I left my work station and travelled about 700km to collect data in a fairly economically endowed village (by Kenyan standards). This was my latest field research looking at financial protection for the informal sector in Kenya. My destination was a little urban centre- Karatina in Central Kenya. The town is busy, lively, dusty/muddy and reportedly crime-ridden. Every corner of the streets is lined with butcheries selling mainly beef, chevron and mutton. There are also several bars as well as mobile-money sending and receiving services (M-Pesa). The picture gives an impression of a meat-eating, beer-guzzling and also a moneyed lot. It was quite tempting to join the ‘nyama-choma’ party if not for the constant reminder of the magnitude of the work I had at hand. Nyama-choma is grilled meat, a Kenyan delicacy eaten with raw tomatoes, onions and chilies, plus ugali made from mainly maize meal.

My initial contact into the study sites is a talkative chap and together with other contacts, one of our conversations centered on common illnesses in the area. There was unanimity on the prevalence of non-communicable illnesses (NCDs) including diabetes, high blood pressure and cancer.  The problem of HIV/AIDS in Africa is old news…Yah jah hah!! These are chronic illnesses with serious implications on life expectancy, health care costs and household budgets.

The discussion took an interesting turn over the causes, treatment and prevalence one of diabetes, which the group considered to be the most common of the NCDs.  It was interesting to hear that diabetes is caused by the stresses of poverty. We are told that cases of diabetes are rising globally. Between 1980 and 2008 about 194 million cases of diabetes have been reported, 70% of which were attributed to aging and population growth. Although current data indicates that sub-Saharan Africa has the lowest incidence of diabetes, it remains to be seen whether this is the result of lack of data, unreported cases and poor diagnosis combined.  Talking of poor diagnosis, most cases of diabetes in much of SSA go unnoticed until it is very late. In the rural areas where only primary care services are available and with no doctors, diagnostic skills and equipment, the nurses and clinical officers merely treat symptoms rather than the ailment. The problem is compounded by poverty and lack of social policies aimed at financial protection of households, particularly the majority of the population who are without formal employment. 

Diabetes is here in Africa and rising very fast. With the difficulties in implementing primary preventive strategies: weight control, proper diet and physical activity, African health systems need strategies not only to protect households from impoverishing effects of treating diabetes and other NCDs out-of-pocket, but also to improve on early detection and management of these diseases to avoid complications and eminent poverty.

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