The change in habits and sedentary of the middle -class urban population also implies a threat to health in Africa.20 million people are affected in this disease.Many in the east, and without diagnosing.But no measures are taken.
Diabetes thrives in Africa and currently affects more than 20 million people.While this advance is also given in other places on the planet, the African case awakens special suspicion, since many of the patients do not have access to public health or, if they have it, they are not aware of the danger that entails and abandons thetreatment.
While diabetes rarely endangers the lives of people in rich countries, it is estimated that in the poor, 80% of the patients die due to complications derived from the condition.In addition, recent studies warn that diabetes and the consequent weakening of the immune system can be great allies of tuberculosis, one of the most deadly diseases in the world.“Diabetes never comes alone in poor countries.When patients arrive at the hospital, they often also have HIV, hypertension and tuberculosis.When these diseases occur together it is very difficult to treat them, ”says Dr. Fayez Maged, an emergency doctor at the Nairobi Co -Co -hospital.
In addition, the economic development of the region is severely affected by this ailment.It is a scourge for the productive force of the continent, since the age strip it usually affects is crucial for the growth of the area.Last year, according to the International Diabetes Federation, approximately three out of four dead by diabetes south of Sahara were less than sixty years old.
In the specific case of East Africa, the percentages of the diagnosed population are not apparently very high, but when the real number of people and the age strip of those affected are observed, the alarms are triggered.In Kenya, according to the director of medical services of the Ministry of Health, the percentage of diagnosis diagnosed in 2013 reached 4.2% (1.6 million people).A figure that does not represent, at all, the real amount of affected in the country, says Dr. Maged."The disease is much more widespread, although there are numerous cases that are not diagnosed," he says in his emergency consultation while the dripping of patients they knock on the door is constant.
Although Kenya has become the fourth economy of the continent, evidence of the few resources destined for both awareness and diagnosis of patients, according to Maged, is that “many people do not know that it is diabetic, it reaches theConsult with necrosis in the extremities and you have to amputate them. ”
ESTE-AFRICAN DIABETES BY COUNTRIES
The money dedicated to the prevention, awareness and control remains scarce throughout the region.According to an article published by the Medical Magazine of South Sudan, the expenses for the treatment of a single patient with type 1 diabetes in East Africa are about 184 euros per year, of which almost 70% is used for purchaseof insulin.But there is no public budget dedicated to prevention.
In the waiting rooms of most Nairobi hospitals, the International Diabetes Day, held on November 14, is noticed by the distribution of pamphlets in exhibitors and tables.It is an initiative of the Danish pharmaceuticaltreatedHowever, when asked Michelle Usaji, who awaits his turn to treat his daughter of a few months for a severe fever inThe Kenyatta National Hospital does not seem to be very aware of what it can mean."I think malaria or tuberculosis are more worrying," he says.
The lack of awareness about its consequences is, surely, the most serious problem of all.Even more than access to your treatment.It is true that, the load that can be supposed for an average African (whose salary is not usually more than 400 dollars per month) having to deal with the health costs of this disease is enormous.However, insulin acquisition is not the main problem, since sometimes, it is acquired for free.
Dr. Fayez Maged believes that there is a lax local perception of diabetes that is given by the invisibility of the disease and the lack of resources dedicated to education in this regard.“People know that it is bad, but most people are not aware that it is something they should be worried about.The disease remains in the shadow of the main causes of death: HIV, traffic accidents, tuberculosis and violence.They will always put it behind them, ”laments the Egyptian doctor for Kenya for three years.
And it does not seem that states are alert to the severity of the situation.In the medical sector, there are those who regret that governments, many times, take the opportunity to do awareness campaigns.“Last year we put an ambulance to do free tests on the street.But we had to pay a lot of rates to the government, although it was a service we offered to citizens, ”explains Maged.
Another of the problems facing the doctors in the area is that, the deficiency of public health systems makes the poorest population, especially the rural, continue to go to healers and herbs to combat diabetes.WHO estimates that in Africa, more than 80% of the population uses traditional medicine as an alternative to conventional medicine.But from the framework of modern states there is no great place for this type of approach, or for adequate coverage of the disease.
Rwanda .It could be the most successful case in the area, although not optimistic.The country has death figures because of the lowest diabetes in the area: just over 5,000 people of working age.The Rwandan State covers 90% of the treatments and dedicates part of the public budget in prevention.
Tanzania .It has the highest rate of deaths from diabetes.In last year more than 47,000 people over twenty years old died from this disease.Although the government pays all treatment costs, health prevention or healthy life models is not enough.
uganda .With a lot of work to do to alleviate the figures of patients.According to official figures, more than 21,000 people died last year in adulthood because of diabetes.Similar data to those presented by Kenya, where the number of annual deaths amounts to 20,000.One of the causes of death in both countries is the difficult access to health, which is not universal.Actually, both the Uganda and Kenyan state cover less than 50% of the treatments through subsidies to public hospitals.But in countries where poverty rates are so alarming-assuming 24.5% in the Ugandés case and 45.9% in the Kenyan case-it is obvious that there are no private insurance for everyone, and that therefore, a greatPart of the population is left without access to diagnosis and treatment.
The situation of many families in the region is so dramatic that they often have to choose between paying diabetes medicines, feeding children or sending them to school.Dr. Madrid María Ferreira, established in Kenya forSeveral years, he says without much surprise that “many times, families that have access to diabetes medication through private insurance provided by the companies where they work, resell it to the black market.If you have to choose between taking the medication or feeding your children, it is obvious that you will feed your children with the money of these medications. ”
All this makes the majority of sanitary workers dedicated to the subject pessimistic in terms of the progress of the disease in the area.“They are not just states.Another problem is that NGOs working in the health sector only dedicate resources to certain diseases such as HIV or tuberculosis.But while they concentrate on this, there are many other diseases spreading.Among them, is, ”says Dr. Maged.
The westernization of habits as a risk factor
Although there are several risk factors of the disease - like the genetic background - one of its main causes is related to population habits;And the local diet in East Africa is not exempt from sin.The feeding of the area is based on the Ugali (a kind of puree made with flour and water), the mandazi (a kind of fried bump in a triangular way), the rice and the chapati (the bread of the East Africa).A combination rich in carbohydrates and poor in proteins, fruits and vegetables, which often does not provide the amount of sufficient nutrients for what WHO considers a healthy and balanced diet.
Wangechi Atieno, a twenty -eight -year -old home worker, travels a minimum of three hours in Matatu (the local bus) every day to go from his home, in the Nairobense suburb of Kikuyu, to the Kileselshwa neighborhood.“Normally as a mandazi and tea with spices for breakfast.Before entering work, such as Ugali with spinach or reds with corn.That gives me energy to face the work day, ”he says while waiting at the bus stop that takes her back home.
But in recent years, the introduction of Western food guidelines has worsened the quality of life of the Africans in the area.The so acclaimed the middle class boom in Africa in general, and in Eastern Africa in particular, has come from the hand of a growing urbanization and a sedentary life.But also culinary tastes have varied with the westernization of the urban population."You can find Women's Sausage Saus Funhering Words everywhere," warns Dr. Maged."What counts is to fill the belly in the cheapest way," says Dr. Ferreira.
The opening of hundreds of chain franchises such as the American KFC, Subway, Domino's Pizza or Mc Donald's is already a palpable reality of the urban landscape of the continent.French fried potatoes, fried chicken, hamburgers and pizzas have become the favorite food of young people in the region, next to the cakes and sweets of chains such as Java House or Dormans coffee shops, or any of the local imitationsof these.Also several alcohol brands have opened venues in capitals such as Nairobi, contributing to chronify obesity and diseases such as diabetes.
“When the weekend arrives, I take my family to the mall.My children love fried potatoes, hamburgers and soft drinks, so we spend the day there, we see some movie in the cinema and take the opportunity to make the purchases of the week, ”says Dickson Obama, computer technician and family father.
However, the situation of diabetes in East Africa does not seem promising.Doctors are making a brutal pulse against local governments, NGOs, food sector companies, traditional beliefs or daily practices of the poorest.And in the words of Dr. FerreiroIt is clear that the matter goes far beyond improving simple sensitization about the disease."How to amend the habits of a kibera child who can eat up to a battery?"It is, once again, the fight against poverty.
