Canada and India's Heart to Heart When Arun Chockalingam was just five years old, his father died of a sudden heart attack. Devastated, the young boy vowed that when he grew up, he’d invent a machine that would prevent anyone else from dying the same way. Decades later, little Arun is now Dr. Arun Chockalingam and, while he hasn’t invented his life-saving machine, he has been true to his word and dedicated his life to finding ways to prevent the onset of heart disease. “My dad dying at such a young age — 42 or 43 — is what drove me, and still drives me,” says Dr. Chockalingam, in transit during a move from B.C. to DC.
He is leaving his position as Simon Fraser University’s director of continuing public health education at the Faculty of Health Sciences and relocating across the continent to take up his new position as founding director of the Office of Global Health at the National Heart, Lung and Blood Institute at the National Institutes of Health (NIH) in Washington, DC.
“It’s unimaginable,” says Dr. Chockalingam of the prestigious appointment. The NIH conducted a worldwide search to fill the position, and offered the job to the Surrey physician without him even applying. The NIH persuaded Dr. Chockalingam to leave his home in Canada, where he’s lived most of his life, and re-plant roots south of the border. Being in the U.S. capital will give him the opportunity to delve deeper into his all-important research and do something to combat the major killer of South Asians: cardiovascular disease.
“The more I study it, the more I understand,” he says. “Heart disease, to a large extent, is a man-made disease. Genetics is one component, but environment is a major player. It’s all globalization and global trade. We’re exporting this bad culture worldwide; you can see McDonald’s, KFC, Pizza Hut throughout the world. People want to have a fast life, and because of that, we don’t cook proper food. We go for fast food, which is full of fat, sugar and salt, and we don’t exercise enough to burn the energy. And that shows on our bodies.”
And in our bodies. Millions of people from South Asia suffer from heart disease, stroke and diabetes, together known as cardiovascular disease (CVD). In fact, a new study from the Institute for Clinical Evaluative Sciences in Toronto revealed that South Asians have a 24 per cent higher risk of developing hypertension and were twice as likely to develop diabetes than whites — both precursors to full-blown CVD. “There are lots of simple solutions — nutrition and behaviour the two major issues — but we’re not adopting them, and that’s part of the problem,” says Dr. Chockalingam.
Enter a second Arun: Dr. Arun Garg, a physician with an equally impressive history. The medical director of pathology and lab medicine at Fraser Health and Royal Columbian Hospital, Dr. Garg is just as driven and committed as his SFU counterpart. The two lived in the same city, were aware of each other’s work, but hadn’t met until 2007, when Dr. Garg was organizing a meeting of South Asian physicians to discuss various health concerns within the community.
“He’s a PhD scientist interested in global health, and I’m an MD clinician,” says Dr. Garg of Dr. Chockalingam. “He brings the research side to the equation and I bring the clinical and policy side, so that’s made a powerful combination.”
So powerful, in fact, that the two docs combined their considerable credentials to mobilize some of the top scientists, clinicians, researchers, academics and public-policy advisors from both Canada and India to join the Canada-India Networking Conference on Cardiovascular Health to be held at SFU’s Surrey campus June 19-23. The objective of the conference, featuring more than 200 participants, is to address what has become an epidemic of CVD in both countries by sharing crucial research and building on that collaboration for the future. The bulk of the conference is by invitation-only, to be attended by these leading experts. However, there will be a public forum of interest to health care professionals and general practitioners (go to www.mitacs.ca/conferences/CINI2010 for the agenda).
“The main conference is by invitation-only because we are selecting the leaders in each field so they will have the commitment and resources to carry out the outcomes,” explains Dr. Chockalingam.
Eight teams of specific and related experts comprise each section of the conference, which was nearly two years in the making. Dr. Chockalingam says, “Even if one concept or one outcome [emerges from each meeting] we will have eight outcomes. And these should not die at the conference; they should be nurtured and carried through so there will be some tangible, measurable benefits over the next three years, five years, 10 years.”
Adds Dr. Garg, “Right from the beginning we designed it so it’s outcome-driven. It’s not a conference in the sense that you just come and listen and go home and do whatever you were doing. We feel that the problem has already been established, and that is that there is a relative increase in the prevalence and incidence of chronic diseases among South Asians, relative to the Caucasian population.”
Dr. Garg concurs with his colleague and co-chair for the conference that the biggest contributors to these diseases are diet and lifestyle. But he doesn’t place the full blame on Big Macs and a bucket of crispy-fried chicken. He says South Asians develop a taste for many forbidden foods at a young age, whether they live in Canada or India.
“Because we start with a very rich diet in soluble carbohydrates and high salt very early, we start to see the effects early in life. But small changes are all [it takes to reverse the damage]: just cut down on salt intake, reduce the soluble, simple carbohydrates. In Indian context that is sweets, like laddoo, kulfi, gulab jamun. Everybody loves them, but if you have one a month, that’s OK.” He also emphasizes the need to get moving, regardless of the exercise you choose. Even yoga, which consists of light stretching exercises, is good. Just as important, he says, is proper breathing, which helps you relax and avoid stress, a contributor to hypertension, which leads to all the other bigger ailments.
We all know lack of exercise is bad for us. We know what it is we should be doing right, but we don’t do it, and Dr. Garg believes one key to fighting heart disease is knowing why people don’t act.
“What I would like to come out of [the conference] is, in the broadest sense: What is the fundamental foundation and psychology of social behaviour in the context of the South Asian culture,” says Dr. Garg. “We need to understand that first before we start to tell people what to do. There are two very good examples [of how it’s been achieved in the past]: one is smoking. Not that long ago, smoking was very prevalent, but through education and awareness, many people don’t smoke now. The other example is the environmental movement of ‘reduce, reuse and recycle,’ which made people a lot more aware. Somehow we were able to push the right buttons for people to accept [those changes]. But when it comes to diet, which is very personal and very emotional, it’s very hard. Especially in the Indian culture, which is a very conservative culture.
“I think we need to understand what fundamentals are required to have a conversation with people about [these issues]. We need to reach out to younger people and older people. Grandparents and grandkids are the two groups we need to work with, because the middle people are so busy trying to make a living they don’t have the time to think about these things. We also need to reach out to temples and congregations en mass [to deliver the message].”
In the meantime, the Canada-India Networking Conference on Cardiovascular Health is a good start for building awareness, transferring knowledge among peers, and committing to a follow-up plan to decrease the incidence of this deadly disease that took Dr. Chockalingam’s dad far too soon.
“It’s all common sense, really,” says Dr. Chockalingam. “When you are dealing with CVD, it is not [just] the clinical symptoms and the clinical approach. We should look at the social determinants: housing, transportation, our educational system, poverty. There are a whole lot of things that contribute, that’s why this conference is even more important because we’re looking at those social determinants.”
If the two Aruns can get key researchers and scientists from two countries to talk to each other about these issues, surely we can get our families to do the same. Our lives depend on it.
|
