By Adeola Mariam Toye
There is no country in the world which is devoid of asthma. The World Health Survey (WHS) on asthma, championed by the World Health Organization (WHO) estimates the global burden of asthma in adults to be 4.3%. The incidence of this disease exceeds 300 million people in the world. However, the prevalence of this condition tends to vary from country to country. The burden of asthma is of public health concern because the disease is a major cause of infirmity, depletes scarce health resources, and reduces the quality of life of affected individuals. This burden is even more profound in developing countries like Nigeria, where health costs are largely borne by the individual patient. In Nigeria, we live and breathe in asthma triggers. It is a nation of closely built houses in the cities, generator fumes, bush burning and factory pollution. All of these spell danger or even death for those suffering from asthma.
Poor information about the condition contributes to its debilitating effects. The majority of those living with asthma are children. There are several studies highlighting the burden of asthma in children in Nigeria, with a prevalence ranging from 5.1% to 14.3%. As their health decisions are often made by the adults around them, there is a need to educate the public on how to prevent an attack and ensure that they lead normal lives. This article is going to provide some insight on the predominant causes of asthma and the steps that should be taken in order to control/prevent this disease.
Identify and Avoid Triggers
There are certain asthma triggers which a lot of Nigerians are not aware of. Asthma triggers bring on the feeling of the throat tightening and a suffocating sense of breathlessness. They include smoke, cold air, some types of food, or even emotions. It may be necessary to keep a food diary to pick out allergies. Rugs and pets give off lots of fluff that may be invisible but cause severe allergic reactions. Pollen is a risk in areas with lots of flowers and other plants.
Perhaps the greatest culprit is dust! It is everywhere. On the roads, in our homes. It sticks to all surfaces including bags, clothes, beddings, curtains etc. Regular house cleaning can help mitigate this effect. Also wearing a mask or covering the nose and mouth with a clean handkerchief in areas with poor air quality is advisable. Avoiding direct exposure to cold air from air conditioners and ceiling fans have also yielded less frequency of attacks.
Another main cause of concern with asthma in Nigeria is stigma. It is baffling how much energy is poured into demonizing every disease. This leads to shame and denial. Thus asthma is viewed as a curse, a punishment for sins instead of a condition that can be prevented and treated. Those who need inhalers are told not to use it thereby causing severe breathing difficulties. Many lives have also been lost due to this as care is sought only when it is too late. Some even keep it a secret and as such the people around them don’t know to get help on time.
Inaccurate and irregular use of inhalers and other medication cause complications and a reduction in quality of life. Doctors, nurses and other health care workers thus have to ensure the patient can demonstrate the correct use of an inhaler to achieve effective treatment. In addition, some people stop using inhalers and other medications after the symptoms stop, without first confirming with the doctor. The high cost of inhalers is another factor that prevents some patients from using them regularly. Most are imported and poor families who are at higher risk of being exposed to allergens can’t afford them.
Poorly Developed Health System
Poor access to care, payment before healthcare delivery are among plagues crippling the Nigerian health sector. A patient with an acute exacerbation of asthma simply doesn’t have the time! They often require treatment within minutes.
Oxygen, nebulizers to deliver medication to open up the airway and provides urgent relief, are part of the emergency care offered to patients. Sadly however, these seemingly simple interventions are not available in many hospitals and primary health care centres across the country.
Those who do have, require a down payment which the relatives may not have at that point in time. This leads to needless loss of life. The absence of universal health coverage is a setback to ensuring quality and timely health care delivery.
Port Harcourt Soot and other Pollutants
Environmental pollution is one of the greatest challenges to mitigating asthma. For months, the quality of health in Port Harcourt, a city located in the oil-rich southern state of Rivers has been embattled by black soot in its atmosphere. This is not unrelated to hydrocarbon from poorly regulated crude refining. Residents report that it envelopes them, being heavy in the air and sticking to every surface including their throats. This has grossly worsened the health status of people with respiratory conditions like asthma and of course leading to the emergence of new cases.
Without mincing words, this is a disaster waiting to happen. All efforts need to be amplified to tackle this problem before it is too late. The Olusosun landfill in Ojota, Lagos emitted smoke and other noxious fumes in recent times. This finds its way into cars even with all the windows wound up. Until one leaves that part of the road, one literally finds it difficult to breathe. Now, imagine the magnified effect of being in traffic, or actually living in that area.
Generator fumes, firewood smoke, and all other forms of pollution need to be curbed. Children who already suffer from the condition should not stay around triggers like dust, rugs or pets who have fur. More awareness needs to be created on the prevention and medical care for asthma. Together, we can reduce the burden of asthma drastically in Nigeria.
Photo Credit: Google
Dr. Adeola Mariam Toye MBBS (Lagos) Is a physician, writer and entrepreneur with an ardent focus on global health, innovation and liberal arts. She is Co-founder at Hellocare NG, a health tech company changing the face of healthcare delivery in Nigeria . Founder at OumissaInspire, a social enterprise for books, health, tech and design. CEO, KhamisLifestyle, a bookstore and literary advocacy company. She speaks French and Spanish with increasing proficiency.