Archives 2014

According to the World Health Organisation, Cancer is responsible for 11% of total deaths in Fiji, and of this amount, around 30% of all cancer deaths are attributable to lifestyle factors including poor diet, inadequate physical activity, tobacco use and excess alcohol intake. Cancers that have a strong association with diet are those of the digestive tract – esophagus, stomach and bowel.

Although there is no definitive evidence to suggest that nutrition can help cancer progression and recurrence in those already diagnosed with cancer, eating a varied diet across the food groups and focusing on vegetables and fruits is of course recommended and will not do any harm.

Let’s look at the specific areas of nutrition related to cancer:

Obesity

Eating a poor diet often results in being overweight and obesity, which is linked to cancer of the esophagus, post menopausal breast cancer, endometrium, bowel and kidney. The best thing you can do to help reduce your risk of these cancers is maintain a healthy body weight by eating a variety of foods from the different food groups, focusing mainly on vegetables and fruits and avoiding nutrient poor processed foods that are high in fat and sugar. And of course, increase your physical activity wherever you can, any movement counts!

Red Meat

Evidence suggests that there is a link between consumption of red meat, especially processed meats such as sausages, salami and ham, and the risk of developing cancer. Always try and have lean meat only, and avoid processed meats wherever possible, replacing these with white meat or fish. Red meat should be kept to 3-4 times per week and only a small serve, no more than the palm of your hand and palm thickness. Remember to choose lean cuts, not fatty meats.

Alcohol

Drinking alcohol is linked to an increased risk of developing cancer of the bowel, mouth, pharynx, larynx, esophagus, liver and breast. Your risk of developing cancer increases from your first alcoholic drink, and the more you consume, the greater your risk. If you choose to drink, it is recommended that you drink no more than two standard drinks per day to minimise your risk. The risk increases even further if alcohol intake is accompanied by tobacco use.

Vegetables and Fruits

There are two factors to consider when looking at Vegetables and Fruits, firstly is their role in weight management due to their low energy content and high nutrient density and secondly, the role specific nutrients play in cancer protection.

Weight Management – Given the strong evidence linking obesity to certain types of cancers, and the important role vegetables and fruits play in weight management, they are an essential part of a cancer prevention diet. When we make vegetables and fruits the focus of our diet, this takes the place of energy dense and nutrient poor foods, and we naturally have a lower energy intake, and higher fibre, vitamin and mineral intake – helping our metabolism to work optimally.

Specific Nutrients – There is very limited evidence to suggest that one particular nutrient protects against cancer, it is likely that it is a combination of the fibre, vitamins, minerals, antioxidants and phytochemicals that all work together to prevent cancer and other disease. The recommendations are for mostly fresh vegetables and fruits as opposed to a supplement, a mixture of raw and cooked and as many different types and colours as possible for maximum health benefits.

References and Further Reading

World Health Organization – Noncommunicable Diseases (NCD) Country Profiles, 2014.

Cancer Council Australia – Food and Nutrition page

Cancer Council Australia – Obesity page

Cancer Council Australia – Alcohol page

Cancer Council Australia – Position statement: Fruit, vegetables and cancer prevention 16 Published August 2007; Updated June 2009

What makes for good digestion?

Eating a variety of different foods every day and getting enough fluids is the best thing you can do for your digestion. Maintaining good digestion is important to reduce your risk of developing diverticular disease later in life, avoiding constipation, hemorrhoids and certain cancers such as cancers of the digestive tract.

Good digestion is different for everyone, but generally it means going to the toilet once per day to pass a bowel motion and having a good appetite. When our digestion is not working so well, you will find that your energy will most probably be low, skin can be dull and your appetite may be poor. Going to the toilet several times a day or more is also not ideal as this may mean that nutrients are not being absorbed during digestion. It is important to see your doctor if you are having problems with your digestion as even though problems are usually dietary-related, more serious health problems need to be ruled out by a health care professional.

Water

Water is essential for good digestion. As waste moves through our digestive tract, it absorbs water along the way to become soft enough to move through our bowel. If there is not enough water to absorb, our bowel motions become hard and difficult to pass. The more you sweat the more water you will need and though peoples daily water needs differ, a general guideline, the requirements are:

Adult women = 2.1L (approximately 8 glasses of 260ml)

Adult men = 2.6L (approximately 10 glasses of 260ml)

An easy way to tell if you are well hydrated is the colour of your urine. If your urine is dark yellow, you are probably dehydrated, if it is light yellow or clear, you are most likely well hydrated.

Fibre

Fibre is the part of our food that is not digested that adds to the bulk of our bowel movements, and acts as the ‘glue’ that keeps it all together. There are two types, insoluble fibre that adds to the bulk, and soluble fibre that is the ‘glue’. It is important to have a good mix of both types of fibre in your diet. We need to aim to have between 25g and 30g of fibre each day.

Good sources of soluble fibre are fruits and vegetables, oats, chickpeas, lentils and other dried legumes.

Good sources of insoluble fibre are the skins of fruits and vegetables, nuts and seeds, wholegrain bread and cereals.

Some high fibre Fijian foods are:

• Jackfruit
• Breadfruit
• Cabbage
• Potato (Skin on)
• Kumala (Sweet potato) (skin on)
• Cassava leaves
• Watercress
• Corn
• Eggplant
• Peas
• Mung Dhal
• Lentils
• Paw Paw

Tips on increasing your fibre intake;

*Choose brown bread that contains seeds instead of plain white bread

*Choose wholegrain crackers over breakfast crackers or other white crackers

*If you eat noodles, add a couple of handfuls of vegetables in each serve

*Replace half of your root crops with green and other colourful vegetables, especially bele

*Use whole meal instead of white flour to make roti

*Make your snacks high fibre – a mix of nuts, seeds and dried fruit, lentil dhal, baked beans, wholegrain crackers, fruit with the skin on, some vegetable sticks with hummus or other bean dip

*Don’t forget to increase your water at the same time!

Physical activity for good digestion

Exercise is important for bowel motility and if you find that your digestion is a little bit sluggish, you might find some benefit with a gentle walk each day or some exercises that stimulate the abdomen area.

References and Further Information

• Better Health Channel – Water
• Dietitians Association of Australia, Nutrition Information A-Z – Fibre
• Better Health Channel – Constipation

WORKSHOP ON DISASTER RISK MANAGEMENT FOR HEALTH (DRM-H) IN THE PACIFIC ISLAND COUNTRIES AND AREAS

On the Opening of the DRM-H Regional Workshop at Tanoa International Hotel, Nadi

Dr Liu Yunguo, Director, Division of Pacific Technical Support, WHO WPRO
Mr Manasa Tagicakabau, Director, Fiji National Disaster Management Office
Representatives of World Health Organization – Manila Office
Representatives of World Health Organization – Suva Office
Representatives of Various UN Organizations
Representatives of the Secretariat of Pacific Community (SPC) – SOPAC Division
Health DRM Representatives of Pacific Island Countries & Areas
Facilitators & Trainers
Representatives of the Media
Distinguished guests, ladies and gentlemen

Good Morning!

It gives me great pleasure to provide some comments on behalf of the Government of Fiji and Ministry of Health – Fiji and to warmly welcome all the participants to this occasion of the Regional Disaster Risk Management for Health Workshop.

Setting the Scene:
According to the 2013 World Risk Report, the Western Pacific Region is notoriously known as the world’s disaster epicenter: 10 of the top 20 countries most exposed to natural hazards such as typhoons (cyclones), earthquakes, floods, and tsunamis reside in the Western Pacific. Furthermore, booming economies expose large geographical areas and dense populations to technological hazards such as air pollution, contamination of large crop productions with chemical hazard materials, structural collapse and transportation accidents.

There are more tropical typhoons forming in the tropical western regions of North Pacific Ocean than anywhere else in the world. More than 25 tropical storms develop each year, and about 18 become typhoons/cyclones. Sixteen of the 18 deadliest tropical typhoons/cyclones in history occurred in the Western Pacific Region. Over the past 100 years, seven out of the top 10 largest flood disasters in the world have occurred in the Western Pacific Region.

Ninety percent of recorded tsunamis have occurred in the Pacific Ocean, which is bordered by the so-called “Ring of Fire” comprised of major geological subduction zones, where 75% of the world’s active and dormant volcanoes are located. Great trans-Pacific tsunamis are typically caused by massive earthquakes located in these subduction zones and occur at mean intervals of once a decade. In a 100-year period from 1895 to 1995, there were 454 tsunamis recorded in the Pacific Ocean, the deadliest of which killed more 51 000 people.

Disaster Risk Management – Health:
In the last 20 years, disaster management has been largely reactive – taking actions during and after an event. Now a now proactive approach focusing on managing risks related to different hazards with specific activities for all the 4 phases of the Disaster Risk Management cycle (DRM), namely: prevention, preparedness, response to and recovery is being taken.

As you all know, in 2005, after the Indian Ocean Tsunami, the Hyogo Framework for Action (HFA) 2005 – 2015 was created to offer a set of actions to substantially reduce human and economic losses and build the resilience of nations and communities to disasters. Countries are now using a more comprehensive and long-term approach to identify hazards, assess vulnerabilities and prepare exposed communities for disasters before they occur.

As a new post-Hyogo (Post 2015) agenda for disaster risk reduction has begun to emerge, aiming to avoid new risk to emerge in addition to reducing existing ones, it is clear that the health sector must take a more active role in disaster risk reduction, with strong linkages to other sectors, and an emphasis on enhancing partnership among governments, communities and organizations.

In Fiji’s Disaster Context:
Fiji is geographically situated in one of the most natural disaster prone areas in the world. Some hazards occur as a consequence of tropical depressions and cyclones or as part of tropical weather condition that normally affects the region

There have been 36 recorded natural disasters in Fiji since 1980, with 221 fatalities and over $1 billion dollars’ worth of economic damage to Fiji’s economy. Natural disasters such as Cyclone Evan which battered Samoa and Fiji in 2012 – 2013 and the devastating earthquake and tsunami in Solomon Islands recently remind us again of the power of nature and the vulnerability the high levels of risk to Pacific nations of both climate change impacts and natural disasters.

The Health costs and implications to these disasters are often under estimated.

DRM – Ministry of Health – Fiji
At this junction, I would like to share Fiji’s Health Ministry’s approach to Disaster Management.

The guiding principles of Disaster Management for Health are defined in a Plan know as the Health Emergency & Disaster Management Action Plan (HEADMAP). This document was developed during the SARS and Avian Influenza events and has been periodically revised. The document attempts to encompass the four phases of disaster risk management and focuses four key components identified in the Regional Framework of Action for Disaster Risk Management for Health; namely Governance, Policy, Planning, and Coordination; Information and Knowledge Management; Health and related services and Resources:

A key focus of Fiji Ministry of Health has also been ensuring that our health facilities are safe during disasters. Periodic inspections of all health facilities are conducted. Planning of new facilities is carefully considered to avoid future hazards.

Our Ministry has established a Unit within the Ministry which looks at after Disaster Risk Management – developing policies, guidelines and standard operating procedures for health staff.

The Health Ministry also works very closely with our National Disaster Management Office (NDMO) to align itself towards a collective vision of ensuring the populations at risk are well prepared and to reduce risks both to human life and to systems important to livelihood.

Conclusion Remarks
Ladies and gentlemen, in conclusion disaster preparedness is everyone’s business. The disaster whether natural or human-caused can sometimes be unavoidable but we can prepare ourselves to be ready if they happen and minimize the impact of the disaster to human being.

Disasters affect all works of life and it our duty to mitigate the effects of disasters.

In Pacific we are fortunate to have kind offers of international assistance in times of disasters and I would like to thank you those partners in assisting us at our time of need.

However, being prepared for the unexpected takes planning and this gathering is a landmark event as we prepare for the next World Conference on Disaster Risk Reduction in 2015 in Japan and stamp our (health) mark towards DRM for Health.

I am indeed grateful to WHO towards organizing this workshop and I wish you all a successful Workshop and I look forward to its outcomes.

Thank you for your attention!

Dr. Neil Sharma – Minister for Health – Fiji