Tanzania: Why Diabetes Still Ruins People's Lives

A woman testing for blood sugar level.

Warnings have come and gone, such as, "With extra sugar, you eat your way to the grave," or "An apple a day keeps a doctor away," meaning that how we eat and live determines our health. Still, government, experts and the World Health Organisation (WHO) have continued warning.

However, the scourge of diabetes, a disease emanating from uncontrolled blood sugar, is still here with us--ruining people's lives and economies whereas the cost of treatment continues to rise. Experts believe there is no other future--it's now time to invest and tame the menace.

The global cost of the disease is now $825 billion per year, according to the largest ever study on diabetes levels across the world, published in Lancet Journal; comparing diabetes levels among adult men and women from 1980 to 2014.

By the year 2030, the cost of treating diabetes is projected to rise to $16.2 billion in Eastern Africa, namely Tanzania, Kenya and Ethiopia. This is an increase from $3.8 billion in 2015, says another study by Lancet Diabetes and Endocrinology Commission.

According to the commission, the current economic cost of diabetes in Sub-Saharan Africa is $19.5 billion or one per cent of gross domestic product (GDP).

However, it estimates that this could increase to one per cent of the GDP in 2030 if rates stay the same and to $47.3 billion (1 per cent of the GDP) if rates follow the projected increases, or to $59.3 billion (2 per cent of the GDP) if rates double.

But, trapped in a vicious cycle of the wanting lifestyles, several people still end up with the disease that should be largely preventable with low-cost interventions.

What are people doing about this?

On the brighter side, however, society is beginning to realise the costly nature of diabetes and other Non-Communicable Diseases (NCDs).

Ahead of the World Diabetes Day, marked November 14 (tomorrow), Your Health spoke to people who have decided to take up daily exercising as a strategy for keeping healthy and save their economies.

Every evening, the open spaces at the campus of the University of Dar es Salaam (UDSM) attract a number of people who take advantage of the landscape for exercising.

Ms Amina Jabir, 29, a resident of Sinza has decided to take up exercising after doctors cautioned her about the dangers of being obese.

"When I gave birth to my first child, a year ago, my doctor told me to cultivate the habit of exercising. He told me that I risked becoming obese. He said my body was potentially becoming morbidly fat. I heeded the call. Here I am now, I feel addicted to it," she says.

Why people prefer jogging at UDSM campus

The UDSM surroundings have rolling grassy knolls and a relaxed landscape. According to a physiologist from Muhimbili University of Health and Allied Sciences (Muhas), Dr Omary Chilloi, this space for exercising is what universities across Tanzania should invest in now as NCDs, such as diabetes continue to pose a threat.

"Tanzania has about 70 universities and colleges. Most of these universities' buildings are in major cities and do not have the required infrastructure to improve students' health. The buildings put up in the 1990s lack essential facilities to support physical activities such as sports grounds and recreational spaces," he says.

"Yet, those universities which were spacious enough and in a position to create such key facilities, are now haunted by another great challenge--of building more lecture theaters and staff offices to meet the growing demands of students who increase every year," he points out.

Dr Chillo believes universities have to rethink about how to prevent NCDs, such as diabetes among the youth, including providing a spacious environment for exercising.

"I believe it's time for universities to rethink on their health policies, be engaged fully in the content of food and the variety of choices that their food vendors offer to the varsity communities."

"Also to preserve the existing facilities and build new supportive infrastructure for sports grounds, cycling and bicycle stands, gym areas, and bathrooms."

Learning from examples

During the survey, Your Health witnessed several young men and women along the service roads of Sam Nujoma Road in the city, jogging. One of them was Mr Joachim Mzava, 28, a resident of Ubungo in the city.

He says that whenever he goes for a jogging session every evening, he is not worried about what it takes to invest in exercising.

"It has become my habit. By the way, it doesn't cost anything, almost. What I fear is the amount of money I would have to spend on illnesses such as diabetes and heart disease, in case they came into my life," he says.

"That's what I am fighting against at the moment. Those diseases," he says, brisking up his pace, panting and sweating as he goes ahead to exercise. "I do this every day, it's for my health."

Mzava says he learnt lessons after his father died of prostate cancer two years ago and his 60-year-old mother is battling diabetes.

"I am a shopkeeper. My mother depends on me for treatment. I know what it takes to take care of a diabetic patient," he says and he narrates how he has been trying to raise medical bills for his ailing mother.

"It may cost me up Sh 50,000 treatment on a day. Since she is not on health insurance, just as I am not, I have to raise the money for treatment. She needs an insulin injection quite often," he explains. For two years now, Mzava's mother is struggling with this disease.

Mzava says he has learnt that diabetes can be prevented through regular physical exercises; maintain a healthy body weight and not eating processed food.

What do the health experts advise?

Dr Fredrick Mashili, a specialist in body physiology and manager of a health organisation, JamiiHealth, says that people can do away with catastrophic health expenditures on diabetes treatment through low-cost interventions.

"Walking and cycling daily or what we call active commuting is simple. The World Health organisation proposes active commuting as a simple strategy for preventing Non-Communicable Diseases," he explains.

"The rewards are robust. First and foremost, it cuts down healthcare costs through prevention. But also it increases productivity at work since absenteeism due to sick leaves will be avoided through this," he points out.

Dr Deus Kitapondya, a medical doctor from Muhimbili National Hospital (MNH) says another cheapest strategy is through making the right food choices.

"One important and cheap strategy to prevent diabetes is by refraining from sedentary lifestyle and avoiding being obese. Obesity predisposes people to insulin resistance, and that's how a person starts suffering from diabetes," explains Dr Kitapondya.

Dr Sajjad Fazel, a Tanzanian public health advocate believes there is need for mindset change. That people should now start analyzing the economic implications of suffering from diabetes vis a vis the returns they can get from investing in preventive measures now.

My personal advice is, "Exercise for your health and your pocket, a small step today will save you a fortune tomorrow."

Dr Fazel, who is now at the Schulich School of Medicine and Dentistry Western University in Canada, goes on to caution how diabetes is fast becoming an economically crippling disease.

"It not only causes the sufferer to bear huge medical costs for medication and treatment but also reduces productivity and hence income."

"A lot of diabetic patients spend large sums of money managing complications caused by uncontrolled sugar levels such as diabetic foot, retinopathy, and peripheral neuropathy, renal and cardiac problems," cautions Dr Fazel.

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