“Over the years I have learned to conserve my energy and use it when and where it is needed most because I am always exhausted. If I must choose between looking like an enthusiastic and dedicated worker and staying healthy, I will always choose the latter,” says Mercy Makholo, who has lived with diabetes for more than a decade.
The 42-year-old sales executive says she struggles to keep appointments and always looks lively because most times, she is on medication or recovering from an illness.
Makholo is part of a growing number of people living with chronic illnesses in Uganda.
Dr James Edward Kakungulu, a general physician at Lifemate Hospital in Kigowa, Kampala, describes chronic illnesses as health conditions that cannot be cured but can be managed.
“They include cardiovascular and cerebral-vascular diseases, diabetes, cancers and chronic respiratory diseases. Most of these are known as Non-Communicable Diseases or NCDs. Unfortunately, these conditions are on the increase because of lifestyle, diet and environmental changes, among other factors,” Dr Kakungulu notes.
These diseases are often painful and affect the person’s overall quality of life. The problem worsens when they have to deal with the illness at work. Makholo says living with diabetes feels like a fulltime job.
“I have to be extra careful about what I eat, when I eat it. I have to exercise regularly, test my glucose regularly and take medication. Any slight deviation from this schedule brings harsh consequences,” Makholo reveals.
Mirian Ndyanabo, a human resource practitioner, notes that illness and work rights go hand in hand.
“Everyone has a right to employment and should not be discriminated against for living with an illness. Therefore, employers have to put in place policies for properly managing employees with chronic illness,” she says adding that whether the employee decides to reveal their illness to their employer is their right.
Ndyanabo says ideally, the office should be a place where employees’ safety is protected while providing them with opportunities for better long-term health. Positive initiatives include having a broader wellness policy in place, supportive team leaders who are educated on holistic approaches to managing chronic disease, and appointing a “workplace champion” who staff can go to for additional support.
What should you disclose?
Much as the employee has a right to choose to disclose their illness, there are instances when it is necessary. For instance, if a person has food allergies or suffers from seizures. Ndyanabo advises that you talk to someone about your situation and what you might need in case of emergency.
“Since you spend eight or more hours a day with your colleagues, it is best to help them better understand how they can help with your chronic illness. Tell a friend or a colleague you know can handle the situation. Be realistic about what they need to know,” she cautions.
Some of the policies employers should have in place include an emergency plan such as a sickbay where an employee can rest in privacy, someone with the ability to handle such issues when they arise and a friendly environment for employees to open up about personal health struggles.
Dr Kakungulu advises employees living with chronic illnesses to disclose their conditions to those in charge. One of the benefits for the employee is the opportunity to reduce work hours. In some cases, to meet operational objectives, an organisation can offer to job sharing arrangements within the role to accommodate the employee who is unable to work fulltime due to illness.
“However, I would suggest the medical certificate should be clear in stipulating what the capacity is for the employee by the medical practitioner and determine what work hours should be recommended,” he says.
For employees who are already dealing with a chronic disease, Dr Kakungulu advises, they should be treated with compassion, understanding, and given support. He urges employers to protect those who are still safe by offering preventative measures.
“Chronic health concerns such as Type II diabetes, for example, can be prevented with a healthy diet and regular exercise. Providing access to exercise facilities, walking and cycle ways, increase the opportunities for, and reduce barriers to physical activity. This two-pronged approach has shown improved levels of blood pressure, blood glucose, cholesterol and triglycerides as quickly as one year after starting a programme, with improvements continuing for at least six years,” the doctor reveals.
It is also important to avail regular screening at work so as to identify individuals at risk of a specific disease early enough. This will help employees who might be at risk to benefit from further investigation or direct preventive action.