ASJ Anniversary

8 THE GLEANER | SUNDAY, MARCH 3, 2019 non-communicable disease, but some inferences may be drawn from statistics on other measures of disease effect. For example, according to the WHO, the leading causes of death (mortality) in Jamaica in 2016 were as follows: n 30% - Cardiovascular diseases n 20% - Cancers n 15% - Other NCDs n 12% - Diabetes n 11% - Communicable, maternal, perinatal and nutritional conditions n 9% - Injuries n 3% - Chronic respiratory illnesses Mortality tables reflect the prevalence of disease in a population only to the extent that the disease is ultimately lethal. Disability-adjusted life-years (DALYS) present a more accurate picture of the burden of disease in a population, since this measure takes into account years of life lost both to premature mortality and disability occurring in people liv- ing with disease. However, given that a large percentage of surgi- cal diseases are cured by surgery, thereby curtailing any deleterious effect the disease might have on life expectancy, this statistic also presents only an indirect and partial picture. According to the WHO, the top 10 causes of DALYS in Jamaica in 2004 were: n 21.3% - Neuropsychiatric conditions n 12.3% - Infectious and parasitic diseases n 10.7% - Cardiovascular diseases n 8.4% - Intentional injuries n 6.4% - Malignant neoplasms (cancer) n 5.8% - Respiratory diseases n 5.3% - Sense organ diseases n 5% - Unintentional injuries n 4.9% - Perinatal conditions n 2.9% - Musculoskeletal diseases Thanks to general and special- ist postgraduate surgical training programmes at The University of The West Indies and prior to that, the Royal Colleges of Surgeons in the UK, particularly the colleges in Edinburgh and Glasgow, and fellowship training in North America, Jamaica now has an adequate complement of surgeons capable of offering the full spectrum of surgical specialties; most if not all of these surgeons, across the specialties, are members of the ASJ. All Jamaicans now have access to advanced surgical services at or through all public hospitals, private hospitals and the University Hospital of the West Indies, as ASJ members are distributed through- out the country. Research into the local clinical epidemiology of surgical disease is critical if we are to design effective public health interventions targeted specifically at our pop- ulation. ASJ members have been acquiring the necessary skills and have been conducting advanced clinical research; this is a new trend, as surgeons now recognise and embrace our emerging role as clinical epidemiologists and public health advocates. Under a collaboration between the ASJ and the Department of Surgery, Radiology, Anesthesia and Intensive Care at the UWI, soon- to-be published guidelines for management of the most common surgical diseases in Jamaica have been crafted. These guidelines will be distributed to all our members and hospitals, and are expected to standardise management of these conditions across the island. Finally, as emphasised in traditional public health practice, the ASJ acknowledges that disease prevention, where this is possi- ble, is more impactful on overall population health than treatment. The National Road Safety Council, with its mandate to promote safe driving practices and advocate for legislation aimed at reducing motor vehicle accidents, was convened on the basis of a paper written by one of the founding fathers of the ASJ, Professor Sir John Golding. Also, several ASJ members partner with the Jamaica Cancer Society in its drive to promote screening for breast, prostate and colon cancers, three of the most common cancers in the Jamaican population. DR JEFFREY EAST Consultant General Surgeon and Former Deputy Dean Faculty of Medical Sciences University of theWest Indies SURGERY CONTINUED FROM 7 ASSOCIATION OF SURGEONS IN JAMAICA 60TH ANNIV SARY FE TURE: T E SUNDAY GLEANER MAGAZINE | MARCH 3, 2019