Sunday, November 23, 2008

When a Bum Stomach Turns Deadly

Whenever there is scarcity there is invariably rationing. We hardly have any healthcare in the Philippines. Organize a “free clinic” and the demand is greater than the water station on the halfway point of the New York City marathon. There is a never-ending supply of poor patients and even if you can only offer them 3 days of anti-hypertensive therapy, there is overwhelming gratitude (cynical colleagues ascribe this to the small profit they will make selling these drug samples).

We were just informed that the First Gentleman (FG), pet name of the husband of Gloria Macapagal Arroyo was returned to the Philippines while en route to Lima to accompany his wife listen to the Arch protectionist Bush preach about free trade and free markets. It appears that FG had gastrointestinal symptoms that required their jet to make an emergency stop in Osaka, Japan where he had an urgent MRI and his cardiothoracic surgeon had to be flown from Manila (as if they had a shortage of these specialists in way medically advanced Osaka) before he was promptly jettisoned back to where he came from. Medical opinion from his various physicians were unanimous in their diagnosis: bum stomach.

Most Filipinos who make it past the critical age of 12 months (we have one of the highest infant mortality rates in the world) still live 10 years less than their counterparts in Japan. This is because we have a silent but terrible epidemic of untreated hypertension and diabetes. The previous staple of rice and salt was bad enough but with the soaring prices of rice, there has been a major shift towards “instant noodles”, even less carbohydrates with a more potent dose of sodium. Blood pressure is a function of blood volume multiplied by peripheral resistance, the elevation being directly attributed to the intravascular shifts that take place with a salty meal. Add the burgeoning number of cigarette smokers among the poor who resort to the hunger-numbing effects of nicotine and there will be no difficulty tracing the etiology of this epidemic.

Even patients in the rapidly disappearing middle class have compliance problems on account of the expensive medications. Compliance drops to near zero for the great majority. Budgets are busted by the time provisions for medications arise.

Hence I wouldn’t even hazard a guess as to how many strokes, heart attacks, and premature deaths would have been prevented had FG just stayed at home.

1 comment:

azron said...

I learn so much from you...