Health-e News – World Heart Day: learning to survive heart attacks

Heart and Stroke Foundation
World Heart Day, which happens every year on 29 September, will see iconic landmarks turned red in honour of the occasion with Table Mountain and the Wheel at the V&A Waterfront in Cape Town being lit up on Friday night.

The day was created and led by the World Heart Federation (WHF) as an event designed to raise awareness of cardiovascular disease (CVD), the world’s biggest killer.

It is seen as a time to promote a heart-healthy lifestyle and improve health globally by encouraging people to make lifestyle changes and be good to their hearts.

The event has the backing of several high-level experts, who are keen to lend their voices to the cause.

Professor Karen Sliwa, Director of the Hatter Institute for Cardiovascular Research in Africa and President-Elect of the World Heart Federation, said “World Heart Day is our chance to shine a light on the world’s biggest killer and work together to improve heart health. This includes highlighting the need for better care of patients with rheumatic heart disease and cardiac disease associated with pregnancy.”

Professor Pamela Naidoo, CEO of the Heart and Stroke Foundation South Africa, said “Around the world 1 in 10 people die prematurely from cardiovascular disease but the power to change this is in our hands. Making small lifestyle changes such as eating more fruit and vegetables, keeping active, reducing alcohol consumption and stopping smoking can save lives.”

President of the South African Heart Association, Professor Liesl Zuhlke – who is also Director of the Children’s Heart Disease Research Unit and a paediatric cardiologist, said “We are urging people to ‘share the power’ this World Heart Day by sharing healthy heart tips with friends and family and inspire people everywhere to be healthier. Our focus is on families and communities as children can have heart disease too and a healthy heart starts in childhood.”

Cardiovascular disease is a major cause of death in South Africa. Heart disease, in particular, features prominently among the conditions that contributed to a significant rise in deaths from non-communicable diseases in 2015, according to Statistics South Africa.

All of them agree that neither heart attacks nor death as the result of a heart attack are inevitable and can be avoided by understanding and managing the risk factors involved.

It is possible for a person who suffers a heart attack to regain good health by getting the right treatment fast.

Medical organisations are using World Heart Day to raise awareness and highlight the seriousness of heart disease for all sections of South Africa’s population and help people take heart health into their own hands.

“We want every South African to understand the link between lifestyle and cardiovascular disease,” said Dr Shanil Naidoo, Medical Director of Boehringer Ingelheim. “Healthy lifestyle choices significantly decrease the risk of heart attacks and strokes and have the further benefit of improving an individual’s quality of life.”

Spot the risks and neutralise them

A heart attack occurs when an artery carrying oxygen to the heart becomes blocked. The likelihood of a blockage increases when arteries are narrowed by fatty cholesterol deposits or plaque – a condition referred to as coronary artery disease.

Risk factors for the condition include smoking, an unhealthy diet, obesity, physical inactivity, diabetes, high blood pressure (hypertension), high cholesterol or a family history of heart disease.

Giving up smoking, modifying poor diets and increased exercise are all good solutions along with the critical management of diabetes, blood pressure and high cholesterol under medical supervision.

“Many South Africans have uncontrolled or undiagnosed hypertension, diabetes and high cholesterol,” said Dr Naidoo.

A 2014 study showed that 78% of South Africans over 50 years had hypertension, with less than half of them being diagnosed and less than 7% having it under control.

“These individuals are placing themselves at an even higher risk of having heart attacks or strokes,” cautioned Naidoo.

“While we cannot change our genetics or age, it is important to understand that we need to be disciplined about lifestyles choices which include regular medical check-ups.”

SOME FACT BOXES:

Recognising a heart attack:

Speed of reaction is absolutely critical to surviving a heart attack and regaining good health. In some cases, a heart attack causes virtually instant death. But in many cases survival and recovery are perfectly possible – provided you know what to do and get to work instantly.

What does a heart attack feel like?

  • There is heavy pressure, tightness, unusual discomfort or crushing pain in the centre of the chest.
  • This may spread to the shoulders, arms, neck or jaw.
  • It may last more than 15 minutes and could stop or weaken and then return.
  • This may be accompanied by sweating, nausea, faintness or shortness of breath.
  • The pulse could be rapid or weak.

Important things to note

  • Women may have different symptoms to men, with more pronounced nausea, dizziness and anxiety.
  • A heart attack can be silent and produce no signs or symptoms.
  • A sharp stabbing pain in the left side of the chest is usually not heart pain.

What to do if you experience or witness a heart attack

  • If unexplained chest pain lasts for more than a few minutes, move quickly. Do not try and figure out the cause, rather call an ambulance and state that you are dealing with a suspected heart attack.
  • If the ambulance is delayed, access private transport to get to the emergency department of the nearest hospital. On arrival, advise the staff this is a suspected heart attack.
  • If you have been trained and you are near a person who loses consciousness due to these symptoms, perform chest compressions at a rate of about 100 per minute.

World Heart Federation – Statement on the Foundation for a Smoke-Free World

Professor David Wood                                

President, CEO, The World Heart Federation. 

As you may have read, September 13th in New York City, a new global initiative was launched named the Foundation for a Smoke-Free World. This foundation – whose leadership includes former WHO official Dr Derek Yach – is a tobacco industry-funded initiative, set to receive $80 million of annual funding over the next 12 years from Philip Morris International (PMI).

Alongside our colleagues at the WHO Framework Convention on Tobacco Control (FCTC) and the Union, The World Heart Federation condemns this initiative in the strongest possible terms as an attempt by the tobacco industry to interfere in, and subvert public policy.

Despite funding a foundation that claims its goal is to ‘eliminate smoking’, PMI continues to invest billions of dollars in marketing cigarettes worldwide, focusing many of these efforts in low- and middle-income countries to gain new customers.

Throughout previous decades, the tobacco industry – including PMI – has sought to maintain its profits by sowing misinformation among the public and blocking policies designed to protect public health. PMI’s recent failed attempt to sue the government of Uruguay for implementing anti-smoking legislation is just one recent example of these efforts.

Tobacco use remains the leading cause of premature CVD mortality, in some regions accounting for 25-30% of all cardiovascular deaths. According to current WHO projections, tobacco use will kill one billion people this century.

As the leading global advocacy organization bringing together the CVD community to lead heart-healthy lives, the World Heart Federation will continue to support all legitimate efforts to achieve a smoke-free world.

The best path to tackle this epidemic and achieve a smoke-free world is by implementing policies set out in the WHO FCTC – not by engaging with an industry that has shown repeatedly that it cannot be trusted to defend, let alone promote, public health.

We ask you to share information about this foundation with your colleagues and networks so that they can also be made aware of the false nature of this initiative.

 

Childhood Cancer in South Africa – CANSA

According to the South African Medical Journal¹ the overall survival rates for childhood cancer in South Africa remain low when compared to international data. Greater awareness of the warning signs of childhood cancer can encourage earlier diagnosis and lead to improved outcomes for all ethnic groups.

Many childhood cancers are treatable with high treatment success rates between 70% and 80% in well-resourced countries, while approximately 80% of children with cancer in Africa die without access to adequate care. Whilst South Africa has an established oncology healthcare service, the infrastructure is overburdened, the cancer awareness in the primary healthcare service is poor, and widespread service delivery challenges exist. A 2014 research paper carried in Stones, David K., et al. entitled “Childhood cancer survival rates in two South African units”, quotes South African overall survival rates at 52.1%. ¹

CANSA’s CEO, Elize Joubert says: “It’s estimated that currently less than half of the children with cancer in South Africa are diagnosed and many of those who are diagnosed are already in the advanced stages of the illness.  Early detection will go a long way in reducing the fatality rate, however this can only be done by creating greater awareness and instilling knowledge in parts of the healthcare system and with the public.”

Cancers in children tend to be different from those found in adults with most of them often occurring in the developing cells such as bone marrow, blood, kidneys and nervous system tissues. According to the recent South African Children’s Cancer Study Group (SACCSG) registry statistics, for 2009 to 2013, the five foremost childhood cancers in South Africa are leukaemia, followed by lymphoma (tumours that begin in the lymph glands), then brain tumours, nephroblastomas, or Wilms tumours – cancer of the kidneys – and then soft tissue sarcomas, which are tumours that begin in the connective tissue. Read more about the types of childhood cancers…

Early Detection is Key

Part of CANSA’s Childhood Cancer Awareness Programme is aimed at educating the public on the early warning signs and in South Africa, the Saint Siluan Warning Signs list is used as per below…

St Siluan Warning Signs Childhood Cancer:

  • S – Seek medical help early for persistent symptoms
  • I – White spot in the eye, new squint, sudden blindness or bulging eyeball
  • L Lump on the stomach, pelvis, head, arms, legs, testicle or glands
  • UUnexplained fever present for over two weeks, weight loss, fatigue, pale appearance, easy bruising & bleeding
  • A – Aching bones, joints, back and easy fractures
  • N Neurological signs, a change in walk, balance or speech, regression, contiguous headaches with/without vomiting & enlarged head

PDF: Childhood Cancer Red Flags Bookmark

The advice given to parents by CANSA should they have any concerns about their child showing symptoms, they need to seek medical help immediately. Children with cancer need to receive the right treatment, preferably in a paediatric oncology unit.

A young cancer Survivor, Thandi* and her mom Jessica*, were being rejected by their community.  Jessica says: “The lack of knowledge and understanding in our village is extreme. The majority still believe that my child is contagious and can harm them.”  CANSA’s TLC Staff in Kimberley stepped in to offer support and information to their community.  (*Names changed to protect privacy)

PPT: Childhood Cancer Awareness | Symptoms | Myths | CANSA TLC Support

PPT: How to Support Your Friend who has Cancer

Support by CANSA TLC

CANSA offers a programme called CANSA Tough Living with Cancer (TLC) that supports not only the diagnosed child or teen, but also the family and loved ones affected by cancer, as well as children who have a parent with cancer.  #CANSAtlc

CANSA embraces a holistic approach to include all aspects of physical, spiritual, psychological and social well-being.

CANSA TLC Offers:

  • support groups
  • prosthetic assistance
  • skills development
  • educational school programmes
  • volunteer training

CANSA TLC Facilities:

Currently, five CANSA TLC facilities for children/teens and parents and families affected by cancer, are available:

Watch video of when CANSA TLC Nicus Lodge was visited by SABC Real Talk with Anele on #MandelaDay 2017:

Do You or Your Child / Teen Need Support?

Parents in need of support are invited to join a TLC Support Group in their area (contact the nearest CANSA Care Centre), or help to establish one if one doesn’t exist. Parents, families, and supporters can also join the ‘CANSA TLC’ Facebook group to connect with others in a similar position.

¹ Stones, David K., et al. “Childhood cancer survival rates in two South African units.” SAMJ: South African Medical Journal 104.7 (2014): 501 – 504.

About CANSA

CANSA offers a unique integrated service to the public and to all people affected by cancer. CANSA is a leading role-player in cancer research (more than R12 million spent annually) and the scientific findings and knowledge gained from our research are used to realign our health programmes, as well as strengthen our watchdog role to the greater benefit of the public.

Our health programmes comprise health and education campaigns; CANSA Care Centres that offer a wide range of care and support services to those affected by cancer; stoma and other clinical support and organisational management; medical equipment hire, as well as a toll-free line to offer information and support.

We also supply patient care and support in the form of 11 CANSA Care Homes in the main metropolitan areas for out-of-town cancer patients; a Wellness Centre based in Polokwane; and CANSA-TLC lodging for parents and guardians of children undergoing cancer treatment.

For more information contact CANSA:
Visit www.cansa.org.za or contact CANSA toll-free on 0800 22 66 22 or email [email protected] – follow CANSA on Facebook | Twitter | Instagram. CANSA offers multi-lingual support on WhatsApp: 0721979305 for English and Afrikaans, and 0718673530 for Xhosa, Zulu, Sotho and Siswati.

NCDs coordinating body for South Africa

Vicki and David Pinkney-Atkinson

 

The South African NCDs Alliance (SANCDA) and its NCDs partners are celebrating a pivotal win with the creation of a national NCDs coordinating body. In July after four years of consistent advocacy, the South African National Health Commission (SANHC) was created.

It marks an advocacy tipping point with the official acknowledgement of NCDs as the leading class of disease mortality in South Africa. At last, there is parity for NCDs with HIV/AIDS and TB. Well, at least on the co-ordination continuum. More successes along the lines of achieved for the MDG communicable diseases are needed.

The SANHC is one of the institutions created to implement and coordinate the South African version of universal health coverage and access, National Health Insurance (NHI). The NHI is in the second phase of the rollout which will target on vulnerable groups:  mother, child, school health, elderly and disabled.

The revised [i] SANHC objectives are
to address the social determinants of health through a multi-sectoral and development approach involving key government departments and non-state actors. SANHC will co-ordinate key sectors in implementing a health in all policies and an all-inclusive approach to the prevention and control of NCDs, including mental health. Promoting health and preventing illness is central to NHI well as to social and economic growth and development in South Africa.”

Plans for a SANHC were outlined by the National Department of Health in early 2013 with implementation due the following year.  Initially, its scope was to address only “social determinants” and their prevention. From 2014 onward the SANCDA advocated for a wider scope that included NCDs prevention and treatment in a co-ordinated multistakeholder and multisectoral approach.  This whole of government and whole of society context is critical for complex societal and health problems as addressed by the United Nations’s transformational 2030 Sustainable Development Agenda.  The SA National Development Plan (2011) is a visionary precursor.

By the end of the end of 2014 all the activity culminated in a meeting with the Deputy Minister of Health where the SANCDA once more called for the swift formation of this high-level body.

The SANCDA’s 2015 Civil Society Status Report underlined it as a major element necessary to combat NCDs and lamented the lack of action. There was a ray of hope by later in that year with the proposed link to the SANHC to NHI.  The 2015 NHI White Paper (1st version) mentioned the creation of a SANHC but still with a very limited scope which was a key focus area for reform and contestation. The SANCDA in its written comments reiterated its call for a national NCDs co-ordinating body as framed by the Sustainable Development Goals.

In July 2017 a raft of NHI related policy was published including the NHI White Paper (2nd version) plus the formation of seven NHI implementation institutions. There was little change to the SANHC scope and the objectives. However, a swift draft revision was circulated (text box 1) in the SANHC serves as the guardian of NCDs prevention and care. The SANCDA awaits official confirmation of the objectives and structure.

And, as a show of good faith, has nominated SANCDA director, Dr Vicki Pinkney-Atkinson, as a civil society representative. The SANCDA will report on further developments.

Box 1:  SA National Health Commission revised terms of reference [i]
a. Identify the social & economic factors that drive premature illness and death from NCDs.
b. Interrogate the means & mechanisms through which these determinants can be addressed, including the interventions required from different government departments and non-state actors.
c. Utilise scientific evidence on the causes of NCDs and how to prevent these. Based on this information draw up feasible and implementable plans to promote health and prevent diseases through interventions by the relevant stakeholders.
d. Research & utilise international best practice on health promotion and disease prevention interventions across sectors, analyse these for their feasibility and relevance to South Africa and make recommendations on implementation through SANHC to member government departments and non-state actors.
e. Periodically analyse surveillance data on NCDs and adapt strategies to changing patterns.
f.  Analyse cost-effectiveness and cost-benefit of interventions to reduce NCDs and ensure the most effective and efficient use of resources across sectors.
g.  Assist government departments and non-state actors to draw up strategic and operational plans that will positively impact on the social determinants of health.
h.  Consider and provide input into strategic and operational plans drawn up by government departments and other non-state actors vis-à-vis objectives and activities aimed at promoting health and preventing disease.
i.  Monitor the implementation of the plans and activities of all sectors with regards to the plans submitted to redress the social determinants of health.
j.  Evaluate existing interventions aimed at the promotion of health & the prevention of illness as well as programmes and projects that derive from the SANHC and make applicable recommendations to the relevant department or non-state actors.
k.  Ensure collaboration between and across government and non-state actors including non-government organizations, academia, representatives of labour and the private sector, to systematically improve the health status of South Africans and reduce the need for healthcare interventions.
l.  Ensure that all sectors that contribute to health and development outcomes of NCDs are aware of their responsibilities and that they implement relevant policies and interventions as directed by the SANHC;
m.  Where circumstances permit, the SANHC may act as a conduit for channelling funding to relevant sectors dealing with the social determinants of health.
n.  Co-ordinate sectors synergistically & eliminate wasteful duplication.

[i] This draft revision awaits official confirmation.