Japanese are known as workaholic nation. But now, death from overtime work has become a social concern in that country. Some believe, most cases are due to the sudden onset of a fatal cardiovascular or cerebro-vascular events. In 2002, the Ministry of Health, Labor and Welfare in Japan announced a comprehensive programme for the prevention of health problems due to overwork.

There are other horrifying effects of hard and exhausting work on emotional health and quality of life. Research confirms that just a week of overtime, with a higher workload, has been linked to the release of increased amounts of cortisol, the stress hormone. The Journal of Occupational and environmental Medicine, found that overtime puts both, men and women, at risk for higher levels of anxiety and depression. This ultimately appeared to increase the risk of mental distress.

From management point of view, overtime and hard work is assumed to be the best way to attain maximal output without hiring extra manpower. The postulation is that output increases in straight mathematical progression with the number of hours worked. But this is not always right. It may be appropriate in limited cases where the hours of work are extended over a concise period. More than a century of studies conducted by business people, university researchers and industry associations illustrate that long term, useful work output is maximised at eight hours a day, five days a week.

Like lots of other renowned businessman, Henry Ford, after conducting experiments for about 12 years agreed to adopt 40-hour work per week. They made the workday 8 hrs from 9-10 hrs and the work-week from six days to five days. They found a relationship between increased output and reduced production costs.

There may be controversies over the direct effects of overtime work on health. But, according to Verite, an independent organisation, it has been found in workplaces around the world – sadness and depression are clear costs correlated with long work hours. Its studies also found that excessive overtime produced stress and stress-related ailments including blood pressure, strokes and heart attacks. In fact, some of the world’s worst disasters have occurred because of critical errors made by exhausted workers.

There is a common saying in developed countries that says, “work smart, NOT hard”. But it does not mean that there is a back door to success. The ‘work smart’ philosophy says work intelligently and wisely. In that case, you need to be knowledgeable and sensible as well. Is it possible to achieve maximum success in a minimum of time? Well, it varies from job to job, situation to situation.

Digging your way out through the ruins of a construction that has collapsed around you can be an example. Definitely, in that incidence determination and hard work persuade in some efforts. But intellectual occupations should not feel like digging through debris. Decentralise, delegate, use other people’s time and brain as much as possible. Some believe this is the quickest way to success. But that is not easy. You need to read and learn a lot to have perception. Sometimes we are investing so much time to prove something unprofessionally and emotionally, which turn out to be unproductive.

Try to choose a job you love, then you do not need to work hard.

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Good friends may help our life last longer, say researchers at Flinders University, Australia . It found that those who had a large network of friends outlived those with the fewest friends by 22 percent. And the friendships usually fight off depression and boost confidence.

People may become more selective as they grow old in their choice of friends. But the most vital factor about friendships is contentment, not the number of friends or what they do together. Some studies have shown that having good friendships contributes to a stronger immune system and better self-care. On the contrary, be aware of bad friends – they might not only get on your nerves at times, but they are also bigger risks than you realise. For example, bad friends encourage unhealthy behaviors such as smoking and heavy drinking. Being in bad group can also help you develop new skills that are harmful for the family and the whole society. The dynamics of a bad group often mirror those of dark part of society in general.

Having good friends can have an intense effect on physical and mental health, according to an Indiana University study. According to some researchers, sometimes friends may be better than family. In fact good relatives are also good friends. They persuade you to take better care of yourself. A good friend not only listens and guides you, but also supports your decisions. They also help to face adverse events.

Good friends also provide material aid, emotional support, and information to deal with the stress factors. Lots of research have shown the health benefits of social support.

Gather a group of friends and find a walking way that everyone knows may be named as ‘Friends Walkathon’, which can be the best way to keep your body in shape. Perhaps the biggest benefit of friends’ circle is in helping to realise that he or she is not alone — there are other people who have the same problem. This is often a revelation and an enormous relief to the individual.

Other studies have shown that people with fewer friends have a tendency to die sooner after having a heart attack than people with a strong social network. It is interesting that having lots of friends may even reduce chances of catching a cold. That is true even though you are probably exposed to more viruses if you spend a lot of time with others.

Dr Tasha R Howe (Humboldt State University) believes that people with social support have fewer cardiovascular problems and immune problems and lower levels of cortisol (a stress hormone). Because, the evolutionary argument maintains that humans are social animals and we have evolved to be in groups. We do need others for our survival. Probably for that reason, people with good friends feel more relaxed, enjoy more peaceful life, which is interrelated to better health.

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Good friends – good health Bad friends – bad health!

Although Bangladesh has made a commendable progress in control of leprosy, the disease still poses a considerable public health threat in certain areas. People with leprosy are cured significantly with successful medical treatment. But the stigma and social isolation becomes a major concern for thousands of people who live with permanent disfigurements caused by the disease. They face more extensive social and psychological adverse impacts than many people consider. But the problem is frequently overlooked and neglected.

There is urgent need to address the affected persons by providing proper care and rehabilitation. People face injustice from leprosy-related stigma and discrimination. Even though leprosy is now totally curable, thousands of people are experiencing rejection everyday from near and dear ones of their families, society and communities they belong to. We must help them live with dignity and protect their rights.

The elimination goal was set by World Health Organisation (WHO) and that is less than 1 per 10000 populations. Bangladesh has achieved nationwide goal by the end of 1998, 2 years before the set target. It stands at 0.28 per 10,000 populations at the end of 2009.

Several areas like Dhaka and Chittagong Metropoliton, certain districts (Nilphamari, Bandarban, Khagrachari, Gaibandha), are still burdened with high number of patients with leprosy. They need particular attention in the context of treatment and stigma. Many people of that area believe leprosy is a curse. Widespread awareness in those communities is much needed. The rising awareness will motivate more people to seek treatment and will make a difference in the life of people who already living with leprosy.The awareness should not only aim at treatment, but also to remove stigma related to the disease. Eight NGOs are assisting the Government in MDT (Multi-drug Therapy) services which are running in 31 districts (272 upazilas) of the country. There are 625 MDT Centers at upazila (sub-district) and lower level, 3 Government leprosy hospitals and 8 NGOs leprosy hospitals in Bangladesh are in action to provide treatment.

Such set up is sufficient to provide treatment but sometimes we need more than just proving free drugs. People who are living with permanent disfigurement and incurable by drug desperately need our assistance to live like a normal member of the society, to exercise their rights which are often violated. We need to ensure justice and protect their rights.

Transportation systems are the major source of noise pollution in this country. Besides, loud music, speech meetings created in the densely populated public places by human beings hit our ears and disturb the environment. Noise pollution is also created from aircraft and rail transport, air conditioners, factories and construction works. Especially residence adjacent to airports and factories experience noise pollution too much and its adverse effects too much.

These days’ audio entertainment systems in the residential city parks are one of the most harmful and irritating factors specially for children and senior citizens. These above different types of noise pollution disturb our health and behaviour in a number of ways including deafness, lack of sleep, irritability, indigestion, heartburn, high blood pressure and heart disease. Just one noise explosion from a passing truck drastically alters endocrinal, neurological and cardiovascular functions in many individuals. If this is prolonged or frequent, the physiological disturbances become chronic and contribute to mental illness.

Noise pollution is measured in decibels. When noise is at 45 decibels, no human being can sleep, and at 120 decibels the ear is in pain and hearing begins to be damaged at 85 decibels. Increased noise levels give rise to a lack of concentration and accuracy at work which reduce one’s productivity and performance. Difficult tasks can be impaired. Instruction or warning is difficult to follow which sometimes may lead to accidents.

Solving noise problems in current situation is not going to be an easy task. But, at least some noise problems can be prevented by discussing and finding a common solution. As a minimum, try to be a good neighbour by not annoying those who live your next door with your music during special social occasions.

Singapore has established itself as a tertiary medical destination in the Asia-Pacific region and beyond. One of the Singapore’s biggest private healthcare providers is Parkway Group Healthcare Pte Ltd, which operates three of premier healthcare providers: East Shore, Gleneagles and Mount Elizabeth Hospitals. Recently Mr. Kamaljeet Singh Gill, the Chief Marketing Officer of Parkway Health came to Bangladesh on a business trip and shared his views with Star Health.

Star Health (SH): What was the impact of global economic recession upon your healthcare business?
Mr Kamaljeet Singh Gill (Mr Gill): The effect of recession took some time to reach Singapore. Healthcare business was expected to be recession-proof. So we monitored the impact quarter to quarter basis upon many parameters like patient turnover and so on. It showed different patterns of ups and downs. Then we changed our marketing strategy to emphasis implying new policy — it was the time to invest more, rather pulling off the paddle from the business; we kept waiting to get the result of the investment in course of time. We emphasised to increase the service to the patients that ultimately helped us to recover the shortfall which was for the time being in fact. We believe that the healthcare is unlike the business of other commodities where the return comes promptly. It takes time to earn reputation form the patients who certify it for the sake of real services on the ground. So we intensified all our service oriented activities.

SH: Singapore has become the hub of medical services with the latest cutting edge technologies and procedures. What are the areas you broaden the horizon to attract more people?
Mr Gill: Parkway has promised to continuous updating the knowledge and technologies. All our hospitals are Joint Commission International (JCI) accredited. This basically tells that we are on the line of delivering standard services. We can handle patients better, faster in a safer environment. We train our doctors and nurses in such way that the patients do not have to wait when they come to us. We provide very specialised and personalised care.

We do not want to see Singapore as a medical tourism destination, but more a medical travel destination who provide the tertiary services (like bone marrow, liver, kidney, heart transplant etc.) when people actually need it; when people need the correct diagnosis and treatment accordingly.

SH: What are the other reasons you put on board to attract patients seeking medical services in terms of financial aspect?
Mr Gill: Well, we ensure the service at a shortest possible time which ultimately helps patients to spend less. We have so many fixed price packages that helps patients to make their budget at competitive price.

Cultural barriers are big problems in abroad. So we have interpreters for better and convenient communication with the hospital. We have liaison offices in countries from where patients come. Patients can consult with the doctors providing their investigation reports before travelling to Singapore that reduces the cost of staying more days in the hospital. Many procedures are done on day case basis now a days.

SH: What is your recommendation to expand the healthcare industry in a country like Bangladesh?
Mr Gill: Hospitals need to be built first and it can be built as many affluent Bangladeshis are there to do that. But more importantly — the talent pool of doctors, nurses and healthcare professionals need to be developed. Bangladesh is a very big market in terms of population. To satisfy the need of large number of patients, these talent pools are crucial where doctor-patient, doctor-nurse and patient-nurse ratio is very poor.

Marriage conflict is a normal part of married life. When two people start life together by the bond of marriage, conflict is bound to happen.

Each person has had different life experience, and undoubtedly, has different expectations of marriage and from his/her spouse. Therefore, each one is going to react differently to life’s challenges.

Marital conflicts are not bad in themselves. It is our response to the conflicts that can be either helpful or harmful. Conflict can range from a minor disagreement over what to have for dinner tonight to the extreme of abuse.

Conflicts over monetary matters, in-laws/parents, time given to each other, domination/control of one partner, insensitivity toward the spouses feelings, unilateral decisions being made, conflict over interests, children and individual lifestyles are common.

Many marital conflicts are caused by lack of good communication. The problem of “not listening” becomes extremely evident, if you raise an unpleasant topic, ask for something or criticise a person. The accused partner may feel very uncomfortable and tries to prepare a defense or some way to get rid of the unpleasant talk.

Conflict is a reality in all marriages. How you deal with that conflict is the ultimate test of your ability to communicate as a couple.

Ignoring a conflict would never be a wise option as what might seem trivial at the surface, certainly would have some unattended underlying issue. Marital conflict stems out of unmet need, want and desire. When one person needs or wants something badly enough, and the other person is unwilling or unable to meet that need, resentment grows.

The first step in resolving any marital conflict is to understand what the conflict is all about. Once you have taken that step, without being defensive during your investigation, the solutions become much more apparent.

Some measures that can be taken to resolve conflicts or minimise conflicts in a marriage are highlighted below:

* Be kind, gentle and loving to each other

* Create a non-threatening environment of understanding

* Providing more empathy than sympathy

* Avoid cutting remarks that could start the “insult cycle”

* Try to keep your emotions under control

* Be willing to forgive

* Take joint decisions: Share your goals with each other

* Couples must approach each other with kindness and concern

* Be careful of your words: If you are angry, wait until you calm down before continuing the conversation

* Show appreciation for what your spouse does

* Communicate: It is better to deal with problems early and honestly than to let them pile up until an explosion occurs

* Do not drag the past

* Admit your mistakes

Marriage is a personal union of individuals. Good marital relationship requires patience, kindness, humility, sacrifice, empathy, love, understanding, forgiveness, and hard work. Following these principles should help any marriage to improve.

The essence of them all can be summed up in one sentence: Always treat your spouse the way you would like to be treated. If you follow this rule, your marriage will have a much greater chance for success. If you discard this rule, failure is just around the corner.