Addressing continual fight against NCDs

A person is taken through the screening process during Kigali Car Free day check-ups. / Courtesy

Chantal Mukeshimana, a resident of Kigali, last week was given a shocking revelation about her health. The 56-year-old says she randomly decided to take part in the car-free zone exercises, and also get screened for non-communicable diseases (NCDs).

She told herself that since she wasn’t busy, she would go get tested. The results, however, showed that she was diabetic, something she did not expect. She is thankful to the government for coming up with this initiative because, ‘it saved her life’.

Another case is Peter Nkiranuye, a 27-year-old who was also diagnosed with high blood sugar levels.

“At my age, I didn’t expect or even think I would have any illness, let alone NCDs. I used to ignore screenings and, I didn’t have any warning signs concerning my health,” he says.

Nkiranuye says that although he thought he was healthy, it is clear there was something he wasn’t doing right. He urges people to always take advantage of the government screening initiatives to get to know where they stand as far as their health is concerned. The two were taken to Muhima Hospital for proper treatment.

In Kigali, seven sites were set aside for the purpose of screening people on NCDs. Other places include Nyarugenge, Gasabo, and Kicukiro districts.

Organised by the City of Kigali and Ministry of Health, the campaign, which started early last week, aimed at raising public awareness on NCDs and how to avoid and manage them. They also tackled the importance of early diagnosis.

The campaign ended on Sunday May 19 during the Car-Free Day which takes place twice a month.

The screening is done mostly on hypertension, diabetes, and body mass index.

According to Louis Grignon Ngabonzima, the site coordinator at car-free zone, they have around 700 participants at all sites.

He says Mukeshimana and Nkiranuye needed immediate medical attention and they were assisted. 

Aside from high blood sugar levels, he says many people were at risk of obesity, meaning that their body mass index is not in the normal range.

“This is due to the sedentary life many people in the city are living, where they spend more time working with little to no physical activity,” he says.

Poor nutrition is also a factor because the same people in most cases rely on fast food or food from restaurants because of limited time to prepare healthy food at home,” he says.

Alphonse Mbarushimana, the project manager of the CFD initiative, says after screening they also provide counselling and advice on how to live a healthy lifestyle.

“We provide counselling to everyone despite their results and if found with any health problems, we take them through what they need to do depending on the information we get from them,” he says.

WHERE DOES THE COUNTRY STAND ON NCDs?

According to recent statistics from Rwanda Biomedical Centre (RBC); overall, the Rwanda NCD survey found that 2.8 per cent are obese, 14.3 per cent are overweight and 7.8 per cent underweight.

Obesity is prevalent in the age group 35 to 54 and females account for 4.7 per cent. Additionally, the prevalence of obesity is more predominant in urban areas with 10.2 per cent and Kigali City with 7.7 per cent.

Edison Rwagasore, Senior Officer — Diabetes, Chronic Diseases and Other Metabolic Diseases at RBC, says in Rwanda, 15 per cent of the population had raised blood pressure and this proportion increased to 40 per cent  for those in the 55 to 64 year age group; making raised blood pressure the most common NCD risk factor for this age group.

He adds that most people with raised blood pressure and blood sugar were undiagnosed and therefore were not on medication.

According to him, this is alarming because many people live with these diseases unknowingly and only show up at health facilities when the conditions are in advanced stages.

“The number and prevalence of people with diabetes is rapidly increasing in low and middle-income countries. For instance, in Rwanda, one in 20 people have diabetes but many are yet to be diagnosed,” he says.

People receive free screening for NCDs.

Rwagasore adds that globally, one in two adults with diabetes is undiagnosed mainly due to a combination of a number of factors, including low awareness among the general public and slow onset of symptoms or progression of type 2 diabetes.

The condition, he says, may remain undetected for many years, during which time complications may develop.

“This calls for people to always make a point to be screened whether they feel sick or not,” Rwagasore says.

He notes that the economic growth observed in Rwanda is associated with rapid urbanisation, and the westernisation of the lifestyle, including a change in diet, leisure activities and working conditions.

Private Kamanzi, a nutritionist and dietician at Amazon clinic in Remera, says NCDs are largely driven by four main modifiable risk factors.

These, he says, include tobacco use, unhealthy diets, physical inactivity, and use of alcohol.

He says there is a need for primary healthcare as a preventive measure by raising NCDs awareness, their risk factors, their complications, and early detection that will ensure early management.

From his point of view, Dr Rwagasore says this radical change in lifestyle is projected to trigger an unprecedented increase in NCDs, including diabetes, hypertension, and cancer.

Since 2016, the City of Kigali, through the programme ‘Ubuzima Burambye’ (long healthy life) Belgian Development Agency in partnership with the Ministry of Health and Rwanda Biomedical Centre, Rwanda Association of Diabetes, Rwanda Cardio-vascular Foundation and WHO, organises once a year a one-week mass campaign on NCDs.

The data on the screened population showed that many citizens participated in the mass campaign: 3,606, 2,147, 5,614 participants were screened in 2016, 2017 and 2018 respectively.

The 2017 mass campaign data analyse report showed that the majority of participants, 65 per cent were male, 71 per cent were less than 45 years old and 45 per cent were from Nyarugenge District when its population represents 25 per cent of Kigali.

Concerning the risk factors, the data indicates that 36 per cent of people were overweight and obesity affected 11 per cent of participants.

All this, Dr Rwagasore blames on the unhealthy lifestyle people are exposed to, given that there is a lot that has been done when it comes to awareness.

In 2017, the current smokers were at six per cent; participants with harmful use of alcohol were at 36 per cent. From the blood pressure screening, the proportion of any type of elevated blood pressure was at 24 per cent.

Mbarushimana says during their counselling sessions, when sharing their lifestyle, most of the people are at risk of developing these diseases because of the things they are exposed to.


THEIR VIEWS

NCDs are a serious global burden which should be everyone’s business. Mitigating the effects of modified risk factors as the critical key to combatting the burden of NCDs is ideal.

Effective prevention and control of NCDs can never happen without sustained engagement across multiple sectors. All people living with NCDs should continue taking their medication to avoid any complications which may arise.

Prosper Dusengeyezu, Public Health Officer - Rwanda Pharmaceutical Students Association

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When it comes to preventing NCDs, I think people should strive to eat healthy. This doesn’t necessarily mean that one has to be rich to eat a balanced diet. There are many cheap and affordable foods that can be found locally and people can grow them at home in small gardens.

Yvette Nkurunziza, third-year medical student

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Parents today have busy schedules, making it hard to sit down to homemade meals every day with their children. Many children’s diets involve takeout foods which are unhealthy. Following up on their children’s diet on a daily basis is important, if this doesn’t happen, unhealthy foods can have a negative effect on their health, even when adults.

James Mugume, Executive Director of Health Alert Volunteers - Rwanda NCDs Alliance Volunteer

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Many strategies have been put across to reduce new cases of NCDs. However, there are still some challenges, such as people not having enough information concerning risk factors. The misconception among some people that NCDs are for rich people is also another challenge when it comes to eradicating the epidemic.

Othniel Nimbabazi, Country Representative - Young Professionals Chronic Diseases Network

editor@newtimesrwanda.com

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