Losing a loved one from heart attack – how early life prevention can save lives

Posted on December 6, 2018 By Febi Trihermato

The author, Febi Trihermato (foreground), taking in the ‘Youth are our Future’ health policy forum. (Credit: AIC)

Recently my eyes were opened about how to implement a healthy lifestyle in our society, and how important it is for disease prevention. This affects me as some of my family members suffer from NCDs. With a background in business and finance, I recently attended the AIC Health Cluster forum under the theme ‘Early-life non-communicable disease (NCD) prevention’ focusing on youth and Indonesia’s Golden Generation.

Even though I grew up seeing my father taking high blood pressure medications all his life before finally passing away at the age of 64 because of a heart attack, I had never realised that NCD preventions need to start with our children and young people. I believed I would be healthy and well if I just did regular check-ups in my forties, like my father did.

I was surprised by the fact that the preventions for risk factors of NCDs can even start during pregnancy (gestational diabetes) and early childhood (malnutrition). Meaning it is everyone’s business to understand this issue, not only for themselves but also for their kids and family. I believe that educated parents will provide healthy and nutritious food, including exclusive breastfeeding, to their babies resulting in a healthy generation. It is also important for parents to educate their children about NCDs early to avoid them starting unhealthy behavior (smoking, physical inactivity and a poor diet) when they become adolescents. This can be supported by governments and business working together with communities, schools and families.

Febi (right) listens to a young delegate at the health policy forum. (Credit: AIC)

Another great thing about this forum was it brought together all the stakeholders in the health sector so the audience could get comprehensive information about NCDs from different points of view.

From the first panel discussion, I found out there was shifting in awareness that while we commonly think of the diseases in adults, there are important opportunities to help children and adolescents reduce their risks, through adoption of healthier lifestyle behaviours. And avoiding things we know we should, such as smoking and excessive alcohol consumption. In Indonesia, we urgently need to open adolescent health clinics that provide care tailored to our growing youth population’s needs, as they experience NCDs too but are less likely to go to clinics. We also need health professionals who know how to promote preventive healthcare to the communities, especially young people.

A key issue to me, was that NCD prevention strategies will not be effective in changing everyday life experiences if there is still no strict regulation on tobacco advertising, promotion and sponsorship (TAPS). Putu Ayu Swandewi Astuti explained there were too many tobacco retailers that can be easily accessed by students and our students are bombarded with tobacco advertising near their schools.

“Recent geospatial mapping found one school in Denpasar had 44 cigarette retailers within a 250-meter radius” Putu said.

Putu Ayu Swandewi Astuti (second from right) from The University of Sydney during a panel titled ‘Media and Advertising: Friend or Foe?’ 

I agreed with her that there should be regulations to limit the density of cigarette retailers in Indonesia. Such a step will help protect our young people, the future engine of Indonesia’s growing economy and financial stability. Our schools and health systems need to empower young people so they are aware of the detrimental impact of smoking and how important health lifestyles behaviours are.

Our government, through the Ministry of Health and Ministry of Education and Culture, supports school programs, including research, to promote healthy lifestyles for young people. A project involving education, health research and students, with Nur Syah showed how school students are easily reached and effective agents of change. Her project empowered students to be a part of NCD prevention strategies in schools.

“We aim at extending two familiar health intervention programs at schools, ‘Dokter Kecil’ and ‘Pos Bindu’, to include NCD prevention through changing student attitudes to healthy lifestyles” Nur explained.

Healthy lifestyle learning manuals for the ‘Dokter Kecil’ (front) and ‘Pos Bindu’ programs. (Credit: AIC)

Lastly, a more sensitive issue, mental health and wellbeing. It’s only something I have recently heard about in Indonesia and there are emerging concerns, but also hope, over the last few years. I sat next to the Indonesian Child Protection Commission (KPAI) delegate and she expressed her concern on increasing youth mental health problems. I was saddened to hear that some of the sufferers, who live with mental health issues, may suicide. I was startled and shocked when she shared a case of a child as young as eight years old.

There is an urgent need for us to support parents and schools to embrace discussions for mental wellbeing, not just disorders. These discussions can help students, parents, teachers and communities understand how they can build resilience and mental wellbeing. However, schools and parents also need help from the government and health workforce to do this. They cannot do it alone.

Unlike a talk-fest, the forum ended with a focus group discussion focused on solutions to various NCDs – mental health problems, diabetes, etc. My group focused on mental health and wellbeing and innovative ways to prevent mental health issues. This was the first time in my life I had openly talked about mental health and wellbeing, I think for most of our group.

I look forward to the forum’s video with messages about how all of us in Indonesia, from business, community, government, health professionals and young people can beat NCDs.

Febi Trihermato is the Indonesia Research Officer for The Australia-Indonesia Centre, based in Jakarta.