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80 000 people in Botswana have Diabetes

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Diabetes has increased in Africa between 1990 and 2015 due to rapid development and urbanisation, which were seen as a boon among economists, but now has health experts worried for the future.

Mauritius leads the pack of countries with a high diabetes prevalence rate of 17 percent, which is two to five times greater than rates in the other African countries according to a report released on Monday by the Institute for Health Metrics and Evaluation (IHME). In Botswana, 80 000 people (about four percent of the population) suffer from diabetes and there are many more who are undiagnosed, reveals Chairman of Diabetes Association of Botswana (DAB), Dr. Joel Dipesalema.

Two and firty children with diabetes are registered with the association. There are three types of diabetes: type 1 diabetes (a condition where the body stops producing insulin, an essential hormone produced by the pancreas to convert glucose into energy); type 2 diabetes (a condition that develops over time where the body is unable to use insulin properly); and gestational diabetes (a form of diabetes that occurs during pregnancy due to hormonal changes, genetics and lifestyle factors). About 90 percent of Batswana have type 2 diabetes according to Dr. Dipesalema, however many of these cases go undiagnosed as there are very few symptoms initially.

Symptoms for diabetes include fatigue; excessive thirst and urination, slow wound healing and skin infections, blurred vision and regular bouts of thrush. As these symptoms can be very mild and develop gradually, many people fail to recognise them as warning signs of diabetes. “It takes on average seven years for a person to get diagnosed with diabetes for the first time,” Dr. Dipesalema said. “Sadly, the result is that a lot of people with type 2 diabetes have already developed complications by the time they are diagnosed.” Diabetes complications are serious and include heart disease, stroke, blindness, amputations and kidney failure. In most cases these complications could have been avoided entirely by early diagnosis and proper treatment. Diabetes is seen as one cause of disability that greatly affects the future development and the use of resources of African states. This is because a diabetes patient requires three times more health resources than a non-diabetic, according to the International Diabetes Federation.

Globally, 366 million people have diabetes. The International Diabetes Federation (IDF) predicts this number to rise to 552 million by 2030.The greatest increase in diabetes is expected to be in Africa. It’s predicted that the incidence of diabetes in Africa will have almost doubled by 2030. The main causes for this dramatic rise are urbanisation and obesity. Dr. Dipesalema said a lot of people are migrating from rural to urban areas in pursuit of work and better opportunities. In a short time their lifestyles change dramatically: they adopt a westernised diet high in fat, sugar and salt, and get far less exercise than they were used to. Cultural beliefs also play a big role.

According to registered dietician Oarabile Ngwako, many African communities still see weight gain as a sense of achievement. “It signifies dignity and respect, and shows that you are enjoying wealth and a good life. Being thin is also associated with hardship, trouble at home and serious illnesses such as TB or HIV/Aids.” This weight gain leads to overweight and obesity, which is a great precursor for type 2 Diabetes. Ngwako advised that diabetes could be prevented through reduction of sugar intakes like canned drinks, putting a stop to tobacco smoking and incorporating healthy meals into diets.

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Healthcare system to improve

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The Health ministry has developed a seven-point programme to guide the country in improving the healthcare system, says Minister of Health and Wellness, Dr Alfred Rabashemi Madigele.

“The seven priority areas will serve as a roadmap and a guardian angel towards improving the overall healthcare system and increasing access to health care while fighting the burden of disease that confronts us,” said Madigele at Masa Square Hotel on Tuesday.

The focal areas include decentralisation; Universal Health Coverage, Tertiary Care, Strategic leveraging on the Private sector; Supply Chain; Research as well as Staff welfare and accountability.
Point-one of the seven priority areas according to Dr Madigele is about empowering the District Health Management Teams (DHMTs) and transforming them into fully fledged Regional Health Authorities.

“In this case, they will be rationalised from 27 to 18 and have the authority to hire A and B Scales, promote up to C1 and manage micro procurement,” he said. Point two is about improving the quality of healthcare services. “The main causes of mortality and their risk factors in Botswana are Primary Health Care issues,” Dr Madigele said.

He added that “Our efforts for the attainment of Universal Health Coverage should thus focus on: Prevention; Comprehensive screening; Early treatment; and Surveillance at the community.”
This he said, would require revamped grassroots efforts in which adequate numbers of community health workers through partnerships with the non-governmental sector will be deployed as necessary.

According to Dr Madigele, the top five causes of death in Botswana in 2017 were HIV/AIDS, Ischemic heart disease, stroke, lower respiratory infections and Diabetes. He said compared to 2007, NCDs among these had increased in burden by an average of 34%. The top five risk factors related to these causes of mortality were unsafe sex; poor diet; high blood pressure; alcohol abuse and tobacco use.

Improving the quality of care, Madigele said will also include the safety and security of patients; attitudes of staff as experienced by patients; time taken in queues either before seeing a health worker or receiving medication and the availability of drugs.

Meanwhile, the health minister revealed that the commissioning of Sir Ketumile Masire Teaching Hospital (SKMTH) is ongoing with the facility scheduled for opening on April 24th. “This will be a phased approach commencing with some services including paediatric oncology, internal medicine, rheumatology and endocrinology, diagnostic radiology, laboratory services and pharmacy”.

A phased commissioning of SKMTH will reduce overdependence on South Africa for referrals, reduce costs and also institutionalise provision of super specialist services within Botswana.

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JUST PROPAGANDA

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Dr Pelonomi Venson-Moitoi has refuted claims that she is under the radar of the Financial Intelligence Agency. Dr Venson-Moitoi who pulled out of the Botswana Democratic Party (BDP) presidential race at the eleventh hour, was last week reported to have had her accounts frozen because she was being investigated by FIA.

It was alleged that the freezing of the accounts would have a negative bearing on her campaign as she could not access her funds. Responding to enquiries on the issue during a media briefing in Kang Village, Dr Venson-Moitoi said the allegations were far from the truth.

According to the former cabinet minister, all her accounts were clean and she was accessing her funds without any challenge. “The person who was saying all those things was lying. My accounts are clean as we speak. I was never confronted by FIA or anyone. As far as I know I am not under any investigations,” she said.

Linked to that, it had emerged that Dr Venson-Moitoi’s campaign was being funded from outside the country especially by the some rich families in South Africa. Reports then suggested that her source of funding was blocked through the intervention of FIA, and that even her accounts were frozen. She dismissed the reports as propaganda that was perhaps spread to soil her campaign.

“I am clean. This is why I am never mentioned in missing funds from National Petroleum Fund or those of Capital Management Botswana,” said the Serowe South Member of Parliament. Last month Dr Venson-Moitoi had reported to the Directorate of Intelligence and Security (DIS) Director General Peter Magosi that she was not happy that she is being followed around the country by security agents.

Magosi dismissed the claims on grounds that his organisation is not the only one that uses private motor vehicles.

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