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E-book Epidemiological Change and Chronic Disease in Sub-Saharan Africa : Social and historical perspectives

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Penilaian

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On a Wednesday morning the primary healthcare clinic in a small rural South African town is busy.1 A line of caregivers, mostly women, wait with babies and small children for routine check-ups and immunisations. In the adjacent waiting room patients sit or stand outside a door marked ‘Chronic Clinic’. A nurse is taking blood pressure readings and recording the numbers in the notebooks that patients have brought with them. When her turn comes, Agnes, a woman in her late forties, enters the consulting room and, helped by the woman doctor in charge, cautiously lowers herself onto a seat. A domestic worker, some weeks ago Agnes slipped while washing a floor and fractured her ankle, which is in a cast. She was treated for this medical emergency in the town’s hospital and has returned there for check-ups. She’s not here for her ankle, but her broken ankle is relevant to her health story, as the doctor is well aware. Agnes is her complex family’s main breadwinner. She was diagnosed as a type 2 diabetic five years ago. The doctor is concerned that her latest blood sugar readings indicate that the condition is not under control. Agnes explains that, although she is receiving government disability benefit, this amounts to much less than her usual wages and so she has had to economise on the household’s food budget. This means cutting out the more expensive items, including fresh vegetables, and relying heavily on the refined carbohydrates which form the staple of most working-class diets in this region – refined maize flour and white bread – supplemented with cheap cuts of meat. She looks anxious as she explains that her living situation is stressful. She’s worried about her finances and what will happen if, for some reason, her broken ankle turns into a more permanent disability. It’s hard to make ends meet and, to add to that, her brother, an alcoholic with mental health problems, has arrived back, unannounced, to stay with her. He is a disruptive presence and on occasions is violent. Elements of Agnes’s story will be familiar to anyone who has tracked what is frequently described as an ‘epidemic’ of chronic non-communicable conditions in lower- and middle-income countries, but there are also aspects of it that are specific to her small town location in a largely rural region of South Africa. Though there is no typical story, Agnes might well agree that this is an ‘epidemic’. Type 2 diabetes, along with a number of other conditions including hypertension, are widely viewed by both patients and medical professionals as ‘new’ diseases, but now they seem to have taken an intractable hold. Agnes knows of many other people in her community, and her extended family, with these conditions but they were rare, if not completely unheard of, in her grandparents’ generation.

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Ketersediaan

Informasi Detail

Judul Seri

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No. Panggil

614.4 ADJ e

Penerbit

London : UCL Press., 2021

Deskripsi Fisik

380 hlm

Bahasa

English

ISBN/ISSN

9781787357044

Klasifikasi

614.4

Tipe Isi

text

Tipe Media

computer

Tipe Pembawa

online resource

Edisi

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Subjek

Incidence of and Public Measure to Prevent Disease

Info Detail Spesifik

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Pernyataan Tanggungjawab

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Versi lain/terkait

Lampiran Berkas

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