At the 1st Pakistan Nutrition and Dietetic Society (PNDS) International Conference on Non-Communicable Diseases (NCDs) in Lahore on Friday, journalists were briefed on NCDs, their prevalence in Pakistan, and what role the media can play in educating the public when it comes to preventive strategies.

Members of the media were briefed by Pulmonologist Dr Javaid Khan, Cardiologist Dr Khawar Kazmi, Diabetologist Dr Abdul Basit, Section Head for NCDs and Mental Health at AKUH, Dr Romaina Iqbal, Founder president and honorary life president of the PNDS Dr Salma Badruddin and President PNDS Fayza Khan.

The briefing was moderated by journalist and media consultant Zofeen Ebrahim, who opened the discussion with a candid admission on the part of most journalists that while the media wants to ally with medical experts in the fight against NCDs, we needed to have a better understanding of the issue in order to effectively impart that knowledge to our readers.

What are NCDs?

Explaining NCDs, also known as lifestyle diseases, to journalists, Dr Romaina said: “In Pakistan, there is a very high burden of NCDs, such as cardiovascular diseases, diabetes and lung diseases and the reason why they are also known as lifestyle diseases is because a lot of the risk factors that culminate into the disease are preventable.”

“For example, poor diet, lack of physical activity, bad air quality are all factors that can be worked upon so that the diseases resulting from them can be prevented from developing in the first place,” she said.

Single largest cause of preventable diseases

The discussion then moved to addressing specific NCDs, with Dr Javed reminding the audience that tobacco remains the single largest cause of preventable diseases in the world today.

Eight million people die the world over each year due to intake of and exposure to tobacco and that nine out of 10 head and neck cancers are linked to tobacco, he told the participants.

Dr Javed lamented that the tobacco industry had considerable influence but added that it was up to the government to realise that tobacco was ultimately not good for any country’s economy.

Another surprising detail that the pulmonologist shared was that 20% doctors in Pakistan were smokers.

He said once one starts to smoke, it doesn’t end there, and smoking does become the gateway to using other harmful drugs as well.

Dr Javed said the government has yet to act on recommendations from the World Health Organisation (WHO) when it comes to smoking. The first one being: make tobacco costly so people cannot buy; second that pictorial warnings of a large size be carried on cigarette packets; and the third one of making public places smoke free.

Prevention first

Speaking of cardiovascular diseases, Cardiologist Dr Khawar Kazmi said prevention, instead of treatment, should be the first priority.

“The impact of cardiovascular diseases on low income families is huge, even more so when a sole earner dies, leaving behind three to four dependants, resulting in disastrous implications for the family as well as the economy at large,” he said, adding that “cardiovascular disease is so prevalent in the country that it merits being treated as a national emergency”.

Dr Kazmi further said that air pollution increases the risk of heart attack and even noise pollution plays a role.

The discussion then moved to diabetes, another NCD that’s quite prevalent in Pakistan and diabetologist Dr Abdul Basit told the journalists that the disease has increased in Pakistan several folds in the last 30 years, and that its signs can be observed even in young children. He said when a mother who has diabetes gives both, the child born is at risk for diabetes.

A healthy diet can help but do we know what it is?

Speaking at the briefing, PNDS President Fayza Khan said patients normally did not take what they ate seriously.

“But the ones that do make changes to their diets and lifestyles do see the change working for them,” she added.

“Another problem is that people don’t understand what a healthy diet means and what it’s supposed to constitute. They have flawed ideas about what a diet is, they think it’s supposed to be expensive, or that they should do keto etc,” she said.

“Moreover, we also see a lot of people advising on diets when they aren’t qualified to do so, such as physical trainers,” Fayza said.

On the question of what one should or shouldn’t eat, Dr Salma said advice on diet should be nuanced and specific to the patient.

“Some patients can work on some things more easily than on others and so we should facilitate them with the smoothest route possible,” she said.

During the discussion, Dr Romaina said how she wanted to have daal chawal as the conference dinner and “everyone told me people will talk about this for years to come”.

“I said that’s what I want to happen,” she said as the group laughed.

What can journalists do?

Dr Romaina said the media can play an important role in increasing public awareness on the dangers of NCDs, along with educating them when it comes to preventive strategies.

She said “we are ready to assist journalists and work with them in the long term to help the public recognise the dangers and equip them with the knowledge to look after their health”.

The discussion then moved toward the journalists and one of the questions that came up was whether the media was doing enough given the scale of the problem as described by medical practitioners and experts?

There was realisation that while mainstream media did cover ‘international days’, there didn’t seem to be enough interest in working on extended projects with regards to health concerns that confront most Pakistani families today.

Speaking about how the media can help, Dr Kazmi said the media should develop public service messages in a manner that can convince even perfectly healthy people to look after themselves and adopt a healthy lifestyle.

“For example, if I tell a young person to fix his diet and his lifestyle, he may not accept my advice. But we want to get the attention of people who are well. Those who are currently paying attention are the ones already suffering from a condition,” he said.

“Changing behaviours is not easy and this is where the media can help...social media is also a powerful tool that can be used to disseminate knowledge that can guide the public,” he said.

Dr Kazmi says the media should also work on ensuring that such important information also reaches those Pakistanis who are on the lowest rungs of the country’s socio-economic ladder.

In the same vein, Dr Salma referred to the importance of radio, saying it forms the main medium through which information can be shared with most Pakistanis. She added that it is critical for the media to reach rural women, who are the gatekeepers of what the family eats.

Dr Kazmi further said that influential anchors can use their programmes to impart important messages about health and added that the media should create enough awareness and noise about the situation that it shakes the government into action.

“We are willing to give to media all the information but we need you [journalists] to package it so that the public is receptive to it,” he said.

He said not to underestimate the power of electronic media and that the platform of morning shows should also be used to reach stay-at-home moms.

Could you be diabetic?

Speaking about what the media can do further, Dr Basit brought the journalists’ attention to a ‘rapid score’ to get an idea of whether one needs to get tested for diabetes.

You can calculate your score too using the following input.

Age: Under 40 (0pts), 40-50 (1pt), above 50 (3pts)

Diabetes in the family: No (0pts), Yes (1pt)

Waist: Men: Under 35.5inches (0pts), over 35.5 inches (1pt) Women: Under 31.5” (0pts), over 31.5 inches (1pt)

If your score is 4 or above, you need to take a diabetes test and consult a doctor.

Dr Basit said “we have been asking the media if this score can be made available to the public”.

On the other hand, the rapid score was sent out by a cellphone company to its subscribers and we are trying that other companies do the same, he said.

Knowledge via entertainment

Coming back to effective modes of imparting knowledge, one journalist said entertainment and infotainment can offer some ways to share such knowledge where the public will accept it wholeheartedly enough to use it, adding that this was a more result-oriented way to go about it as opposed to traditional journalism.

One problem that journalists pointed out when it comes to working on health stories was a lack of availability of complete data.

Responding to this concern, Dr Basit said some work was being done in order to make that happen and develop a central registry.

Another idea that came up was that the media should take up a specific health issue and carry an extended campaign on it.

Dr Javed said it was not necessary that we will start to see immediate results from media campaigns, adding that big behavioural changes take time. He brought the participants’ attention to the fact that in the west, smoking decreased in a big way and a major reason for that was public service messages.

A television journalist pointed out that although they want to report on health, they do not have a lot of time to do it in and as a result they end up bringing on a general doctor to comment on a very specific issue that requires an expert’s opinion.

“We’d like if specialists were more available,” she said.

Meanwhile, Fayza Khan shared that the media tends to call specialists and quacks in the same show or segment which is “not the right way to address an issue”. She added that experts of culinary science were not nutritionists and that selections of guests for programmes should be carefully done.

Another idea that was floated was that media brings on board celebrity spokespersons who may have suffered from a certain illness and they can then do advocacy as the public will listen to them.

The group agreed that even if huge campaigns could not be undertaken at once, taking individual steps will count for something and then perhaps the government will also be more receptive to action on its part.

“We want to become friends with the journalists and we want to work with them and continue to engage with them so together we can create positive change,” said Dr Romaina as the briefing concluded.