Some three million children in Britain are obese, and treating childhood obesity is far from easy. If we are to have any chance of responding adequately to the epidemic of obesity we need to find, firstly, a treatment that works and, secondly, a way to scale it up so that it can be used across the country. Both problems are hard, but the scaling up is, I suggest, the harder problem. I was therefore impressed to encounter an organisation in the backstreets of Southwark that is making real progress with both problems—and already beginning to work not only in Britain but also across the globe.
MEND (Mind, Exercise, Nutrition, Do it!) is a social enterprise that is research driven and has developed a family and community based treatment for childhood obesity. The treatment has been shown in a randomised trail to be published in Obesity next year to reduce waist circumference and body mass index and to increase cardiovascular fitness, physical activity, and self esteem.
The differences between rural and urban China are stark. Beijing, Shanghai, and other major cities are filled with new buildings, best illustrated by those built for the Olympics, whereas rural China has as many as 300 million people living on under a dollar a day, more than any other country. Indeed, China can be described as three countries: a low income country in the West, a middle income country in the middle, and a developed country in the East.
People living in the big cities have access to the latest medical technology, whereas those living in the countryside are served by a “village doctor” (many of them once the famous barefoot doctors) with limited training. So far most health research has been conducted in large hospitals in the cities, but a new programme—the China Rural Health Initiative—plans to build a platform for research in rural areas Last week in Beijing I heard the plans for the initiative.
The China Rural Health Initiative is the flagship programme of the China International Center for Chronic Disease Prevention, which is based at the George Institute China, with Peking University Health Science Center its lead domestic partner. There are also five partners from five of the provinces closest to Beijing, which together have about 190 million inhabitants, and six international partners, including the George Institute in Sydney, Duke University, and Imperial College.
Perhaps I should have realised from the title, but when I began to read The Book of Dead Philosophers I didn’t expect it to be funny. In fact Simon Critchley’s stories of how “190 or so” philosophers died and some of what they said about death is at times hilarious—as well as rich with meaning.
Let’s begin with Freddie Ayer, the Oxford logical positivist whom as a student I saw lecture in Edinburgh. The story of his encounter with Mike Tyson the New York party of an underwear designer is well known, but I’d not heard it. Tyson had begun to assault Naomi Campbell, and Ayer confronted him. “Do you know who the fuck I am?” asked Tyson. “I’m the heavyweight champion of the world.” “And I,” replied Ayer, “am the former Wykeham Professor of Logic. We are both eminent in our fields; I suggest we talk about this like rational men.”
Slowly but surely the internet is transforming industries—finance, travel, music, entertainment—but so far it has had little impact on public services. But can it transform public services and if so how and when? These were the questions that ran through a day of “cocreation” organized by Patient Opinion, an organisation founded by GP Paul Hodgkin that allows patient to share their stories of the NHS with the hope of improving services.
The long term vision of the social entrepreneurs at the day is that the internet can make all public services, including the NHS, police, and local government, more responsive, more bottom up than top down. Patients will not be seen simply as needy recipients of care but people who through sharing their stories and experiences can help others.
Posted on November 11, 2009 by Dr Mohammad Al-Ubaydli
We are getting some nice coverage about the Stelios Award. First to cover is the The Deaf Blog, a blog about the achievements of people with hearing difficulties.
David Molyneaux from Liverpool said that an alien observing earth for the first time would think that it had only three diseases: AIDS, TB, and malaria. He is one of the “three dinosaurs of neglected tropical diseases (NTDs)” who spoke at the meeting, pointing out that sums that are very small by the standards of AIDS could make a huge difference in alleviating the suffering of the world’s poorest people from schistosomiasis, onchocerciasis, sleeping sickness, elephantiasis, and the other neglected tropical diseases. Some of these diseases can be treated very effectively and cheaply. Deworming people—as animals have long been dewormed—for 60 cents a year could make huge differences to child growth and development and levels of disability.
Neglected tropical diseases have received some funds and had successes with treatment and eradication, but why have they not received the attention and funding of AIDS when much more could be achieved with much less money?
Last week I was privileged to hear a brilliant talk—by Nicholas Janni—on what Henry V or rather Shakespeare has to teach us about leadership.
Prince Harry was, as most people know, a dissolute youth, hanging out with drunks, pimps, whores, and undesirables with the great Falstaff chief among them. But when his father, Henry IV, dies he turns away from those scoundrels. “I know thee not, old man,” he tells Falstaff: “Presume not that I’m the thing that I was.”
Once he is king Henry needs a mission, a great cause—and that mission is to conquer France not for wealth or for aggrandisement (although we may be skeptical) but for “honour,” something very important in the 15th century and not well understood in the 21st (except perhaps by the Mafia).
Janni, a coach to chief executives around the world, is keen to promote what the Greeks called “mythos” as opposed to “logos.” We live in a world where logos—business plans, strategies, and accountants—are dominant, and we must rediscover mythos, the world of myth and imagination. “Imagination,” said Einstein, “is more important than knowledge”: it shows us what can not simply what is.” Studying Henry V allows us to enter the world of imagination and inspiration—“Oh for a Muse of fire, that would ascend the brightest heaven of invention.”
Posted on November 7, 2009 by Dr Mohammad Al-Ubaydli
Demos is one of my favorite think tanks, a left-of-center research institution responsible for many of Tony Blair and New Labour’s policies. Peter Bradwell and hiscolleagues are running an interesting research project through a series of focus groups with citizens in different parts of the UK. One of the topics is how personal medical information is shared and I was invited to present to a group in Bradford. The city, along with Nottingham, has the lowest internet usage in the UK so I was curious to hear what they thought. The full slides are on the PHR encyclopedia and the video is below.
There are two things that surprise most Brits when I tell them about electronic medical records. First is that very little information is shared. This is not out of privacy fears, but just because too little information is in computers, and too few are connected to each other. That is why when you go to your doctor they often have no idea what happened at your previous appointment with another doctor. And second is that the UK, or at least England, is one of the most advanced countries in information sharing. It is perhaps as good as it gets in data connectivity at a large scale.
But it is early days, technology is advancing quickly, and technology gives you choices. So the question to the audience was: what choices would they make in sharing information?
Posted on November 5, 2009 by Dr Mohammad Al-Ubaydli
“I would like to congratulate Mohammad for reaching the shortlist of this year’s award, it is not an easy task to be nominated because there was stiff competition. I have been impressed by Mohammad and all short listed entrepreneurs and will look forward to awarding the prize to the winner and seeing how they use it to grow their business.”
Sir Stelios Haji-Ioannou
I spent a wonderful afternoon today with Sir Stelios, the Leonard Cheshire Disability team, and the two other finalists for The Stelios Award for Disabled Entrepreneurs. The winner will be announced at the Confederation of British Industry’s Growing Business Awards ceremony on November 26th. It was awesome meeting Stelios, the wealthy founder of scores of businesses, including the easyJet airline. And I also got to chat to John and Roy, and hear their stories.
Posted on November 4, 2009 by Dr Mohammad Al-Ubaydli
I attended the launch event for the NESTA report by Laura Bunt and Michael Harris, The Human Factor: how transforming healthcare to involve the public can save money and save lives. The three speakers were Andrew Lansley, Shadow Secretary of State for Health, Tim Kelsey, Chairman of Dr Foster Intelligence, and Jonathan Kestenbaum is Chief Executive of NESTA.
a suggestion that patients should be allowed to pool their purchasing. 1,000 patients with diabetes could, for example, choose together and then buy together the care they need from the provider they want.
Tim Kelsey’s suggestion that patients should be allowed to choose the primary care trust that would look after them.
Dr Mohammad Al-Ubaydli
Dr Richard Smith
