As Tanzania is getting ready for the third National Non-Communicable Diseases (NCDs) are a serious cause for concern, largely due to lack of information and awareness. Many can be helped with the right diet and lifestyle changes (NCDs) Scientific Conference in November this year, about 70 percent of people with NCDs are still not aware of their various conditions until they go to the hospital for different treatment.
According to World Health Organization (WHO), NCDs, also known as chronic diseases, tend to be of long duration and are the result of a combination of genetic, physiological, environmental and behavioural factors.
Speaking to Your Health, Dr Paschal Ruggajo the Nephrologist and NCD Specialist at Muhimbili Health Allied Sciences (MUHAS) says, NCDs treatment is expensive and stretches many health budgets especially so for countries in the Sub-Saharan Africa region including Tanzania.
Adding to that, he says Tanzania is currently observing between 30 to 40 percent of in-hospital admissions. Morbidity and mortality and numbers are likely to increase as per WHO projections.
The NCDs conference is therefore set as a platform that aims to bring together various health stakeholders who directly or indirectly work in combating NCDs.
“In Tanzania, the scientific conference is an essential component of the NCD week. The latter is a week of organized activities related to health promotion, early identification, prevention and advocacy of NCDs in Tanzania,” says Ruggajo.
“As a way of fighting NCDs, health stakeholders are working hard to promote multi-sector engagement in health promotion, screening and early detection and intervention at the community and primary health care level so that we prevent and control of NCDs,” he adds.
Emphasising on the burden of NCDs in Tanzania, Professor Andrew Swai the Chairperson of Tanzania Diabetes Association says that the major NCDs include cancers, heart disease, lung disease and diabetes. He says, these major ones are some of the biggest causes of death worldwide.
He adds that every year, 15 million people die before the age of 70 from NCDs, with 86 percent of these premature deaths occurring in developing countries.
Death rates from NCDs are nearly twice as high in low-and middle-income countries compared to high-income countries.
The burden of NCDs is expected to keep rising dramatically over the next 20 years in low-and-middle-income countries.
“There is a high chance of saving lives if people are ready to learn more on what to eat. Minimize the use of salt, sugar, cooking oil and more. One should not use more than 1 teaspoon of salt a day, not more than five teaspoons of sugar and a family of four people should only use 500ml of cooking oil for four months,” says Swai.
Elizabeth Lucas, 56, is one of the many patient who never knew she had diabetes and blood pressure until she was taken for malaria treatment. She was in a very critical condition. During her treatment she was asked a lot of questions that made the doctor suggest a diabetes test.
According to her some of the questions included how often she needs to use the toilet at night, if she was losing weight without trying, and if she notices a blurry vision once in a while.
After a set of questions she was taken for diabetes test and it turned out to be positive.
“I never knew I was diabetic. I am currently on medication however, it is not improving as well as it should according to my doctor. He says it might take years and can morph into a lifetime disease as we came to know about it at the late stages,” says Elizabeth.
Over the years, Elizabeth has not had the best diet habits as Professor Swai explains. She believes a lot of awareness is needed in Tanzania to help people prevent themselves from getting NCDs.
The Annual Health Sector Performance Profile 2017/2018 had, from 2015, shown that there is an increase of NCDs patients. For every ten diseases being treated at hospitals, hypertension and accidents are among the issues that feature most in that category.
While for every ten death causes in the country, five of those are due to NCDs with hypertension ranking at number two as a source of death for people above 5-years-old.
According to Tanzania Steps Survey, a report by the Ministry of Health and Social Welfare, Institute of Medical Research in collaboration with WHO, more than three fifth (68.4 percent) of the population never had their blood pressure measured (men 83.1 percent and women 54.7 percent).
In the survey, a population of 24.5 percent (men 24.8 percent and women 24.2 percent) had hypertension (excluding those already on medication) upon measurement.
The same report indicates that with diabetes, results revealed that 91.1 percent (men 93.4 percent and women 89.1 percent) of the surveyed population never measured their blood glucose.
Prevalence of self-reported diabetes was found to be 1.7 percent (men 1.4 percent and women 2.0 percent)
Waziri Ndonde, exercise and health specialist from the Physical Activity Association of Tanzania says most of the NCDs can be prevented by lifestyle changes.
He says that WHO recommends 300 hours of exercise a week. “This will help people avoid spending too much time without allowing their bodies to exercise. It is important for people to make sure they manage their busy schedules and make time for exercise.”
He adds that in order for the body to be strong, there are five areas that everyone has to consider. There is body composition this includes the BMI, cardiorespiratory endurance this is the ability that the heart and lungs have to manage their work, muscular endurance, muscular strength and flexibility.
Conducive work spaces
With lifestyle changes he says, some of the NCDs are a result of severe and continuous stress. Stress at workplaces is another challenge that contributes to the increase of NCDs.
About 60 percent of working people usually spend more hours of their lives at their workplace. It is important for both employer and employees to make sure they make work place all the more friendly.
“Employers should set realistic goals that are friendly and achievable for employees and help them get time for social activities. Too much of unrealistic goals creates more tension and at the end of the day they fail to deliver. The outcome of failure is what causes stress,” says Ndonde.
Exercise and diet
If people will be able to invest more into exercise, getting a proper diet, and going for regular check-ups, Tanzania will have more chances of reducing NCDs patients.
According to WHO, in 2008, a total of 3.2 million deaths were due to lack of exercise. Deaths which are due to lack of exercise rank number four globally.
Kelvin Julius, 32, is a gym instructor at the Kevoo gym. He says the number of people enrolling themselves at the gym never remains the same.
Almost each client he enrols at the gym are those who have been instructed by doctors. Most of them are those with hypertension issues and those who want to cut down weight.
He says for the past seven years he has been working as an instructor, he has come across people who exercise for different reasons and it has never been easy for all them to reach their target as exercising has never been an easy task for people to complete.
Majority do give up in early stages while those who choose to stick around a little longer with the gym end up running away as soon as they start seeing positive results.
“For people with hypertension, I prefer to put them on aerobics for about 15 minutes a day depending on their health. If one is weak I always ask for their doctor’s contact details so that they suggest what the best way forward for the patient could be,” says Julius.
Adding to that, he says people who want to reduce weight are the ones who can be handled without much special attention as it is always known what the right exercise and proper diet plan can do for them.
Dr. Khuzema Rangwala the Ear, Nose and Throat surgeon at the Comprehensive Community Based Rehabilitation Tanzania (CCBRT) says poor lifestyle contributes to lack of quality and enough sleep not only NCDs.
He says, sleep boosts the immune system and helps with good and sharp memory. Lack of sleep comes along with fatigue that can cause stress.
An adult needs at least 8 hours of sleep. However majority spend only four to five hours as they spend time drinking and socializing.
They say prevention is better than cure. This rings true for our community and for the many that feel the weight of treating NCDs, financially and physically, it is time we re-allocate our efforts to preventative measures.