“What happened?”“He/she just collapsed and died.” In May alone, I heard that question and answer a couple of times. In the news, both print and electronic formats, sudden deaths are becoming common. My curiosity is not what causes it. That we know. Bitange Ndemo My interest is to establish if such deaths can be predicted and if so what we need to do to save lives. A number of doctors that I contacted in the course of writing this column paint a grim picture on this matter. They were all in agreement that this phenomenon, which they refer to as Sudden Cardiac Death (SCD), are on the rise in developing countries and will continue to be witnessed in the foreseeable future. There is a rider, however, that I kept hearing from them. These deaths that are causing a strain on the economy are preventable. Many of these deaths, they told me, are related to lifestyle diseases. The missing link is the lack of awareness. While most developing countries have kicked out diseases like polio through awareness campaigns, lifestyle diseases have not attracted similar attention. One of the major problems in my view, is the way health statisticians capture and communicate SCD data. My investigation on top causes of death in Kenya reveals that the language of reporting the data cannot in any way inform corrective action. The Kenya National Bureau of Statistics classifies heart diseases as one among the top ten causes of death in Kenya but the Institute for Health Metrics Evaluation (IHME) refers to the same as Ischemic heart disease (decreased blood flow and oxygen to the heart muscle). Academic research papers, however, refer to these deaths from heart conditions as SCD, which resonates well with what the public knows and most likely fear most. While I respect professional jargon by health experts, there is indeed a need for pathologists especially to provide expert causes of death and a more general but precise information for the public as a strategy to mitigate against the rise of these diseases. A 2012 study, ‘‘Sudden Cardiac Death in Low-and Middle-Income Countries’’ by Vedanthan, Fuster, and Fischer, revealed that Cardiovascular disease, and the incidence of Sudden Cardiac Death (SCD), will increase significantly in low- and middle-income countries. Thus, SCD threatens to become a global public health problem. The study suggests that SCD could be as a result of genetic predisposition, behavioural risk factors, biological substrates, and environmental triggers. The study also says that it is possible to identify high-risk markers and predictors of SCD and ultimately allow for development of risk scores that can be tested in a wide spectrum of patient populations. In essence, SCD can be predicted and victims as well as policy makers can take measures to prolong life. As a stopgap measure, the paper urges policy makers to implement community-based SCD surveillance on a widespread basis. Many of the health clinics can be utilised for preventive measures where quarterly campaigns are conducted to get the people, especially older generations, to have a quick check up of blood pressure, diabetics and many other non-invasive procedures that predict incidences of SCD. Our failure to begin such campaigns means that the health bill will balloon. A 2016 report by IHME shows that the risk factors that drive the most death and disability combined are non-communicable diseases and high blood pressure since 2005 has been consistently been among the top 10. Policy makers especially now when universal health is among the key deliverable for the current administration, we must seek to avoid hospitalization by equipping clinics with diagnostic equipment throughout the country, stepping up campaigns for regular check-ups, encouraging regular exercise and traditional diet and use of mobile alerts for patients to take their medicines. Studies show that even though there are high incidences of non-communicable diseases, few indeed comply with doctor prescriptions. Ethiopian athletics legend Haile Gebrselassie once said, “Once you have commitment, you need the discipline and hard work to get you there.” To mitigate SCD, we will certainly need the commitment and discipline to work out and embrace a diet regime. Bitange Ndemo is an associate professor at the University of Nairobi’s School of Business. The views expressed in this article are of the author.
