The Lancet: Blood pressure control: a challenge to global health systems (4) Personal health books (4)

17 September, 2019

Dear Neil and friends of HIFA,

I kept waiting few days in order to get some reactions to my proposal of BMI/BP checking in hospitals. Only Joseph (Ana) replied, for this I thank him sincerely.

We should avoid inter-personal exchange of opinions but Joseph made a question and with your permission, Neil I answer.

1) How much will this service cost?

2) How far will it reduce mortality?

Very little is the answer to question number 1.

Very much is the answer to the question number 2.

I'd like to underline once more the logic-the spirit behind my proposal, that is in short: persons are the first responsible of their health, not doctors.

From ever we doctors have expressed our taumaturgic approach to medicine and patients, we cure, we heal, we know which treatment is best, we give health.

Patients keep begging a treatment, most times unaware of their condition and the causes behind it.

Things must change: the health system is there mainly to *inform* or to *make a correct diagnose* instead of curing. Yes, if you become aware that your BMI is more than 30 or your BP is more than 140mmHg then you will change your living style, you will be treated accordingly. You are responsible of your health, I as a doctor am responsible of informing you adequately.

Now Joseph you see here the logic behind:

1) PHB (personal health booklet) is the best way of informing the patient, to reduce the power of doctor on the patient's health for he has to make public his diagnose, to communicate it to the patient. In written words!

2) NTCG (national therapeutic clinical guidelines), to which doctors must(!) adhere. Also here the logic is to reduce/control the over power of doctors and give power to patients. Yes, they have the Right(!) to be treated adequately, uniformily.

3) BMI/BP checking in hospitals. Again...I inform you about the risk of being overweight/obese or having high BP. Health is your.

Thanks again and greetings from Dodoma

Massimo

HIFA profile: Massimo Serventi is a long-standing Pediatrician working in Africa since 1982. He currently works on a volunteer basis in an excellent missionary/credited hospital in north Uganda, St. Mary's Hospital-Lacor-GULU. He has worked for several NGOs in 6 African/2 Asian countries. His interests include clinical and community pediatrics, adherence to clinical guidelines and school education as the major determinant of good health. massimoser20 AT gmail.com