The war is over but Sri Lanka’s workforce is sitting on a fast-ticking time bomb -- the working population is sick. Not only are workers heading towards major illness and death, this may also be a vital factor obstructing the rapid development of the country.
A study of a cross-section of the workforce in the districts of Colombo, Gampaha and Kalutara which gives an insight to the bigger picture across the country has thrown up a shocking disclosure, the Sunday Times learns, and if urgent action is not taken, non-communicable diseases (NCDs) lie buried like landmines sending many to an early death.
Nearly one-fourth of the working population surveyed is either diabetic or on the brink of becoming so. (see box)
It was from November last year, continuing even now, that health teams fanned out across the three districts, firstly visiting the Presidential Secretariat followed by the Sri Lanka Broadcasting Corporation, the Sri Lanka Rupavahini Corporation, the Auditor General’s Department, Lake House, the Attorney General’s Department and many other workplaces to screen not only government workers but also those in the private and non-governmental sectors.
Health checks for the working population came about after Western Province Health Minister Jagath Angage queried why men at the peak of their life, mostly breadwinners who were around 50 years old were dying. He was attending many a funeral regularly, points out Western Provincial Director of Health Services, Dr. Harsha De Silva, explaining, “A majority of deaths were due to heart disease, diabetes mellitus and strokes.” (Every day in Sri Lanka, 250 die of NCDs, with 100 falling victim to heart disease daily, according to Dr. De Silva.)
Activated by the disturbing finding that none had gone for a medical check-up, the provincial health office came up with a plan to screen the workforce of the Western Province which has a population of 5.7 million, amounting to more than one-fourth (27%) of the population of Sri Lanka. “Political commitment came from President Mahinda Rajapaksa, WP Governor Alavi Moulana and WP Chief Minister Prasanna Ranatunga,” says the Provincial Director.
Mobilizing the Medical Officers of Health in the 41 MOH areas in the WP to list out all workplaces which had more than 25 employees, they also floated the ‘Uththama Shrama Pooja’ which came up with the novel concept of seeking the support through advertisements of retired health personnel for the screening of the workforce. That’s how they enlisted 1,400 doctors, nurses, medical laboratory technicians and para-medics, all retired personnel for this programme.
Explaining the details, Dr. De Silva says that 75 health workers including 35 doctors initially instructed the 400-odd employees of the Presidential Secretariat to fast the night before. The next day, they went there once again and opened a file for each employee, registering them and taking height and weight for the calculation of the body mass index (BMI). Bleeding them thereafter for the fasting blood sugar level as well as the lipid profile (serum cholesterol), they were then sent for their meal after which the medical examination not only of such indicators as blood pressure but also eye and dental health were undertaken.
Thereafter, lifestyle modification advice was given while discussing how stress could be reduced, he says.
The same procedures took place at all other workplaces, so far bringing nearly 12,000 in the three districts under this safety net.
The target for screening is a huge 60,000 this year, the Sunday Times learns.
The tests were followed up with the “high-risk” people being propelled in the direction of medical help of their choice be it private or government sector hospitals. To deal with the sudden influx of patients and not to burden the state facilities a separate laboratory equipped with the latest machine and a fully-automated biochemical analyzer, has been set up at the Maligawatte District Hospital. Five more ‘Diabetes and Cardiovascular Community Risk Clinics’ have also been set up at Maligawatte, Talangama, Sedawatte, Delkanda and Wellampitiya, says Dr. De Silva, adding that the plan is to develop the mother and child clinics to cover the ‘family clinic’ concept with the father too being included in this vital healthcare network.
The risk clinics and the analyzer were the contribution of the Sri Lanka Medical Association under its Nirogi Lanka Project, it is learnt, while Medi House and Nawaloka and Asiri Hospitals chipped in by providing free testing for those with complicationsThe effects are tremendous, according to Dr. De Silva. If replicated across the country, in the short term work production would increase and in the long term fewer patients would come to hospital with complications.
A healthier workforce with fewer sudden deaths is the goal.
- Diabetics among the working population -- 12%
- Pre-diabetics among the working population -- 15%
- Hyperlipidemia (bad lipids) among the working population -- 70% (Triglycerides -- 26% with LDL or “bad cholesterol” as high as 35%. The bad cholesterol is a marker for heart disease, it is learnt.
- Underweight among the working population – 7%; overweight – 34%; and obese – 7% (Usually, in a general population 20% are underweight and 20% overweight, according to health experts, although this survey is on the working population only 34% could be an indicator that the scale is tilting towards those who are overweight due to their sedentary lifestyle.)
What should be done to ward off the modifiable risk factors?
Conceding that the working population is caught up in a vicious circle of getting up early, sending children to school, getting into a vehicle and heading for office, getting back the same way in the evening, sitting before the TV at night and getting to bed thereafter, Dr. De Silva says a conscious effort needs to be made to overcome this unhealthy lifestyle.
Without boarding a bus at the stand closest to your home, walk about 2km and then get into the bus, he advises. The same could be done after work.
Stressing that clean cities would tempt people to walk more, he urged the local government bodies to set in motion programmes to prevent garbage dumps and dust accumulation. Recently some specialists from Thailand showed how cities could be made healthy by introducing green belts and walkways.
It’s happening in Colombo city and others like Panadura, Maharagama and Dehiwela-Mount Lavinia should follow suit, he says.
Non-communicable diseases come about due to the way you live your life, but give us a lead time of 10 years. We need to grab that and change our lifestyle without deliberately getting on the path of death, he adds.