Lot to give, got to live - the restless minds of the “Liver on Tour” project

Abstract

The Liver on Tour was a special project devoted to increase the public awareness on Liver Health and Liver Diseases that the Portuguese Association for the Study of Liver Diseases launched throughout the country in 2010.

Key Words: Liver disease; Hepatology; Hepatitis; Public health

Core tip: The Liver on Tour was a special Project devoted to increase the public awareness on Liver Health and Liver Diseases that the Portuguese Association for the Study of Liver Diseases launched throughout the country, between mid-April and mid-June 2010, and consisted of a road show, travelling through and reaching all 18 district capitals of Portugal. It was mainly focused on giving simple, reliable and practical information about liver problems with emphasis in messages trying to raise public attention on Liver Health. In a ten million people country where there is evidence of more than 10% being affected with some form of liver diseases, all efforts need to be made to enroll everyone in this never ending battle. High priority to education, gathering on board committed doctors with expertise in mass communication and engage reluctant policymakers (pressured by well-informed voters): A formula that could be a brighter way to raise the standards in prevention, detection and management of liver diseases.

TO THE EDITOR

The Liver on Tour (LOT) was a special Project devoted to increase the public awareness on Liver Health and Liver Diseases that the Portuguese Association for The Study of Liver Diseases (APEF) launched throughout the country, between mid-April and mid-June 2010, and consisted of a road show, travelling through and reaching all 18 district capitals of Portugal. It was mainly focused on giving simple, reliable and practical information about liver problems with emphasis in messages trying to raise public attention on Liver Health. “Meet the liver”, “Care for your Liver”, “Mind the Liver”, were repeatedly announced sound bites, and had a professional media support so that liver problems reached the level of widespread lay public interest and, of course, politicians rule makers, while members of the APEF Board were literally on the road, claiming for help and protection for the liver.

Although pointing out the need for understanding and for taking care of the Liver, the deep goal was directed to the knowledge of the social and individual threats of Hepatitis, Alcoholic Liver Disease and The Obesity Epidemics. Hepatitis B and Hepatitis C were major players in these topics, and all efforts were made to promote public to decide to look (individually) for serological markers of infection to, give referral and guidance to liver specialists, creating an environment of highly awareness and concern on liver problems.

We believe that policy makers, in these times of funding constraints, will only be sensible to these matters if the public itself realizes how deep and broad impact liver diseases may cause either individually or collectively.

The scientific responsibility of all the pedagogical messages and contents of this Road Show (which included small conferences and media interviews) was from the Board of Direction of APEF.

It was one of our tasks to show how liver diseases may lead to social exclusion and how social exclusion can promote liver diseases. The stigmata and inadequate understanding and misperception often associated with liver diseases are truly cumbersome and there is an urgent need to overcome these misconceptions: Liver diseases were shown not to be caused only by self-inflicted deviated behaviors, previous drugs use and alcohol abuse, but instead that there is a wide spectrum of causes, chances and risk factors, that may affect each and any one of us, regardless social, cultural or, economic status.

Our itinerant road show, located in central areas of the main Portuguese towns, addressed precisely these topics, stressed the fact why liver diseases are generally referred as “silent killers”, how the liver itself copes with inflammation and regeneration, which ubiquitous factors challenge our livers. The hepatotropic viruses of course, alcohol consumption, excess weight and medical conditions as diabetes that cooperate to damage liver cells, were object of description, thorough but simple, clear enough to raise the public curiosity and awareness without frightening but with plenty of hope and need for global commitment.

Several thousands of people, from teens to elderly, walked through the exhibition displayed in the truck, reading carefully all the texts and pictures, from historical trivia to the most advanced virtuosities of liver technology. A small questionnaire was distributed, trying to promote the understanding of eventual individual risk factors for liver diseases and to evaluate a possible previous perception of the exposed topics.

The media came along and had different approaches depending on the places and towns we visited. Local radios interviewed liver specialists, national TVs broadcasted several messages regarding liver health. Underage drinking and alcohol marketing were actively challenged. Our presence in several students’ parties, the recruitment of local doctors to get themselves to be available for questioning and even for some counselling, were extremely important to bring everyone together. We were able to gather thousands of in loco measurements of body mass index, and thousands of leaflets with simple knowledge on viral hepatitis were widely distributed.

In a ten million people country where there is evidence of more than 10% being affected with some form of liver diseases[1], all efforts need to be made to enroll everyone in this never ending battle. High priority to education, gathering on board committed doctors with expertise in mass communication and engage reluctant policymakers (pressured by well-informed voters): A formula that could be a brighter way to raise the standards in prevention, detection and management of liver diseases.