by developing a poor health seeking behavior.
Some physicians have stated that pain is beneficial, and I agree because it is our body’s way of telling us that something is amiss. We owe ourselves the duty of paying attention to that pain depending on the circumstances and identifying the causative factor. There are many reasons why doing this might not be top priority or even possible. “It is a headache and will go away”, “it is not serious”, “I cannot have any serious problem because I am young and healthy”, “I don’t have time to go to the hospital or clinic because I am always busy at work”, “the clinic takes too much time which I don’t have during the week so I will do it over the weekend” or “my clinic is by my house on the mainland and I spend all day on the Island”. And the list goes on.
On the healthcare provider side, some of the issues/reasons are malaria is endemic in Africa and so common things occur commonly as we usually say, and so headache/fever/aches and pains is classic and will be treated as malaria. There is a gross shortage of doctors and other members of the healthcare system and so the doctors do not have to time to prod and take a long-term history for every patient so they go by your most immediate presenting complain which may not capture your complete health picture as with the case in question.
The current health care infrastructure in many African countries is limited to symptomatic and curative management at which point some damage has already been done, physically, mentally, socially and financially. We have only started to realize the full extent of the benefits of healthcare technology and informatics. We are blessed with brilliant healthcare professionals who use limited resources to diagnose and treat patients, which reduce our healthcare costs but also impact our health outcomes negatively with our life expectancy in the low 50’s.
As a case study, let’s compare Nigeria to a high-income country like the United States of America, where they are patient centric and rely heavily on healthcare technology. Health care costs in the US are very high for a plethora of reasons, but their health outcomes are much better with a life expectancy in the 70’s for both sexes while it’s in the 50’s for Nigerians. They are obviously doing some things right.
Let’s also compare Nigeria to a relatively middle-income county like Cuba. Their life expectancy is in the high 70’s, number 35 in the world, above the United States at number 37 and they spend one tenth of what the United States spends on health. Their weapon for success is preventative health. The Cuban healthcare system is a good model for many to emulate. Hospitals are used for acute and emergency cases while most people utilize outpatient clinics to manage their health or their chronic diseases on a regular basis.
The United States and Cuba do not have the best healthcare systems in the world, but they have achieved what many countries are striving towards.
To those countries, I say it takes a nation. It’s a grassroot movement from the ground up and it’s the political will from the top down, all working together to ensure the best health outcomes.
It begins with educating children in elementary through high school about their health and how their lifestyle impacts their health. It involves educating communities and providing free and easily accessible health literature. The basics need to be explained on a population health level such as the importance of eliminating salt from their diets for those with particular heart related conditions, the benefits of walking or having some sort of exercise regimen and the need to use prescribed medications as directed and so much more.
Members of the healthcare profession should be re-trained and educated about how their care of the patient must have a balance between preventative and curative management. They should be educated on how to develop a culture of health in the hospitals and other healthcare facilities: proper hygiene practices, the best use of healthcare technology, patient safety and how all these positively impact patient outcomes.
If we all embrace a culture of health and preventative health becomes a norm in our societies, we will create an environment which makes it easier to combat preventable diseases as well as sudden outbreaks of deadly diseases such as Ebola and Covid-19.
The government needs to invest more resources into providing better preventative healthcare services. The public and private sector must be tasked with the responsibility of maintaining a healthy workforce which in turn increases productivity and improves the quality of life of its employees and promotes a healthy and sustainable future.
Dr. Lolade Adeyemi is the Chief Operating Officer for Magna Carta Health.
Magna Carta Health is a preventive health services digital health organization focused on changing the face of healthcare in Africa. Magna Carta Health prevents death , disability and disease with the aid of technology.