Together with 100 other countries worldwide, today Malta is celebrating World Heart Day, the theme of which this year is “Team up for Healthy Hearts!” Being the world’s largest killer, heart disease was responsible for almost 43 per cent of deaths in Malta last year, so it is no wonder that Charmaine Gauci, the newly appointed director of the department of health promotion and disease prevention, considers this area as one of the top priorities in her new remit. She believes in the need to empower people to take up healthy lifestyles.
Dr Gauci explained that, as part of the major reform of health care within the Health Division, a new directorate has been set up within the Public Health Regulation Division to be responsible for health promotion and disease prevention.
“Disease prevention and health promotion are overlapping areas and although I was in no way involved in the health care reform, I believe this is a step in the right direction,” she said.
With her vast experience in the disease surveillance sector – she was head of the Disease Surveillance Unit for the last 10 years – Dr Gauci’s areas of specialisation included epidemiology, public health, communicable diseases, nutrition and health promotion.
Dr Gauci said she took up the post as a challenge – and a very big challenge, for that matter. It is challenging enough when you consider that two bodies have now been merged into one, but the directorate is currently divided between two different buildings, with two websites, two different sets of staff and different policies.
“My idea is an amalgamation of all our staff, seeing what their areas of specialisation are and starting to set up the directorate by assigning people to the areas that suit them best,” she said.
She goes on to speak about Mario Spiteri, the former director of the Health Promotion Department, who told The Malta Independent on Sunday last week that he had suspected his appointment would not be renewed.
He said that he also suspected that his efforts to promote sexual health were a possible reason why his tenure as director was not renewed.
As Dr Gauci made it clear that she is working closely with Dr Spiteri, who is giving her a very good hand-over, she insisted that any of the issues mentioned would not in any way affect the way she plans to embark on campaigns regarding sexual health.
“The scientific basics for health promotion are still there, even though there are naturally a number of things we can always improve upon. I would like to identify other ways and areas that may not have been tackled in the past,” she said.
Asked what she plans to improve and how she intends doing so, Dr Gauci talked about the need to go beyond creating awareness and to bring about behavioural changes in order to promote healthy lifestyles.
“Statistics show that there is quite a good awareness among the general public of the risk factors that may affect our health. In a nutshell, my idea is to go beyond this by adopting an inter-sectoral approach and empowering people to take up healthy lifestyles.
“We need to find a way of making people transform our health promotion messages into a behavioural response and it is for this reason that I am proposing an inter-sectoral approach.”
Dr Gauci said that the recently established inter-sectoral committee dealing with issues of obesity has begun holding meetings, and other such committees, dealing with pandemics and sexual health, have also been set up. She also made the point that there is a need for more of these committees on various other issues.
“From my experience in disease surveillance, I have seen that working in collaboration with other departments helped in reaching our goals. For example, we work very closely with the Education Division concerning cases of communicable diseases in schools and I intend to enhance this type of collaboration on various issues,” she said.
“The idea is to include the health aspect in all the government’s policies. It is useless promoting exercise when you know accessibility to facilities needs to be improved, or when you are well aware that children do not have time due to too much homework, for example, so health promotion must be dealt with by means of a concerted effort by all sectors,” she explained.
Asked which areas she considered as top priorities that she would like to work on, Dr Gauci pinpointed cardiovascular disease, mental health and cancer, although she explained that we still need to see where our priorities lie.
Naturally, she explained, cardiovascular disease incorporates a number of different areas, including two that certainly cannot be forgotten when you consider the Maltese scenario – diabetes and obesity.
“We need to see where the burden really lies in Malta. As regards mental health, we have no evidence as yet, but we believe there has been an increased demand for psychiatric care,” Dr Gauci said, adding that she would like to delve deeper into the non-
communicable disease sector to see what the actual burden is when it comes to frequency and cost, in order to develop cost-effective strategies to reduce the incidence of these illnesses.
She insisted on the need for a clearly mapped-out strategy and the importance of evaluation and self-criticism.
While admitting that results would not be immediate, Dr Gauci said she hoped to be able to identify the right areas and start seeing improvements, “otherwise, if our campaigns fail to bear any fruit, we will have to admit that we have been doing something wrong and will have to correct our mistakes”.