A Nigerian public health practitioner based in Ireland, Oladimeji Oyeleye, in a recent interview with The Guardian, spoke on the global burden of diseases and the implication for Nigeria and other developing countries. He also spoke on inclusion of integrated biomechanical programme as part of broad-based treatment of diseases in Nigerian health plan among others. Excerpts:BackgroundOladimeji Oyeleye is the name. I am a public health practitioner with interest in international development. I graduated from the University of Ibadan with my first degree in Physiotherapy. I currently work within the Health Service Executive (Irish Public Health System) in Ireland as a chartered physiotherapist and running a private practice on the North side of Dublin.However, my academic and professional qualifications include MPH (Masters in Public Health) , University College Dublin (UCD) Ireland; M.Sc (Masters in Development Studies) , UCD Ireland; Certificate programmes (Open University, United kingdom (U.K); and Advanced training in Lower Limb Biomechanics (Ireland). I have attended, trained and presented at conferences in Europe, Africa and the Middle East. Finally, I am a member of the Irish Society of Chartered Physiotherapist (MISCP).Recently, you spoke about the global burden of disease and the inclusion of broadbased treatment programme in Nigerian health plan. Can you clarify your position'The Global Burden of Disease of the World Health Organisation in 2005 estimates that chronic or Non-Communicable Diseases (NCD) accounted for 54 per centof deaths in developing countries, compared with 36 per cent attributed to communicable (infectious) diseases. In 2005 alone, 35 million deaths were recorded due to NCD with many more sufferers left with varying degrees of disabilities.The share of chronic diseases is predicted to rise to 65 per cent by 2030 and will cost developing nations up to $84 billion by 2015 if nothing is done to slow their growth. The increasing prevalence of non-communicable diseases will put additional strain on households and the healthcare systems of the affected nation.In Nigeria for instance, chronic disease burden causes greater number of adult medical admissions and deaths compared to communicable diseases like HIV/AIDS, etc. It also poses a serious threat to health and longevity. The WHO 2008 estimate informs us of 41.5 per cent and 41.8 per cent of male and female under-60 death respectively ' in other words, the per cent of total mortality.However, NCD affects people across all the socio-economic divide and its impacts are not just at a personal level for the sufferers alone. There are direct consequences: Ill-health (morbidity), hospital admission, increased cost of care, medical complications and death; indirect effects: disability, reduced productivity and human capital, socio-economic impacts on a community and the nation; and intangible costs: Pain and suffering, anxiety and anguish, bereavement, impact on relationships and family dynamics and other psychological fallouts.Let me also use a simple scenario to explain the impact of NCD in the daily lives of an average person. We take between 8,000-10,000 steps daily (over 115,000 miles in our lifetime, more than travelling round the globe four times). Our feet house a quarter of the bones in our body with hundreds of ligaments, tendons, soft tissues and sweat glands.The human foot is the foundation of our interaction between the human skeleton and mother earth. Leonardo Da Vinci described the human foot as an 'engineering work of art'. The human foot encounters 1.5-2 times the amount of our body weight standing, walking and running. Normal foot will function without making demand on other parts of the human body. This means the muscles move the joint, arches (building block) distributes the pressure and the fat pads absorb pressure from the sole of the foot.Therefore, anything that interferes with this interaction will ultimately affect our ability to walk and function. Increased pressure on the foot due to inappropriate footwear and increased body weight, for example would lead to changes in the structure of the foot. This manifests as problems anywhere along the human skeleton between the foot and the skull.However, a lot can be done to reduce the death and disability from NCD. This involves a broad-based approach of prevention and health promotion; early detection and prompt intervention; and rehabilitation (cradle to grave programme), involving all age groups. One of such broad based approach is the integrated biomechanical programme.What is integrated biomechanical programme'Integrated biomechanical programme incorporates prevention, early and prompt intervention, rehabilitation and treatment for secondary complications of NCD like stroke, diabetes, and other musculoskeletal injuries like knee, back, neck, ankle, hip and foot problems. Other problems like heel pain, flat feet, shin splint, postural problems, limb length discrepancy, growing pain (in children), etc will benefit from programme of this nature.But this integrated biomechanical programme may not accommodate the masses and it may be for the rich only'No, no. Let me explain that. The programme is designed to be accessible, affordable, client-centred and high quality making a previously unavailable service promptly delivered at the door-step of all Nigerians. Furthermore, the cost saving from this is staggering; it reduces hospital admissions and outpatient visits, increases outcome of ill-health, reduces morbidity and disability, increases quality of life and life expectancy.What about the side effect'There is no side effect and complication with this initiative as it is entirely a non-invasive approach with no exposure to any chemical or radioactive agent. The programme uses state-of-the-art technology in diagnosis and treatment with highest possible efficacy.Is it available in Nigeria now'Yes, it is available, but Nigerians would soon realise the inherent benefits, compare to other forms of treatment of diseases. We shall soon embark on seminars and workshops to canvass our position on why the three-tiers of government, the public and private sector must embrace it.
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