Life expectancy has been increasing over the past two decades across the world with several nations in Sub sub-Saharan Africa rebounding from high death rate due to HIV/AIDS.
In Botswana women have a longer life expectancy than men, living to an average of 68.4 years compared to 63.6 for men. Between 2005 and 2016, death rates from HIV/AIDS decreased by 42% and malaria by 43% while Pre- birth complications and maternal disorders decreased by 30% and 29% respectively. However, this progress is said to be threatened by increasing number of people suffering health challenges related to obesity, high blood sugar, alcohol and drug abuse. This is according to a health research conducted at the University of Washington’s Institute for Health Metrics and Evaluation (IHME).
The study, which examined the Global Burden of Disease (GBD), injuries and risk factors, the years that one lives in good health and those that one lives with an injury or illness, analyzed 300 illnesses and injuries in 195 countries between 1990 and 2016. The results were published on Thursday in the journal, The Lancet.
For most countries, changes in healthy life expectancy for males and females between 1990 and 2016 were positive, but in dozens of others, including Botswana, Belize and Syria, healthy life expectancy in 2016 was not significantly higher than in 1990. Healthy life expectancy takes into account not just death rates but the impact of non-fatal conditions and considers years lived with disability and years lost due to premature mortality.
According to the study, in 2016 Botswana’s disease burden was found to arise from unsafe sex, high fasting plasma glucose, high systolic blood pressure, high body-mass index and alcohol use.
HIV, respiratory infections, diarrhea and tuberculosis were the diseases most prevalent among men. For women, lower respiratory infections (such as pneumonia and bronchitis), and congenital anomalies were the most prevalent illnesses. Congenital illnesses are conditions that one is born with, which can affect one’s development and general well-being.
Maternal and child Deaths
The study has also found that from 1980 to 2016, giving birth has gotten less safe for mothers in Botswana. The ratio of maternal deaths grew from 74 per 100,000 live births in 1990 to 118 in 2016. Globally, the ratio of maternal deaths fell 30% over the same time period, from 282 to 196 per 100,000 live births. One of the co-researchers of the study, Dr Charles Shey Wiysonge, said it was encouraging that Batswana are living longer. However, he lamented that the high number of maternal deaths, “have overshadowed significant gains against HIV/AIDS”.
Dr Wiysonge is a GBD collaborator from South Africa who serves as a Professor of Clinical Epidemiology at the Faculty of Medicine and Health Sciences, Stellenbosch University. Dr. Nicholas Kassebaum, Assistant Professor, IHME said, “in many nations, improvements in maternal health are accelerating, but in others, women face daunting challenges, including the absence of trained professionals to assist with pregnancy and childbirth, and deal with life-threatening emergencies. As a result, reproductive health care must be a higher priority, including the expansion and improvement of reproductive health and family planning services and, for complications in childbirth, more advanced obstetric care.”
The study says that in 2016,1550 children under the age of 5 died, a ratio of 28.2 deaths per 1,000 live births. This ratio has been falling by 2.6 % each year since 1990. On the global level, 5.8 million children under age 5 died, representing a 52% decline in the number of under-5 deaths since 1990. In 2010 for example, the highest risk factor to good health among children under the age of five was being underweight, while among those aged between 15 and 49, the highest risk factor was alcohol abuse.
The researchers also examined the role that socio-demographic status – a combination of income, age, fertility rates and average years of schooling – plays in determining health. They noted that socio-demographic status is much less responsible for the variations seen for ailments, including cardiovascular disease and diabetes.
“Factors including income and education have an important impact on health but don’t tell the full story. Looking at healthy life expectancy and health loss at the country level can help guide policies to ensure that people everywhere can have long and healthy lives no matter where they live.” said IHME Director Christopher Murray.
BoMRA warns of cancer-causing impurity
Botswana Medicines Regulatory Authority (BoMRA) is investigating if ranitidine, a common heartburn medicine, has a chemical contamination, which could cause cancer.
The drug is also known as Zantac, Uptake, Austin and R-Lok.
BoMRA issued a warning recently following an announcement on September 13, by the US Food and Drug Administration (FDA) that it had learned that some ranitidine medications, including those known by the brand name Zantac, contain low levels of N-nitrosodimethylamine (NDMA), an impurity that could cause cancer.
NDMA is a possible cancer-causing chemical linked to liver damage. Since last year, the FDA has been investigating NDMA and other impurities in blood pressure and heart failure medicines known as angiotensin receptor blockers or ARBs. However, the FDA cautioned that levels of the NDMA appeared low and not much higher than when the chemical is present in foods like processed or grilled meat. The FDA said: “Although NDMA may cause harm in large amounts, the levels the FDA is finding in ranitidine from preliminary tests barely exceed amounts you might expect to find in common foods”.
Over-the-counter ranitidine is approved to prevent and relieve heartburn and can be prescribed to prevent ulcers of the stomach and intestines. In a statement, BoMRA told people they could still keep taking the medicine or ask doctors to prescribe one of many drugs that treat heartburn or ulcers. The health product watchdog cautioned patients who had been prescribed Ranitidine from stopping without an alternative, advising patients instead to talk to their health professionals before they stop or switch to other medicines.
“BoMRA is urgently liaising with the registered suppliers of ranitidine-containing medicines to investigate the presence of NDMA in Botswana ranitidine products; and will update the public on the outcome of these investigations,” reads the statement.
BoMRA Spokesperson, Israel Kgosidiile said there is no evidence at this stage that the impurity has caused any harm to patients.
“There is no recommendation for patients who have ranitidine to stop taking it. If a patient has any questions they should speak to their doctor or pharmacist,“ he stated.
‘Cancer took away my boobs, not my life’
Sun Health: What events led up to your diagnosis, or, how did you discover that you were suffering from cancer?
Mpho Kgaodi:My journey with Breast cancer started in 2012. Around April I felt a lump on my right breast. It was not painful at all, just slightly itchy. It was on the upper part of my breast. I ignored it for about three days but it kept nagging me and then I decided to go see my doctor. He also confirmed that there was a lump on my breast He sent me for mammogram that confirmed an abnormality on the structure of my right breast. I then went to see him with the results and he informed me that there are two ways to test that lump – Biopsy, which meant that he will be taking a piece of that lump to send it to the laboratory for examination and the other option was to totally remove the lump, Lumpectomy. I decided that he removes the whole lump, because I really didn’t want that Lump on my breast.
SH: We know that about 10% of all breast cancers are hereditary. Are there other women affected in your family?
MK: I don’t know of any other woman or even man in my family who has had cancer, though it is hereditary.
SH: What were your first thoughts when you received the diagnosis?
MK: I cried for a brief moment. I was overwhelmed with emotions, fear of death. I quickly recovered from that dreadful thought and remembered that I have a great husband and three boys. I felt that I had so much to live for.The doctor informed me about the options I had regarding treatment and he gave me time to think about it. I drove back home to Lobatse and by the time I arrived at my house, I had already made up my mind that I am going for total removal of the breast. I broke the news to my family and they were just as shocked as I was when the doctor broke the news to me. I explained to them my decision to go for surgery and they were very supportive. Few weeks later, I went for a mystectomy.
SH: How long were you in treatment
MK: The surgery was followed by Chemotherapy. The first time I walked into the oncology centre, I found so many people there already. I then realised that I am not the only person with cancer, it is so many of us. It gave me strength and courage. I had heard that the side effects of chemo are brutal, seeing those people made me realise that if others can do it so can I. I decided to go for it as I had so much will and spirit to stay alive and raise my kids. After the second session of chemo, I started losing my hair, nail beds turned black. I was never discouraged though, despite my aching body and the constant nausea after chemo. I had six cycles of it. In 2013 around April again, I experienced severe pain on my left breast, but with no Lump. My doctor again recommended I go for a mammogram. It confirmed cancer which was still at stage 1. I then insisted that they remove the breast. I would lose both my breasts but I knew staying alive for my boys was more important. Other people thought the pain was psychological, and I knew what I felt and my mind was made up. I had the second mastectomy and had to go through another cycle of chemo which I completed. I am now on oral medication. I take my tablet daily. It is recommended that I take it for ten years. I have just started on my year 6 on the tablet. I do go for regular check ups, to establish if the cancer is not back.
SH: What helped keep your spirits up and gave you support during this period?
MK: A good friend of mine and colleague told me about Journey of Hope Botswana. He introduced me to them, and I had tremendous support from them. I also went to Cancer Association Botswana to introduce myself. My family has also been my backbone, supporting me through it all. I am so greatful. On days that my spirits are low, I always take my mind to positive thoughts. I try to remind myself of the good times, sometimes I even find myself laughing out loud.
SH: How has this affected you at a psychological level?
MK: My life has not really changed for the worst. Like the saying “when life gives you lemons, make lemon aid out of them”. I lost my job after the second diagnosis of cancer. While this affected my family financially I never got discouraged, as this gave me time to take care of my family. I am a full time stay home mom. I walk this journey with my family. My boys understand that I had Cancer but now I am okay. They sometimes check if I have taken my medication, and they would even ask about my next appointment. I am blessed to have them.
SH: Facing the diagnosis of breast cancer is one of the most feared experiences in our society. What has been your experience as you worked with communities through Cancer Association of Botswana (CAB)?
MK: Working with CAB has been eye opening. Through motivational talks and other actives like the annual stiletto walk, the message has been positively received. There is still a lot to be done though, especially to make people understand that breast cancer is NOT a death sentence. So many lives can be saved.
SH: Amongst raising awareness, cancer awareness month is about celebrating individuals like yourself and their triumphs over cancer. Is there anything you would like to say to the community of cancer survivors and women in general?
MK: I have learnt so much from being diagnosed with cancer. I appreciate life more. I never used go and see a doctor without any pains or any thing “wrong” with my body. Now I do it regularly and so far I always get a clean bill of health. I encourage everybody to do regular self -breast examination. It is easy, convenient, cost-effective and can really help with early detection. I believe there is a lot to be done as far as breast cancer awareness. Remember men can also have breast cancer.
To all those who are going through cancer at the moment, remember you are not alone. Let’s walk this journey together. Let’s walk with Hope, Courage and Strength. There is life after cancer. Cancer took away my boobs it did not take my life. As October is breast cancer awareness, let’s support those affected, honour the survivors and remember the fallen.
PINK RIBBON ALWAYS
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