It may not be evident to everybody but there are usually numerous people working behind the scenes, anticipating how our health will suffer or benefit and preparing strategic measures to help us deal with what we sometimes may bring upon ourselves. Key to this is what everybody simply calls the Health Promotion Unit, a unit which falls under the Health Promotion & Disease Prevention Directorate (HPDP) and is entrusted to protect and promote health in the Maltese Islands.
Heading a team of 29 employees with several other external primary care professionals working in close collaboration within specific initiatives, Dr Charmaine Gauci has been at the helm directing the whole set-up since 2007. Becoming a medical doctor in 1991, she works today far from the clinical field and rather within the community with a good ear to the ground, listening to what people out there really need, and working to achieve the possible in protecting and promoting health.
“I must say that I enjoyed working in clinical practise and after graduating had my stint in various specialities from casualty to gynaecology, paediatrics….. However I found myself fascinated with the whole concept of public health, so much so that I proceeded studying and achieved a Master in the topic and then followed up with a PhD in epidemiology. I eventually headed the Unit for the Prevention and Control of Infectious Diseases until the 2007 reform which saw the enmeshment of this unit with the Health Promotion Department giving an emphasis on prevention. It was ideal – both my interests were now under one hat. I applied for the post of Director and was successfully accepted, and have held the post since.”
The HPDP is divided into three distinct units which work in tandem. The Infectious Disease Prevention & Control Unit is responsible for the surveillance of prevalent infectious diseases and takes action accordingly. “In summer for instance, one common threat is food-borne illness. When reports are lodged in, even by individuals who experienced food-borne illness after eating certain foods or after eating in certain establishments, we investigate. We also investigate cases of meningitis and where the cases are related to school children, we check the patients’ contacts, visit the school, and doctors talk to parents of peers so that prophylaxis are distributed to lessen the carriage of this dangerous disease.”
Dr Gauci also explains how the HPDP is roped in every time illegal immigrants land in Malta, most especially to screen for tuberculosis which is prevalent in African countries. “It is a fact that immigrants who are infected with TB, will develop acute forms of TB after arriving in a country such as ours with low TB prevalence. Hence upon arrival we screen all immigrants for active TB and treat and isolate as necessary. This will limit the spread of this infectious disease, protecting staff, the general population and the migrant population.”
The second unit is the Health Promotion Unit which takes care of observing our lifestyle, its changes and the repercussions of such. One of the current initiatives is to enhance healthy cooking skills based on the Mediterranean diet with a key cooking personality being roped in to create easy-to-prepare recipes that are simple, cheap and effective towards meeting dietary needs. Targeting obesity is a high priority, by supplying helpline services for free nutritional advice, weight management classes, and free aerobics with much of this being successfully done through roping in local councils and health centres.
“There are seasonal promotions such as the one during summer to help educate people combat heat effectively. Then there are the ongoing promotions such as the one which encourages our population to quit smoking via educational means, the Quit helpline and smoking cessation classes. All this apart from breast cancer awareness, sun damage awareness, cancer prevention…. We work hard to be present where people congregate – at trade fairs, village fairs, banks, schools, hotels….. employers are our allies within many establishments and their cooperation is fundamental towards reducing sick hours off the job by keeping their employees healthy.”
A new unit was established - the Non-Communicative Disease Prevention & Control Unit which works towards building long-term strategies to prevent illnesses and maintain health. For example, we developed the NCD strategy to target priority diseases such as cardiovascular disease, respiratory disease, arthritis, osteoporosis, mental illness, dental health via the four biological risk factors high blood pressure, cholesterol, diabetes and obesity coupled with a healthy lifestyle approach. Another strategy was the healthy weight for life strategy, which launched earlier this year.
“Being constantly one step ahead of what needs to be done means working on evidence-based projects that allow us to analyse and compare with other countries so we obtain the best outcomes. One such project is the healthy cooking campaign which is seeing recipes being filmed on compact disk and ready for distribution to the public which took to the idea well. We need to continue with awareness but need to increasingly work towards behaviour change, which we know does take time.”
Incidentally time is another precious part of her life within her family. Being married and the mother of a teenager means she is constantly juggling things as most women do. However she strongly believes that being a successful woman today is also about finding time to balance out the act. “Many women do everything they can to keep things running smoothly and then forget they have to care for their own wellbeing. As a professional my aim is to help people avoid illness or rather, learn how to maintain good health. Part of the good health recipe is adopted by myself so that I dedicate time to my own relaxation – I walk every day, I swim as often as I can so that pools are handy places all year round, go to Zumba classes, I crotchet…..”
“I am involved in lots of things related to my work. Being a senior lecturer at the University of Malta, I pass on my experience to students and am also currently the president of the Malta Association of Public Health Medicine .
Does she miss her medical practise? “I never practiced as a general practitioner but I still take care of my immediate family’s medical needs when these arise. I would miss the doctoring had it not been for the fact that my profession allows me plenty of public contact when I go out on the field and rather than medicate, I listen to people and encourage them to live a healthy lifestyle and take measures to protect them from infectious disease. It’s a different way of being a doctor isn’t it?”