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We must have a breastfeeding culture

Tuesday, August 2, 2016

Though seemingly a step forward in the progress towards a healthy population, one of the biggest mistakes the United Nations ever made was to declare in 1948 that “health is a right.” As usual the entire statement of the Universal Declaration of Human Rights is never quoted. Which is, that that right is subject to progressive realisation. In other words it is not guaranteed to be attained immediately. In plain language you have to work at it! Health is not an automatic right. You cannot assume that because an organisation or government has made a proud-sounding declaration that that means you are automatically going to be healthy.

Few people work at being healthy. The attitude seems to be that “my health is a right” so when I am ill somebody must make it right. Because is so. Because I deserve it. Because somebody, somewhere decided that health is a right without stressing the equally important second part that health is not a gift given to you at birth and not money to use as you grow and not a right that weakens as you age. Health is a living dynamic process between you and your genes and your bacteria and your environment that you have to pay attention to it and pay your dues to it. 

So, yes, as minister after minister love to declare from a platform, it is a personal responsibility but governments have to work at assisting people to be healthy. Pompous words and editorials and conferences about programmes to decrease non-communicable diseases (NCDs) mean nothing unless governments put in place systems that encourage people to be healthy. 

When the Minister of Health talks about consuming the wrong foods, when he correctly identifies the fact that it is poor people who are more vulnerable to ill health because of their diet, because fast food is so much cheaper than nutritious food, that is not good enough! Emile Elias is correct when he says that we have a belief that if we talk about a problem, it solve! 

The Minister has a duty, his job, to convince the rest of his Cabinet colleagues that they must do something about the price of fast food and the price of healthy food. If that means subsidising our farmers to grow more fruit, vegetables, rice and ground provisions and sell them at a profit but still within the means of the average Trini rather than subsidising multinationals and allowing them to import cheap junk to make Trinis sicker, then so be it. Every major country in the world feeds its people and subsidises its farmers.

This present Minister and his predecessor have both been at pains to present the economic case for promoting healthy living. It’s based on how costly it has become for the Ministry of Health to provide treatment for these non-communicable diseases that are terrorising people. Forty billion dollars spent between 2005 and 2016! And rising annually because we apparently spent $6 billion for the past financial year? 

Since this is Breastfeeding Week let me point out for the umpteenth time that healthy feeding begins in the womb and immediately continues after birth with breastfeeding! Study after study has shown that if you want to combat the NCDs in adults you have to start prevention as early as possible. Talking about preventing obesity in six year olds or even three year olds is stupid. By the time a child starts nursery school, who fat, fat, because children are set up to become fat, inside the womb and during the first year of life.

I challenge the media to do some walking and go into any health centre and see the treatment meted out to pregnant women and the babies inside their wombs. Antenatal care in T&T is still in the Victorian age. Our prematurity rate, although we don’t know what it is, was somewhere in the mid teens the last time PAHO looked at it. Fifteen per cent babies born underweight? 

Underweight babies tend to grow up to be overweight adults who suffer from NCDs (diabetes, pressure, heart attacks and strokes).

Even if the baby is born healthy, problems immediately arise and continue for the first few months of life because of the difficulty that women find to breastfeed in our hospitals and most of the private nursing homes. Even though great strides have been made in breastfeeding, we live in a bottle feeding culture. Its importance is not stressed in schools, antenatal clinics, private medical offices or in the hospitals.

After birth, women are not given adequate maternity leave to allow them to breastfeed successfully (another place where government should act). Offices are not breastfeeding-friendly (another place where government should take the lead). Health care providers from nurses to GPs to obstetricians to paediatricians are not breastfeeding friendly. Mothers are still being harassed in cinemas and concert halls if they attempt to breastfeed. And the milk industry is still being allowed to sell their formulas under the guise of “growing up milks” and to enter health centres to influence mothers into buying inferior formula and to advertise their products at “Health Fairs” often with the connivance of the same Ministry of Health that claims it is trying to develop a National Infant Feeding Policy.

Look, it’s simple. If you want to fight obesity and its accompanying NCDs, you have to have a breastfeeding culture. Breastfeeding babies decreases adult obesity and its complications by 30 per cent. How much is 30 per cent of $6 billion? No other factor influences the problem of obesity and NCDs like breastfeeding. Ignoring that fact is plain nonsense. 


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