On my way home from the centre where I work in Dhaka, Bangladesh, I drive through an area with four closely located private universities. Yesterday I was stuck in rush hour traffic. Students were swarming on their way out of class. Suddenly I could hear music behind me.
A big white carriage drawn by a team of six horses passed me. The wedding carriage was being followed by a complete marching band in burgundy uniforms. Everyone – and Dhaka is densely populated – stood and stared. What made it bizarre even by Bangladesh standards was the “groom”: high atop the wedding carriage was a seven foot tall bucket of Kentucky Fried Chicken emblazoned with the face of Colonel Sanders accompanied by the words “Hot” and “Juicy.” The rest of us frozen, the carriage proceeded to do laps around the traffic to advertise the chicken and the newest branch of the local franchise.
Dhaka has few international fast food franchises. The “Best” of the West has yet to invade here as it has other developing countries–much to the dismay of my sons who occasionally lament the lack of cheeseburgers and fries or foot long sandwiches. However, it is hard to compete with the Colonel and fried chicken especially when pulled atop a wedding carriage.
My public health colleagues were aghast when the KFC branch opened near the universities. The placement is genius on behalf of the franchise – here is a large population of young people with disposable income and time on their hands, just like college students anywhere. My colleagues are concerned about the health implications for their sons and daughters. Already at risk for diabetes and heart disease as they age, the introduction of low cost, readily available, well-advertised, fried and salty food might put this group at additional risk.
The burden of non-communicable diseases is poorly understood in Bangladesh – as in many low income countries – where these items are not yet incorporated into existing information systems, because like fried chicken and cheeseburgers, non-communicable diseases were long considered the purview of wealthy nations.
Efforts must go into creating health systems that are prepared to deal with these conditions now. Diseases like diabetes, heart disease, chronic pulmonary disorders and their risk factors like obesity and smoking are here to stay. And if the economy continues to develop we will see increases in both imported unhealthy lifestyles and chronic illness.
Tracey Koehlmoos is programme head for health and family planning systems at ICDDR,B and ajunct professor at the James P. Grant School of Public Health, BRAC University.