Breaking out of denial

While the Department of Health currently operates on an annual budget of P40 billion, the total annual expenditure for smoking-related illnesses (cancers, lung diseases and cardio-vascular complications, not to mention lower productivity, absenteeism and fires caused by cigarettes) total P400 billion.

Should Congress pass the “sin taxes” law, which would impose higher taxes on cigarettes, among other things, the government would be able to raise an additional P60 billion in revenues, money which could go a long way towards battling smoking-related ailments.

As they say: “You do the math.”

Dr. Tony Leachon, a consultant on non-communicable diseases (NCDs) with the DOH, presents these figures as part of his advocacy to raise awareness about the need to move from a mentality of “treatment and cure” to one of “prevention,” which in the long run is cheaper and more effective.

“We are currently facing an epidemic of NCDs, with six out of every 10 deaths in the country attributable to stroke, cardiac arrest, chronic respiratory disease, Type 2 diabetes and cancer,” Leachon said, speaking at the conclusion of “Moving as One,” a conference billed as “A Global Call to Action for a Public-Private Partnership for Cancer Care and Control.”

NCD’s are also called “lifestyle diseases,” and apart from an unhealthy diet and lack of exercise, Leachon singles out smoking as a culprit. Science has already determined the link between smoking and a number of diseases, but as Leachon points out: “We know it’s bad for our health and yet smokers allow themselves to suffer and die prematurely – this is really absurd.”

The sin taxes would, in theory, impose higher taxes on cigarettes and make them more expensive, putting tobacco out of reach of the young and the poor, the population most vulnerable to NCDs in both the short and long term. Another pending piece of legislation, which would require the use of “graphic” warnings on the health risks of smoking in cigarette packs – already in place in neighboring countries – could also help bring down the number of smokers and prevent more young people from taking up smoking.

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Bringing together the different sectors involved in health care, specifically in fighting cancer, is the goal of “Moving as One.” Dr. Cecile Llave, chair of the conference, explained that while oncologists specialize in specific areas of the body, there is a need to move from “one organ to the whole body,” and from involving just the medical community to all other sectors involved in health care and health promotion.

To this end, speakers at the conference came from a wide range of experiences: cancer survivors, cancer activists, specialists, nurses, midwives, barangay health workers, community organizers, the media, and of course government officials. Health Secretary Enrique Ona delivered the keynote address.

Or as Kara Magsanoc Alikpala, who spoke on “Ating Dibdibin” which is a community-based breast cancer initiative, put it: “I can see all the rock stars of the cancer community in the room!”

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During the conference, much emphasis was laid on prevention – the promotion of a healthy lifestyle and of wellness that is, as Leachon wrote in an article, “not only about what goes on in a doctor’s office. It encompasses workplace wellness programs, community-wide wellness programs, building bike paths and walking trails, getting junk food out of our schools, making school breakfasts and lunches more nutritious, increasing the amount of physical activity of our patients and those individuals at risk.”

It also means individuals – you, dear reader, and this columnist – taking personal responsibility for their health, and seeking all the paths towards good health, even the inconvenient, the difficult, the unsavory.

Dr. Jeejane Adevoso, a doctor diagnosed with cervical cancer at age 26 who is currently battling breast cancer, sent in an essay on her experiences as a cancer survivor (she was hospitalized and so could not make it to the conference). She writes: “I believe everyone… can attest to how grueling it is to battle this disease. Anyone who has or is affected by cancer, directly or indirectly, involuntarily succumbs… to the overwhelming and, most of the time, consuming condition. Every facet of your life is affected. Every ounce of your character is tested. So just imagine how depressing it would be if a patient faces the ordeal alone. As it is, knowing that you have been diagnosed with one of the most dreaded diseases is depressing: facing this without any support is self-persecution.

“Battling cancer really drains you out. My disease brought out the best and worst in me. I had a long period of denial and depression. It took a few months before I even allowed people to see me. I practically closed the world out. And it took a long time before I was able to finally speak up and face what I have.”

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Even medical professionals go through denial. Marichen Dychangco, president of the Philippine Oncology Nurses Association, confessed that after her mother was diagnosed with breast cancer, it took her a year to go for a mammogram, and some months before she could get the results and face the consequences. “I am not a very good patient,” she said ruefully.

But, if we love ourselves and believe we have a lot more to do, then we must break through the denial, the fear and the depression to move on and seek not just treatment and a cure, but also a healthier life.

Leachon offers a tantalizing possibility. How about our smoker President Aquino announcing in the next State of the Nation Address that he would be giving top priority to health and for a start that he would give up smoking? That would be exciting – and truly meaningful.