Soy una persona con bastante experiencia personal con las ENT, soy cuidadora, y profesional de la salud. Mis padres murieron de diabetes (mi padre murió de diabetes con complicaciones renales y mi madre murió de sobredosis de insulina mientras trataba de manejar su diabetes). Los cuidé mientras crecía.

Recibí capacitación profesional como estudiante de enfermería y adquirí conocimientos generales sobre los factores de riesgo de estas enfermedades y que la historia de mi familia me ponía en un alto riesgo para la diabetes, hipertensión y otras condiciones. Sin embargo, las decisiones alrededor de mi salud estaban limitadas por el poco acceso a ambientes que promovieran la salud, por ejemplo: no había actividad física en los colegios y los gimnasios privados eran muy caros. Las opciones más fácilmente disponibles eran comida chatarra y bebidas a base de azúcares. También hay una falta de programas de prevención contra las ENT y de servicios para diagnósticos en el país.

Esto me condujo al fatídico día en el que mientras estaba en un turno de 36 camas en la unidad de pediatría, me colapsé y me llevaron a la unidad de emergencias para resucitación. Entonces, me diagnosticaron diabetes mellitus a los 35 años de edad.

Necesitaba más información y comprensión sobre el tema, así que empecé a hablar con colegas, compañeros y personas que vivían con diabetes, cuidadores y profesionales de la salud, nutriólogos, dietistas, expertos y activistas que buscaban lograr una prioridad en las estrategias de prevención para aquellas personas en riesgo de vivir con ENT. De mi experiencia, he aprendido que el diagnóstico oportuno es un gran desafío y que éste es el caso de muchas otras personas. Con respecto a esto, los estudios para identificar las ENT son un paso muy importante ya que nos ayuda al diagnóstico temprano. Esto permite la prevención de las ENT así como una gestión más rápida y eficaz de la atención de las ENT para mejorar los resultados de la enfermedad, y de esta forma prevenir la aparición de otras ENT o complicaciones asociadas.

Prevenir es mejor que curar, es más barato, más fácil de manejar y se reducen los costos. Con las medidas preventivas adecuadas en marcha en todos los niveles del sistema de salud, tendremos una sociedad más sana. La prevención de las ENT deberían ser prioridad para todos los sectores: el gobierno, políticos, profesionales de la salud, organizaciones de la sociedad civil, e individuos bien intencionados: todos debemos contribuir. La inversión en la prevención de las ENT puede reducir la mortalidad, mejorar la productividad e impulsar a la economía.

La concientización sobre las ENT es una estrategia de prevención efectiva, pero está sumamente descuidada a nivel de base debido a la falta de infraestructura y recursos.

Al menos, hubiera tenido alguna oportunidad de evitar la diabetes y otra ENT si existieran suficientes programas de prevención de enfermedades a nivel nacional, estatal y local en el país.

As one with lived experience, caregiver and healthcare provider, my community is my fellow people living with one or more NCDs. All of them face challenges similar to mine, managing my health conditions; poverty, timely diagnosis, lack or poor access to healthcare services, knowledge deficit, etc.

Mr R.T. was diagnosed with Diabetes Mellitus and hypertension years before he had his first stroke in 2016 on his way back from the Church and was rushed to an emergency department. He received lifesaving service and recovered without noticeable disability. As his bedside nurse and NCD advocate, I shared information with Mr R.T. and his family members on NCD risk factors and on the importance of secondary prevention.

Unfortunately, Mr R.T. had a second stroke due to lack of resources as he could no longer subscribe to the wellness clinic services, he had no funds to procure drugs, (as a retiree, his name was removed from the health insurance scheme) he started indulging in alcoholism, inactivity and unhealthy diets. Secondary prevention has its roots deep within the healthcare system’s response, even though Mr R.T. had access to the right information he could not sustain a preventive lifestyle owing to the limited support available from public healthcare facilities. Now, Mr R.T. is being supported by the NCD community in his locality who share items like drugs, food, toiletries, etc., with their peers.

Disease prevention and NCD risk management programs need to be in place to reduce the burden, for this to happen, "all hands should be on deck". Establishment of disease prevention programmes should be a joint responsibility of government, decision makers, civil society organisations, communities, and people living with NCDs.

Investment in NCD prevention and establishment of NCD support groups should be funded for accessibility, affordability, sustainability and effective service delivery. Early detection of disease risk factors can be made possible by screening. In the case of Mr R.T., he would have benefited from risk elevated screening, as having had the first stroke increased his risk of developing a second one. Screening that aims at early detection and treatment follow up is necessary for the prevention of NCDs. As the saying goes "A stitch in time saves nine".

As a Clarion call, regular health screening aimed at early detection and management and follow up might save millions of lives.

Living with NCDs is severely debilitating, thus the need to prevent it. Exposure to risk factors, lack of public awareness, health education and a lack of resources are contributing to the development of NCDs. These factors are either social or commercial determinants of health. Information/health education on the prevention and management of NCD risk factors will go a long way to reduce, control and manage these diseases. This much needed information is not readily available and when it is, it isn't adequate due to lack of adequate manpower, work overload, lack of expertise, lack of political will and or policies not being translated into effective programmes. The proximity of services is another big barrier. Disease prevention programs/screening should be close to service users, for easy access and should be made affordable looking at the poverty level.

The Senate committee on health are custodians of health matters in the country. They are responsible for national health policies and laws. Health planners, implementers and health service providers should review health policies, planning, implementation and service provision on NCD risk factors prevention, control, management and care in such a way that these are available, accessible and affordable at the grassroots and at all levels of healthcare (primary, secondary and tertiary). It's one thing to provide services, and another for it to be utilized. The general public should be ready to make use of these programs and services, which will require community outreach led by those living with similar conditions and supported by local decision makers.

I call on the senate committee on health to swing into action by:

1. Making policies on disease prevention that can be translated into effective programmes.
2. Controlling and regulating the sale and advertisement of unhealthy food and beverages.
3. Screening to cover all levels of health care (primary, secondary and tertiary levels). Policy planners, implementers and healthcare providers to embark on capacity building through training of healthcare professionals on adopt a continuum of care approach.