At Makhetha Township in Blantyre, there is a meaty business that presents a forest of risky eating habits that cause high blood pressure, a non-communicable disease (NCD) that affects one in three adults worldwide.
Throughout the year, motorists from all corners of the city park at the roadside market for a bite of nthumbwana or kanyenya, a delicacy comprising fried goat meat. The customers fork their fatty picks with toothpicks, dip them in a mass of salt and chew them bit by bit. By the time the ritual is over, frying pans expose a pool of cooking oil that could cause cancer if recycled.
This could be a common sight in the country’s roadside trading centres, but Makhetha is a prime nthumbwana destination.
In the words of the sellers, even “biggies” travel from Chilomoni, Namiwawa, Sunnyside and Manja, over 10 kilometres away, just to put out their hunger. When the youth say “biggie’, they mean the well-to-do potbellied businesspeople or working class who often lead a laid-back life.
“On Saturdays, the road is clogged by cars as people flock here to quench their hangovers. I think biggies prefer this destination because they hardly get this at home,” says one of the young men, fanning a smoky fire.
Notwithstanding overloads of fatty food materials and smoking that characterise the country’s drinking culture, the Makhetha spectacle offers a glimpse of how some Malawians are eating well at owner’s risk.
According to the World Health Organisation (WHO), increasing salt intake, fatty diets, harmful alcohol abuse and smoking raises the risk of high blood pressure. Other risk factors include lack of physical activity and obesity which are becoming more common in urban areas.
“High blood pressure—also known as raised blood pressure or hypertension—increases the risk of heart attacks, strokes and kidney failure. If left uncontrolled, high blood pressure can also cause blindness, irregularities of the heartbeat and heart failure,” reads a factsheet compiled by WHO.
On Sunday, the United Nations organ founded on April 7 1948 commemorated the World Health Day focusing on high blood pressure as a public health concern.
According to a factsheet released in commemoration of the day, nearly a third of the adult population worldwide has high blood pressure and the proportion increases with age, from one in 10 people in their 20s and 30s to 5 in 10 people in their 50s.
A myth is widespread that the disease excludes the poor, but its prevalence is highest in some low-income countries on the continent, with over 40 percent of adults thought to be affected.
A study conducted by WHO and the Ministry of Health in 2009 shows that 33 percent of Malawians, over 15 years of age have the disease which can be prevented by self-care and modifying lifestyles: taking less salt, eating a balanced diet, avoiding harmful use of alcohol as well as tobacco substances and taking regular exercises.
The findings are based on a sample of 5 000 patients in Lilongwe, but the figures could be higher since most Malawians hardly go for check-ups when they are feeling well.
Dr Philip Burgess, a lecturer at College of Medicine in Blantyre, is conducting a fresh research in conjunction with Malawi-Liverpool-Wellcome Trust Clinical Research Programme.
It is likely that the numbers of people with high blood pressure will grow in Malawi, warns the researcher.
“Some researchers believe this is linked to a lack of exercise, a greater number of people living in cities rather than the countryside, and an increasingly westernised diet comprising fizzy drinks, high fat foods, fried foods etc,” Burgess explained.
He reckons most do not know that they have the condition—saying: it has no symptoms until a complication arises.
“Sometimes people may experience headaches, dizziness, fatigue or palpitations, a feeling of the heart racing,” he says.
Last year, Adventist Relief Agency (Adra) was using interactive theatre not only to sensitise various communities to non-communicable diseases, but also to establish their attitudes. A report from the fact-finding outreach shows most Malawians think NCDs are exclusively meant for the rich urban dwellers. The communities confessed that they hardly check their blood pressure since health centres are far from their settlements while others consider it a waste of time going for check-ups when they are not sick.
In an interview, some Blantyre residents said the imperious necessity for regular check-up presents an extra burden to health workers who see large numbers of patients every day.
“Most health facilities have shortage of skilled health workers and they are compelled to attend to someone who is in pain because those in need of check-up can wait for another day. We need more staff and clinics to make blood pressure measurement accessible,” said Makhetha resident Angela Kamwambi.
True to this observation, most health centres across the city are characterised by long queues of people seeking treatment of both communicable and non-communicable diseases, but few if any vying for checkups.
The country’s healthcare delivery has changed a lot over the years and there is need to focus on non-communicable disease as well.
Spending huge amounts on infectious diseases—such as malaria, diarrhoea, tuberculosis as well as HIV and Aids—has become the norm when it comes to national budgeting and healthcare approaches. But this does not guarantee the country a health population for behind these diseases is an array of silent killers, including high blood pressure.
However, high blood pressure is both preventable and treatable. Creating an enabling environment for self-care, healthy behaviours and check-up can cut the toll. In some developed countries, prevention and treatment of the condition has brought about a reduction in deaths from heart disease, says WHO.