Prof. Janabi: Rate of lifestyle diseases in Tanzania is alarming

Noncommunicable diseases (NCDs) such as cancer, chronic respiratory diseases, asthma, cardiovascular complications and diabetes have become a major threat in Tanzania. Although some of the diseases ma be passed on in families, they are largely attributed to lifestyles. To delve into the realities of these conditions and how they can be prevented, our reporters, Herieth Makwetta and Lilian Timbuka interviewed the Executive Director of the Jakaya Kikwete Cardiac Institute (JKCI), Prof Mohamed Janabi. 

QUESTION: Professor, what exactly causes these NCDs?

ANSWER: People don’t engage in physical exercises. They don’t eat healthy foods as well. In recent years, the majority of the people have been eating fatty foods. Too much drinking of alcohol and cigarette smoking are other risk factors for NCDs. But also, too much salt consumption can cause high blood pressure.

How prevalent are the diseases currently in Tanzania?

We conducted a study recently in Kisarawe, in close collaboration with our counterparts from the US. We were shocked after our research findings indicated that at least 28 out of 100 persons reached were found to have high blood pressure. Again, during last year’s celebrations of World Heart Day, we offered a free-heart diseases screening here at the institute. At least 300 out of 400 who were screened, there were those who were diagnosed to have high blood pressure and other complications.

Let’s talk about the cost of treatment. How is it? Can people afford it?

Unfortunately, in African countries, apart from NCDs, there is also an increase in the prevalence of infectious diseases. These include malaria, typhoid, Ebola. There is a huge investment in the health sector required to curb both NCDs and the infectious diseases that I mentioned. The thing is, the NCDs differ from infectious diseases in terms of treatment cost. The treatment cost for a minor heart surgery is Sh6 million, and at least 30 million for rare open heart surgery. There is need for the African countries to embark on prevention of NCDs than investing sufficient funds for treatment.

How about those people who are on long-term medication. There are concerns of adverse side effects. How do you address this?

Every medication has side effects. For example, pain relief medications and medication to treat high blood pressure and heart diseases all have side effects. Personally, I do consider two things when prescribing to a patient—first, the medicine’s side-effects and its benefits to the patient. If the benefits outweigh the risks, we usually go ahead and prescribe the medications. So far, the medicine for treating heart conditions that I know, have more benefits than side-effects. Some people believe in misconceptions, they are not told about the other side of the consequences such as early death that a person may encounter if she or he doesn’t use medication.

Some of the misconceptions include use of medication can lead to dizziness, infertility in men, etc, but it is also good to remember that when a patient (hypertension patient) is not using the medication, he or she can develop other complications such as blindness, cardiovascular, kidney failure, therefore it is better to use the medication to treat the disease than not to use it just because of fears of side effects.

Whose responsibility is it to educate patients on this?

I think sometimes we, healthcare providers are to be blamed for failing to provide adequate explanations to our patients about the possible side effects and the associated issues. But speaking from the experience, the said side effects occur rarely. When you observe that at least 100 patients with hypertension suffer from other complications, it is not necessary that the complications are caused by use of medications.

How about the health workforce? Do you have the number of specialists you need to handle the patients?

We receive patients from Tanzania and neighbouring countries like the Democratic Republic of Congo (DRC), Malawi, Kenya, Uganda, to mention a few. We also receive officials from the embassies to Tanzania for heart treatment. We normally attend to at least 300 patients per day. Our clinic schedule is open between 6am and 8pm every day. We have 12 specialists for heart diseases, but there are other departments offering services to patients and hospital staff.

With the small workforce that we have, I am forced to distribute them to perform surgeries in both children and adults, and I assign others to attend patients who have been admitted in the wards, while others are responsible for performing heart screening at the clinic. TanzaniaS is ranked the third among leading countries that offer heart treatment services in Africa. However, we still face an acute shortage of specialists. We are currently training at least 28 local specialists with a view to generating competent heart specialists who will work in regional public hospitals.

What is the prevalence rate of children born with heart diseases in the country?

The prevalence rate is high. For example, last year in Tanzania, at least 2 million children were born with heart diseases. But at least 400,000 children out of the population are projected to die due to various heart diseases’ complications including delivery complications.

Apart from offering heart treatment in the region, does JKCI conduct research related to heart diseases in Tanzania?

Of course, we have published widely on the heart diseases burden in the country. We have made at least 25 publications so far. Therefore we are conducting a number of research studies. We have had cases where majority of the research works are conducted by foreign experts. We are therefore made this initiative to be able to generate our own original studies that suit our context.

Does a large number of people currently visit JKCI for treatment?

I am delighted to say that a majority of Tanzanians are now aware of importance to do medical checkups. I also take this opportunity to commend the media in the country for cooperating with health institutions in creating public awareness on the importance of having regular medical checkups. Previously, people were scared to undergo surgeries, but now everything has changed as we receive a number of people for both screening and treatment.