Jan. 26. 2020. Obesity and Instant Cup Noodle

“Oh, my goodness, look at your belly!”

My senior in the air force was shocked. He frowned at my fat stomach in the group shower room. A rush of water from the shower head was indifferently flowing down from my chest, and I reluctantly looked at my flaccid, honey jar-shaped belly. I was filled with a deep sadness. I asked myself, “What has happened to my body since I enlisted in the air force?” The public has a stereotype of a military man who has a muscular body covered with a clean, perfectly ironed uniform. Unfortunately, this image did not really apply to me.

My military duty, 24/7 air traffic controlling at the Republic of Korea Air Force, required daily eight-hour shifts, including on weekends; it was an incessant shift cycle of midnight (2:00 a.m.–8:00 a.m.), swing (8:00 p.m.–2:00 a.m.), afternoon (2:00 p.m.–8:00 p.m.), and morning (8:00 a.m.–2:00 p.m.). I was mentally and physically fatigued, and worst of all, I ate innumerable noodles and junk food during the quick break of the midnight shift. My troops offered two boxes of instant cup noodles (twenty-four noodles per box) in each quarter of a year as a consolation to all shift workers who abandon a regular lifestyle. Gobbling instant cup noodles to fill up my stomach was the sole comfort for me to get through the lethargic midnight duty. However, noodles had a negative effect on my health: I gained thirty-five pounds!

Eating instant cup noodles is at risk of obesity! 

The Ministry of Food and Drug Safety in South Korea reported that one instant cup of noodles typically contains 1,700–1,900 mg of sodium, exceeding the World Health Organization’s recommended daily allowance of 2,000 mg of sodium, and 7–9 g of saturated fat, more than half of the recommended daily allowance of 15 g. Hypertension due to high sodium intake can cause heart failure, myocardial infarction, angina pectoris, and osteoporosis. In addition, saturated fat raises the level of LDL cholesterol, which increases a person’s risk of heart disease and stroke. In 2018, the World Instant Noodles Association reported that South Korea ranked first in the world in noodle consumption, with an average of 73.7 packets of noodles per person per year.

The annual physical strength exam was just around the corner in my troop, and I was eager to regain my thin, muscular body. I had to overcome my habit of eating unhealthy food as a form of stress relief. I immediately stopped eating noodles and began doing one hundred sit- ups whenever I had a spare moment during my midnight shift. After coming back to the barracks around 8:30 a.m., I skipped breakfast and jumped rope 2,000 times without a break every day before bed. Furthermore, prior to my swing shift, I did 2,000 push-ups—forty per set for a total of fifty sets in various poses—with my subordinate and went jogging in the vicinity of the airfield for one hour each day. The key was instilling this intensive exercise regimen into my daily routine. After two months of intensive effort, I was able to return to my muscular body shape, and most important, I ranked in the highest level of the physical strength exam.

A month after being discharged from my military duty, I lived in three different states, each of which has a distinct atmosphere and lifestyle. Sadly, the more I dealt with new stress from adjusting to new environments, the more my weight fluctuated. Moreover, living a well-balanced life of studying, working, and exercising was always challenging to me because I feel exhausted when I spend most of my time at school. To stay up until late at night studying, I had to eat junk food for additional energy.

Luckily, I still had the military spirit motivating me to improve the gloomy status of my body’s condition. To keep myself motivated, I tried to find the best types of exercise to keep me excited and having fun. First of all, I continued dancing salsa, which I learned in South Korea; I have always joined salsa performance teams whenever I moved to a new state. I wanted to become a better dancer and flexible enough to perform fascinating dance moves, so I started hot yoga earlier this year. After sweating so much at the yoga class every day, I can feel that I am improving my respiration, energy, and vitality with a balanced metabolism. I also have completely changed my diet. These days, I choose nutrient-rich, high-protein sources that contain low saturated fat and few calories, such as chicken breasts, tuna, shrimp, scallops, and nut products. The United States Department of Agriculture’s recommendation for adults is to consume a minimum of two to four servings of whole fruit per day; I consume fresh fruits and drink 100 percent real fruit smoothies on a daily basis to intake essential nutrients such as potassium, vitamin A and C, folic acid, and dietary fiber.

My life has been a cycle of gaining and losing weight. How do I stop the vicious cycle of fluctuation in my weight? After making several attempts to return to healthy living, what I have realized is that maintaining a desirable lifetime weight is much harder than transiently dieting. Healthy living truly requires a lifetime dedication. Most important, daily exercise that is faithfully executed and derived from a proper understanding of my own physical constitution is essential for moving into a continuous healthy lifestyle. As the old saying goes, slow and steady wins the race. No matter what the circumstances, it is important to pursue a healthy lifestyle through exercise and a balanced diet on a regular basis. I am looking forward to the day that I become a well-balanced man who enjoys a healthy lifestyle with constant exercise and nutrient-dense foods.

Nov. 3. 2016. Malaria Day in the Americas 2016

I guess no one likes mosquitoes. That’s really annoying creatures. I don’t quite understand why they exist and they are beneficial to nothing. Well… everything should have some reason for its existence, but for mosquitoes, I cannot find even a slight credit for them. At least cockroaches don’t harm you. They are just ugly… Oh, do they spread some kinds of disease from one site to another? I am not sure. I need more research, but I don’t want to know more about cockroaches at this point. When I was in Africa, I had a cockroach story. They were everywhere and they lived with me. A big giant cockroach made some sound of a footstep whenever they walk around the floor, and I was freaked out to see they even walk on the wall. 

Aug 7. 2014. Cockroach

Of course, I also had a mosquito story. I was mobbed by mosquito troops, and I was a fragile prey to them every night. Luckily, I didn’t get any disease – malaria, dengue, or chikungunya – from mosquitoes. Did Long Lasting Insecticidal Nets (LLIN) save my life? Or thanks to malaria pill? Repellent? Long sleeves and pants? I have to admit that I didn’t thoroughly use any of them. Protecting myself from mosquitoes needed a lot of dedication. LLIN disturbed my sleep because my feet or arms always touched the net, and I felt like I was a captive animal. Taking malaria pills for a long period damaged my lung slowly, so I couldn’t always rely on them. Repellent stunk and was bad for my skin. One day, I thoroughly applied repellent to my whole hand, and then began to use the computer mouse, and I was surprised that the surface of the mouse melted and it stuck to my palm. Wearing long sleeves and pants was the easiest one but you know, mosquitoes were really clever to find my area of bare skin! Do you really want to wear socks and gloves under the scorching sun? When you get a mosquito bite on the toe, it is not itchy, but strangely, it is chronic pain. Lastly, I hate to say this: mosquitoes can even bite you through your shirt… How is it possible?! I got many mosquito bites on the middle of my back, and sadly, I couldn’t scratch that itchy area. Though you have very good interventions to prevent malaria, ensuring high fidelity by implementing them as planned is a whole different story.

Aug 18. 2014. Malaria, Dengue, and Chikungunya

Mosquitoes are much more than annoying insects. Bothering your sleep in the middle of the night is not a big deal because they threaten your life in Africa and the Americas. I haven't experienced how it feels when I get malaria, but I heard how it is. I realized NGO Korean staff in Africa (needless to say for native Africans) who don’t get malaria must be so abnormal because malaria is so common, and I guess they suffer from this at least once during their lifetime. One of Koreans who I met experienced malaria and gave a talk to me graphically. “You can’t even have the energy to move your body from your room to the kitchen to drink water because you were seriously dehydrated… With an awful crashing headache, sweats, and shivering, you are able to know what the hell is…” They are still staying there, overcoming several times of malaria, to accomplish 5-year of development plan from NGOs. I feel so sorry for them because I feel like only I escaped that area and be in a malaria-free comfort zone now. What can I do for them? I pray that they always maintain good health, be safe, and be happy on the barren soil. I count on them! 

  

“Malaria Day in the Americas 2016” commemoration took place on November 3, 2016 at the PAHO/WHO Headquarters in Washington D.C. to share the malaria intervention strategy and celebrate each country’s effort to eradicate malaria. To decrease the burden of malaria in the Americas, PAHO/WHO, United Nations Foundations, the George Washington University Milken Institute School of Public Health, and the Johns Hopkins Bloomberg School of Public Health Center for Communication Programs (CCP) have been working together to identify and implement the best malaria prevention, control, and elimination strategy. 

The forum of this year was “End Malaria for Good.” Five countries in the America experienced malaria outbreak, in Venezuela, Colombia, Dominican Republic, Ecuador, and Nicaragua. The malaria control is difficult because there are P. vivax (malaria parasite) technical challenges, the risk of emergence of drug resistance to P. falciparum (another malaria parasite), and social processes through mining, agriculture, and migration. Plan and action for malaria elimination 2016-2020 (5-year plan) in the Americas are 1) malaria core interventions (diagnosis), treatment, vector control, 2) surveillance, 3) Health systems strengthening, 4) Advocacy, communications and partnership, and 5) Tailored approaches to elimination and prevention of re-establishment. 

At the regional level: advocacy, networking, capacity building, technical groups, pilot experimentation, operational research, communication strategies, monitoring and evaluation, certification and other standardized processes, guideline development, and direct technical cooperation should be established, while at the country level: development of political and strategies platform, and technical support of control of foci should be established. The two key elements are 1) Priority foci as key interventions, and 2) Early detection, timely investigation, and prompt response to core intervention. 

USAID also shared their Latin America and Caribbean Regional Malaria Program. Their primary focus is tailoring interventions to elimination through analysis of the epidemiology of malaria to determine the most effective set of intervention, developing evidence, and strengthening capacity to implement the selected approaches and activities. Tailored approaches are through expanding passive case detection networks, private providers strategic behavior change communication strategies. For capacity and evidence, quality assurance programs, tailored guidelines for implementation of a rapid diagnostic test and quality assurance systems, therapeutic efficacy studies, and molecular surveillance have been implemented. For vector control, entomological and insecticide resistance monitoring systems, leveraging other investments in the region, prioritizing countries with high levels of transmission and significant investments in vector control for malaria are good examples. 

Malaria Champions of the Americas Award this year went to Costa Rica, El Salvador, and Suriname, and Costa Rica received the top prize. These three countries were exemplified in malaria control. Costa Rica has achieved a 100% decrease of malaria since 2000 through the robust implementation of the national Plan to Eliminate Malaria, El Salvador has achieved a 98.9% of malaria since 2000 through the National Malaria Program affiliated to the Ministry of Public Health, and Suriname has achieved to drop the Annual Parasite Index from 88 in 2004 to 1.06 in 2015 through the Ministry of Health malaria Program. 

I look forward to seeing malaria-free world in the near future! 

  

Sept. 26-30. 2016. PAHO WHO 55th Directing Council

It’s been a while. Time flies and I am back to my blog. This time, I am in Washington D.C., the capital city of the United States. I still remember the moment when I was in Sierra Leone. Yes, I think I was there with full of passion. I miss at that instant. I gave responsibility to myself of being a messenger from on-the-ground to let my people know what’s going on in Africa during the Ebola outbreak. Well, I thought I would always go back to Africa again and would resume writing my blog. But you know, our life is filled with various requirements that we have to deal with, livelihood, due dates, reports, friends, family, food, clothing, shelter… endless lists! Just doing those priorities are already overwhelming, so finding time to do extra stuff is always hard. I’ve never admitted that I might be too self-centered, which seriously conflicts with being a selfless public health professional.

The definition of “health” by World Health Organization (WHO) is:

“Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity. The enjoyment of the highest attainable standard of health is one of the fundamental rights of every human being without distinction of race, religion, political belief, economic or social condition.”

This is where my heart goes to. It was simply unfair to me that people in least-developed countries don’t even have access to clean water and die from diarrhea. Can you believe that? Children are dying from diarrhea… I began my public health career because I thought I could contribute to WHO’s mission, health is a fundamental human right. However, dreaming our ideal world and taking action is always a different story. During the bible study in this evening, one of the members was shocked and told me “Read the news!” Well, I didn’t catch up with the news, President Park’s leaking confidential documents to her friend in my home country fast enough. I was embarrassed and couldn’t help but to see members were so outraged by this recent news. How am I supposed to know the real-time news in South Korea while I am crazy about getting a good score at class in the United States? But think about this. Even if you are really resenting, nothing would change. It just happened, and probably it’s already been happening for a long time even before you know about that. And most importantly, you’d have never stopped that because you’ve had no connection to politics at all. I think I’d have been more comfortable if I hadn’t noticed that because I know I wouldn’t and couldn’t intervene personally in that issue to solve the problem.

Pan American Health Organization/ World Health Organization

Going back to the ambitious definition of health from WHO, why does this matter to me? Why do I try to care about the people in the rural area of Africa who I’ve never met and could be hardly going to know me? Where is my real identity in this effort, thinking about the health of unfamiliar people in an unfamiliar culture in Africa while indifferent to what’s happening in my country? It’s just nonsense. When you jump into the airplane to provide humanitarian aid and assistance to the country where suffering from Hurricane Matthew, in what sense do you do that? Is it from the humble heart of caring about the dignity of people and wishing to accomplish the Universal Declaration of Human Rights by the United Nations (UN)? Or is it from the arrogant mindset that you’re the one who is in the position to offer the necessities like an angel? Or is it for displaying your showmanship and proving you’re a nice person to people around you? It’s hard to judge. Only you know what you have in mind. You may donate a certain amount of money to support a child with the pure thought that you feel really sorry because the only thing you can do is to simply donate with one click. Or, you’re taking advantage of vulnerable people to write the paper, get a promotion, and shine your image of helping hands. Caring about people is not simple. Yes, this is public health that I’m doing.

To be honest, working at WHO was my dream. It still is. But perhaps, I should have been dazzled by the splendid image of WHO. Who would disagree that WHO is awesome because it is the only international government organization that takes responsibility for leading and guiding international health? Who wouldn’t want to look like a cool and fancy person who wears a formal suit at this UN’s specialized agency? But if you do public health just because you want to have this superficial image of the organization, you’re putting the cart before the horse. I’ve always mentioned WHO in my personal statements and say “I want to be Dr. Lee Jong-wook!” When I was a master student, my academic advisor was dubious and asked me “You’re so ambitious but too general. So what do you want to do?” Yeah… at that time, WHO seemed to be ambitious but general to me, so I was just the simple image of that. In D.C., there are so all kinds of cool buildings. Wow, White House! Wow, IMF! Wow, World Bank! Pan American Health Organization (PAHO)/ WHO building is right across the street from my home! But before being captured by that illusion, let’s think about the real purpose of the existence of these organizations. All the WHO meetings, discussions, guidelines… Are these for who? Do all countries respect and follow WHO’s soft power of regulations, guidelines, and recommendations well?

The 55^th Directing Council, 68^th Session of the Regional Committee of WHO for the Americas was held in D.C. during 26-30 September 2016. The council meets every year and I was privileged to attend this meeting. Heads of delegation from 47 countries in the Americas gathered to work on, approve, and declare the major public health issues.

What I hope is that all works from WHO would have a great impact on our societies. Getting out of its grandiose image, it’s time for WHO to prove its real functions without constraint to limited budget. I want to see that people around the world would clearly understand and know the role and importance of WHO, and appreciate their existence. The disease outbreaks, such as Ebola, Zika can be prevented under the strong surveillance system, and we don’t even have to worry about the situation to find the funding resource to respond and develop vaccine because those diseases would never occur. We can’t lose our hope to achieve our vision, everyone has the right to the highest possible level of health. Certainly, we can make the world free of needs, free of wants, and free of poverty, hunger, and diseases, if we all have true hearts that better of others.

P.S. Newsletter about PAHO/WHO Directing Council has been posted. :)