This week a friend of mine confided in me that she had not been sleeping properly. Apparently, in recent weeks she had been having unexplained headaches and had found out that her blood pressure was slightly high. More importantly, her diastolic blood pressure was more elevated than normal. Incidentally, she had a family history of cardiovascular conditions. I inquired whether she has had a conversation with anybody. To my surprise, she was unwilling to have a conversation because, in her view, a diagnosis of high blood pressure at her age was an exception.
This conversation lead to a decision to try and understand why as a country we still struggle to have conversations around chronic diseases. I will, therefore, want in this piece to put out some key facts about a number of chronic diseases and why we need to start having open discussions about their prevalence. Data available from the Ghana Health Service indicates that, between 1988 and 2007, the number of reported new cases of hypertension in the country’s outpatient public health facilities increased by more than 1,000 per cent. Since then the numbers have been consistently increasing. Sadly, estimates indicate that in most urban areas less than 10 per cent of people with high blood pressure are aware. Of those with clinically diagnosed hypertension, only 5 per cent are managing to achieve consistent blood pressure control.
According to the International Diabetes Federation, it is also estimated that undiagnosed diabetes accounts for about 70 per cent of those with the disease in Ghana. Similar accounts can be given for other chronic diseases like angina, glaucoma etc. Based on the data I have started asking myself why we are unaware of our health status as a people. Conversations I have had with others point to a number of reasons. Primarily amongst these reasons is a lack of education on chronic diseases and a tendency for many with these diseases to feign ignorance or live in denial. Also, some are unwilling to discuss their health status to the point that talking about it is greeted with hypocritical scorn. As a result, many prefer to live in oblivion. I have thought considerably about this situation and have decided to use my own story as an example to help lift the lid on discussions around chronic diseases.
History has it that my great grandmother was blinded for a long while before she passed away. In fact, I remember her brother who was blinded and lived in my paternal hometown. My first memories of village folk tales were around the fact that many in my dad’s family lived extremely long lives but eventually went blind. This, to the village folk, was a curse that meant people had to marry into that family with caution. As fate would have it my grandmother and her sister after whom I was named were blinded in old age too. As I type, my dad has lost his sight too for close to a decade. Before any reader would go down with the superstitious line that has transcended my paternal family for over two centuries, I must state clearly that it was due to a genetic defect that predisposes us all to glaucoma. Thankfully, our generation empowered with this vital information is taking steps to ensure that our eye pressures are monitored. This is to ensure that the so-called family curse succumbs to the power of science. The family curse of blindness is not due to witchcraft or sorcery but to our genetics.
Truth is many chronic diseases have a genetic predisposition. It is known that blacks generally are more likely to suffer from hypotension in midlife than other races. It should therefore not be an embarrassment for anyone in midlife to routinely check whether they have any underlining chronic disease; especially in our country where genetic data and family medical histories are hardly correlated. It is also not an issue to speak about having any of these underlying conditions openly.
It is important to note that the mean age at which hypertension, just as an example, is diagnosed in Ghana is 36 years and that majority of those over this age with a clinical diagnosis will be on some form of medication. It is therefore not embarrassing for one to be diagnosed or for one to be on medication. In fact, many of those in your age group, with whom you may be having a conversation, are either taking medication or are among the sizeable number who are walking time bombs with chronic diseases they are unaware of. Do not let their hypocrisy make you feel embarrassed. Ignorance is not a sign of superior genetics but naivety.
Our society would benefit tremendously if we decided to have open and honest conversations about these things. The amount of peer support that this can generate is unimaginable. It would also ensure that side effects and other unpleasant effects of the disease or prescribed medication are explored and addressed. It cannot be right that in an era of abundant information our generation will conspire to die out of ignorance than to stay healthy based on information.
I have chosen to speak out about my own chronic disease not because I enjoy talking about it but because it is a reality I have to live with. A battle I have to consistently fight, a fight I know should I lose I would succumb to the folkloric family curse and contribute to the spread of medical oral literature without any scientific basis. I am also aware that the cycle of blindness can be broken and I am pretty determined to give this fight my best shot. In doing so I have chosen to use this article to encourage all those who may have been diagnosed with one chronic disease or the other, to come out openly and tell their story. These stories over time could become the catalyst that would ensure our society begins to confront this new frontier that threatens our life expectancy.
To my friend who decided to confide in me, I have this advice. Speaking up was a good thing, you are not an exception, at your age you are actually the norm. With this vital health knowledge, you are well prepared to take your destiny into your own hands and live a fruitful well-balanced life. In my practice as a pharmacist, I am aware of many who have lived with chronic diseases for close to five decades with little impact on their activities of daily living or quality of life. You should be thankful that you know what lies ahead of you. With a bit of luck and concordance, you have a much better advantage than many who have little idea what their chronic disease status is. For this, you must be thankful.
If you are a reader who has reached this far and are in midlife with no idea what your chronic health status is, get yourself checked. Do not live in ignorant oblivion and become a statistic of the fierce chronic disease creep. It is not a smart thing to do, and the implications on you and your loved ones can be immense. Always remember these diseases strike when least expected and when they do, they are lethal. Let us all have the courage to speak up and not wait till things go wrong.
By Kwame Sarpong Asiedu