Programme Director
First Lady of the RSA: Madam Bongi Ngema-Zuma
His Royal Highness: Hosi-Ngove
Executive Mayor of Greater Giyani Municipality: Councillor P Hlungwani
Delegates from the Mabunda Royal Council
Deputy Chair of the Bongi Ngema-Zuma Foundation: Mr Makhathini
Trustee of the Bongi Ngema-Zuma Foundation: Mr Makhamba
Honoured guests
Officials from various state departments, Bongi Ngema-Zuma Foundation and other significant stakeholders
Ladies and gentlemen
Good morning.
It is an honour for me to be here today, commemorating World Diabetes Day with the Bongi Ngema-Zuma Foundation, the Mabunda Royal Council, the Provincial Health Department, Mopani District Municipality and members of the community.
Diabetes is a major health problem in South Africa, which has been singled out as a non-communicable disease that requires priority attention. However we as a Department of Health can’t do this alone and are therefore very happy that we are partnering today with the Bongi Ngema-Zuma Foundation and other significant stakeholders in the fight against diabetes, but also that we can partner with the Foundation beyond just marking this day each year.
It's been a long journey since the initial intent was expressed to start the Bongi Ngema-Zuma Foundation to raise awareness about diabetes and I must sincerely congratulate the First Lady for the excellent progress that she and her Foundation have made in meeting their goals to promote diabetes education and care. The Foundation’s first community outreach took place at Mercy Clinic in Gauteng and has since expanded to many corners of South Africa to enlighten the citizens and educate them about the signs and symptoms of diabetes, the dangers of not seeking medical advice and the complications resulting from non-adherence to prescribed medications and lifestyle changes.
Why are we so worried about Diabetes and why do we mark this day? The following statistics would I think worry anyone concerned with health and health care.
According to the International Diabetes Federation (IDF):
- 366 million people have diabetes worldwide;
- In South Africa, there is an estimated number of 6,5 million people with diabetes;
- Four million deaths can be attributed to diabetes every year;
- One million diabetes-related amputations occur every year;
- Every eight seconds someone, somewhere in the world, dies due to diabetes related complications.
Recently in South Africa we completed a study called the SANHANES and it was found that for people of between 45-54 years, 16.7% had sugar levels needing treatment and in the 55-64 year age group 24.4% had such sugar levels. The problem is though that these problems start when a person is much younger and the proper way to prevent diabetes when you get older is to start living a healthy lifestyle while you are still young.
Deaths from Non-Communicable diseases (NCDs) amongst younger people are particularly high in poorer countries. From both a prevention and control (care and treatment) perspective, diabetes shares many of the same characteristics and requires very similar interventions as other major non-communicable diseases such as high blood, cancer and lung conditions. The way to prevent these conditions is through good diet, more physical activity, no smoking and much less alcohol.
World Diabetes Day was created in 1991 by the International Diabetes Federation and the World Health Organisation in response to growing concerns about the escalating health threat that diabetes poses now. World Diabetes Day became an official United Nations Day in 2007 with the passage of United Nation Resolution 61/225.
The campaign aims at keeping diabetes firmly in the public spotlight so that we do what is necessary to prevent diabetes before it affects you, and that people with diabetes look after themselves properly through leading a healthy life-style and taking their medications as prescribed. In addition though we see this day for reflecting as a Department of Health what we are doing to curb the growth of diabetes and to commit ourselves to doing more in fighting it.
“Diabetes Education and Prevention” is the World Diabetes Day theme for the period 2009-2013. The World Diabetes Day logo is the blue circle, which is the global symbol for diabetes.
The latest data from the District Health Information System shows that there are 2 new diabetes clients per 1000. Diabetes can no longer be ignored and it is important that you all know about diabetes and the associated complications that will develop if not properly managed. What has been called Type 2 diabetes accounts for 90% of all diabetes cases and is a major public health problem affecting around 65 people out of every 1,000 people.
Whilst this number may appear to be quite small, it is important to note that between 35% and 80% of type 2 diabetes cases remain undiagnosed in the early stages, and by the time the patient is eventually diagnosed, approximately 20% of patients already have complications of the disease.
Today we are launching the updated diabetes guideline to assist health professionals at primary care level to provide evidenced-based care to people diagnosed with diabetes. The Society for Metabolism, Diabetes and Endocrinology of South Africa or SEMDSA, worked very closely with the Department of Health in the development of the updated guideline and I can assure you that we are now up to date with worldwide developments in the treatment of diabetes.
We know though that issuing guidelines is not enough, we will follow this up with proper training and supervision so that all our health workers know the best and most scientific ways to treat diabetes. But it is not just the medication that will make a difference if you have diabetes, you must also listen to what the health worker tells you and also change your lifestyle if you want to live a long life with diabetes. You must also take the medicines in the way that the health worker tells you. If you are not sure of what they say ask them and ask them again, don’t be shy. They are here to make sure you get better and this won’t happen if you are unsure of their directives to you.
We also have here to-day the “Strategic Plan for the Prevention and Control of Non-Communicable diseases in South Africa 2013-2017”. Today is the beginning of our community distribution of this very important document. This strategy outlines the broad framework and plan to prevent and control non-communicable diseases. It includes prevention needed at various levels and introduces the Integrated Chronic Diseases Model that we strongly believe will improve patient care and patient satisfaction with our services. In terms of this model if you happen to have both diabetes and are living with HIV for example, you will come on one day and see one practitioner. The Integrated Chronic Diseases Model provides a holistic and comprehensive approach to dealing with all chronic conditions.
However it is important that practitioners dealing with chronic diseases have a good knowledge of each condition so that they can give both good medical care as well as accurate and clear information to patients. So as a companion to the model we have a comprehensive but short document for all health workers to use called the PC101. This includes the drugs that are on the Essential Drugs List so that when a drug is prescribed it should be available at all times.
The recent rise in incidence and prevalence of diabetes can be directly attributed to “life-style” changes linked to urbanisation, industrialisation and globalisation. Changing lifestyle requires a combination of community and population wide interventions including changes in legislation and regulations as well as individual behaviour change. These are certainly not mutually exclusive interventions as, for example, healthy eating is as much dependent on availability and affordability of healthy foods as it is on individual decisions and behaviours.
There are very specific symptoms that may accompany the disease and if you have any of these, please go to your nearest clinic for a check up: thirst, frequent urination, weight loss, as well as blurring of vision, poor wound healing and general body weakness. Sometimes there are no symptoms, especially in older persons, so being checked is important because you’ll know your status in time. If it’s found out that you have Diabetes after the tests, you’ll then be given necessary medication to treat it before it gets worse. Diabetes relentlessly progresses before a diagnosis is made. Diabetes is progressive – it cannot be stopped. A healthy lifestyle can however significantly slow down the progression of diabetes through to its complications.
NCD prevention and control has been fully integrated into the Primary Health Care package of services and the Supervisor’s Manual at primary health care level. NCDs have also been highlighted in the training curriculum for community health care workers, as well as the integrated school health services.
I have a third document here that I want to share with you. This is the Bill that was recently passed by cabinet to be circulated for public comment and that is the “Control of marketing of Alcohol Beverages Bill” or, in plain language, the legislation that will effectively ban alcohol advertising; alcohol sponsorships and promotion of alcohol products. Alcohol is a risk factor for just about every cause of illness and death in South Africa including diabetes, and we are very confident that passing this Bill will save many lives in South Africa.
This Bill will also save many households where a large percent of the household income is spent on alcohol, and where women and children get abused by men returning home drunk, violent and depressed. We cannot have a situation where on the one hand we try to tell school children about the dangers of drinking and then when they come out of school there is a big Billboard showing how wonderful alcohol is for you, and how it will make you successful. When the child gets home this is reinforced by advertisements on radio and TV.
The industry will not stop pushing their products onto you as community members, so the only way for us to stop this is to introduce legislation that stops the promotion of this very dangerous product that kills around 130 people every day.
At least half (and possibly a lot more) of people with pre-diabetic conditions and/or raised blood glucose levels are not aware that they have a condition that either requires lifestyle or medical intervention or both. Screening is thus a critical part of Diabetes prevention. Go today to get tested but also tell your family members and friends to do this at your local clinic. As is the case with HIV and AIDS, every adult must test for diabetes, especially if you are in the high-risk group, or are 45 years or older. The sooner you know your status, the sooner you can start the appropriate intervention, and the greater your chance of retaining a healthy life.
Sharing this day with the First Lady, Madam Bongi Ngema-Zuma, as one of the high profile individuals who are making a difference in communities in general, and in the lives of people with diabetes in particular, is a great honour for the Ministry and Department of Health. I once more want to thank her personally and her Foundation for keeping issues of diabetes in the forefront of people’s minds. Without health it is difficult to break out of the cycle of poverty and unemployment and to live a fulfilling life. I therefore urge all of you to be our partner together with Madam Ngema-Zuma and look after yourselves, and also live more healthily for a longer life.
In closing Programme Director, I’d like to take this opportunity to remind everyone here to go and register to vote for the 2014 national elections immediately when we disperse or they might as well do that tomorrow, which is the last day open for voters’ registration. Make sure you are registered and you know where you’ll be voting from on the Election Day.
Voting is your right, exercise it…
I thank you all.
