Anemia in Yemen [Archives:2005/842/Health]

May 16 2005

By Dr Muna Yehia Al-Zalab
Al-Jumhori Educational Hospital
For the Yemen Times

One of the most common health diagnoses of Yemeni patients is anemia, whether acquired or inherited. In general, there are several causes of this disease as will be explained further, however the focus of this report is what makes anemia a common disease among Yemeni people and Yemeni women in particular.

Anemias are a diverse group of disorders that have in common a reduction I the amount of circulation of hemoglobin or erythrocytes, resulting in a decrease of the amount of oxygen reaching the tissues of the body. Normal hemoglobin levels are different for men (14-18g/dl) while for women it is around (12-16 g/dl). When a person is anemic, then the level of hemoglobin falls much below these normal levels.

Of all types of anemia, the most common type in Yemen is the malnutrition anemia or what is known as the Iron Deficiency Anemia (see figure). From the name it is obvious that this type is mainly caused when the person is underfed or suffers from loss of blood that was not compensated for such as women during delivery or children living below the food poverty line, which unfortunately exceeds more than 40% of the total number of children in Yemen. It is also caused by deficiency of vitamin B12 and folate also anemia is associated with protein malnutrition and scurvy. Other causes for this disease could be due to infection, renal failure, liver diseases, or there is hemolytic anemia, which is caused by corpuscular defect or abnormal hemolytic mechanism.

Symptoms and signs:

The main symptoms include tiredness, lassitude and weakness. Angina of effort, faintness, headache, pallor skin, conjunctiva, nail bed tc

Anemia is diagnosed through reviewing the history of the patient, physical examination of some features on the nails, skin, abdomen, CNS, urine and blood. And the treatment of this disease is directed to the underlying cause as well as general medications.

In Yemen there is the morbidity among women is higher than that compared to men. Gender roles and responsibilities render women more vulnerable with 25% of poor women suffering from malnutrition. Women's excess work burden in terms of both household work and productive employment increases women's vulnerability to poor health. Not only that, but also infants are dangerously subjected to this disease and are vulnerable to its consequences including underweight and stunting. Pregnant and breastfeeding women are most likely to be anemic especially with the prevalence of lack of awareness and domination of a male culture that sometimes leads to sacrificing women's health and nutritious meals for the male members of the families in some areas. Another significant factor that increases the possibility of Anemia among women is the lack or shortage of health facilities with regards to reproductive health. Postnatal care is only available to 25% of the women in the republic according to statistics 2002 which means that 75% of the Yemeni women who may suffer from bleeding because of reproductive issues may not be provided with adequate medical care, and sometimes even with the availability of the health care, the provision of the service is questionable.

In general, many of the Anemia cases in Yemen are directly linked to other diseases especially Malaria especially in the coastal and warm areas. It could be also linked to liver diseases, kidney failure, cancers, ulcer and digestive system parasites and worms such as tapeworm, and these types are infection diseases and people living in shabby and unhealthy environments where there are no sanitation and clean water services are more subjected than others to contamination. However, there are genetic causes for certain types of Anemia such as sickle cell anemia or hemolytic anemia as well as glucose-6-phosphate dehydrogenises. And these are because of certain genes carried by the parents and hence the possibility of carrying the disease increases because of the traditions that encourage marrying the first cousin or next to kin. Because of ignorance and lack of awareness a generation of anemic children could be caused and negatively impact the society over a longer term through increase of the economic burden.

It is worth mentioning when talking about this particular aspect of this type of disease is that the Islamic religion encourages and calls on potential grooms and brides to try as much as possible to marry into healthy families because this would lead to healthier generations and hence a healthier future for the community as a whole. However, such knowledge is not spread enough for the Yemeni people to learn and hence they stick to harmful traditional practices. This is why media should play an important role in advocating for a healthier society, starting from pre marital medical checkups then prenatal and postnatal care and mother and child care as well as trying to change the views and attitude that discriminate against women in nutrition or against children's rights to happy and healthy childhood.