PREVENT OR PERISH
Heightened stress levels and unhealthy lifestyle choices make executives vulnerable to a host of fatal ailments and diseases. As hospitals and polyclinics focus on providing the best-in-class facilities for executive health, the onus of making the most of these rests solely on executive doorsteps. Mayank Singh reports

Muscat Private Hospital (MPH) introduced an Executive Health Screening (EHS) programme on November 10, 2008. The programme offers a comprehensive evaluation of the medical history, lifestyle habits and a complete physical examination of working executives. The aim of the package is to find out risk factors like heart diseases, cancer, diabetes, high blood pressure, vision and hearing abnormalities and so on among executives. Say Dr Rami Neemtallah, medical director, MPH, “The need for such an offer comes from the statistics, which show that the cost of healthcare in the Middle East is rising rapidly. This can be brought down only if we start focusing on prevention and not on treatment alone.”

According to a McKinsey Study titled, ‘Gulf Cooperation Council Health Care: Challenges and Opportunities,’ health-care delivery in GCC countries will cost about $60bn by 2025 increasing five fold from the $11.9bn in 2008. Treatment demand will rise 240 per cent, with cardiovascular diseases experiencing a steep increase of 419 per cent and diabetes related-ailments increasing by 323 per cent by 2025.

Increased threat perception
People working in the corporate sector are perceived to be at a higher risk due to a number of reasons. The pressures for delivering numbers, adhering to deadlines, frequent travelling and an increasingly competitive environment lead to a stressful working environment, which can be fatal. Says Dr D Ashokan, assistant chief medical officer, Hatat Polyclinic, “In today’s market-driven environment, stress induces internal disturbances leading to physical and mental debilities like diabetes, hypertension, coronary vascular diseases.” Adds Dr Benny Panakkal, cardiologist and group medical director, Badr Al Samaa, “Stress is one of the underlying causes of diseases like heart attack.” The corporate sector in Oman has itself seen the untimely demise of a few CEO’s in the last couple of years, bringing into focus the need to maintain a work-life balance.

Time constraints force a number of executives to make lifestyle choices that increase their risk quotient. Says C G Vaz, head-human resources, Bank Sohar, “Since people are busy they just grab anything that they get and eat it. This leads to an intake of junk food.” The growing popularity of fast foods such as pizzas, burgers etc leads to complications like obesity, diabetes and high blood pressure. According to a World Health Organisation study the incidence of Type 2 diabetes and obesity amongst GCC nationals is unusually high relative to the rest of the world. For example, the obesity rate amongst GCC nationals stands at 40 per cent, one of the highest in the world.

A sedentary lifestyle and the lack of exercise, compounds the problem. “Everyone whom we talk to says that they do not have the time to exercise. There are others who start exercising and then give up,” says Mona Mogharbi, clinical dietician, MPH. High stress levels leads to fatal secondary habits like smoking. Says Dr Panakkal, “Stressed out people light up a cigarette as a reflex action. In 70 per cent of heart attack cases smoking has been found to be the single biggest factor.”

Personality traits
Overachieving executives who revel in the corporate sector’s cutthroat environment may be the most vulnerable to fatalities. Explains Dr Panakkal, “Most successful people are Type A personalities. Such people are ambitious, workaholics, prone to stress, anger and get agitated fast and thus have a higher chance of suffering a heart attack.” In contrast Type B personalities are less stressed, easy going and playful.

In today’s man-eat-man corporate culture, traits like aggression are seen as a necessary prerequisite for moving up in life, leading more executives to conform. Paradoxically, the attributes that helps one to rise up the hierarchy, may ultimately prove to be one’s nemesis.

Stressful working conditions, an unhealthy lifestyle and personality based vulnerabilities make executives sitting ducks to a host of ailments. Says Dr Panakkal, “High blood pressure, diabetes and heart attacks are silent killers, as they do not have a visible manifestation.” The risk of sub-clinical diseases or ones that are at an asymptomatic stage (whose symptoms may not be apparent readily), makes it important to go in for preventive health check-ups regularly. For example, traditional stress tests detect a cardio vascular problem only if the blockage of a coronary artery is 70 per cent and above. Says Dr Neemtallah, “If a stress test is negative it does not mean that a person is fine. There are instances when he may be at a starting point of a blockage. Almost 50 per cent of heart attacks happen in people who are at an asymptomatic stage.”

Recent medical research has disproved commonly held notions like women being less prone to coronary heart diseases and heart attacks than men. While the hormone composition of a women’s body may lead to heart attacks at a more advanced stage of their life (around ten years later) than men, the fact is that, ‘twice the women die of the first heart attack than men, and a third of women in the world suffer from heart and cardio vascular diseases. And while one in every 30 women dies of breast cancer one in 2.6 women die of cardio vascular diseases.’

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Companies get proactive
The sudden demise of a senior executive or a sudden illness imposes an economic burden on companies. The replacement cost of a CEO or senior executive is a cost that most organisations would like to avoid. Growing awareness about the risks is encouraging companies to bring in better health care policies and systems. Says Vaz, “How much stress can one take, if companies do not take care of their employees they will snap at some point, or the focus may get diluted.”

BankMuscat has put in place an Executive Health Check programme covering a focus group of 77 senior managers and above. Says Salim al Kaabi, assistant general manager, Human Resources, BankMuscat, “Due to business demands and other expectations, most senior officials usually spend long working hours in office. In their quest for achieving a successful life, many senior executives often sacrifice their health. It has been shown that most of the time, people learn about their worsening health when it is already too late to be treated.”

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The bank has tied up with Badr Al Samaa and MPH to implement the Executive Health Check programme. It involves a thorough fitness regime with an expert fitness instructor for a period of three months. “Its benefits include a better understanding of a manager’s current health status. It detects and averts problems at an early stage providing an avenue for counselling on the desired healthy behaviour and updates clinical data at the hospital,” says Kaabi.

Nawras has a special health care package for its employees working in its customer service contact centres. Says Mohammed Rabia Al-Ghailani, chief people officer, Nawras, “They use a hands-free device throughout the year and handle high levels of pressure as they are the first line of interaction with customers and so we focus closely on their health.” Everyone working in the customer service contact centre is sent for a yearly medical check up. For instance, close to 200 of its employees were sent to Apollo Medical Centre for a health screening from January-March 2008. The company has a medical and life insurance cover for its employees (nationals and expatriates). It has tied up with institutions like Apollo, MPH and Welcare to provide healthcare facilities to its employees in Oman. The coverage extends beyond Oman and people can get treated internationally and get the bills reimbursed by the telecom major. Says Ghailani, “As a company we believe that if we look after our employees, they will in-turn look after our customers better.”

Bank Sohar too has an insurance policy which gives its employees a medical coverage in Oman and certain countries in Asia. In addition, assistant general managers and above are entitled for a preventive health check up every year. Though the facility is available, few executives at the bank have bothered to avail of it. Says Mahira al Raisi, chief manager, manpower planning and recruitment, Bank Sohar, “We need to do more health awareness programmes.”

Every employee at Petroleum Development Oman (PDO) has to undergo a full health check up once in two years at the company’s medical facilities. Says Sandeep Kumar. J, COO, Apollo Medical Centre, “It is mandatory for employees of PDO companies like Halliburton to undergo a routine medical check up periodically.”

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Quality of life
Apart from providing for medical check ups, a number of companies are also working on looking after the overall well being of their employees. Bank Sohar is planning to introduce yoga classes for its staff this year. A decision to this effect was taken after the HR department got a number of such requests, especially from women. The bank also has a health club scheme for middle and senior level managers. The bank pays the annual membership fees for these executives and their family members. Close to 80 per cent of the executives have availed of such memberships. Says Munira Abdulnabi Macki, DGM, human resources and corporate support, Bank Sohar, “People stay in an organisation because of the environment and not just the money. Each one of us spends so much time at work that one would like to come to a place where one is happy and gets the support of one’s company.”

Nawras earmarks an annual budget for team building programmes for various departments. For example, in 2008 the contact centre staff spent an entire day at the Coral al Nahda resort in Barka indulging in sports and spa treatments. The company gives its executives the choice to choose their working hours. For example, people can come to office at anytime between 7.30am to 9am and work for eight hours. “We believe in productivity rather than policing,” says Ghailani.

BankMuscat’s tie-up with Badr Al Samaa and MPH involves a through fitness regime with an expert fitness instructor for three months. The programme includes yoga classes. PDO has been raising awareness about health issues by supporting initiatives like the cancer awareness, diabetes control etc.

Growing dietary consciousness
As consciousness about leading a healthy lifestyle grows, food manufacturers and supermarkets are making efforts to introduce healthy products. Though still a trickle these are worth taking a note.

Areej Vegetable Oils and Derivatives (AVOD) introduced Khafeef vegetable Oil, with claims of being the lightest frying oil in the market. Sohar Milk recently launched a low cholesterol yoghurt in the market. Says Eng Salem al Bortmany, deputy general manager, AVOD, “We felt the need to introduce such an oil since no single oil fulfilled all consumer expectations in terms of lightness, health, reuse and good performance.” Khafeef uses healthier mono-unsaturated fats, and contains more anti-oxidants and vitamin E than most other frying oils. The company claims that the product has met with a good response from the market especially from young families.

Sarel Myburgh, deputy general manager, Al Fair corroborates the trend, “The demand for healthy food is growing, there is a trend towards more healthy foods, organic foods with less calories, fruits and yoghurts.” Al Fair, a popular supermarket has over 1000 SKU’s (stock keeping units) related to healthy foods on its shelves. In addition, the chain also has diabetic ranges in its shops. “We have customers coming in with labels of healthier products asking us to procure them,” adds Myburgh. To satisfy this growing demand Al Fair has introduced products like Omega hi fibre whole meal breads, Promovil soya yoghurts, St.dalfor’s diabetic jams, Dorset’s muesli range and salads imported from the US.

State-of-the-art facilities
Private clinics and hospitals are introducing tailor-made health screening packages for executives to suit their convenience. As most executives are hard pressed for time these tests are compressed into a few hours. For example, if executives went in for individual kidney function tests, blood count, lipid profile, liver function tests, TFT, ECG’s one at a time, these tests can take upto a few days as a patient would have to go to a number of doctors. Secondly, going in for individual check-ups proves to be far more costlier than taking an executive package. For example, Apollo Medical Centres, Executive Health Check Up costs between RO80-120, Hatat Polyclinic’s Wellness package for men above 40 years costs RO75 and the package for women RO120 and Badr Al Samaa’s Executive cardiac check up programme comes for RO65. If these were undergone individually the costs of these tests would go up to RO150 or more.

Apollo has created a VIP lounge for people undergoing an Executive’s Check up. An executive is taken care of by a personal attendant from the moment he arrives at the polyclinic till he leaves. The polyclinic gets 8-10 executives every week. Says Kumar, “We promote the package saying, ‘you deserve a day with us.’ In 2009 we are planning to promote health check up service areas.”

Hospitals have also been spending money on getting the best in class equipment for such treatments. For example, MPH’s EHS package includes a state-of-the-art heart scan on 64 detectors CT. The non-invasive procedure can detect any abnormality in the heart and analyse coronary arteries for calcifications and obstructions even if they are as low as 10 per cent. The detectors are also used for colon cancer screening. For more complicated treatments like bypass surgery, kidney transplant, cancer etc polyclinics in Oman have a tie-up with super specialty hospitals internationally. Badr Al Samaa has plans of opening up a super specialty hospital in Muscat in the next two years. Says Dvevassy K O, manager marketing, Badr Al Samaa, “6000-8000 patients from Oman fly to countries like Thailand, India and Germany for advanced medical treatment and we would like to provide them with such facilities here.”

Insurance issues
The lack of an insurance cover for health screenings is cited as a major problem in popularising preventive healthcare in Oman. Says Dr Ashokan, “Insurance companies do not want us to investigate whether a person has a health problem or not, but it is in the larger interests of the insurance company and patients that we look at preventive healthcare.” In principle there is no denying that medical insurance is a coverage for an ailment that happens to a person and not a coverage for something that may happen to someone.

Deepak Kamath, country manager, Oman, Axa Insurance says, “We believe that an annual health screening should be compulsory for executives over the age 40 as it is in the interest of individuals and companies.” He adds, “Axa has products that cover health screenings in Oman.” For example, people subscribing to Axa’s Global Area 1 plan are entitled for a health screening after nine months of membership. The RO1500 per annum premium may be a bit steep for most, but Kamath suggests a way out, “The price for the policy drops to a third (RO500) if one excludes the US from its coverage. One can always take a travel insurance policy, while going to the US.” Thus there are insurance companies which are ready to come up with tailor-made solutions for executives, what is needed is more awareness to disseminate the need for such solutions.

Patient education in the Middle East has lagged far behind advanced countries like the US and Europe. Conventionally, talking about diseases has been a taboo subject in West Asia and Asia, but with the growing health threats faced by various strata of society there is a need for health awareness programmes. Says Neemtallah, “Private healthcare organisations should work together to produce brochures, education materials etc and the media should focus on this.” And it is upto executives to set the standards as Myburgh says, “As stress levels increase it is important for executives to look after themselves, because if you do not take care you lose not just health but also your managerial abilities.” The choice for executives is simple – prevention versus demise, take your pick.

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