There are about 48.5 million people living in Kenya and about 10% of them are estimated to have diabetes, though most researchers assume that the number has been underestimated. Research on hypertension is equally spotty – about 25% of adults in East Africa have been found to have hypertension, however 56% of Kenyans have never had their blood pressure measured.
It is not just the statistical analysis that is weak – if you live in rural Kenya, the slums or in poorer parts of the country, access to reliably available, affordable medicines, diagnostics, and equipment is sorely lacking. If you’re a diabetic, this means that often you don’t get insulin or metformin, blood sugar measurement strips or machines, or whatever else you might need. If you have hypertension, the pills and equipment to check your status may be too far away or too expensive, as are professionals to tell you what you need to do to control your noncommunicable disease (NCD).
“For me the country is really ready to tackle NCDs. You can this see from the online information, the NCD action plan, and the Red Cross strategy, and they recently finalised a three-year programme,” said Dr Tuvshin Chimed after her trip to Kenya in March. According to her, the Red Cross walks the last mile in situations that are less then ideal, and so their volunteers on the ground are best placed to explain what each community needs.
That is where Rono Vestors, a Kenya Red Cross volunteer attached to the NCD prevention and control project in Nairobi County, comes in. He has been volunteering with the Red Cross to support NCD sufferers since he realised that they needed consistent help in terms of psychological support, awareness creation, frequent check-ups to lessen the risk factors, and also to adhere to proper care and management of their diseases.
About 55% of people who have diabetes also have hypertension. For this reason, on his visits Rono gets the view of each NCD sufferer he sees on their changes in blood pressure, BMI, sugar levels, nutrition and other related vitals. He does regular NCD screening, because uncontrolled diabetes or hypertension can lead to complications. He also does nutritional counselling because that is often the first step to help control blood sugar levels and lower obesity levels.
Rono began volunteering when he realised that there was an alarming rate of NCDs in Nairobi County. He started out on the NCDs facilitation team, conducting school health programmes designed for NCD awareness and the promotion of healthy living in 18 schools in the county. He was also conducting NCD screening at the community level.
It was at his meetings in the community that he realised that the majority of the sufferers have no formal education and they require consistent sensitisation on behaviour change for healthy living. “They are economically unstable and can’t afford to pay for their frequent NCD check-ups and medications,” which is why a volunteer is the best answer in this community, said Rono. He added that most of the sufferers are not aware of the risk factors and need continuous dialogue, which is why he visits with each of his NCD sufferers about once a week. In the span of two years, he has found that his sufferers’ vitals improved drastically. They also started to self-screen, monitor and manage their NCD as they had learned to use the community equipment to check their blood pressure and BMI. The nutrition counselling he provides helped not only his NCD sufferers but also their neighbours and friends, as the majority began to adhere to NCD prevention and management techniques, including weekly exercise routines in the support groups like the Defeat Diabetes Association. He has also seen the community take an interest in voluntary screenings without any coercion from any external party.
Despite all of his hard work, Rono wishes there was a well-equipped NCD triage desk/unit in each and every facility where screening and provision of NCD information and medication could be provided without any fee being charged. He feels that the local desk could help eliminate the myths that surround NCDs: that NCDs mainly affect the rich; NCDs are mainly diseases of the elderly; all NCDs are preventable; no cost effective solutions exist for NCDs; you can’t change human behaviour when it comes to NCDs. None of which are true.
But, what Rono has learned during his time as a Red Cross volunteer is that anyone can be a change agent in NCD prevention and management. “The fight against NCDs starts from an individual mind.”