Jeffrey Moyo Features Writer
ZIMBABWE’S health services are struggling to cope with a growing tide of patients suffering from an age-old condition — diabetes. A shortage of drugs, especially insulin, has exacerbated the problem. But lifestyle and diet has contributed too, say health experts. Eating “fast foods” heavy with fat and carbohydrates, such as chips and burgers, and consuming heavily sweetened soft drinks, encourages the development of diabetes in ordinary people, and are poison to those who already suffer from the condition. Some even blame the increased consumption of imported genetically modified foods.

While Health Ministry officials in this Southern African country say they have not been able to capture annual data on diabetes patients for the past eight years due to financial constraints resulting from Zimbabwe’s economic decline, they acknowledge that diabetes is a fast growing disease that threatens the nation’s health.

But Zimbabwe is not alone. According to the World Health Organisation, the increase in the incidence of diabetes is a global problem and projects that by 2030 it will be the seventh leading cause of death, closely following cancer, HIV and Aids, malaria and other well-known killer diseases.
However, while public health services in Western nations have managed to bring this incurable disease under control, Third World countries are still struggling to provide the resources needed to combat diabetes.

This was highlighted some years ago by Dr. Luis Sambo, the WHO’s regional director for Africa at the time, who pointed out that almost 80 percent of all deaths due to diabetes occurred in low and middle-income countries.

The WHO also noted in its 2012 annual report that diabetes (among other non-communicable diseases)was more prevalent in developing countries than in richer countries.

Diabetes is basically a condition where the body is unable to control the sugar levels in the blood. When food is taken the body converts fats, carbohydrates and even proteins into glucose (sugar) that is converted into energy that the body needs by the release of the hormone insulin. Insulin regulates blood glucose levels, but if the amount of glucose in the blood is too high it can seriously damage the body’s organs.

There are two main types of diabetes: type 1 and type 2.
Type 1 diabetes is hereditary and develops as a result of the body failing to produce any insulin. For this reason it is often referred to as insulin-dependent diabetes because it requires the daily injection of commercially produced insulin to keep the patient’s blood sugar levels stable. It is also sometimes known as juvenile diabetes because it usually develops in young children or during the teenage years.

In type 2 diabetes, the body does not produce enough insulin, or the body’s cells do not react to it adequately. This is known as insulin resistance. It is usually a condition that develops later in life, but is exacerbated by lack of exercise and poor diet and is often associated with people who are overweight. Ensuring a healthy diet and regular exercise can more easily control type 2 diabetes, although, because it is a progressive condition, patients are likely to need some medical intervention later in life.

According to Isaac Phiri, deputy director for Epidemiology and Disease Control in Zimbabwe’s Ministry of Health and Child Welfare, about one in 10 Zimbabweans suffer from diabetes, but by far the majority of these — between 75 percent and 80 percent — suffer from type 2. This is similar to global statistics.

Phiri said: “Currently, diabetes statistics represent over 100 000 visits or consultations at outpatients departments every year. New cases reported in 2011 alone were over 10 000.”

Before Zimbabwe’s economic collapse, pharmaceutical companies used to manufacture insulin — the first line of treatment for diabetic patients — for local consumption.

But this has long ceased to be the case. Pharmacist Bekezela Dube said most pharmaceutical companies stopped producing insulin or closed shop altogether at the height of Zimbabwe’s economic decline.

“Today players in the local pharmaceutical sector are still struggling due to a number of factors, triggering a shortage of insulin,” said Dube.
Clemenciana Bakasa, principal director of non-communicable diseases in Zimbabwe’s Ministry of Health agrees. She said inadequate funding hampered the local manufacture of insulin and also led to the country downsizing imports of the drug.

“Zimbabwe doesn’t manufacture insulin drugs anymore, but depends on imports from other countries like Denmark and India. With limited funding, we often import insulin in very small amounts, subsequently creating shortages in the public sector,” said Bakasa.

Other health officials, speaking on condition of anonymity, said Zimbabwe used to make affordable doses of insulin prior to the closure of companies specialising in its manufacture. But this was not enough to meet demand, and even then government did not hand it out free of charge to poor people suffering from diabetes.

However, one health ministry official blamed genetically modified food for the shortage of insulin: “The consumption of genetically modified foodstuffs has added an increase to the number of people with diabetes here, resulting in local stocks of insulin failing to cope with the rising demand,” the official said.

One person who knows just how difficult it is to obtain a reliable supply of insulin these days, is 63-year-old Mildred Chimhanda from Harare’s medium income suburb of Westlea.

“I was diagnosed with diabetes 13 years ago and use insulin for treatment. But it’s not easy to get the medication nowadays,” she said.
Chimhanda said her own mother had succumbed to diabetes, which, she said, had been diagnosed as type 1, the type that is usually inherited.

Not surprisingly Chimhanda’s granddaughter, Tracey Sithole, was also diagnosed with diabetes two years ago. The frail looking 19-year-old told this reporter: “Yes, I live with diabetes and. . . at times when I evade lectures as my colleagues back-bite me suspecting I have Aids.”

One of the effects of diabetes is weight loss, if there is a consistent shortage of glucose in the blood.
But most health experts agreed that bad diet was mainly responsible for the increasing number of diabetes patients in Zimbabwe.

According to Harare-based diabetes specialist Tryphine Halimani: “People whose diet consists primarily of fast and fatty foods weigh more and have an increased risk of insulin resistance compared to people who limit their consumption of foods high in fat.”

Zimbabwe’s former Health and Child Welfare Minister, Henry Madzorera, agrees. He also attributed rising cases of diabetes to people’s poor eating habits and lack of physical exercise.

“The problem is that people’s eating habits today are causing them to be overweight.” And this, more than anything, contributed to people becoming vulnerable to developing diabetes.

Statistics from the World Health Organisation confirm this. Its 2012 annual report states that 90 percent of people with diabetes around the world found themselves developing the condition largely due to being overweight and inactive.

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