EDITORIAL: You are what you eat

The growing prevalence of non-communicable diseases in the country is worrisome, given the high cost of their treatment The growing prevalence of non-communicable diseases in the country is worrisome, given the high cost of their treatment

In a country where infectious and communicable diseases like cholera, HIV, tuberculosis and hepatitis B continue to take a heavy toll year after year, it is bad news that there is now a heavy presence of non-communicable diseases among the populace as well. A study of select chronic diseases, conducted by Nepal Health Research Council from 2016 to 2018, has shown that chronic obstructive pulmonary disease (COPD) is the most prevalent among the Nepalis aged 20 years and above, followed by diabetes, chronic kidney disease and coronary artery disease. Barring coronary artery disease, the other three diseases seem to be more prevalent among males than females. What the study has done is brought to the fore the bare facts regarding the prevalence of these common non-communicable diseases across the seven provinces. But even without the study, the general public, especially urbanites, were already starting to realise that they were increasingly falling prey to them.

It is not difficult to see why the select non-communicable diseases are on the rise in Nepal. Urbanisation and changing lifestyle and leisurely activities apart, environmental and occupational pressures are abetting these diseases. Tobacco use, alcohol consumption, high blood pressure and sugar levels, abnormal lipids and risk of COPD only aggravate them. The study, carried out in 72 districts encompassing all seven provinces, has made quite a few interesting revelations. For instance, Province 3 shows higher prevalence of diabetes in comparison to the other provinces, largely due to the high concentration of urban centres, which includes the capital. This urbanisation coupled with physical inactivity, popularity of junk food and obesity is contributing to the disease. Similarly, Karnali Province has a high prevalence of COPD cases, caused more by inhaling of smoke given out by the burning of biomass fuels for cooking.

The growing prevalence of non-communicable diseases in the country is worrisome, given the high cost of their treatment. A kidney transplant or cancer treatment, for instance, costs a fortune in Nepal, which is beyond the means of even the middle class family. In such a situation, prevention is the best policy. Early interventions would be effective in reducing the risk behaviours associated with these most common non-communicable diseases. The government must, therefore, introduce an effective health promotion and chronic disease prevention programme. Taxation on the use of not only tobacco and liquor but also on high calorie junk food might help in curbing their use. In the rural areas, the promotion of better ventilation in the kitchen or the use of improved cook stoves will see respiratory disease go down. Job transition from agriculture to the urban centres, especially to the service sectors, means decreasing physical activity. So there is a need to encourage people to engage in regular exercise, sports and yoga to stay fit. Specific health promotion campaigns aimed at a target group or province will go a long way in keeping these diseases in check. But the government can only do so much. The people themselves must take the initiative to take care of their health.

Online system

Gradually the government offices are also embracing online service to provide their services in a hassle-free manner. After the government launched the online service at the Kalanki-based Land Revenue Office (LRO) a few months ago, LROs even outside the Kathmandu Valley have switched to online service. A report from Dhankuta said Dhankuta LRO has also started providing its services through the online system, which is expected to deliver quick, hassle-free and foolproof service to the service-seekers.

With the launch of the online system, service-seekers can now access information regarding the status of their land through a mobile application. The best part of the system is that the LRO issues an automatically generated notification to the landowner when his or her land plot is being sold to others. This system will keep the landowner on the alert should his or her land be sold by some fraudster. The online system also does not accept a land transaction form until it is fully filled up with the required information along with a photo of a witness. The Ministry of Land Reform and Management has so far launched the online system at 78 LROs. But the people must be educated about the system that benefits all.