Læknablaðið : fylgirit - 01.07.1978, Page 155

Professor W. Watson Buchanan:
ON ARTHRITIS AND RHEUMATISM TODAY
Arthritis and rheumatism are fast becoming Western Europes most
prevalent, most expensive and most neglected group of diseases.
Epidemiological studies which have been carried out in many Western
European countries including Iceland and Great Britain indicate that between
1 -2% of adults have rheumatoid arthritis. A greater percentage have
symptoms as a result of osteoarthritis and studies carried out in London
indicate that the commonest disease of the elderly is osteoarthritis.
Approximately l-2f7o of the adult population suffer from other deforming
and painful forms of arthritis for example associated with the skin disease
psoriasis, and in the young teenage boys, ankylosing spondylitis. The
commonest cause of the young being off work is slipped disc. The high
prevalence of these diseases is now causing serious economic considerations
to the countries of Western Europe. In the United Kingdom it is known
that 1 CP/o of sickness abscence in industry is due to arthritis and rheumatism
of one sort or another. This is currently costing the Chancellor of Exchequer
some 400 million pounds of sterling a year. This is equivalent to 10% of
what is being spent currently in the National Health Service (NHS), and
this is approximately the same as the drug bill in the United Kingdom.
In other words an enormous loss and this is only a small proportion of
the cost for this does not take into account the cost of hospitalor domicillary
medical care, drug therapy, surgical treatment, aids, gadgets etc.
But why then are these diseases being neglected. Particularly as they
are painful and can cause severe disablement? The answer is that they
do not make news. They are therefore not featured on televison and they
do not make the headlines in the newspapers. They, by and large, begin
slowly and they cripple rather than kill. The other reason is that the
joints are not represented in the psyche as the heart so there is no
emotional context with the joint. For instance if professor Christian
Barnard had to transplant the human hip this would not make news. If he
transplants a human heart everybody gets excited.
In the past the Ieelandic population was nearly eliminated by the bubonic
plague. Today in Iceland and indeed in the whole of Western Europe
there is a new plague, the quiet plague, which is causing untold misery
and suffering, not to mention economic losses. There are however signs
that things are beginning to change for the better. This year, a World
Rheumatism Year now, attention has been drawai to the problem, and
many governments are now becoming extremely concerned. At the moment
in the United Kingdom only 4.9% of the NHS budget is being spent on
arthritis and rheumatism. Waiting lists for joint operation can be as long
as 8 years period. This now has become an acute political problem and
it is quite inhuman to expect the arthritic patient to wait for this period
of time for an operation of an proven benefit. No politician or health
administrator would indeed suggest to a patient to consider waiting this
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