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Writes Jacob Ngwenya
World Kidney Day is celebrated on the 14th of March every year. This year’s World Kidney Day is all about “Kidney Health for All: Advancing Equitable Access to Care and Optimal Medication Practice”. The goal is to raise awareness about the importance of ensuring equitable access to appropriate treatment and care for people living with kidney disease, to improve their quality of life and delay the progression of the disease.
Recent medication breakthroughs have shown significant success in delaying chronic kidney disease (CKD) progression and reducing associated complications. Yet, not everyone has equal access to care! Now is the time to act and shift focus towards building capacity, increasing awareness, and ensuring equitable access to care. This approach must involve multiple levels, including health policies, healthcare system delivery, healthcare professionals, and patient engagement.
Your kidneys filter your blood to get rid of waste and toxins from your body. They also regulate your blood pressure. Having healthy kidneys helps keep your body in good condition and improves your general well-being.
Kidney disease (also known as nephropathy) is common in people with diabetes. Having high blood pressure and blood glucose levels above target for a long time can damage the small blood vessels (also known as microvascular disease) in your kidneys. This causes the small blood vessels to leak and not filter the blood properly.
This means the kidneys do not work as well as they should. If you have kidney disease, you may also be more likely to have other diabetes-related complications, such as heart disease and damage.
Kidney problems must be picked up as soon as possible. Early detection is the best way to prevent more damage. If you have type 2 diabetes, have your urine and blood checked by your doctor for early kidney damage when first diagnosed with diabetes?
After that, have your kidneys checked every 12 months to look for early signs of damage. If you or your child have type 1 diabetes, speak to your doctor about when to start having your/their kidney checked. Ask your doctor how often you should have your kidneys checked, as they may recommend more frequent checks.
This is very important if you already have damage to your kidneys or are planning a pregnancy. Your urine sample will be checked by a pathology lab for a protein called albumin. If small amounts of albumin are detected, this is known as microalbuminuria. Microalbuminuria is an early sign that the blood vessels in the kidney are being damaged and leaking protein. A blood test that measures the rate at which your kidneys filter blood and how well they are.
There are several things you can do to reduce your risk kidney of problems. Keep your blood glucose levels within the target range. Over time, high blood glucose levels damage the small vessels in the kidneys. Keep your blood pressure as close to the target range as possible. Aim for 140/90 or less.
Your doctor will advise you on a blood pressure target to meet your individual health needs. Do regular physical activity. This is a great way to reduce your blood pressure. Aim for 30 minutes on all or most days of the week. Check with your doctor before starting a new physical activity program. Reduce your salt (sodium) intake. Choose foods low in salt, use salt-reduced products, and limit how much salt you add to foods. Ask a dietitian for advice. Do not smoke.
If you do, try to quit. Smoking increases your blood pressure and causes damage to the small vessels of the kidneys, which may increase the risk of kidney problems. Ask for help if you feel you cannot give up smoking on your own. Talk to your doctor. If you think you have a bladder or kidney infection, contact your doctor immediately.
Symptoms can include cloudy or bloody urine, feeling the need to pass urine more often, and/or a ‘burning’ feeling when passing urine. Choose water as the best everyday drink. If you have existing kidney disease, ask for specific advice on how much water to drink every day.
Speak to your doctor or diabetes health professional about what you can do to help keep your kidneys healthy. Speak to your doctor, psychologist, or social worker if the health of your kidneys is causing you worry or anxiety.
As people living with chronic kidney disease under the banner of Beat NCDs Zimbabwe, we lament the conditions that we are subjected to in our day-to-day battle with this ailment.
Renal dialysis, our only hope, is characterized by never-ending breakdowns and persistent reagent stock outs leaving us at bare as death lingers over our heads.
Drugs are ever out of stock at government hospital pharmacies, forcing us to turn to the private sector where we encounter outrageous out-of-pocket expenses as most of us don’t have medical insurance to fall back on. Astronomical dialysis therapy charges in the private sector deter us from seeking help there as their services are preserved for only the elite.
Renal services are largely centralized in Zimbabwe forcing some of us to incur a lot of transport expenses or in the worst-case scenario, become internal medical refugees as we have no option but to do whatever possible to save our dear precious lives.
Practically we are people with invisible disabilities as we now have impairments that hinder us from operating normally and need an assistive device to function or survive. This condition must legally be considered a disability which might assist some of us in accessing the elusive healthcare services that we need.
Mr Jacob Ngwenya a health advocate and a policy entrepreneur with Beat NCDs Zimbabwe called upon the government to ensure that kidney health for all be taken seriously as an integral part of universal health coverage(UHC) dubbed Health For All by 2030, leaving no one behind which has become a rhetoric song with no tangible results on the ground. NCDs contribute a lot to disease burden, disability, and death but they don’t get the attention they deserve.
The best way to tackle any health condition is to embark on a prevention strategy that will raise awareness of the disease for the ordinary man on the street.
Unfortunately, there are no proper targeted awareness programs on the ground, leaving people exposed to NCDs like chronic kidney disease and other conditions that can be the consequence of CKD or the predisposing condition to CKD.
NCDs awareness for conditions like CKD are of paramount importance as 90% of people with chronic kidney disease are not aware that they have it. Policy-wise, NCDs fall very far short of the attention they need as it is business as usual even though NCDs are a pandemic in slow motion.
Just like HIV, we need an Act of Parliament to effectively tackle NCDs in Zimbabwe. The legislative and oversight role of the parliament is our only remaining hope to salvage the situation and turn the tide on NCDs response in the country. There is a great need to bridge the information, care, and investment gaps for NCD prevention and control. All the determinants of health need to be considered and dealt with such that favourable outcomes are attained.
Right now, a lot of health-damaging foods are finding their way to our tables with some marketing techniques that send well-packaged adverts which promote harmful products in the name of profits ring. What is mind blogging is the fact that it seems as if the Standard Association of Zimbabwe is no longer carrying out its mandate as a lot of health-harming foods are finding their way to the market unabated.
Zimbabwe is considered to be one of the countries that are top consumers of alcohol and it is mind boggling why sin or corrective tax was not imposed on alcohol in Zimbabwe for such a long time. A sin tax is a model of tax imposed on certain health-harming products which will see the cost of the product go up and will, in turn, see a reduction in the uptake of the said product and at the same time raise some revenue for health as part of domestic health resource mobilisation.
A lot of health-harming foods are freely found everywhere in Zimbabwe promoted by a lack of checks and balances on trans fats, ultra-processed foods which are high in sodium, and sugary foods.
Legislative and policy interventions are the only way to ensure that we achieve universal health coverage(UHC) by 2030! leaving no one behind this ensuring that everyone everywhere accesses the quality healthcare services they need without enduring any financial hardships.
Let us bear in mind that a healthy nation is a wealthy nation and at the same time no health no prosperity. There is no health for all without kidney health health for all. Now is the time to act and effect change in kidney health in Zimbabwe
Jacob Ngwenya is a health policy entrepreneur with Beat NCDs Zimbabwe who has a wealthy disability, HIV and noncommunicable diseases (NCDs) lived experience and dedicates his time and effort to creating an enabling environment for these vulnerable groups to help foster the principle of inclusion of people with lived experience in co-creation, implementation, monitoring and evaluation of policies, programs, and services that affect them.
CONTACTS
Tel: +263785837994
Email: beatncdszim.@gmail.com