Studies warn of public’s lack of medical knowledge [Archives:2006/950/Health]

May 29 2006

Mohammed Rajeh
In an attempt to publicize the poor state of medical conditions in Yemen by examining the spread of diseases and epidemics in a country where most of the population experiences is impoverished, a group of graduate students from Sana'a University College of Medicine have undertaken studies to bring to light information about the public's medical knowledge and how such knowledge may affect their way of receiving medical attention.

The studies, conducted at the medical students' own expense, reveals the following important information.

Disease ignorance

The first study concentrated on diabetes in Yemen. According to the study, the main problem is not Yemen's constantly increasing number of diabetes cases, but lack of patient information about the disease.

Diabetes is a disease wherein the pancreas produces little or no insulin, a hormone that helps body tissues absorb glucose (sugar) so it can be used as an energy source. The condition also may develop if muscle, fat and liver cells respond poorly to insulin.

In those with diabetes, glucose levels build up in blood and urine causing excessive urination, thirst, hunger and problems with fat and protein metabolism. This type of diabetes is called diabetes mellitus, which differs from the less common diabetes insipidus caused by lack of the hormone vasopressin which controls the amount of urine secreted.

Diabetes is classified into two types. In Type 1 diabetes, formerly called insulin-dependent diabetes mellitus (IDDM) or juvenile-onset diabetes, the body does not produce insulin or produces it only in very small quantities. In Type 2 diabetes, formerly known as non-insulin-dependent diabetes mellitus (NIDDM) or adult-onset diabetes, the body's delicate balance between insulin production and cells' ability to use insulin goes awry.

Researchers conducting this study visited many clinics and public hospitals, meeting 250 diabetes patients – 151 men and 99 women. Eighty-nine percent had no idea about diabetes types or its causes. Fifty-three percent believed it is a hereditary disease, while 38 percent couldn't answer the question. Regarding the diet that diabetes patients must follow, 44 percent only followed it rarely, 36 percent don't follow it regularly and eight percent don't follow it at all.

Epilepsy considered madness

Another study considered the health and social problem of epilepsy, confirming that most Yemenis have no idea about how to deal with epilepsy patients. However, the most important point that the study referred to is the absence of studies and statistics reflecting the disease's spread in Yemen. The study also revealed society's lack of medical knowledge, which considers epilepsy madness.

Epilepsy, also called seizure disorder, is a chronic disorder briefly interrupting the brain's normal electrical activity, thereby causing seizures. It is characterized by a variety of symptoms including uncontrolled body movements, disorientation or confusion, sudden fear or loss of consciousness. Epilepsy may result from a head injury, stroke, brain tumor, lead poisoning, genetic conditions or severe infections like meningitis or encephalitis. In more than 70 percent of cases, no cause is identified.

The study involved 1,328 families in Azal district in Sana'a, where 168 epilepsy cases have been discovered, which is considered a high number in a small region. The study estimated that the rate of its spread, according to gender, is 14 cases for every 1,000 males and 11 cases for every 1,000 females.

Seventy percent of those infected are poor and suffer low living standards. Their situation is not considered the illness's cause, but it prevents most patients from obtaining medication.

The study referred to the fact that most epilepsy patients live in complete isolation, as the community deals with them very uncertainly, and patients frequently are abandoned. It warned that many epilepsy patients are mistreated and do not receive medication at all.

Stroke – a real problem

Another group of students visited Al-Kuwait Hospital to study brain strokes. The study involved 505 patients, 51 percent of whom are between 45 and 65 years old.

Stroke, which is caused by a lack of blood flow to part of the brain, results in permanent damage to brain tissue and in many cases, permanent disability for the patient. For example, a patient who has had a stroke may develop paralysis on one or both sides of the body, have difficulty walking, eating or performing other daily activities or lose the ability to speak or understand speech.

According to the study, high blood pressure is the main factor causing strokes among Yemenis.

Regarding stroke types, the study pointed out that 82 percent of patients suffer hemorrhagic strokes, whereas 61 percent suffer ischemic strokes. The study found that strokes are one of Yemen's leading causes of death and a leading cause of serious, long-term disability.

Therefore, researchers conducting this study recommended the Ministry of Health pay more attention to this issue by supporting studies and research in this field and raising public awareness on how to deal with this disease.

Toxemia threatens pregnant women

Research also focused on the medical state of maternity issues like pregnancy, delivery and complications due to early marriage. Maternal fatalities during pregnancy and delivery are estimated at 365 cases for every 1,000 deliveries.

The aim of the study, conducted by 10 students under the supervision of Dr. Ahmed Al-Haddad, was to learn the factors leading to toxemia in pregnant women. Considered the main reason leading to death among Yemeni mothers and infants, the study found that toxemia causes 15 percent of maternal deaths, compared with two percent in developed countries.

The study included 2,686 pregnant women in public hospital delivery departments in the capital and in other governorates between August 2004 and February 2005. It exposed that illiterate women, those who chew qat and those giving birth many times are most subject to toxemia during pregnancy.

Study results raised questions of the impact of medical awareness campaigns conducted by NGOs and involved local authorities. According to the study, such efforts weren't able to encourage pregnant women to request regular care. It pointed to medical facilities in many regions, particularly rural areas, which lack equipment and qualified personnel, although huge governmental budget sums are devoted to supporting maternal health care.

Disability and a hard life

Disability occupied a large portion of the studies, one of which involved 400 disabled individuals over 18 years old who visit the Artificial Limb Center in Sana'a. The study estimated that 58 percent of handicapped are males, whereas 42 percent are females. Sixty-five percent live in urban regions, whereas 35 percent of disabled individuals who can reach the center live in rural regions.

Fifty-one percent of disabilities were due to amputations resulting from car accidents. Other types of disabilities were from polio, cerebral palsy and disabilities due to accidental falls, firearm accidents and medical errors.

The study referred to low quality of services offered to the disabled in some institutions and the absent of these services in many other establishments, which create difficulties and obstacles that obstruct their uneasy life. Research concluded that society must make certain changes to enable those living with disabilities to participate more easily in business and social activities.

Alternative medicine

Another study focused on the state of alternative medicine in Yemen, mentioning that most citizens feel that alternative medicine is more effective. Lack of trust and dissatisfaction with offered medical services were the main reasons for their return to such types of treatment.

Herbal medicine is the most common alternative medicine in Yemen, followed by massage and acupuncture. The most common diseases this kind of treatment attempts to heal are: chronic pain, arthritis, headaches, stomachaches, respiratory diseases and mental illness.