“One of the first duties of the physician is to educate the masses not to take medicine.” Sir William Osler (1849-1919)
Becoming a cardiologist or a cardiac surgeon was my dream during my early years in medical school. Both of my grandparents died from heart diseases when I was a teenager, adding to my motivation to become “the man in the white coat”. My exposure to clinical sciences since my third year in medical school stimulated my curiosity further. In most courses, the lecturer started with the definition and epidemiology of diseases. ‘Epidemiology’ – this new word changed my perspective on health and diseases. “Why do some people get sick, while others remain healthy?”, “If people can remain healthy, then why should anyone be ill?” My curiosities later motivated me to apply for an assistant’s position in the Department of Public Health. I passed the selection process, and was recruited as the late Dr. Suharyanto Supardi’s assistant in 1996. He later became my supervisor, my tutor, and my respected friend.
Time flies – this is my 10th year in the department. Having had opportunities to teach within the department and carry out research in the Community Health and Nutrition Research Laboratory in the faculty, I feel passionately about chronic disease prevention. My teaching responsibilities include courses on chronic disease epidemiology and research methods, which mostly focuses on chronic disease risk factors, including obesity, elevated blood pressure, physical inactivity, unhealthy diet, and smoking.
Talking about smoking causes me to think back to April 1, 2005 when I was in Sweden preparing for my mid-term seminar. A short message popped up on my mobile phone and shocked me - Dr. Supardi had just passed away following ten months of treatment for cancer. He was only 52. I recalled visiting him in hospital on February 17, 2005 before I departed for Sweden. Having the chance to talk to him for almost an hour, I witnessed the pain he was experiencing, both from the disease and from the treatment. I never thought that it would be our last chat.
June 2004 – I was in a seminar in the Faculty, giving a presentation about the health consequences of smoking. A colleague sent me a shocking message – the specimen of Pak Supardi was positive for cancer cells, clinically lung cancer stage 4. I never thought that it would happen – he had been complaining of shortness of breath since January and had quit smoking since then. Being a heavy smoker, he used to have doubts - or rather, denial – about smoking: “Will it be of any use to quit since I have been smoking for almost my entire life?” I really wished he had asked this question many years earlier, and I believe that honestly he knew that the answer was ‘yes’.
These are not just tales about my grandparents, or my respected tutor, these are stories common throughout the world. We are living in a world of risk; we are being exposed to the risk factors of disease and are getting sick. These facts lead to questions such as “Why should we be sick if we can prevent the sickness?” These questions have guided my research for this thesis.
“I never think of the future - it comes soon enough.” – Albert Einstein (1879-1955)
The future chronic disease epidemic is coming soon. This thesis is not, and does not intend to be, a cure to such an epidemic. Rather, let this thesis, with its imperfections, be a motivating factor for us as individuals to regain our right to have healthier lives and a healthier world. Let it also be, with its methodological limitations, a stimulant to research communities in the developing world that something needs to be done to fill in the gap of knowledge in this field. And allow it also to be, with its population-based evidence, a document of advocacy for health authorities. Finally, let it be a challenge for all who read it to translate this small piece of work into appropriate, effective action.
I dedicate this thesis to the late Dr. Supardi and those suffering from chronic diseases – because I believe, as he did and many of us do, we have the right to prevent disease, to promote our health and to live in a healthier world.
Excerpt from Nawi Ng's dissertation published by Umea University, Sweden.
Available at: http://www.diva-portal.org/umu/abstract.xsql?dbid=775
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To back up Dr. Ng's writing, one example is the vast Adverse Childhood Experiences (ACE) Study from the CDC in Atlanta, Georgia, USA. www.acestudy.org This rich study which now has about 40 peer-reviewed publications showing its many aspects and details of how repeated childhood trauma brings about numerous chronic diseases.
A summary of these and over 300 other peer-reviewed published studies on how repeated childhood trauma causes "mental illness" can be found in Whitfield CL "The Truth about Depression" and "The Truth about Mental Illness." (Health Communications, Inc. 2003 & 2004)
Posted by Barbara Whitfield on 5th Dec 2006
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