Health

1. Entire towns are falling off their ladders

   Published on Monday, August 30th, 2010

   It’s Safety New Zealand Week.  This morning I was reading in the Dominion Post of a renewed campaign to alert us to dangers at home. Apparently last year more than 650,000 of us were injured in the home – one every 48 seconds. Staggering!

   This afternoon ACC kicked off its campaign with a statement detailing more grim statistics. These include more than 17,000 accidents in bathrooms each year, 87 stair-related accidents every day, and 133 injuries per week to children from running through glass or falling from windows.

   Last year we paid out $622 million through our ACC levies for the treatment and rehabilitation of people injured in the home. (I love the way ACC refers to “New Zealanders” and “their” levies, as if they are from another country.)

   We’re obviously a careless bunch because in the past 12 months 5,400 people were injured using a ladder at home – that’s 15 people every day. Never mind that this equates to a significantly-sized town of ladder victims alone.

   Having Safety Week has to be a good thing, but I would like to know how we fare in relation to other OECD countries. I suspect these figures are not apparent because others don’t have such generous systems as our ACC, and they simply have to fork out for their own carelessness. Or it is just the male can-do attitude that gets us into trouble around the home and up ladders.

   I’ve seen lot of ACC television adverts over the years – people tripping over toys and the like – and sometimes I wonder whether we’ve become too self reliant on others doing our thinking for us. Perhaps this is why we are so accident prone.

   Now I’ve not been above carelessness myself over the years, with a busted elbow and compound fracture of the arm.  Discreetly I did this outside the home.

   Perhaps one answer is to have a home-accident prosecution system akin to the workplace one. 

   Other possible solutions are living away from home, having only single storey dwellings without roofs, licensing the use of ladders, or hiring an expert, which would make many of these incidents workplace claims. Just a thought.

   

2. Does end of the global Swine Flu Pandemic mean we’re better prepared for next time?

   Published on Friday, August 13th, 2010

   The World Health Organization (WHO) earlier this week officially declared an end to the pandemic concerning the influenza H1N1 virus, popularly known as swine flu. 

   However WHO Director-General Margaret Chan recognised that here in New Zealand we’re still experiencing the effects of a second wave of H1N1.
   “In the post-pandemic period, localised outbreaks of different magnitude may show significant levels of H1N1 transmission. This is the situation we are observing right now in New Zealand,” Mrs Chan said.

   The outcome of this for some has been particularly tragic.  However, as recently reported in NZ Dr, this year’s weekly rate of flu consults is well down on last year.

   Communications before, during and after were to my mind a great example of how to get it right.  Unfortunately not everyone has seen it that way.  As the predicted apocalypse did not occur, many people say the whole thing was a money-making venture by pharmaceutical companies.  While these theories make for great headlines they also significantly diminish the genuine efforts of public health protection teams globally, who potentially saved hundreds of thousands of lives.

   We will never know how bad it could have been had the level of alarm not been raised.  After all only 450 people died in the UK compared to the predicted 65,000 which surely proves it all an unnecessary scaremongering exercise?  Shame on the health experts for saving some lives.  When dealing with statistics it is easy to forget that only one number matters to people – the one that affects them. 

   Closer to home our own public health protection specialists implemented a textbook case of how to effectively contain a highly contagious and potentially deadly disease.  You can read about it in the BMJ’s May 21st edition. 

   Dr Craig Thornley, Medical Officer of Health at Auckland Regional Public Health Service shared with us a brief overview (below) of the basics of the response in New Zealand which highlights the complexity behind some very simple messages.

   • The pandemic response in New Zealand had several partly-overlapping strategic phases, all of which had been previously laid out in the New Zealand Influenza Pandemic Action Plan.
   • The first phase was termed ‘keep it out’, and was about delaying introduction of the virus into New Zealand to give healthcare services time to mobilise their plans. This initially seemed critically important as reports were being received from Mexico that suggested that the illness had a high mortality.
   • We were concurrently running a ‘stamp it out’ phase: when people with swine flu were diagnosed in the community we launched a rapid response to “ring-fence” spread by distributing antivirals (mainly Tamiflu) to those they had been in contact with. Again, this strategy was also intended to try to delay spread.
   • We moved into the ‘manage it’ phase when it became clear that swine flu was widespread in the community. During this phase a range of groups mobilised to support those who were unwell to ensure that those with mild-to-moderate illness could be managed away from the hospitals; hospitals re-allocated capacity to deal with the increased workload, particularly in intensive care units (who experienced high demand with sick young people requiring very aggressive life support); public health units focused attention on outbreaks in residential institutions; and a variety of strategies were applied in primary care to help cope with the influx of swine flu patients.
   • Throughout each of these phases, there were intensive health education campaigns on ways to prevent flu spread, protective equipment was distributed to healthcare workers (the healthcare workforce being one of the most-exposed groups), and systems for testing and making treatment available were streamlined.
   • All of this was designed to “flatten the curve” to try to delay the peak of the outbreak, reduce the overall number of cases and spread the caseload across a period of time instead of having a massive early epidemic peak that could have jeopardised provision of healthcare and many other services. As the nature of the illness caused by swine flu became clearer, strategies were tailored around protecting those that were most vulnerable.

   Communicating risk so people take action to protect themselves appropriately is a tricky thing, and when people are protected from the risk it can be tempting for people to think the risk wasn’t there in the first place.  Unfortunately even one untimely death is one too many though. Best we not get complacent about the next infectious threat that comes our way.

   

3. There is no silver bullet for changing behaviour, it takes hard work and time…

   Published on Friday, July 16th, 2010

   New data showing that fewer young people are smoking offered some refreshingly good news yesterday.  Thanks to years of hard work by different organisations, each tackling different aspects of the issue, we are seeing some real progress.  

   The value of long term investment in social marketing and education, combined with a range of regulatory changes over many years, has surely been proven.  It also highlights the many challenges inherent in motivating behaviour change.
    
   A consistent increase in price to the point where smoking has become unaffordable is part of the story but isn’t the only factor. We’ve also seen wider cultural and societal shifts along with a better understanding of health protection and promotion.

   Another success factor is the ability to use single-minded messages like smoke-free, quit, stop and cut it out.  Interestingly, some of these messages are negative. This is something often deemed inappropriate but in this case seems to have done the job, showing yet again that we can’t apply a ‘cookie cutter’ approach to these things. The messages also left no room for confusion through use of words like moderation, balance and variety. 

   While this single-minded approach has been a common success factor in addressing some issues there are actually very few situations where a ‘silver bullet’ solution can be found.

   Unintended consequences can arise from taking a single message too far. Adherence to the skin cancer prevention slip, slop slap message has potentially resulted in substandard Vitamin D status for some, which could lead to poor bone health, diabetes and heart disease.

   It is at this point that for me the good news around smoking could take a bad turn. I can once again see this great success story being misrepresented and cited as a blueprint for reducing population obesity levels. Demonising one food or even one food company on the basis of the anti-tobacco lobby’s success would be misleading and show a lack of understanding of consumers as individuals.  

   Such an approach fails to take into account the complex social, cultural, psychological and (let’s not forget) life-giving attributes of food.  You can’t put these things in a patch and stick them on your arm.  Single minded messages might sometimes be useful but their interpretation depends on the perspective of each individual. 

   If we want to shift our energy balance in the right direction we need to focus on burning the excess fat stored in bodies than vilifying individual food products.  It is never going to be a precise process that ‘fixes’ a problem. It has taken anti-smoking groups decades to reach this point and their work continues. Here’s hoping we take the appropriate lessons from this good news.

   

4. No cure, but other miracles

   Published on Wednesday, May 19th, 2010

   As PR and communications specialists we are sometimes humbled and often inspired by the communications initiatives of those whom typically we’d regard as amateurs. (Perhaps this is a sign that we take ourselves too seriously.)

   One such experience has been a blog titled Mike’s Big Adventure which was started in February by Tracey as a way of sharing with family and friends the journey on which husband Mike and her set out to beat his recently diagnosed aggressive form of stomach cancer. Given little hope by traditional oncology, they traveled to a clinic in San Diego for a different solution.

   If you’ve ever had someone close to you very sick, you’d agree that this little blog was a wonderfully effective way of staying in touch. Narrative updates at the press of button, without the need for endlessly repetitious phone calls.

   Mike and Tracey returned to Auckland around mid-March to carry on the treatment with the comfort of family and home. 

   While there was no cure, there were miracles – the simple ones of support and love.  Almost every day, without fail, Tracey blogged on the joys and anguish of this terminal adventure. She shared a very personal perspective and her blog following grew exponentially.  At times it has surely been the best-read blog in New Zealand.

   What started as a journey of hope, became a mechanism for coping with the struggle and powerlessness of saying goodbye and losing the one you love most.  

   There was no happy ending, and at the funeral Tracey said that the only way that she could cope with speaking at the very large gathering to farewell Mike was to treat it like another blog.  Later that evening there was a Blogger Party, the modern equivalent of an Irish wake.

   Through her blog Tracey showed us how natural communications can be. Outside of her close family, whanau, friends and workmates (of both her and Mike), she built a community of support through a modern tool of communications.

   Thanks Tracey for showing us how good and purposeful a blog can be.

   PS: This blog touched thousands of people in different ways. At Network PR, it was a special experience because Tracey is the mother of a colleague, Cameron.

   

5. Another tragedy and chorus call for the Government

   Published on Wednesday, May 12th, 2010

   The nation is shocked by the death the young James Webster, caused in all probability by drinking a bottle of vodka taken from his grandmother’s cupboard.

   It is an absolute tragedy and without doubt we all feel for his grieving mother, father and sister.

   Another young person dies.  This week it was alcohol poisoning, and a few weeks ago it was a car accident.

   In these tragedies we have become used to the chorus urging the government to “do something”. Now it’s arguing the age of purchasing liquor; a few weeks ago it was about raising the driving age. And just last week, PR Matters featured Jane Dodd’s blog talking about how to encourage changes to teen drinking habits.

   It appears that if we don’t know what to do as parents or as a community, there is blind faith that the Government will solve it.  This has now become a reflex action.  In the latest case, doctor and mother of a student at the same college as the dead boy Margaret Abercrombie says: “…people look to the Government for leadership and that’s wholly appropriate.”  She goes on to say, if there were a broader change in our behaviour and attitude to alcohol that would reduce the costs to society and the likelihood of this occurring again.  This is a young man dying of alcohol poisoning, but I seriously doubt any amount of legislation could have changed the outcome for this boy, because as far as I can ascertain, teenagers have always, and will continue to, do silly things.

   Perhaps it’s worth reflecting that one reason for people’s lax behaviour and casual attitude may be that for too long we have relied on governments, not personal conviction, for our frameworks and moral compass.  In reality it might be argued that the more our government takes control of our lives, the less responsibility we feel we need to take ourselves.

   James Webster consciously did a very stupid thing.  He took vodka without his grandmother knowing; we’re told he was intent on doing something “naughty” that night; and he wasn’t upfront with his parents. 

   The fact is that alcohol, in some form or other, has been part of the right of passage for young people.  For young James it was a dead end.  

   Let’s stop looking to government to provide life’s behavioural and ethical framework.

   

6. Why do the words poo, boobs and underage drinking all have similar effect on young people?

   Published on Thursday, May 6th, 2010

   Communicating effectively with young people is considered a special skill, even a gift. They can be the harshest critics and their responses unpredictable.

   It was therefore a brave set of comedians who took to the stage in Auckland at the weekend at the Stand Up for Kids show as part of the international comedy festival programme.  Most began their sets with a reference to having thought specifically about what kids would find funny – given they usually entertain adults.

   And funny it was, to all of the audience no matter what their age with simple, old-fashioned humour that entertained without patronising.   One of the comedians began by reading out a list of words he had told himself to avoid, given their age.  You guessed it: bum, farts, boobs and the like were amongst them, and of course, the kids loved it.     

   It put into sharp relief what has been making me feel uneasy about the way we are communicating with older ‘kids’ around drinking alcohol.  It is an area that I think needs a serious rethink if we are to make any useful changes to teenage drinking habits.

   The way the ‘grown-ups’ are talking about how the ‘kids’ are, or rather are not, handling their alcohol intake will surely only add to the naughty factor and therefore its appeal.  Where is the communication that aims to teach our kids how to develop a healthier attitude towards a product that they can enjoy in moderation? 

   The debate in the media and around office water coolers is probably small fry compared to the debate that is likely being stirred amongst many young wannabe drinkers themselves, none of whom are likely to be supporting an increase.  Maybe we need some good comedians to get onto the job of helping build understanding amongst younger people that alcohol can be both good and bad depending on how you use it.   

   By the way, there are two more shows this weekend.  I highly recommend it for kids of all ages.

   

7. Will New Zealander’s need to rethink their stance on GE foods and Nuclear Power so we can keep up with the rest of the world?

   Published on Tuesday, November 10th, 2009

   First off, I need to state that I am a complete fence sitter when it comes to GMOs and Nuclear power. The way I see it is that in an ideal world, we would enjoy the potential benefits while we fully manage the risks. But reality is always less simple.

   It has occurred to me of late that in the not too distant future, New Zealanders are going to have to think quite seriously about the potential of GMOs, nuclear power and other technologies that will enable us to meet our carbon emission targets, growing power demands and attempts to stay in the game, let alone keeping ahead of it.

   British scientist Dr Robert Winston has said that we need to be more open to new technologies so we can keep pace globally. He’s not wrong. Last week at the annual Food and Grocery Council conference, two of the keynote speakers highlighted changes that may need to take place if we are to feed the world and ensure human intelligence keeps pace with computers. 

   If GMOs are the only means of preventing billions of people starving to death, it will be pretty hard to keep it in the box. Then on the flip side, movies like Food Inc paint the food industry as giant manipulators of the world in order to reap the profits. Are we equipped to reconcile these positions and at the same time solve these very real problems?

   Honest and transparent communication will become even more critical, but often the truth is too boring. We truly need a media who report, not sensationalise the realities of these positions. With shrinking newsrooms under increasing commercial pressures and the more experienced journalists often being let go, this is sadly less likely to happen. Perhaps the emerging social media sphere will evolve into a forum based on true expertise?

   New technologies always raise new questions. Would a science that enabled a paraplegic to walk be halted because it breached our moral ethics? Currently there is already a scientist in Europe who uses himself as a human guinea pig – or should I say android, to test mind driven robotic implants. 

   The reality of new technologies being able to solve some very serious and imminent problems is upon us. And as clean, green nuclear free New Zealand, how well are we informed to be able to manage these dilemmas?

   As the Hon Maurice Williamson pointed out, had we invented Viagra we would be sitting very pretty economically. But we didn’t! So what’s next? Which companies will have the intestinal fortitude to take on people power for causes that they believe are for the good of the people? This is an interesting dilemma but who is debating it?

   

8. A Fish Supper

   Published on Tuesday, October 27th, 2009

   I love my neighbour, I’d be stupid not to. His name is Greg and he cleverly caught the pictured four and a half pound snapper on the Hauraki Gulf on Sunday.

   He and his cousin went out at dawn, apparently pausing somewhere about 40 minutes from our houses, to pull up ten fish and casually make their way home again.

   Yesterday, on Labour Day Monday, Greg made a fragrant bed of manuka shavings, rubbed the biggest of the catch with brown sugar and salt, and smoked it.

   We ate the fish still warm from the smoker with dill potatoes, bread and butter and a salad of greens from my garden.

   It was a wonderful meal; the fish was moist, perfectly flaky with just the right hint of smokiness.

   In New Zealand we are so close to where our food comes from we sometimes take it for granted.

   We shouldn’t, we are blessed with the best food in the world. Wild, farmed or cultivated, we have enviable standards of production, a stunning range and seasonal freshness.

   But one doesn’t just have to hunt and gather for the good stuff, our supermarkets, green grocers, butchers, bakers and fish mongers are a treat.

   For a comparison and a reason to thank our lucky stars go and see Food Inc, an American documentary that seeks to highlight the underbelly of US food production and agricultural processes. It’s a frightening portrayal if indeed it is a fair and accurate one, well worth a look.

   

9. No nonsence nanoscience

   Published on Friday, September 25th, 2009

   What a week when we’ve just witnessed the miracle of our very own John Key on Letterman , and a scientist tells us that immortality is only 20 years away.

   The 61-year-old American, who’s been right before, says that at the rate our understanding of genes and computer technology is accelerating, new nanotechnologies will be capable of replacing worn out organs inside a couple of decades.

   If that’s not tempting enough, nanotechnology is also being attributed with the ability to extend our mental capabilities to such an extent that humans will be capable of superhuman wonders like being able to write whole books in a matter of minutes.

   But wait, at a recent liability symposium  nanotechnology was highlighted as an emerging risk, despite the fact material and particles on a molecular or atomic scale are already in daily use in consumer products. 

   So nanotechnology, where small appears to be the new big, heralds in exciting new boons, but also signals some potential and as yet not-even-imagined pitfalls. 

   For example haven’t we been down this road before is with asbestos. This former wonder product has a fatal legacy and has delivered a hefty bill to the insurance industry because of mesothelia disease. This illness was unknown when the product was released for use.

   So while some scientists may look forward to a world where humans have cyborg limbs thanks to nanobots, our suggestion is to tread wearily when claims of immortality are bandied about. Imagine going to hospitals to have a new liver dropped in like some car part….wait there could be something to this.

   

10. Critics are emboldened in a crisis, so don’t fall for making excuses

    Published on Monday, September 21st, 2009

    The Sunday Star Times yesterday reported that Auckland’s new community laboratory company, Labtests (which won the contract from DML) believed that some of the complaints it was receiving about its service were the result of “propaganda”.

    Its chief medical officer, Dr Michael Coglin, said that some complaints were being encouraged by the company’s critics and were without merit. The suggestion was that people’s confidence in the service could be undermined by this “propaganda”.

    However heartfelt, this was an extraordinary statement.  No one expects Dr Coglin to be a media or crisis expert, but it is difficult to comprehend that his advisors have not shared with him the anatomy of an issue or crisis. What he is experiencing is as normal as it is real, and any organisation that handled an issue of this nature the way Labtests has was surely headed for a crisis.

    On changeover-day plus-one, they were virtually boasting that everything was running smoothly. The reality was different and got worse.

    It is a fact that in any crisis, critics are emboldened.  Remember the lab contract was competitive and contentious, so there were many with strong held views. In this type of situation, people who would normally say nothing speak out, thereby encouraging others. Extraneous matters suddenly assume some relevance, or at least appear to. But at times like this, it is not the company in crisis that adjudicates on what is relevant and what is not. That lies with its critics and the media.

    What can you do about it? Not a lot. Stay humble and avoid enflaming the situation with attacks on the critics. At a time like this you can’t do better than follow the C.A.P formula: show Concern for what is happening, constantly update people on your responsive Actions, and, if you get the chance, provide some Perspective. But here’s a warning, never leave your “perspective” floating out there alone, or it will be interpreted as an excuse. Dr Coglin’s comment looked much like an excuse.