Experts have identified Non-Communicable Diseases (NCDs) as the leading cause of death worldwide, saying they present a huge threat to health and development. At the second edition of the Positive/Wellness Summit organised by Sickle Cell Advocacy and Management Initiative (SAMI) to mark its 15th anniversary, the experts maintained that the federal government, financial, health and private sector’s involvement is needed in tackling the burden. Aderinsola Bamidele reports.
More often than not, according to experts, some Non-Communicable Diseases (NCDs) were caused as a result of individual lifestyles which could have been prevented had they been educated and aware of the consequences of their choices.
They reel off tobacco use, physical inactivity, indiscriminate alcohol intake and unhealthy dietary patterns as the major behaviours that cause NCDs. Also, living in a toxic environment, air pollution and inhaling of second-hand smoke are also contributory factors for NCDs.
According to the World Health Organisation (WHO), the main types of NCD are cardiovascular diseases (such as heart attacks and stroke), cancers, chronic respiratory diseases (such as chronic obstructive pulmonary disease and asthma) and diabetes.
Others include cancer, sickle cell anaemia, mental illness, neurological and substance use disorders, road traffic injuries, and oral health disorders among others.
These diseases are, to some extent, preventable and manageable. But it is estimated that by 2030 they will cause 75 percent more deaths than malnutrition and infectious diseases.
Although there are no official statistics for the burden of NCDs in Nigeria, but 2019 WHO NCD Country Profiles, NCDs accounted for 29% of all deaths in Nigeria with cardiovascular disease, predominantly hypertension, responsible for 11% of all NCD deaths, and premature mortality due to NCDs at 22%. Premature mortality due to NCDs is defined as the probability of dying between ages 30 and 70 years from any of the common NCDs.
Out of these, diabetes accounted for two percent; cancer, four percent; injuries, eight percent, and cardiovascular diseases, 11 percent.
With the theme: The Strength of it All: The Future of NCD in Nigeria.” The summit, which is aimed at promoting consciousness, education, and empowerment concerning (NCDs) in Nigeria, took a holistic look at different healthy practices that will help sufferers and individuals who are at risk to thrive instead of surviving.
To prevent NCDs, experts recommend a balanced diet, regular exercise, and adequate sleep.
Many NCDs can be prevented by reducing common risk factors such as tobacco use, harmful alcohol use, physical inactivity, and eating unhealthy diets.
In her opening remark, the Founder of SAMI, Ms Toyin Adesola, said that NCDs greatly impact the country’s health and economy.
Adesola said: “The economic burden of NCDs is numerous since chronic disease treatment is always very costly. People with NCDs have high healthcare bills, and their families face increased financial risk. Thus, an increase in household expenses on health leads to an unprecedented financial catastrophe and impoverishment. Sickle Cell Disease (SCD) is NCD as well. In our 15 years of dealing with people with SCD, we found out that the awareness of NCD is not much compared to communicable diseases like Human Immunodeficiency Virus (HIV), COVID-19, or Tuberculosis but NCDs are limited to specific persons but NGOs like ours and others try to talk about these issues.”
On what the government, financial, and health sectors can do to tackle the burden of NCD, Adesola appeals to the FG to finance the treatment of NCD just like they do for communicable diseases.
She also urged the financial sector to consider giving health insurance to persons living with SCD and other NCDs to help cushion the burden.
Adesola said: “We need the medical, government, corporate people and those in the financing sector because one of the challenges of NCD is that for health insurance we see it as a pre-existing condition and these are the people who need health insurance the most. They hardly give people with SCD insurance and even when they do, it comes with a high premium, and people can barely afford it and they struggle and some eventually pass on.
“We are trying to bring these issues together and see how we can strengthen it and support each other by having a proliferation of all these issues. What are we doing for health finance and how can they have access to healthcare now that doctors are leaving the country among others? NCD need more access to a specialist.
“Government should finance NCD more. There is a lot of financing for communicable diseases. When you talk about SCD and cancer, the rich and upper class may be able to get treatment but people in rural areas will be blaming it on spiritual things which half of the time is poor health management. The medical sector should find ways to manage people’s health by involving the corporate sectors; it is about funding entertainment shows while there are lots of sufferers dying as a result of poverty.”
Also speaking at the summit, the Art Therapeutic Coach, Olayinka Enahoro defined art therapy as a type of creative therapy that professionally licensed psychotherapists use in counselling to help patients interpret, express and resolve their emotions, thoughts, and deep-seated mental health issues.
She emphasized that stress, which is one of the issues with NCDs affects the body and mind, adding that it can also be reduced using art therapy.
Enahoro said: “Stress is one of the issues with NCDs. When we are over-stressed, our brain releases a hormone called cortisol and if you live a highly stressful life, cortisol starts running around in your body in excess and starts giving rise to all sorts of other things. The brain also releases hormones when viewing or creating art and its related expressions, and these hormones can help reduce the amount of cortisol in the body. They help to reduce stress and, by extension, all the opportunistic ailments such as weight gain, depression, female fertility problems, digestive issues, erectile dysfunction/ low sex drive among others.
“The brain does this by helping to release our daily dose of feel-good hormones such as dopamine, oxytocin, serotonin, and endorphins, contributing to improved health and positive emotions among others. Art is viewing it, doing it, and by art, we don’t necessarily mean painting, drawing but dancing, art involves drama, poetry, and music. There is evidence to show that bedside music of cancer patients can actually be used as a tool in health and healing. There is a book titled “Brain on Art that talks about how the brain when exposed to art and its expressions can release certain things and it can chase away the cortisol.
“There is something that the brain does when it comes to creating art. There is something called neuroplasticity in which you are rewiring your brain because stress helps to destroy certain things and as you age as well, the neurons in the brain begin to slow down. Art can also help in the early onset of dementia. This year, I found out that Sickle Cell patients who engage in art regularly either creating or listening to music can have less of a crisis because of the way one of the chemicals released has helped the blood cell to expand and can pass easily. It is important to put art into our daily life to help in reducing stress so we can be more focused.”
Speaking on the impact of nutrition, the former president of the Nigerian Institute of Food Science and Technology (NIFST) and Nutritionist, Mrs Dolapo Coker, said that food is the major ingredient for wellness.
She said: “The macronutrients, the vitamins, and enzymes in food are actually what give us wellness. You are your own first consultant because it is the way you feel that you will tell the doctor. So, you consult yourself first by checking what you ate or drank and why you are feeling the way that you do. And as such, if you identify that thing, you will avoid it.
“Water is essential. When you don’t feel comfortable even with a headache and you think of taking water, you will be surprised that you will feel much better. Probably something you ate was not doing well with you but when you dilute your system with the water, it washes it away and you feel better.
“You must not have a favourite food and as such that is what you eat most of the time. It is good to eat a variety of food because the macronutrients in different foods differ and they will do you a lot of good. Don’t run away from oil and fat because some of the vitamins are in the oil and fats. Why not eat the ones that God created rather than go to the pharmacist to buy drugs? You are your own doctor, study yourself, even for those who don’t sleep well, try to study what you have eaten or drank that day and then you can identify it and therefore you sleep. Daily exercise is also important. You collect vitamin D from the sun.”
Mental Health Therapist and Chief Executive Officer of Reuel Consulting Limited, Totuse Francis admonished parents, guardians, and people living with Non-Communicable Diseases, NCDs, not to put all their hope in medication when dealing with crises associated with the disorder.
Francis said that people living with NCDs, especially sickle cell warriors, are trained to deal with pain so they find themselves on several drugs and at some point the body becomes dependent on the medication.
He said: “The thing about dependency on medication is once the body gets used to it, and then it doesn’t work anymore, they increase the dosage and it goes on and on because the pain they experience is sometimes unexplainable.”
Francis explained that sometimes the pain can make them feel like ending their own life when all the medications they take seem not to be sufficient to take away the pain.
Another aspect of this kind of experience that they have is addiction. When it comes to the issue of drug or drug addiction.
Francis suggested different ways of dealing with sickle cell crisis aside from drugs, “There are different techniques in therapy to help sickle patients different help.
There is psychotherapy, which is like talk therapy, there’s cognitive behavioural therapy, and there is just stop therapy so that different aspects or different techniques when it comes to therapy. We adapt the one that works well for the person. It is different from medication where only psychiatry is to recommend medication.”
On the role of Neurology in Sickle Cell Disorder, Prof Mustapha Danesi a Consultant Neurologist said: “Black people are more prone to be SS. Sickle cell disease is quite common in this part of the world.
“It is very difficult to know the exact prevalence but we do have a large number of people here with sickle cell. I can’t say the exact figure but it is very large. The majority of sicklers in the world are found in Africa.”
Danesi explained that it is best to start testing immediately once they discover a person has sickle cell. Check the system to find out whether they have very high cerebral blood flow.
“So the earlier they start testing the better for the patient, because if you start testing early you will be able to discover those who are at risk and then give preventive treatment and preventive measures. So that at the end of the day, they will live a normal life, but if you don’t start early like in this part of the world you may have complications before you start taking treatments. So it is better to prevent than to start treating after they have had these complications,” Danesi said.
The one-day summit looked at several topics including ‘Understanding the Role of Neurology in Sickle Cell Disorder’ by Prof Mustapha Danesi, ‘The Crisscross Effect: Mental Health and Non-Communicable Disease’ by Mr. Toluse Francis, among others.
There was a panel discussion on building a resilient healthcare system to empower and improve NCDs in Nigeria.
The panelists include Prof Gladstone Airewele, Dr. Oge Ilegbune, Yewande Sheu, Sharon Browne-Peter, Halima Jafiya, Timleyin Edwin, Dr. Kehinde Giwa, Dr. Joy, Dr. Emeka Nwunna, Dr. Benita Uzonwanne, Mr. Peter Osikoya and hosted by Adesola.
The summit was supported by Xcene Research Ltd, among other partners.
