Sunday, October 6, 2013

Physical and Spiritual Health and Vitality

This week is “Hospital Week” in the Methodist Church in Fiji.

According to Rev. Maraya Ryland Nasenaivalu, chaplain at the Colonial War Memorial Hospital, who prepared the week-long reflections on the theme “Jesus is Life,” the aim of the week-long devotions is not only to encourage members to reflect on Jesus as the source of healing and fullness of life, but to also be careful with their own life style every single day.

Figures shared by Rev. Nasenaivalu from the CWM Hospital show that between 2008 and 2012, at total of 128,755 patients were admitted of which 124,355 were successfully treated while 4,206 died.  Approximately 692,728 outpatients were seen during the same period.

While the Methodist community is reflecting on the issue of life and health, we as a nation should  also be reflecting with gratitude on those who continue to serve, as a vocation, as doctors, nurses, orderlies, paramedics, nurse-practitioners, lab and x-ray technicians, dentists, physio-therapists and the many others who we come to for healthcare.

On Monday a Fiji Times article stated that “thirty per cent of Fiji's population or 102,000 people above the age of 25 suffer from diabetes,” calling non-communicable diseases (NCDs) “Fiji's biggest killer.”

The Ministry of Health’s 2010-2014 NCD Prevention and Control Strategic Plan, has the following shocking statistics which are already more than 10years old:

Tobacco use has an overall prevalence of 36.6%, 42% of which smoke daily. The mean age for initiation of smoking is approximately 18 years. There is generally low consumption of fruit and vegetables in Fiji, 65% consuming less than one fruit serving a day. Only 1.2% of males and 0.6% of females consume 5 or more servings of fruit a day. In terms of vegetables consumption 2.9% of males and 2.2% of females consume 5 or more servings per day. In fact 26.4% were found to eat less than one serving of vegetables in a day. 77.3% of alcohol drinkers were binge drinkers (i.e 77.3% of 45% prevalence). The prevalence of kava drinkers was 65% with 79.6% continuing to do so.

Women, people aged 35 years and over, urban dwellers and Indo Fijians were found to be the least active cohorts in terms of physical activity. Physical activity at leisure is wanting in the Fiji population. 29.9% of people were overweight and 18% were found to be obese. Females were by far more obese than males in terms of BMI and abdominal obesity. There was evidence of rapid increase of obesity with age up to 30-34 year age group implying maximal weight gain is occurring in the younger generation in Fiji

The prevalence of diabetes in the 25-64 year age group is 16% of which 53.2% were previously unknown. Of the known cases, 2.1% were not on medication, 32.2% were on medication but had uncontrolled fasting blood glucose, and only 12.5% were on medication with good glucose control. Diabetes is the most common cause of non-traumatic amputation and second most common cause of adult blindness in Fiji.

The prevalence of hypertension is 19.1% of which 63.3% were previously unrecognised. Of the known cases, 10% were not on medication, 15.4% were on medication but had abnormal blood pressure, and only 10.9% were on medication as well as controlled blood pressure.

82% of all deaths are attributed to NCDs, with coronary heart disease and stroke responsible
for all deaths in the 40-59 age group. Another Fiji Times article on Monday quoted Ministry of Health NCD advisor  Dr Isimeli Tukana sharing that diabetes led to about 400 amputations per year and that  the latest survey conducted in 2011 with the WHO revealed that the contributing factor towards NCDs was the change in lifestyle.

"If we don't change our lifestyle, particularly our children, and the way they eat and the way they live, we won't be able to solve the problem. We have to protect our children, "he was quoted as saying.

Within the community of faith in which I serve, the recent call by the chief shepherd of the flock, Rev. Dr. Tuikilakila Waqairatu for the church to become “smoke-free” and for ministers, pastors, leaders and members to break the habit of excessive kava consumption has been a challenge for many.

The writer says the recent call by the chief shepherd of the flock,
Rev. Dr. Tuikilakila Waqairatu for the church to become "smoke-free"
and for ministers, pastors, leaders and members to break the habit
of excessive kava consumption has been a challenge
Those who give excuses and go to the extent to quote scripture to justify their habits may need to look at the bigger picture or the reason behind what a number of news media organisations refer to as “the kava ban” within the Methodist Church.

Rev. Dr. Waqairatu has explained his concern for the spiritual and physical vitality, or lack thereof, of members of the Methodist community whose excessive consumption of kava is really substance abuse. His challenge is for those who have “given their lives to Christ, “to use these lives responsibly, in the service of God and creation and to keep the “temple of the Lord” (the body) holy and clean.

Beyond the theological aspect, the issue of physical vitality – health and wellbeing should also be considered. Those of us who have had the unfortunate experience of feeling like the “living dead” after a late night (or early morning)  “grog session” can understand the level of productivity we struggle to have the day after. Translate that to Saturday night and you can understand the condition of church goers or even the preacher on Sunday morning .

The vitality of the family is also at stake in this equation. Second-hand cigarette smoke inhaled by chidlren, money that could be used for essentials or saved for when the need arises (instead of going to moneylenders who ensure that they get their “pound of flesh”) spent on cigarettes, kava, water bills and electricity (can’t mix without water, not many drink in the dark) and the lack of quality family time take their toll on the family’s health and wellbeing – physically, emotionally and spiritually.

The sentiments expressed from a physical perspective by Dr. Tukana and a spiritual one by Rev. Dr. Waqairatu are, if we reflect on them honestly, true. The challenge lies in our willingness to break habits we know to be bad, in order to embrace a lifestyle we believe, and, in some cases actually preach, to be good.

Yesterday (Tuesday) morning  as the sun rose, my son joined me for our first early morning swim together. As I finished a lap and  turned back to see my Tuisawau working hard on the kickboard, I had no regrets in hanging up my “black belt in under-kava” in order to embrace this challenge lifestyle change for my own physical and spiritual health, and that of my family.  I am grateful for my friends around the tanoa who respect my decision and my limits and are happy with my company anyway.

To those who may scoff at this article and protest the challenge, two quick questions:
What is the reason that you drink – because its cultural, because of the taste, the effect or just to drink the time?

If we can’t do something or consume something in moderation – is it worth doing it at all?

The desire to live a life to the full is not only an issue of intensity but also full in terms of duration. It is impossible to live a pleasant life without living wisely and well and justly.

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