Winning the war against asthma

Francis Okoye, CNS Correspondent, Nigeria
Asthma affects more than 300 million people world wide. The Global Asthma report 2014 says that asthma is a major global health problem. Although there is no permanent cure for it, it can be treated and controlled. Good asthma control means no or very minimal symptoms, and a low risk of asthma attacks or other poor outcomes. More importantly, good asthma control means that a person can live life normally.

But low awareness, inadequate health systems, and non availability of proper asthma care are major factors that contribute towards poor management of asthma, adding to avoidable emergency hospitalization at times too. Citizen News Service (CNS) recently organized a webinar for media in lead up to World Asthma Day 2017. Experts at the webinar included Dr Kevin Mortimer, Department of Respiratory Medicine, Liverpool School of Medicine, and honorary lecturer at Malawi College of Medicine and Prof Surya Kant, Head of Respiratory Medicine Department, King George’s Medical University, and also the National President of Indian Chest Society. There was also a community voice in Chakatip Kiatduriyakul, a finance expert from Northern Thailand, who shared her personal experience of managing asthma living normally with it. Chakatip revealed from her personal experience that dust in households as well as smoke in the atmosphere help asthma symptoms to make a comeback, even after years of subsiding. Her advice is “Live in a clean environment, free from dust and throw away or donate unused stuff. Remove the clutter from your mind and from your house.”

Dr Surya Kant recommended the 6D approach for asthma management—(i) Doctor, who knows how to deal with asthma, (ii) Diagnosis-doctor must make the correct diagnosis using the right tools, (iii) Drug/dosage-doctor must recommend the right drug and dosage, (iv) Device-doctor must recommend the right device for drug delivery, (v) Deliberation-doctor must deliberate with the patient on what is best for asthma management, (vi) Adherence- patient must adhere to treatment as per doctor’s advice. Knowing (and hence) avoiding the modifiable risk factors for asthma- tobacco smoke, bio-mass fuel smoke, recurrent infections, and obesity can help a person get control over the disease. In the opinion of Dr Mortimer, “Asthma is a disease of poverty. Poor control of asthma, poor access to asthma treatment, a big risk of financial impact a risk of dying from asthma are all associated with poverty. Health system strengthening is the only solution and this is applicable to other NCDs as well. Most rural areas are either not served at all or served very poorly by health services. To achieve effective asthma care for all, and especially the rural poor, health systems need to be strengthened in a  broader sense. And a key part of that strengthening needs to be access to funded basic effective treatment.”

Automobile makers should work more on reducing pollution from automobiles; this will in turn reduce cases of asthma worldwide. Legislation on industrial pollution is also called for, so that occupational and outdoor pollution can be managed and minimized. There should be quality assured medicines for asthma care and control, like we have for TB. There should be a system available to everyone in the same way as the TB and HIV community has seen access to quality assured TB medicines. Little is being done in terms of community mobilization on asthma, Creating awareness, information on care, treatment and management at the rural level by NGOS and healthcare providers can help a lot. “Organised community groups, like religious communities, can harness individuals to create more awareness and rally support for those living in vulnerable conditions”, said Dr Mortimer. Each individual can contribute in their own way to reduce the incidence of asthma. The most obvious one is to stop smoking. People should also limit use of diesel cars that pollute the atmosphere in the city.

Francis Okoye, Citizen News Service - CNS
May 6, 2017

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