Diabetic and hypertensive patients queue up for medication at Adjumani Hospital last week. PHOTO/MARKO TAIBOT.
At 52, Ms Zainab Musa Acan, a resident of Karoko Village in Adjumani Town Council, has faced significant life changes since being diagnosed with diabetes and hypertension in 2020. Running a business in Nimule, South Sudan, at the time, the diagnosis initially left her feeling hopeless.
Counselling helped her come to terms with her condition and the new reality of managing a chronic illness. “I have been on medication since 2020, taking my drugs twice a day without fail,” Ms Acan shares. The treatment comes with side effects: drowsiness and frequent urination. To manage her condition, she has adopted a vegetarian diet and made other significant lifestyle adjustments.
Beyond the physical toll, Ms Acan’s illness has placed a heavy financial burden on her. Once the primary breadwinner, she now struggles with reduced strength, making it difficult to maintain her previous business activities. “I am not as active as I used to be. I cannot travel long distances for fear of missing my medication or instructions from my healthcare providers at Adjumani Hospital, who are monitoring my condition,” she says.
Her story exemplifies the challenges faced by individuals managing chronic illnesses in rural Uganda—balancing health needs with economic survival while navigating limitations in healthcare access.
Mr Justus Mawa, a resident of Rusia East in Adjumani District, has lived with diabetes and hypertension for 25 years. Successfully managing his condition, he now chairs the African Health Empowerment Action and Development (AHEAD), an association for individuals diagnosed with diabetes and hypertension in the district.
Mr Mawa acknowledges the challenge of access to medication, citing occasional shortages of essential drugs at hospitals. He recalls the even greater difficulties of 20 years ago when patients had to travel to Arua or Gulu regional referral hospitals for medication.
Diagnosed in 1999, Mr Mawa prioritises his health by adhering to medical guidelines and maintaining a disciplined lifestyle. “To live positively with these diseases, I follow medical advice, maintain a proper diet, and ensure I get enough rest. As a result, my condition has stabilized, but I continue to follow instructions from health workers,” he says.
Challenges
In the 1990s, accessing healthcare in Adjumani was a significant challenge. “Life was very difficult back then. Services were unavailable in the district, and every month, I had to travel to Lacor Hospital at my own expense to buy medication, which cost me up to Shs50,000,” Mr Mawa recalls. Despite these struggles, Mr Mawa has successfully managed his health. His journey highlights the progress in healthcare accessibility in the region and the importance of adherence to medical advice for those living with choices are fuelling the rise of diabetes and hypertension.
He cautions against excessive alcohol consumption and smoking, habits that significantly worsen these conditions. Dr Drametu reveals that diabetes patients at the hospital surged from 2,800 to about 3,800 last year. “For Type 1 diabetes, patients must rely on daily insulin injections for life. With Type 2, medication is also lifelong. Stopping treatment abruptly can be fatal,” he warns.
To prevent Type 2 diabetes, Dr Drametu emphasises physical activity. He urges people to avoid prolonged sitting and engage in walking, running, or cycling for at least 30 minutes daily. He discourages reliance on gyms, explaining that static exercises can lead to heart failure. “People should avoid excessive weight gain and prioritise eating greens regularly,” he advises. Adjumani grapples with a high prevalence of diabetes and hypertension, according to Mr Yunus Atama, the district biostatistician.
Over the past four years, health facilities recorded 5,944 diabetes cases and 18,427 hypertension cases. In 2021, there were 2,015 diabetes cases and 5,541 hypertension cases. In 2022, diabetes cases slightly dropped to 1,676, while hypertension cases stood at 5,485. In 2023, diabetes cases increased to 1,908, with hypertension cases rising to 5,780. “These statistics underscore the need for enhanced health interventions and awareness campaigns to manage and prevent the growing impact of these chronic illnesses in the district,” Dr Atama said.
Ministry of Health interventions
The Ministry of Health’s 2024 performance review of work plans highlighted the urgent need for targeted action against diabetes and hypertension. The Ministry of Health’s Strategic Plan 2020/21 - 2024/25 aims to reduce the prevalence of non-communicable diseases, including diabetes and hypertension, through various interventions such as promoting healthy lifestyles, improving healthcare access, and strengthening health systems.
A study on hypertension trends in Uganda from 2016 to 2021 found an increasing prevalence across the country, with significant increases in the western and central regions. The 2030 Agenda for Sustainable Development recognises NCDs as a major challenge. Heads of state and government committed to developing ambitious national responses to reduce premature mortality from NCDs by one-third by 2030 (SDG target 3.4). WHO plays a key leadership role in the global fight against NCDs and in achieving the SDG.
