A Matter of the Heart: The Silent Killer of the Most Vulnerable People

I met Yves when he was 18 years old, but he had the appearance of a 13-year old child. It was probably a result of his heart condition, which had never been treated for all these years. Yves was born in Haiti where there is no specialized structure to address cardiovascular diseases. In 2012, our team operated on Yves. He is a privileged one. In Haiti, there are thousands of children in the same situation, half of whom will not reach the age of 2.

Haiti’s massive 2010 earthquake caused a huge humanitarian crisis and emergency health responses were largely focused on infectious and diarrhoeal diseases, and malnutrition. However, according to the Ministry of Public Health, Haiti is also undergoing an epidemiological transition from infectious to non-communicable diseases. The latter have become a serious public health concern with rapidly increasing incidence.

Indeed, high blood pressure is already a real humanitarian crisis in Haiti. It affects almost one in two people over 20 years old, and it is the leading cause of death on the Caribbean island. Out of its population of about 10 million, 2 million people have hypertension and 300,000 have diabetes. Since 2010, an epidemic of cardiovascular disease has spread across the country, fostered by the precarious and stressful living conditions in a country still getting to grips with the aftermath of the earthquake, wood and coal pollution, a diet heavy in salt and fat, overcrowded urban environments, smoking, alcohol and the lack of prenatal screening.

Haiti is not unique. Cardiovascular diseases are the leading cause of deaths worldwide. Their alarming increase represents an imminent threat to the health and future of our most vulnerable populations, particularly women, children, displaced people and migrants. In developing countries, there are three times as many deaths due to cardiovascular disease as there are in developed countries.

The political declaration of the “High-Level Meeting of the United Nations General Assembly on the Prevention and Control of Non-Communicable Diseases”, held in 2011, recognized that the global burden of non-communicable diseases is one of the major challenges to development in the twenty-first century. Non-communicable diseases have enormous socio-economic costs, especially in poor countries, which already face other structural public health, humanitarian and development challenges.

The Heart Fund leads the efforts of civil society to raise the awareness of UN Member States, the media and the entertainment industry about the gravity of this particular crisis. That is why we are participating in the World Humanitarian Summit  to propose a joint call to action by all health, humanitarian and development actors to declare cardiovascular disease to  be  a major crisis. This may not have the photogenic impact of the victims of a tsunami or a battlefield but its consequences are no less significant as it insidiously touches families and communities everywhere.

But Haiti is fighting back. Our “Heart Force Coalition” is the country’s first public-private initiative to fight cardiovascular disease. In practical terms, this means disseminating information and raising public awareness, establishing screening for at-risk and vulnerable populations such as diabetics and hypertensives, and promoting social improvements such as greater physical activity, controlling tobacco and alcohol consumption, improving nutritional practices and countering environmental pollutants. Cardiovascular disease is also a stimulus to strengthening the public health system. That brings wider benefits for everyone including for other health conditions.

Meanwhile, Yves’ heart is also beating stronger and he is getting into soccer.

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