In sickness and in health

A look at Thailand and the world's healthcare scene over the past year, as well as trends and policy foreseen by experts in 2016.

The good and the bad

Dengue fever and public paranoia

Thailand's most-discussed health issue of 2015 undeniably was dengue haemorrhagic fever especially because it happened to a public figure, Channel 3 actor Thrisadee "Por" Sahawong, who has been in Ramathibodi Hospital's Critical Care Unit (CCU) since early November.

Thrisadee is suffering from a severe bout of the mosquito-borne viral infection and required resuscitation multiple times. He fought internal bleeding and eventually had his left foot amputated. Even though his condition has shown slight improvement, he still remains under the watchful eyes of medical specialists.

As of Dec 9, Thailand has seen around 129,000 infected cases of dengue fever and 125 deaths, according to figures from the Bureau of Vector Borne Disease under the Ministry of Public Health's Department of Disease Control.

The case of Thrisadee has certainly sparked a public scare among Thais. But it has also triggered people's hunger for knowledge about the tropical disease. People are now aware that there is no cure for the disease and specialists can only provide treatment based on a patient's condition.

Fortunately, a vaccine against the dengue infection developed by French pharmaceutical giant Sanofi, was approved earlier this month for use by Mexico, making it the world's first approval for any vaccine for the disease.

Charlie Sheen: I am HIV-positive

US actor Charlie Sheen revealed last month on the NBC morning talk show Today that he is HIV-positive and has paid people millions of dollars to keep the diagnosis a secret.

The 50-year-old actor admitted that he was diagnosed four years ago. The reason behind his revelation, he said, was to put a stop to shakedowns from prostitutes and others who threatened to blackmail him. 

Some praised Sheen for his courage. Others said he was no hero because they were sceptical if Sheen has opened up his status with his sex partners.

Notwithstanding, at least this case has raised global awareness regarding the disease and that the HIV-infected people can live normal lives as long as they are on antiretroviral medication.

Basketball player Magic Johnson who revealed his HIV diagnosis in 1991 encouraged Sheen to spread awareness about HIV and Aids. Johnson, who set up Magic Johnson Foundation in 1991 to raise money to fight against HIV/Aids, wishes that Sheen would join him in educating the world about the infection.

Processed meats under fire

After years of doctors' warnings, the World Health Organization (WHO) finally declared that processed meats raise the risk of colon and stomach cancer and that red meat is probably dangerous, too. Based on the WHO's International Agency for Research on Cancer (IARC) which involves the analysis of 800 studies from around the world, processed meats are now classified as Group 1 or "carcinogenic to human" and red meat as Group 2A, which means it is "probably carcinogenic to humans".

The WHO's new cancer classification caused tremendous public shock wave, so much so that the WHO had to come out and stress that the explosive report linking the consumption of processed meats to cancer was not calling for people to stop eating meat altogether.

Meat producers around the world, of course, had negative feedback over the report. Australia's agriculture minister called it "a farce", while the North American Meat Institute (NAMI) said the IARC "tortured the data to ensure a specific outcome". German butchers also rejected the findings while Italian food and farming groups urged its consumers not to get into a panic.

New influenza shield

The new and more comprehensive influenza vaccine was introduced in Thailand for the first time in September, meaning the jab will be more cost-effective especially when compared to the old vaccine.

This new quadrivalent flu vaccine, or the shot that protects against four different flu strains, has actually been promoted by the WHO since 2012. In Thailand, however, many people still question the efficacy and cost-effectiveness of the vaccine. But according to medical specialists, the quadrivalent vaccine yields an additional 18% efficacy to the previous type, which already renders 50-70% effectiveness in protecting people against influenza.

This year in Thailand, almost 70,000 people suffered from influenza, with 28 deaths reported, according to statistics from the Bureau of Epidemiology under the Ministry of Public Health.

Dangerously sweet

Sugar intake is a healthcare concern not just in Thailand but around the globe.

In March, the WHO released a new guideline on sugar intake which said that the world is eating too much sugar and that people should cut their intake to just six to 12 teaspoons per day -- an amount that could be exceeded with a single can of soda.

Thailand did take some actions against sugar intake too. Earlier this year, the Department of Health under the Ministry of Public Health in collaboration with the Thai Health Promotion Foundation launched a health campaign entitled "Waan Pordee Tee 4g", literally "4g Is Properly Sweet", to curb the amount of sugar consumers put into their beverages.

Café Amazon was the first coffee shop chain to adopt the campaign by providing its customers with 4g sugar sachets instead of 6g. This sugar sachet shrinkage will start next month at Café Amazon branch, located inside the Department of Health.

The Thai Health Promotion Foundation considered Café Amazon's decision to provide smaller sugar sachets as the right move. The foundation cited one of the reasons people's sugar intake gets out of hand is because they do not know how much sugar is in one sachet.

Health trends and public policy for 2016

Nutrition and diet

Functional foods should gain wider acceptance, commented anti-ageing specialist Dr Thidakarn Rujipattanakul. Exotic ingredients like nutrition-filled quinoa and chia seeds, which this year were exclusively sold in upscale supermarkets, will due to greater demand become more accessible to the general public and most likely be found in convenience stores. 

"Superfoods will gain wider acceptance among the public which would then contribute to the prices becoming cheaper as more shops decide to sell them on their shelves," she said.

Probiotic, which denotes a substance that stimulates the growth of micro-organisms, especially those with beneficial properties (such as those of the intestinal flora), and is classified as good bacteria in your gut, should also create a buzz among health-conscious people.

Dr Thidakarn believes 2016 will bring about a trend for high fibre diets, which was left out in 2015, a year when most health conscious individuals focused on diets with protein, carbs, low fat and more.

She said fibrous foods are an essential part of a human diet, which can sometimes be overlooked. Eating an apple without peeling the skin is an all time favourite for many because for one it can also lower the risk of colon cancer.

Fruits you can eat with seeds like pomegranates and strawberries and vegetables like bamboo shoots are popular options to help fed the good bacteria in the gut. This good bacteria will help your immune system to function properly.  

Eating habits 

As a large number of Thais residing in Bangkok depend on meals prepared from outside, food businesses are expected to increasingly see the importance of adding nutrition to their dishes. 

"My guess is that chain restaurants will be providing more nutritious meals to cater to a wider health-conscious society," the doctor commented. "Fast food outlets are already jumping on the bandwagon to offer a more wholesome meals for customers, with fruits, vegetables and smoothies to keep up with the trend to eat well. There is also a good chance that food businesses at grassroots level will be adopting a more healthy approach to their dishes to keep up with the trend."

Fitness/Wellness

The public focused largely on cardio-related exercise such as running, cycling and aerobics for their fitness training in 2015, so it is likely that weight training should become a popular fitness option for 2016. 

She based this presumption to the popularity of Thai celebrities showing off their well toned muscles and figure on social media outlets.

Dr Thidakarn suggests planking exercises for people who have little time to hit the gym. 

Anti-ageing

Techniques to look young will involve a more tailor-made approach especially when it came to taking vitamin supplements.

The procedure, she explained, starts with a blood test which would determine which vitamins are lacking to boost one's appearance. Vitamins are then prescribed accordingly so you are not overloading your body with vitamins you don't require.  

One anti-ageing technology which should pick up in 2016 is a piece of equipment which harnesses the power of ultrasound to tighten the brow, chin, neck and chest skin naturally.

Clinics and hospitals offering filler injections, which are a cosmetic treatment used to smooth wrinkles or pitted scars in the skin, will increasingly use a more state-of-the-art contraption that resembles a jet gun, which uses high pressure to send the filler into skin pores instead of needles. 

Public health policies

Health promotion and disease prevention are two of the main topics found in the 2016 National Public Health policies recently announced by the Ministry of Public Health that will be advocated next year, said Supreda Adulyanon, acting manager of the Thai Health Promotion (ThaiHealth).  

He said the Thai healthcare system will be going headlong in their approach towards combating disease prevention at all levels. In their effort to promote health, the broad target of these policies is to assure Thais of all walks of life and ages are given the opportunity to develop a healthy lifestyle, with a focus on nutrition.

Another integral part of these polices is the proactive role of family doctors at tambon and village levels and issues of traffic injuries. "To achieve this, one cannot solely depend on our healthcare system," said Supreda.

"Traffic injuries for example is a case in point. The Emergency Medical Services (EMS), which is mainly run by the health sector, contributes to around 5% of all effective measures to reduce the death toll on roads. So to actually get to the root problem, ministries such as the interior, transportation, police and others, including local, administration, private and civic agencies have to effectively collaborate with each other to combat traffic fatalities which are reported to be ranked second-highest in the world."

Nutrition is facing similar problems, he said, as it is interwoven with agricultural and the industrialised arena, as well as consumer protection and marketing.

Thailand has a fast growing ageing society that requires economical and social interventions and healthcare to help them lead a proper lifestyle.  

"In this regard, ThaiHealth could be one of the arms of the health sector to co-ordinate with other non-health sectors to accelerate the procedure to address these aforementioned policies," Supreda concluded. 

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