adminCatherine Murombedzi
SINCE 1998, the world has recognized May 3 as World Asthma Day and this has helped in raising awareness.
Asthma is not curable, but through proper medication and appropriate management the disease burden can be reduced. The causes of asthma are not wholly understood, but include a mix of genetic predisposition and exposure to triggers.
Short term medications are used to relieve symptoms. Long term inhaled steroids are needed to control the progression of severe asthma.
Growing up with an aunt who was asthmatic in the 80s was a difficult time for her and the family at large. Aunt Laura was the elder sister to my mother and each time she went back to her rural home in Hurungwe, Mashonaland West, she would fall ill. She got better on returning to Harare, a city environment. She got all names, ‘lazy woman’ who does not want to till the land, fetch firewood and hew water from the stream. She was said to get better on seeing the bright lights. Firewood smoke would see her packing her bags back to the city, they touted her. As a married woman who could not fulfil her expected chores in the rural home she was seen ‘unfit’ to have had a man pay lobola for her.
Being young I did not understand her condition, but the wheezing, coughing, shortness of breath and the chest movement that was visible even when aunt had a jersey on disturbed me. Aunt looked ill, sounded ill, however, she was not treated as an ill person, but rather lazy. I guess with chronic illness, the family got tired and had to accept her that way. Poor Aunt Laura, one who got sick when work called her to be the mother she was expected yet failed to perform. By being sedentary most of the times aunt gained weight and became obese which became a problem too.
Aunt Laura used to drink water from a clay pot where a live frog was kept. This was believed to help her breath better as the frog had an ability to breathe under water.
If aunt was alive today, with awareness and understanding, I would strive to make her life comfortable. What made aunt ill on getting to the rural home was the ‘triggers’. No-one bothered to understand asthma in that manner that when she came to town she got better. A day after sitting in a smoke filled kitchen and blowing the cinders to cook, suddenly aunt had a severe attack. She was given a pet name ‘mugara dzakasungwa’ (one who has bags packed ready to travel)
She was even fingered as a witch who had an evil spirit that did not want her to stay at her husband’s homestead. All this was a result of lack of awareness on why aunt got asthmatic attacks when she went to Hurungwe.
Asthma is a chronic non-communicable disease affecting 300m people globally. Symptoms include wheezing, coughing, chest tightness and shortness of breath.
True, aunt was poor she could not work in the fields and relied on help. Aunt’s life improved for the better when Bobo one of her sons started work as an accountant at one of the new upmarket clinics in Harare. Bobo took aunt and lived with her permanently. Aunt was placed on medication and used an inhaler and the attacks became less.Bobo being educated understood that the rural environment was not suitable for his mother. Tilling the field, the dust, cooking using firewood and the grass thatched kitchen filled with smoke triggered the attacks.
The floors in the rural area were smoothed with cow dung and this again could have had a negative impact on aunt’s health as she slept on the floor.
The quality of aunt’s life improved but a calamity struck. Bobo had a fatal road accident that took away aunt’s pillar. During the funeral which in our custom sees mourners keeping vigil until the deceased is laid to rest, saw aunt’s condition neglected. She sat day and night for 72 hours in that room with over twenty mourners. The bereavement, sleeping in a congested room was too much and aunt did not wake up on the day Bobo was to be laid to rest. She was pronounced dead on arrival at the clinic.
The congestion, the dust, the polluted air was too much for Aunt Laura.
With the knowledge I have today, Aunt Laura’s death was avoidable. As much as people said the pain of losing her son killed her, I see the real cause of death was being indoors for a lengthy period where the air was polluted. No one really bothered to check if she was taking her medication during the funeral.
Dr Jeremiah Chakaya Muhwa, of Forum of International Respiratory Societies (FIRS) and member Board of Directors, International Union against TB and Lung Disease (The Union) said asthma worsens poverty because the sufferer misses work thereby enlarging the poverty loop. He said this during a webnair preceding World Asthma Day.
“People with persistent symptoms must take long term daily medication to control the underlying inflammation and prevent symptoms and exacerbations,” Dr Chakaya Muhwa said.
The World Health Organisation (WHO) states that asthma does not kill on scale of chronic obstructive pulmonary disease (COPD) or other chronic diseases, failure to use appropriate medications or adhere to treatment can be fatal.
“During episodic onset of symptoms during asthmatic attack, bronchial tubes in the lungs become inflamed and narrow making it difficult to breath. Asthmatic attacks may recur on a daily or on a weekly basis with differing intensity, depending on an individual,” the WHO stated.
The Cochrane Review is pleased to announce that Yoga may have health benefits for people with asthma. Yoga may have a beneficial effect on symptoms and quality of life but effects on lung function and medication use are uncertain.
Yoga is a breathing and meditation exercise and during randomized trials involving 1048 men and women in India, Europe and United States who had mild to moderate asthma it was found to improve the quality of life of the sufferers.
SDGs target to reduce premature mortality from NCDs by one third by 2030. With awareness showing that a patient must know what triggers their attacks, this goes a long way as prevention is the best medicine.
What then can a rural person in Zimbabwe habitating under the trigger conditions do where access to medication is constrained do to improve their quality of life? With the abundant sunshine solar energy has to be harnessed. A solar summit was held in Harare in 1997 and the late Vice President Simon Muzenda was passionate about the programme. This can see many once thick forests now turned deserts getting lush green again. For now solar projects are on individual basis and the rural poor do not afford the cost.
Asthma-related deaths are avoidable if triggers are avoided. Medication can give relieve to a sufferer thereby leading a near normal life.
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