How to avaoid Diabetes

World over, the prevalence of type 2 diabetes is in the increase.It is an emerging epidemic in Saharan Africa, the place that is a home to HIV/AIDS, Malaria, Tuberculosis and other communicable diseases.This chronic disease affects people of all age, race and ethnic groups. It is by now a known cause of premature death.Being the leading cause of kidney failure, lower limb amputation, and blindness in developed countries, as well as increasing the likelihood of death from heart disease,diabetes mellitus is a modern-day scourge.Most cases of diabetes type 2 are preventable, while type 1 is genetic.The challenge is how to avoid diabetes. The steps below relate to preventing type 2 diabetes:

1. Note the different types of diabetes- ie About 90% of people with diabetes have type 2 diabetes
2. Be concerned-Understanding how Type 2 diabetes impacts your life is an important part of motivating you to want to try and avoid getting it. 
Over-consumption of fructose and other simple sugars is a major concern in relation to developing diabetes Type 2. However, the specific kind does not matter as they all have the same effects on the body
3. Pay special attention to any risk factors for diabetes that apply to your life:
The risk factors for Type 2 diabetes include:
Obesity ie  BMI greater than 29
Age more than 45 years
Having siblings or parents with type 2 diabetes -genetic predisposition
A diagnosis of heart disaese or high cholesterol
Up to 40% of women who had gestational diabetes

Diets high in sugar, cholesterol and processed  food

Irregular or no exercise - less than 3 times per week 

4. Act early: If you have the risk factors associated with diabetes, it is important to get regular screening tests – simple urine and blood tests – and to respond by controlling your lifestyle factors. If tests reveal that you have "pre-diabetes" (metabolic syndrome), it means that you have an increased chance of being diagnosed with Type 2 diabetes in the future

5.Change your dietary habits 

A diet rich in sugar-laden foods, as well as foods high in cholesterol, increases your risk for pre-diabetes and Type 2 diabetes development .The following dietary suggestions focus on do's and don'ts.

Increase your daily servings of fruit and vegetables .Aim for seven to nine daily servings of fruit and vegetables.

Eat good carbohydrates :Eat whole grains, whole grain rice, breakfast cereals with 100 percent whole grain content, whole grain pasta, etc. 

Stop drinking sugar 

Stop snacking on sugar 

Eat less fat 

Keep treats for special occasions 

6. Loose weight 

f you're changing your eating habits to healthier ones as a lifestyle choice, you'll lose weight with a lot less effort than if you focus on the deprivation-thinking of a "diet". Eat healthy and exercise well, and the weight will start to remove itself. 

7. Exercise regularly to avoid diabetes.

 

• Take walks during your lunch break. If you can walk half an hour each lunch for 5 days a week, you'll be keeping yourself fit and healthy.
• Avoid the rush hour by exercising near your work after knock-off time. Go home a little later, exercised, and unstressed because the traffic levels have eased.
• Get a dog or start walking your existing dog - dogs make it easier to exercise and are a form of responsibility that obliged you to get out.
• Walk to your local shops rather than taking the car. Unless you've got heavy packages to carry, walking locally makes good sense. It's a good opportunity to go with a friend or family member too, and to have a chat. Conversing while walking makes the walk seem shorter.
• Renew the songs on your iPod or MP3 player. Give yourself a great excuse to walk or run while listening to your music selection.

8. Return for testing. After 6 months to a year of improving your diet and exercise habits, return for a test to see how your blood sugar levels have changed .

• Always keep monitoring up with your doctor. Follow your doctor's advice.
• If you need help, consider speaking to a registered dietitian who can assist you with developing a meal plan.
• Consider seeing a psychologist if you have underlying emotional issues that cause you to consume too much or to eat an unhealthy diet.

Latest doctors` strike may be a sign of a bomb waiting to explode

BY HENRY MUHANIKA

18th March 2012

It is only a few days ago that the latest doctors’ strike whose impact to society is still being felt came to an end, after the intervention of our President.
At this time, when members of the public who endured the brunt of that unpleasant experience are feeling deserved relief, a person who dare suggest that what we have seen may be a proverbial calm before the storm is likely to be branded a pessimist, if not a trouble rouser, unless he presents his case convincingly. This is a challenge to be overcome in this column.

By the way, discussion on the subject is still going on in our midst, mainly because the first round of the latest strike was associated with about 200 deaths countrywide and much suffering of innocent patients.

Hence, there are all sorts of comments about the incident, some based on reliable information while others are derived from rumours. You then hear viewpoints which generate more heat than light, as one political analyst put it the other day.

There is a local English daily newspaper which this week came up with an eye-catching front page story with a headline which screamed: “ No more doctors’ strikes”.

A person with a few bucks to spare could not avoid buying this newspaper, as the temptation to find out who has discovered the magic wand to solve a problem of this magnitude is too big to be ignored. The writer was a victim of this newspaper selling antic and bought it straight. He has no regrets as the story gave him a theme for this commentary on silver platter.

In short the story was about President Jakaya Kikwete’s speech while addressing elders of Dar as Salaam during the week, his main theme being the just ended doctors’ strike.

He is quoted to have narrated the history of the strike and, as expected, used the opportunity to try and convince his audience that his government and previous ones have done their best to improve the working conditions of doctors and other health sector workers, only that the efforts are constrained by inadequate financial resources.

In any case, it is true the President said he expected the doctors not to go on strike in future, and this is where the “no more doctors’ strike in future” headline originated.

What is the basis for the President’s expectation that from now onwards a strike by doctors will be history? Analysis of his speech reveals two reasons. The first reason he gave is that professional ethics and the country’s laws do not allow professionals in sensitive areas like the health sector to go on strikes, as doing so may put lives of citizens at risk.

The second reason appears to be that, after all, some of the demands of doctors will be met and costs involved will be incorporated in the 2012/2013 national budget.

Now, the interesting aspect here is that on different occasions when the doctors have opted for going on strike, professional ethics and laws barring them from resorting to such actions have been in place - one may even say doctors are not ignorant of their professional ethics and the Hippocratic oath they take on graduation, even if not all of them may be conversant with the law which prohibit strike in professions of this nature. But experienced colleagues can guide them on this aspect in time of crisis.

From the aforesaid, we note that there are enough precedents to show that when workers’ frustration reach a boiling point, they tend to put aside matters of professional ethics and regulations as they opt to lay down tools at any cost.

Of course, when the most powerful government leader says he does not expect doctors to resort to a strike option again because the laws of the land do not allow them to do so, those who read such statements between the lines should be able to decode the veiled message - which is simply that the government has been lenient enough in the past and won’t hesitate to use the stick in case incidents of this nature recur in future.

But can this approach guarantee that professionals in sensitive areas won’t lay down tools when shortchanged while politicians, parliamentarians, administrators and others engaged in less taxing jobs enjoy better salaries and perks?

As we conclude, we may as well make it clear that those who consider the doctors’ latest strike as calm before the storm do not necessarily wish our country chaos but see signs indicating that workers in other sectors, who find it difficult to make ends meet, are too restless to guarantee industrial harmony.

Henry Muhanika is Media Consultant

Email: hmuhanika@yahoo.com

SOURCE: GUARDIAN ON SUNDAY

Tanga integrates mother, child health insurance fund in development plans

IPP Media: Living at Mikanjuni location, Donge Village in Tanga city, Ashura Omari, 37, has three children, Rama, Kassim and Mwantumu.

Apart from Rama – the first born, Ashura’s other two children were delivered by traditional midwives.

When the young woman, married to Choyo Salimu, a fisherman, felt labour pangs for her first child eight years ago, she requested her husband to take her to hospital.

She packed a pair of kanga and a kitenge in a bag and took with her 2,000/- which was all she had saved from fish sales.

On a bicycle, Choyo pedalled to Makorora Health Centre.

Cycles of powerlessness: How can we improve the health system?

By Dr. Hamisi Kigwangalla


I woke up today reeling from nightmares of what is happening to poor people in Tanzania. I was recently in Tabora conducting research on reproductive health, where I had an opportunity to interview a man who consented to participate in our research. He willingly agreed to share his experiences on the barriers to accessing reproductive health services. His distressing story illustrates the experience of many people across the country.

The whole story starts with this beautiful young lady who got married to this fine young man. The woman got pregnant after some time. She went to the nearby antenatal clinic for care and was advised by the health workers there to go to Kitete general hospital for delivery. But due to lack of finances the family decided not to go to Kitete and rather to go to a traditional birth attendant.

Unfortunately, when the day came the woman didn’t immediately notice that she was in labour. When she finally realized and told her mother-in-law, she was told to just wait and be strong, because she is a woman. So she waited. At night, the pain became aggravating and grew stronger and stronger. She woke her husband, who was fast asleep and drunk, but he assured her everything was alright and that she should wait as his mother had earlier said, because she knows better.

Finally, he noticed his wife groaning and struggling. They quickly awoke the whole family and took her in a cow-pulled cart to the traditional birth attendant, where they were confident that they will receive delivery services. When the traditional birth attendant came and examined the lady in the cart, she quickly noticed that the head of the baby could easily be seen. Upon further examination, she noticed that the woman had twins and that she had lost a lot of blood. Realizing she could not help, the birth attendant told them to rush to the nearby dispensary. It was very late at night and not even a single car passed that way. Suddenly the woman became too tired even to cry. Her movement decreased. The situation was desperate. The husband was sobbing and his cheeks were full of tears. Everyone was quiet, perhaps begging mercy from God. When the midwife was awakened, she quickly jumped off her bed and went to examine the woman. She noticed the woman had twins, had lost a lot of blood and that both the mother and babies were distressed. She opted to call the ambulance from Kitete and at the same time to infuse the patient. She knew she could not be of any further assistance.The poor woman struggled to wait for the ambulance to no avail. The husband sat beside his wife, weeping calmly, his heart full of guilt. As minutes passed, he became aware of the reality that his wife was dying. No sooner than the ambulance arrived, the woman passed away. This is a testimony from the husband.

To this moment, he still cries for his dead wife and twin children. He lost the three most important people in his life in one day. I listened to the story with a chill, as I became aware of the multiple barriers that so many people in this country have to face. These barriers contribute to “cycles of powerlessness.”

The first cycle is within the individual; he or she has to be liberated and enabled to demand for his or her rights. This entails a person who is confident and can make decisions about his or her life and his or her children. Unfortunately many people – especially women – remain trapped in this cycle by a lack of information and autonomy.

Second, a person must overcome barriers imposed by people who have the most direct influence over their lives; i.e. their in-laws and their own families.

Third, there are barriers imposed by the social environment (community) and fourth by the health system. All these barriers create a cycle that is difficult to break – particularly for poor women.

These barriers reflect the obstacles to achieving health equity for women and children in Tanzania. The fact that about 80 percent of Tanzanians live in rural areas, and that more than half of all births occur outside health facilities, compels a strong case towards reforming the health system. We must target improvements in primary health care in order to improve the security of the poor majority living in rural areas. The Government should direct more resources to strengthening primary health care services bringing them closer to the people. Will the budget that is going to be tabled next month in Parliament reflect this?


Dr. Hamisi Kigwangalla is an independent public health consultant and social justice activist. Call 0715636963

PAMJ launches a jobs and announcements portal for announcers

The Pan African Medical Journal
ISSN: 1937-8688 - www.panafrican-medical-journal.com.
Published in collaboration with the African Field Epidemiology Network (AFENET)
Now tracked by DOAJ, AIM, Google Scholar, AJOL, EBSCO, Scopus, Embase, Index Copernicus, HINARI, CABI, PubMed Central, PubMed, Ulrichsweb, etc..
PAMJ launches a jobs and announcements portal for announcers targeting health professionals from Africa and beyond. (Access PAMJ-Jobs here)
Announcers, why you should post your job announcements on PAMJ-Jobs? With a readership of more than 4000 unique visitors per month and a database of more than 3200 (and counting) registered users from more than 79 countries (70% in Africa), PAMJ Jobs is an advertising solution for recruiters targeting doctors, health professionals and public health professionals from Africa. How to post a job announcement? Just contact us at sales-service@panafrican-med-journal.com for guidance or fill our online quick Ad form. Information requested usually includes the start date of the announcement, the expiration date, the detailed content of the position and the contact information of the recruiter. What will happen to your announcement? Your announcement will be posted on PAMJ-Jobs and sent to PAMJ mailing list on a monthly basis. Monthly statistics (number and location of hits) will be provided to the recruiter; allowing him to track the penetration of his announcement. How much will it cost to post job announcements to PAMJ? Recruiters/announcers will be charged a yearly flat rate; this will allow them to post an infinite number of announcements in a year. A fee-per-posting is also available for once-in-a-while announcers. What else can be posted on PAMJ-Jobs? Other announcements like conferences, meetings, seminars, workshops etc... can be posted on PAMJ-Jobs. For more on PAMJ-Jobs, visit: www.panafrican-med-journal.com/pamj_jobs/ For quotation, contact: sales-service@panafrican-med-journal.com For other advertisement opportunities with PAMJ, visit: http://www.panafrican-med-journal.com/ads.php

Uganda opens nodding disease clinics to treat children with nodding disease

Uganda has opened new clinics to help the thousands of children suffering from nodding disease, a mysterious syndrome that can be fatal.The disease is said to have affected most children in northern Uganda. The neighbouring countries are also believed to be affected by this disease, Tanzania and sudan in particular. The cure of this disease is still unknown!

Coke, Pepsi change recipe to avoid cancer labels

Coke and Pepsi are altering their drink recipes to avoid a California law requiring them to carry cancer warning labels, the Associated Press reported.The Global post has repoted that the soda giants are reducing the amount of 4-methylimidazole in their caramel coloring – a chemical that's been added to California's list of carcinogens.