Thursday, February 26, 2009

What Does “Fine” Mean?


When there are limited resources, decisions need to be made as to who gets what. In health care the term is triage. This becomes apparent when some people tested, who had very high levels of blood sugar or pressure, said they were recently tested at the hospital and they were “fine”. I went to the hospital to find out how our results could be so different.

The hospital treats sick people. Anyone with glucose level below 10.0 mmol or systolic below 100mm is “fine”. This results in people being treated as generally aged and very sick, disregarding the younger population. To further complicate matters, the hospital considers blood sugar levels of 7.0 mmol to be normal whereas in the US this person would be considered diabetic, normal levels being 3.5-5.3 mmol. My results show the average to be 7.0 mmol. People are hardly ever weighed as part of hospital procedure and have no idea of their size or the relationship between weight and blood sugar/pressure.

The national public health program seems to be focused on increasing the awareness of exercise. The current jazzercise program is almost laughable as people in villages get up at 5:00 am to wave the arms and legs to rap songs. The village gets a large sound system with the program. There is no mention of weight control, not even a scale. My results show no difference between jazzercise people and others. I have found that telling people they are obese is not in the Fa’asamoan tradition and may hurt young people feelings. But people know they are fat, but they are not aware of the consequences, other than you no longer can move or you need two seats on the bus.

The good news is that when people are told of the relationship between weight and health many take it upon themselves to change their eating habits. This is apparent with those people tested last August and their current readings. They are my going to be my poster children and hopefully not only keep them out of the hospital, but also have them feel good about themselves, setting a new standard to “fine”.

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