The year 2013 has been declared by the Lithuanian government to be the ‘Year of Wellness,’ but to some people, like 60-year-old Dainius Kepenis, founder of Palanga Health School, health expert of the Parliament’s Health Committee and president of Lithuania’s Health Union, that means a whole lot more than just the declaration. Known as an outspoken and avid zealot of a healthy lifestyle and well-being, Kepenis has long been seeking a radical change in the often non-effective health policies. Among his yet seemingly unrealistic pursuits is ultimately to link a healthy lifestyle with lesser social security payments, or granting certain bonuses and encouragement on behalf of a municipality for a person who opts for a healthy lifestyle and well-being. Does this sound incomprehensible? Not to Dainius Kepenis, with whom The Baltic Times sat down for this interview.
Do you believe the newly appointed government and all the health policy makers are mature enough and health issue-conscious to make a real breakthrough on the of health and well-being front?
The facts are clear, that they have braved up to declare 2013 the ‘Year of Wellness,’ means a lot to me. And some people, like the community of all healthy lifestyle supporters and, exceptionally, the new Health Minister Vytenis Andriukaitis, whom I’ve known for 20 years as a staunch advocate of well-being, are among those to be most credited for the declaration. However, the ‘Year’ has not started off as well as most were expecting for a simple reason: no money has been shelled out for it. But knowing the mentality of most high-ranking officials both in the ministries and government, and also how the things work there, I perhaps should not be surprised by that. Again for a simple reason: many positive things targeting the public’s consciousness are expected to be done for free in the country, out of somebody’s devotion and zest.
Doesn’t it mean that the Year of Well-being is doomed at its very start?
Well, we’ve had some events aiming to trigger the goal. But, in fact, that has been done by a dozen people, wellness activists, who would have done it anyway, without any particular declaration and the pomp.
Frankly, when I look at the make-up of the government, I can see some action coming towards materialization of the ‘Year of Wellness’ only from Health Minister Vytenis Andriukaitis. And though he is currently embroiled in the explanations over his blunt call for cutting off funding for private medical establishments from the State Patient Fund, I hope he will speak out and act with all his heart for the agenda when the heat over the observations dies out.
Perhaps you have discussed some of the agenda together?
As a matter of fact, we have.
Can you lay out its core objectives?
One of the fundamental ideas the minister has focused on still before the appointment is separating the fields of patient treatment and well-being. Unfortunately, until now, completely different polar items have been mixed up in the same basket. I mean in terms of policies, funding distribution and health strategy planning. In a word, we’ve always had kind of a mishmash. What the Lithuanian Health Union has been speaking of for many years, sometimes seemingly non-understandably for many, the minister has uttered quite clearly just before his appointment - these things need to be set apart. On behalf of the Union and the Lithuanian Health Chamber and some other health organizations, I am to meet Andriukaitis in the coming weeks and I am really eagerly looking forward to finding out whether he hasn’t budged.
Let’s say you’re the health minister or his top advisor. What strides would you make?
Well, the first thing that has to be done, as I said, is separating the different fields of medicine and, subsequently, funding and policies. In short, sorting out the hodgepodge. To put it simply, I tend to say that illustratively, that now the whole of Lithuanian medicine stands on four pillars. The first one and a massive part of medicine is the so-called “crash medicine,” which engulfs all the traumatic incidents, from an auto crash to falling out of a tree. Another pillar is genetic illness-related medicine, taking up a portion of lung conditions, diabetes, cancer and more. The third significant part of it is what I call “illnesses of laziness and an inappropriate lifestyles,” i.e. all that is related to our sluggish lifestyles. And finally the fourth and the last pillar in the foundation is what I call our health watchdogs, like Public Health bureaus and others. Keeping all of them at the same place is a big nonsense. When Andriukaitis said before being appointed minister that he intends to seperate all the pillars, he perhaps didn’t give much thought how intricate it would be. Particularly bearing in mind the pharmaceutical industry’s massive impact on the current Lithuanian medicine model, which works in its favor, especially the strongly cohesive holding of the first three pillars, that produce the biggest number of medicine buyers.
What else would you do if you were the new Lithuanian health minister?
I’d definitely dig out the fourth pillar - all the health institutions that are tasked with a healthy lifestyle and wellness promotion, and put them aside, channeling funding to them not from a single health budget, but from one specially designated for the cause. In fact, when it comes to the fourth medicine pillar, there are many single institutions preaching health and well-ness ideas, but they do not speak in a single loud voice.
And that causes a big problem since they cannot withstand the three-pillar mammoth combination of the “disease and trauma medicine,” catering to treatments rather than promotion of wellness, and [thereby] satisfying the pharmaceutical companies’ appetite. All those sometimes very tiny healthcare and well-ness organizations have to be united under a flag of a single health institution that could counterbalance the impact of the mammoth “crash, congenital and reckless lifestyle medicine.”
That is interesting. Whom would you put at the helm of it?
The Lithuanian president or the prime minister. Maybe somebody else, but not the officials in charge of the whole hodgepodge and money.
Is there anything else you’d like to change?
Yes, a lot of things. I really would like to call all the people responsible for health and well-being promotion in the country, from insurers to clergy to educators and family doctors, for an open talk and unity. Unfortunately, all of them now are furrowing the land on their own, sometimes not even having an idea that another health worker is treading next to them. I’d like all of them to sit down and talk and coalesce into one organization, one capable of withstanding the power of the “illness medicine.” And more than that, I’d like them to have a day in the calendar celebrated as the day of Promoters of Healthy Lifestyle and Well-being.
Well, first maybe it would make sense to have you elected as mayor of the resort town of Palanga, where you live, and first see how you change things here. Tell me, off your cuff, what you’d do differently here?
Every city, town and smaller settlement has to clearly say who is responsible there for health and well-ness.
Don’t be mistaken: I’m not speaking of local physicians. For that purpose, most towns, Palanga included, have the so-called Health Boards running. Can you tell me whether you are aware of this and any of its activities in Palanga?
Frankly, I am not.
So what does it tell to you?
You tell me.
That it has been a bureaucratic unit that no one has ever heard of. It makes no sense to speak of its activities.
Well, the Board may be asleep, but then why doesn’t the mayor wake it up? Particularly when the Palanga schoolchildren’s health has been deteriorating every year. It is a gut-wrenching feeling to see the drastically declining numbers! There are so many children with vision and vertebra deviations! I have never heard of the mayor’s initiative in addressing the problem.
You’re a seasoned traveler and, no doubt, you’ve heard of, and perhaps experienced, some of the health initiatives in some thriving world capitals, like Copenhagen, that had imposed the so-called “fat tax,” or New York City that has most recently set higher taxes on sugar-rich soft drinks? Isn’t that something Lithuanian resorts could follow?
Why not? I’d support that kind of initiative anywhere in Lithuania, as well as any other initiative aimed at spurring a health lifestyle and well-being. I’ve recently spoken to a Finnish health activist. He told me that, some time ago, Finland had been among the leading countries in cholesterol-related illnesses and fatalities. But the Finnish government has addressed the problem by carrying out a sweeping healthy lifestyle program and health reform that has put the Finns among the healthiest people on the planet.
Why can’t we do that in Lithuania?
Speaking of Lithuania and its municipalities, from the majority of health officials, you’d hear the same lame excuse: “There’s no time for that!” Second, the officials do not feel responsible for our health. Third, they are mired in the intricacies and formalities of regulations and laws outlining their activities. Too bad for all of us.
Aren’t you the lonely warrior on the battlefield?
No, I am not. There are a bunch of people out there who are ready to stand for the cause at any moment.
Have you heard of any other Lithuanian mayor or government member, except the Vilnius mayor Arturas Zuokas, straddling a bike on the way to work?
Perhaps I haven’t. On the other hand, the mayor-on-bike would deal with lots of sneers, and suspicions of a cheap populism. But sure, the personal example on the executive level means a lot in promoting a healthy lifestyle and a new attitude to things. And believe me, sometimes just a good initiative suffices to make a change. Why, for example, couldn’t some Lithuanian mayor encourage his townfellows to set personal health goals? Like shedding off ‘x’ kilos a year, or completing some other health cornerstones? It wouldn’t be hard for the mayor to check out how the people succeeded in meetings the goals and announce the Well-ness Winners at the end of the year, thus setting an example for others. Maybe the town could hand the winners invitations to local fitness clubs or something like that. I don’t think the idea requires a lot of investment, but I just don’t see many mayors doing that.
Why is it so crucial to address the issues of wellness today in Lithuania?
Because they go well beyond our national borders and just pinpoint what the current world, and Lithuania, suffers from. Recently, the World Health Organization has announced that every year, over 50 million people worldwide succumb to little mobility related illnesses, including a number of cardiovascular, arthritic, pulmonary ailments, diabetes and sometimes cancer.
As a big health nerd, have you ever seen a doctor in the past century?
(Grins) Well, I went to see a doctor a couple of years ago after I stepped on a nail that pierced my sole. And the other time I scratched off some skin from my finger with a shave. And, not to lie, I went to see a doctor when being reissued a driving license… And, finally, once I swung by my family doctor just to see how she looks and introduce myself (grins).
Did she recognize you?
I think so! Surprised, she asked me why I came in…
You’re 60. Do you feel the age?
Oh, God, no! I feel as if being 27. Physically, I do exactly the same things today as I did when 27. And my biological age, that has been assessed several times, puts me in the age range of 30 years. I really like that!
I bet. Good luck with your endeavors.