Our project works: diverse achievements

Combating non-communicable diseases in the military

During my tenure with the Army Medical Corps in Sri Lanka, I led a crucial project addressing non-communicable diseases (NCDs) among army personnel. This initiative involved comprehensive prevention strategies and widespread awareness programmes, significantly contributing to the health and well-being of service members. This project highlights my commitment to public health and effective programme management in challenging environments.

 

Introduction

Non-communicable diseases (NCDs), including cardiovascular diseases, diabetes mellitus, chronic respiratory conditions, and cancers, represent a growing global health burden. Within military populations, these conditions pose a unique challenge, as they directly affect operational readiness, physical fitness, and long-term workforce sustainability. Although military personnel are generally perceived as physically fit, emerging evidence suggests increasing trends of NCD risk factors due to lifestyle transitions, occupational stress, and aging service populations.

During my tenure with the Sri Lanka Army Medical Corps, I led a comprehensive project aimed at addressing the rising prevalence of NCDs among army personnel. This initiative focused on prevention, early detection, health promotion, and behavioural change strategies, contributing significantly to improving the overall health profile of service members.

---

Background and Rationale

The Sri Lankan military workforce has undergone considerable transformation over the past decades, particularly following the end of the civil conflict. With reduced active combat operations, lifestyle patterns among personnel have shifted toward more sedentary routines, accompanied by dietary changes and increased exposure to modifiable risk factors such as smoking, alcohol consumption, and unhealthy eating habits.

Screening data collected during routine medical examinations revealed a growing incidence of hypertension, type 2 diabetes, obesity, and dyslipidaemia among mid-career and senior personnel ( all personal with more than 30 years old).These findings aligned with national trends reported by the Ministry of Health Sri Lanka, indicating a broader epidemiological transition toward chronic diseases. Our medical team visited to all army camps and physically examined army personnel to collect those data.

.

The need for a structured intervention became evident to mitigate long-term health risks, reduce healthcare costs, and maintain operational efficiency.

---

Project Objectives

The primary objective of this project was to reduce the burden of NCDs among Sri Lanka Army personnel through a multi-faceted, preventive approach. Specific objectives included

• Enhancing awareness of NCD risk factors and prevention strategies
• Promoting healthy lifestyle behaviours, including physical activity and balanced nutrition
• Implementing regular screening and early detection programmes
• Strengthening institutional capacity for long-term NCD management
• Encouraging leadership involvement in health promotion initiatives

---

Methodology and Implementation

The project was implemented across selected army camps using a structured, phased approach.

1. Baseline Assessment

A cross-sectional health assessment was conducted among army personnel to identify the prevalence of key risk factors. This included measurements of body mass index (BMI), blood pressure, fasting blood glucose, and lipid profiles. Additionally, behavioural risk factors such as smoking, alcohol use, physical inactivity, Family risks and dietary habits were assessed using standardized questionnaires.

2. Health Education and Awareness Programmes

A series of targeted health education sessions were conducted, focusing on the prevention and management of NCDs. These sessions covered:

• Importance of regular physical activity
• Nutritional guidance, including reducing salt, sugar, and unhealthy fats
• Risks associated with tobacco and alcohol consumption
• Stress management techniques

Interactive workshops, visual aids, and group discussions were utilized to enhance engagement and understanding among personnel.

3. Lifestyle Modification Interventions

Structured physical training programmes were introduced, tailored to different age groups and fitness levels. Collaboration with military trainers ensured integration of health-focused exercise routines into daily schedules.

Dietary interventions were also implemented in collaboration with camp kitchens, promoting balanced meal plans aligned with national dietary guidelines. Efforts were made to reduce the availability of high-calorie, low-nutrient food options within military facilities.

4. Screening and Early Detection

Regular medical screening camps were organized to facilitate early diagnosis of hypertension, diabetes, and other NCDs. Personnel identified with risk factors or early-stage conditions were referred for further evaluation and management.

Electronic health records were utilized to monitor individual health parameters over time, enabling continuity of care and data-driven decision-making.

5. Leadership Engagement and Policy Support

Recognizing the hierarchical nature of military organizations, senior officers were actively engaged in promoting health initiatives. Command-level support was instrumental in ensuring compliance and participation.

Policy recommendations were also developed to institutionalize health promotion activities, including mandatory annual health screenings and integration of NCD prevention into routine training programmes.

---

Results and Outcomes

The project demonstrated measurable improvements in several key areas:

• Increased awareness and knowledge of NCD risk factors among personnel
• Improved participation in physical activity programmes
• Reduction in modifiable risk behaviours, particularly smoking rates
• Early identification and management of previously undiagnosed cases of hypertension and diabetes
• Enhanced collaboration between medical and operational units

Qualitative feedback from participants indicated a positive shift in attitudes toward personal health and well-being. The integration of health promotion into daily military routines contributed to sustained behavioural changes.

---

Challenges and Limitations

Despite its successes, the project encountered several challenges:

• Resistance to behavioural change among certain groups
• Operational constraints limiting consistent participation in programmes
• Resource limitations, particularly in remote or under-resourced camps
• Need for continuous monitoring and reinforcement to sustain outcomes

These challenges highlighted the importance of adaptive strategies and ongoing leadership support.

---

Leadership and Management Insights

This project provided valuable insights into leadership within a military healthcare context. A transformational leadership approach was essential in motivating personnel, fostering a culture of health, and driving organizational change. Simultaneously, situational leadership was applied to address varying levels of readiness and engagement among participants.

Effective communication, stakeholder engagement, and interdisciplinary collaboration were critical to the success of the initiative. The project also reinforced the importance of evidence-based practice and continuous evaluation in public health programme management.

---

Conclusion

The increasing burden of non-communicable diseases among military personnel represents a significant public health concern with implications for operational readiness and long-term healthcare sustainability. This project demonstrated that a comprehensive, prevention-focused approach can effectively address NCD risk factors within a structured military environment.

Through targeted interventions, leadership engagement, and institutional support, the initiative successfully promoted healthier lifestyles and improved early detection of chronic conditions among Sri Lanka Army personnel. The experience underscores my commitment to advancing public health and implementing impactful healthcare programmes in challenging and resource-constrained settings.