About 30 years ago, non-communicable diseases were rarely heard of. Even if a few cases were found, the cause remained unknown. Due to the lack of testing, manpower, and resources for non-communicable diseases, they were not widely discussed.
In villages, when someone died of heart problems, people used to say that a “witch” had attacked their heart. Nowadays, there is at least some awareness that deaths can occur due to high blood pressure or other health issues.
However, in recent years, people who used to walk for one to two hours daily have now become completely dependent on motorcycles and scooters. Along with this, the habit of walking and exercising has significantly declined. Physical activity has decreased, leading to an increase in obesity among many Nepalese. As a result, the burden of non-communicable diseases has also increased.
Developed countries are managing to control the outbreak of non-communicable diseases. However, in developing countries like ours, these diseases are spreading like an epidemic. We are constantly running in this competitive world, believing that work is unavoidable.
In the past, the burden of non-communicable diseases was lower. But today, non-communicable diseases have replaced infectious diseases that were more common three decades ago. Urbanization has increased in our living spaces. In the past, people in villages engaged in farming, naturally exercising through their daily work. Nowadays, people are physically inactive.
Additionally, dietary habits have changed. In urban areas, people consume packaged foods, meals fried in the same oil for months, and unhealthy diets that contribute to heart diseases and other non-communicable diseases. Instead of consuming nutritious food, we have started eating more greasy market-available food. The number of people doing desk jobs has increased.
Cities lack spaces for physical exercise. Food quality is poor, and people have no choice but to eat what is available. There is less consumption of vegetables, fruits, and home-cooked meals, while fast food, pesticide-treated vegetables, and high salt intake have become more common.
Many people think they are eating healthy because they consume fruits daily. However, the excessive use of pesticides in fruits and vegetables has also contributed to the rising burden of non-communicable diseases. Another major concern is air pollution, particularly in cities. Kathmandu Valley, being shaped like a bowl, traps polluted air, directly affecting the lungs.
Recent statistics show that the death rate from non-communicable diseases has increased to 71%. These diseases include high blood pressure, cardiovascular diseases, diabetes, asthma, cancer, kidney problems, etc. These diseases are not caused by a single factor but by multiple contributing factors.
Developed countries are controlling the spread of non-communicable diseases, but in a developing country like ours, they are becoming an epidemic. We are constantly running after work, neglecting our health. Our own negligence has made us more vulnerable to non-communicable diseases.
If the government does not take initiatives to ensure food safety and reduce air pollution, the situation will become alarming in the next two decades. This issue cannot be tackled by individuals alone; the state must take strong action.
The government should strictly regulate the use of pesticides in vegetables to ensure they do not harm public health. Three decades ago, people in villages were mostly engaged in farming and consumed homegrown, pesticide-free food. They ate traditional meals like maize, wheat, and roti. However, children today consume junk food such as instant noodles, biscuits, and chips. With such unhealthy dietary habits, non-communicable diseases are bound to increase. While chasing other aspects of life, people have stopped prioritizing their health. Awareness about personal health should begin from a young age.
There are individual responsibilities, but the government has a bigger role to play. The state must ensure food quality. For example, shopkeepers claim that samosas in the market are fresh, and we believe them. However, they fry various items in the same oil throughout the day, which we are unaware of. The government should regulate and monitor such practices, setting rules on how long cooking oil can be used before disposal.
If the policies regarding health are effectively implemented, non-communicable diseases can be prevented. However, the government has failed to focus on this area. Among South Asian countries, Nepal ranks first in drafting policies, laws, and guidelines. However, in terms of implementation, it ranks among the weakest.
Monitoring the quality of food and other essential items is the government’s responsibility. There was a plan to move vehicles older than 20 years out of Kathmandu Valley to reduce air pollution, but it was never implemented. While the government has introduced policies to reduce the burden of non-communicable diseases, it has failed to enforce them.
Trucks emit thick clouds of smoke, but there is no proper inspection. Authorities take bribes and allow violations. As a result, ordinary people are suffering, yet we are not paying attention. The government needs to be more accountable for the long-term consequences of this issue. When rules are enforced, people are compelled to follow them. However, due to the government’s lack of structural planning, the situation of non-communicable diseases will only worsen. Eventually, even if the state spends billions, it will be difficult to control the crisis.
Therefore, instead of focusing solely on treatment, the government should emphasize prevention. Screening for non-communicable diseases and raising public awareness should be prioritized. However, screening efforts are still lacking.
Leadership within the Ministry of Health is more concerned about gaining popularity and applause rather than addressing fundamental issues. Small yet significant steps, like designating government land for physical exercise spaces, could have long-term positive effects.
However, the government prioritizes constructing a 15-bed hospital in such areas, driven by the mentality that they need to gain votes by showing off new infrastructure. Instead of focusing on long-term solutions, short-term political gains have taken precedence.
Nepal has written many good policies in its national health strategy. Our constitution and laws are well-framed. However, the problem lies in poor implementation. If health policies were effectively enforced, non-communicable diseases could be prevented. Unfortunately, the government has failed to pay attention to this crucial matter. Among South Asian nations, Nepal ranks first in formulating policies, laws, and guidelines, yet it remains the weakest in implementation.
