Hypertension or blood pressure is one among the Non Communicable Diseases (NCDs), which are known as silent killers. Lurking subtly without showing symptoms, it conspires to the development of cardiovascular diseases that account for approximately 17 million deaths a year globally. That makes it a disease that claims a heavy death toll worldwide. Hypertension causes 7.5 million deaths annually (12. 8 per cent of all segments) and the risk of dying from hypertension in African countries is more than double as compared to that of high-income countries.
The Ethiopian Herald spent a few hours with Dr. Frederick Bukachi who is an International Medical Consultant, Cardiologist at the University of Nairobi. Dr. Fredreric shared his Kenya's best practices in combating hypertension and other Non Communicable Diseases (NCDs). Excerpts:-
Would you relate to us Kenya's move to contain hypertension and other NCDs ?
First of all I would like to thank you for inviting me to share my country's experience with regard to hypertension. Hypertension is number one pressing problem in Kenya. The government,together with partners, has come up with different programs to try and contain the problem over the last one and half years. The first thing was to understand the magnitude of the problem. A national survey was conducted, which showed clearly that 50 percent of rural population, has hypertension and many of them have no inkling about hypertension. So there has been a clear program to improve awareness about the problem.
The second issue has been that of training health workers to be able to understand how to diagnose the problem and also to be able to advice their patients and clients clearly on how to treat hypertension appropriately and control the other risk factors associated with it. The third aspect is that the government and other partners had been involved in providing the required medication to control hypertension and related complications. Obviously, the medicines are expensive and a lot of partnership is required to make those medicines available to wider population. Those are the initiatives that the government put in place together with other partners.
So where do you think the gap lies?
The gap has been at different levels. There is a gap in the knowledge of the general population. One third of the population who have hypertensions even do not know that they have high blood pressure. There have to be deliberate efforts to bridge that gap by providing the necessary information. The second gap is in the knowledge among health practitioners. As much as they treat high blood pressure everyday, many of them still do not have a standardized way of treating hypertension. They use different methods and so on. So, one of the things is that we have been doing works in bridging the gap by providing a uniform way of treating hypertension. We have developed a national guideline for treating blood pressure. Ethiopia can also develop one.
Is it possible to contain the problem?
We have made a lot of progress in a year and half time. We have been able to screen one million people and we have identified about 300,000 that are already put on treatment. We also train health workers in 300 different health facilities across the country. That is a very good step. Our hope is that in the coming two or three years, we could upscale this to the whole country. I think that is a good step towards containing the situation. But clearly there is a long way to go because there are others competing interest when you come to providing resources to control hypertension.
Are Kenyans developing a culture of going to health facilities to check hypertension? If you don't mind tell me if there is a special method used to attract the public to blood pressure test?
Yes there are. There are different methods used. One is, having community health workers going out to public places. They go to public gatherings such as markets,churches, schools, to screen people voluntarily. During the screen they also talk about hypertension. Also as a matter of policy we advise every one going to health facilities to have the blood pressure taken. Whether you are going for headache or injury or a flu you must have a blood pressure checked. So, those are different ways to screen the population.
What were the main challenges the country faced when practicing hypertension treatment?
The challenge has always been that when we look at the numbers got from health facilities, most of them are women. And when we look at the people clear most of them are women. One big challenge is that most men are not forthcoming for screening. I expect that may be a challenge in this country and other African countries. So, when we put a program in place, we need also define ways which men can encourage for screening. The other challenge has been expensive medication that uses appropriately to treat hypertension and blood pressure. And again government needs to review their budget and invite other partners work with them in order to be able to provide affordable medicines to the population. So, these are the two major challenges.
How do you see the commitment of the government in reducing hypertension and other NCDs?
I think our government knows. It clearly knows times have changed. Unlike ten or 20 years ago, when high blood pressure and heart stroke were rare , the number is increasing and this is something that governments could not ignore. The Statistics shows clearly that the number has increased. Therefore, our governments has put in place a mechanism to combat NCDs just as much as we have programmes for malaria, HIV, childhood diseases and others. I think there is a clear view for now to be able to address NCDs.
If you have additional comment the floor is open for you?
When you look at the entire Africa, hypertension at the moment is the second major public health problem after HIV and AIDS. And if you look at many African countries, hypertension is among the top three major public health diseases. Therefore, it is timely. At the moment the battle is not just for individual countries. Regions must begin to share their resources and knowledge to see how to become victories in the battle.
Thank you for your time.
It is my pleasure.