15 November 2015

Tanzania: Fighting Stubborn Diabetes With Healthy Lifestyle


Just yesterday the World commemorated the World diabetes day with its theme 'healthy living starts at breakfast'. According to Tanzanian health experts, the level of diabetes within the population has grown twice in comparison to the few years.

Diabetes.co.uk explains the theme 'healthy living starts at breakfast' as follows: A healthy breakfast should keep blood sugar levels from getting too high and should keep you full through the morning. Whilst cereal and toast may be cheap, these options typically raise blood sugar levels rapidly and may leave you hungry again before lunch.

According to the health experts, in the last ten years a majority of the population believed that the diabetes was a disease that only affects people with a high income. However, fact is that diabetes can strike anyone, regardless of the financial status.

In the 1980s, the prevalence of type 2 diabetes within Tanzania was among the lowest in the world: About 0.8 per cent in cities and about 0.9 per cent in rural areas. However, the disease poses an increased economic burden on the population nowadays, as well as on the national budget for health care.

According to www.diabetesresearch.org, diabetes afflicts more than 380 million people worldwide. Additionally, the World Health Organisation estimates that the number of people living with diabetes will more than double by 2030.

Today, diabetes takes more lives than AIDS and breast cancer combined. It is a leading cause of blindness, kidney failure, amputations, heart failure and stroke.

Sound Living brings you an interview with a person living with diabetes and one story of a woman who lost her husband to the disease six years ago. They share their experiences of living with diabetes, and how the disease's costs affected them.

Mariam Shomari, 42, is a primary school teacher. Her husband went through a very tough time struggling with the diabetes complications, as the family lacked the money for sufficient treatment.

"My salary is small, as it is the case with the majority of teachers. My husband did not make more than me, he did not earn a lot at his carpentry job. Consequently, all we could afford was the most basic treatment, which still cost us more than Sh150,000 a month," says Mariam.

As time passed, Mariam says, her husband developed diabetes foot. Thankfully, his brother volunteered to pay for the treatment as he profited a lot from his own business.

According to Mariam, the doctors recommended radiation treatment for her late husband. After several clinic visits at Muhimbili National Hospital (MNH), he was finally admitted for said treatment. However, it came at a price: After two months of radiation, Mariams husband lost his sexual ability.

"Even though his diabetic foot improved, he was emotionally affected by his impotence. He became very quiet and unhappy," says Mariam.

To her, it felt as if the radiation treatment was meant to finish off her husband, Mariam says. He remained unhappy and depressed, until finally, six months after the treatment, he died. It was another three months later that Mariam learned that her husband was possibly overdosed during the radiation - and that this may have caused his impotence.

"I happened to meet another diabetic person with a similar case at the MNH" Mariam shares. "This person's result showed that an overdose of radiation may cause impotence." According to Dr Mary Mayige from St Laurent diabetes, there are two types of diabetes: diabetes type 1 and diabetes type 2. The change in lifestyle for many Tanzanians has led to an increase of the disease within the country.

In Tanzania, one person out of 10 people is currently diabetic. According to Dr Mayige, another five out of ten are diabetic in the early stages.

"The increase in diabetic cases in Tanzania is caused by the change in lifestyle and the food we eat. Levels of exercising are getting lower as we go. Our nourishment leads to lifestyle diseases such as diabetes. Information about dieting as well as exercising needs to be taught and improved from an early age on. We need to help Tanzanians to know more about creating a diabetic-free society," says Mayige.

Ramadhani Kaboja, 53, a retired police officer, has been living with diabetes for more than twenty years. His journey with the disease has never been an easy one. The clinic visits are very expensive, depending on where the patient is coming from and how many visits are needed monthly.

"My case is very complicated", Kaboja says. "I have to control what I eat and take care to live an active lifestyle in order to control my sugar levels. Regular checkups and clinic tests are necessary to have the occasion to learn more about my disease, and to get reminded of proper ways to take the medication."

According to Kaboja, the regular clinics visits helps him to have his blood pressure, weight, teeth, eyes, feet and ears checked regularly. This way it's possible to keep an eye on whether any medical attention is needed in controlling the consequences of the disease.

For the treatment described above, Kaboja needs between Sh100,000-150,000 for a monthly visit. However, his financial position does not allow him that frequency. All he can afford is one visit every three months.

Just last year, Mr Ramadhan Mongi, executive director of Tanzania Diabetic Association (TDA), told this paper that the prevalence of the ailment has shot to more than 6 per cent within adult population in urban areas. According to him, during the ten years before that rate was at only three per cent. He thus calls for additional efforts to fight the disease. A study in the Kilimanjaro Region showed that the total direct costs relating to the treatment of diabetes accounts toa quarter of the minimum wage. Consequently, about 46 per cent of the patients struggle permanently with financial difficulties.

Research in Dar es Salaam reported that only one out of five residents suffering from diabetes received government-funded treatment.

On the Tanzania Mainland, diabetes clinics have been established in each of the 19 regional hospitals, four referral hospitals, as well as three district hospitals.

Additionally, in Dar es Salaam City, diabetes clinics have been established in each of the three district hospitals. Last but not least, a number of diabetes clinics have been established in Zanzibar and in Pemba. Until the regional network was established early in 2005, diabetes services were provided at regional hospitals only as part of routine outpatient care, typically conducted by staff lacking any specialist diabetes training.

In the past years the Muhimbili National Hospital in Dar es Salaam has become the national centre of excellence for diabetes care. It houses a medical laboratory, a foot clinic and provides a diabetes information centre that trains doctors, nurses, and people with diabetes from around the country.

The hospital also sees patients that are referred from the regional hospitals. Still, there remains much to be done as referrals may be hampered by costs and the limited transportation network in the country.


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