Tag Archives: Africa

Hats off to Tanzania Albinism Project

In Tanzania, where some of the oldest human fossils have been found, and where Mt. Kilimanjaro rises above the clouds, a group of international dermatologists are hoping to help a very vulnerable population.

The region has one of the highest incidences of albinism in the world. Although the condition is rare in the western world, it is quite common in sub-Saharan Africa, according to some studies. (While the incidence of this genetic condition is about 1 in 37,000 U.S. residents, the rate in this region is as high as 1 in 1,400.)

The people with albinism are also subject to discrimination, stigma and even murder.

Sun Damage to Back of an Albino Individual

But, another important concern is the health of the albinos whose pink skin is exposed to the African sunshine, and where many of the occupations are outdoors and in the field.

Many of the locals with albinism die of cancer before age 40; in fact, fewer than 2% make it to their 40th birthday. And almost all of the children with albinism show signs of sun damage before age 10.

Because of a lack of funding, many can’t afford hats to protect themselves; because of a lack of education, many don’t know the link between sun damage and cancer.

That’s according to Dr. David McLean, the secretary-general of the International League of Dermatological Societies, a nongovernmental organization affiliated with the World Health Organization.

Dr. McLean has been visiting the region for the past 2 decades, helping to establish and grow the Regional Dermatology Training Centre (RDTC), an ILDS program, in the town of Moshi in Tanzania.

He is also among a group who recently spearheaded a project to make hats — the ones with 7.5-cm rim — available to the albinism population in Tanzania. [Listen to Dr. McLean below.]

Called “Hats On for Skin Health,” a collaboration between the ILDS and Stiefel, the project is a global effort to raise funds for the purchase of hats and other protective items for albinos in Tanzania.

Sun-Protective Hat on an Albino Girl

The items will be distributed by RDTC that manages a mobile skin care clinic, which regularly visits people with albinism living in the region and educates the locals, especially parents, about albinism. The lesson they try to get across, said Dr. McLean, is to let their children play outdoors, but cover them up first.

The group has located a hat manufacturer in Moshi, which is currently producing template models for children and adults. Many of the workers, said Dr. McLean, have albinism. “We think that’s definitely part of the solution going forward,” he said.

The cost of manufacturing a hat in Africa? Less than $2.50. The hats are expected to last for at least for 10 years.
To start the campaign, Stiefel, a subsidiary of GlaxoSmithKline, has donated $25,000, and Dr. McLean hopes that dermatologists, other professionals, and even the public, get involved with the campaign.

“Our people are on the ground there. We know what happens to every donated dollar,” said Dr. McLean.

The group expects to have handed out at least 15,000 hats by this time next year. Visit www.hatsonforskinhealth.org to learn more.

(Photos courtesy of the patients and staff of the Regional Dermatology Training Centre, Tanzania.)

By Naseem S. Miller (@ReportingBack)

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With Summit Set, NCD Movement Gains Steam

During the EASD meeting in Stockholm last week, I spoke with International Diabetes Federation (IDF) CEO/executive director Ann Keeling about recent progress in efforts to focus attention on the global health epidemic of noncommunicable disease (NCD). Ms. Keeling had flown to Stockholm from New York, where she attended an NCD side panel event held during the United Nations’ 2015 Millennium Development Goals (MDGs) Summit.

Photo of Ann Keeling taken by Miriam E. Tucker

Unlike the sparsely attended UN NCD panel in April, this one was packed. “It was amazing. There were something like 200 people in the room. Senior government people were making strong statements about NCDs,” she told me.

Why the difference? In May, the UN announced a resolution—sponsored by 130 countries—to hold a special Summit on NCDs in September 2011. Just as the UN Summit on HIV/AIDS in 2001 brought attention and international aid to that cause, the NCD summit is expected to focus the world’s attention on the emerging epidemics of diabetes, cancer, heart disease, and tobacco use that are disproportionately affecting poor and middle-income nations in terms of both health and wealth.

Ms. Keeling chairs the NCD Alliance, a coalition comprising the IDF, the World Heart Federation, the Union for International Cancer Control, and the International Union Against Tuberculosis and Lung Disease. Formed in May 2009, the Alliance had lobbied for the UN NCD Summit. Now, with a year to go, it is gearing up for it. Last week the Alliance issued an official plan of action leading up to the Summit.

Over the next year, the Alliance will continue to lobby governments and the private sector to raise awareness of NCDs, including arguing the business case for investing in prevention and treatment. The fact that NCDs affect working-age adults means that economies are threatened, Ms. Keeling said. “In a generation, there will be cities full of sick people and a sick workforce. This has huge implications for competitiveness.”

The current 2015 MDGs, which do not mention NCDs, are falling short. The Alliance is calling for NCD indicators to be included in successor goals aimed beyond 2015 but not to wait until then to act, as some governments have suggested. “Why on earth would you wait 5 years? We have a real chance to intervene in Africa, where obesity and diabetes are rising fast. If we can start now, we can head off something that would be so much worse in 5 years’ time.”

Photo taken in Tanzania by Jen Wen Luoh / via Flickr Creative Commons

Two additional events last week reflect increased recognition of the importance of NCDs. The Organisation for Economic Co-operation and Development (OECD), which influences developing nations on spending priorities, issued a report entitled “Health: OECD says governments must fight fat,” describing with stark statistics the rising burden of obesity worldwide.

And last week during the Clinton Global Initiative, Medtronic announced a $1 million grant to the NCD Alliance in preparation for the 2011 Summit. That’s significant, Ms. Keeling said. “When companies and philanthropists put big pledges on the agenda, it signals what’s important.”

-Miriam E. Tucker (@MiriamETucker on Twitter)

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Filed under Cardiovascular Medicine, Endocrinology, Diabetes, and Metabolism, Family Medicine, Health Policy, IMNG, Internal Medicine, Oncology, Pediatrics, Primary care, Pulmonary Diseases and Sleep Medicine, Uncategorized

Diabetes Doesn’t Spare Sub-Saharan Africa

Contrary to widespread belief, diabetes is not rare in sub-Saharan Africa. In an article included in the June 26th special diabetes issue of the Lancet, Dr. Jean Claude Mbanya and his associates outlined what is currently known about diabetes in that region. The statistics may surprise those who are unfamiliar with modern life there.

Just as in the developed world, lifestyle change brought on by rapid urbanization—decreased physical activity and increased consumption of energy-dense and high-fat diets—is believed to be a major contributor to the rising burden of obesity, diabetes, and cardiovascular disease now being seen even in many historically impoverished nations, wrote Dr. Mbanya, president of the International Diabetes Federation (IDF), and his colleagues.

Blood sugar testing in the Democratic Republic of the Congo / Photo courtesy of the International Diabetes Federation

According to the IDF’s Diabetes Atlas, there are now about 12.1 million adults with diabetes in sub-Saharan Africa. That number is projected to nearly double, to 23.9 million, by 2030. Currently, more than a third of the population of sub-Saharan Africa live in urban areas. That is expected to increase to 45% by 2025. And by 2035, more people are expected to live in urban than rural areas.

While diabetes rates of less than 3% have been reported in rural and some urban communities, frequencies of 3%-10% have been noted in urban populations, comparable with rates in developed countries. In urban parts of Dr. Mbanya’s native Cameroon, for example, the diabetes rate rose from 1.5% in the 1990s to 6.6% in 2003.

In most of sub-Saharan Africa, existing health care systems are typically devoted to “the unfinished agenda” of communicable disease, not to chronic noninfectious conditions. There is no medical insurance or free national health care available in most countries, so patients themselves have to pay. “Thus, when an individual with diabetes cannot afford the cost of drugs, the situation could be fatal,” the authors wrote, also noting that mortality rates attributable to diabetes in sub-Saharan Africa are highest in working-age adults aged 20-39 years.

“Agents such as generic glucose-lowering drugs and antihypertensive treatments should be funded just as drugs for HIV/AIDS are, along with support for delivery mechanisms and chronic disease education and care models,” they recommended.  In addition, “A multidisciplinary, politically driven, and coordinated approach in areas of health, finance, education, sports, and agriculture can contribute to a reversal of the underlying cause of this epidemic.” Indeed, that’s a good prescription for the entire world.

-Miriam E. Tucker (@MiriamETucker on Twitter)

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Filed under Cardiovascular Medicine, Endocrinology, Diabetes, and Metabolism, Family Medicine, Health Policy, IMNG, Infectious Diseases, Internal Medicine, Primary care, Uncategorized