14 December 2012

Namibia: Bigger Is Not Better If It Is Unhealthy

THE Namibian government reportedly justifies the pampering, approximately to the tune of N$30m (US$3 million), of ministers and their deputies, with state-of-the-art luxurious E-Class Mercedes Benz vehicles with the excuse that they are too fat.

Obviously, the government (through the Ministry of Works and Transport whose minister remains in place following the recent Cabinet reshuffle) sees a logistical problem. Their solution: A short-term one that’s treating the symptom rather than the cause by buying new and bigger cars in order to create more room, and more space for the ministers to fit into their cars.

The Namibian disagrees. Instead the paper editorialises that the country’s skewed resource allocation is the problem. Apparently, there is a direct link between our leaders and politicians’ fattening bellies (or poor health you may call it) and the malnourished Namibian children. This is so because only few rich Namibians are consuming most of the national cake while 70 percent of the country’s population goes to bed hungry every night.

So are the majority of Namibians, they too seem to agree. I won’t blame them because the apparent indifference of politicians and the government towards public corruption and the inaction to tackle Namibia’s growing income inequality are what is creating this public perception. What is the public policy priority here? To pamper ministers with luxuries or to address Namibia’s poverty head on? You be the judge!

But Health Minister Richard Alex Kamwi is right. ‘Big’ is a public health problem if it is unhealthy. They call it overweight or obesity. In the Namibian context, it also referred to as the rich man/woman’s disease. And sometimes in our part of the world being fat is viewed as a sign of ‘wealth’ and ‘good life’.

Overweight (defined, in policy studies literature, as having a body mass index (BMI) of 25 kg or higher) and obesity (defined as having a body mass index of 30 kg or more) can adversely affect an individual’s health, and therefore reduces his/her life expectancy. Medically, overweight and obesity are associated with conditions such as diabetes, heart disease, asthma, high blood pressure, and high cholesterol, kidney failure and other related chronic diseases.

Research also tells us that in the form of medical costs, human capital cost, productivity costs, transportation costs, the likely economic impact of overweight and obesity is astronomical. In other words, obesity and overweight have consequences for all of us as a nation. In addition there is also a social dimension in the sense that obese and overweight people, especially children and women, are likely to be stereotyped or discriminated against.

Of course Namibia is not at an alarming stage yet, however studies are showing that obesity is sub-Saharan Africa’s new killer, making it the fastest growing public health problem for the continent. As citizens adapt to more urbanised lifestyles of unhealthy fast food consumption, and little physical inactivity (mainly due to an increasing number of people driving instead of walking or due to more people doing office work instead of manual and physical demanding jobs found in rural area), so increases the risk of obesity and overweight.

Compounding this problem is also lack of accessible parks and recreation programmes in most of sub-Saharan African cities, with many municipalities’ recreation programmes and urban policies being outdated and still rooted in colonial policies. Studies on obesity and overweight (policy makers, municipalities and town planners pay attention!) have proven that having parks and recreational programmes do make a difference in terms of reducing overweight and obesity.

The crux of the matter is that the long-term solution to our fattening leadership is not necessarily bigger cars but more public policy in terms of parks and recreation, dietary standards, and prevention measures.

What is also true here is that the fattening of our leaders is certainly a matter of individual choices and preferences; therefore it’s an individual responsibility issue. However, the magnitude of potential economic impact makes it a public policy problem not just a health problem affecting an individual. It is also, suffice to say, that obesity and overweight know no boundaries, therefore it is not a problem that’s only confined to leaders, politicians or the rich.

It is against this backdrop that, just like the need for alcohol and drug abuse policies and legislative interventions, there is also great need for Namibia to focus on obesity and overweight policy-intervention now instead of waiting until the problem (economically, medically and socially) reaches a point of no return. It is called preventative health care!

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