Dr Patrick Martin, the Chief Medical Officer in St Kitts and Nevis, talks frankly about what really needs to be done to tackle the NCD “tsunami”.

“There is no doubt in my mind that our people know there is an NCD problem …. However, knowing and doing are two different things. And that’s where we are now: converting the knowing into doing.”

I am Dr Patrick Martin and I have been Chief Medical Officer since October 2004. In terms of NCDs in St Kitts and Nevis, we are experiencing a tsunami of high levels of hypertension, diabetes and obesity.

There is no doubt in my mind that our people know there is an NCD problem related to risk factors such as physical inactivity and excessive consumption of fat, salt and sugar. Indeed, when I’m out and about and someone sees me eating a hotdog, they’ll be very quick to tell me, “Wait, Doc, you’re not supposed to be eating that!” People know. However, knowing and doing are two different things. And that’s where we are now: converting the knowing into doing.

Fast food is seen as cool

Eating fast food is considered a status thing. If you want to be cool then buy fast food. It shows that you can afford it. Some parents have even told me that they see vegetables as poor people’s food, that they equate them with the poverty of their childhood.

There are those who can make lifestyle adjustments to challenge NCDs but there are other people who can’t do this on their own. We need government policy to address the realities of the typical man and woman in the Caribbean who has real difficulty making healthy choices because of the environment they live in.

“We all felt good after the 2007 Port of Spain Declaration on NCDs but we have had zero resources to make it happen. So we’re pretty much left to implement on our own.”

Not just a health sector matter

We have learned that tackling NCDs is not just a health sector matter and have been slowly building capacity to reach out to other sectors. As Chief Medical Officer, I have to speak the language, not only of public health, but also economics, finance, trade and behaviour change.

We all felt good after the 2007 Port of Spain Declaration on NCDs but we have had zero resources to make it happen. So we’re pretty much left to implement on our own.

Things can’t be done from a single country perspective. It’s necessary to think and act regionally. For example, we have national food-based dietary guidelines in St Kitts and Nevis which is a major achievement. What we really need now is regional action on food labelling. It’s feasible to implement an effective approach to NCDs in St Kitts and Nevis, but not without regional support.