By Zodidi Mhlana
Gogo Ncesh is doing her morning exercises.
She wears her lizard-patterned leggings and lemon socks and clutches her three-legged silver stick to stop her from falling. These indoor daily walks are part of her exercise routine.
Gogo Ncesh spends hours each day strengthening her right side, which was left paralyzed. She also devotes time to reading, writing, and practicing speech to restore power to her brain.
Although her speech is limited, her warm spirit shines through her smiles and giggles, and the few words she utters. She has been doing this for six years.
Ncesh Mala of Florida, Johannesburg, life’s changed on September 12, 2018.
On that morning, her daughter-in-law found her drenched and unconscious in the garden.
Ncesh had woken up as usual to bathe her six-year-old grandson preparing him for school. Her clinic card from that day notes she was “found unresponsive” and “had no history of chronic illness”.
Ncesh’s daughter-in-law, Soyise Tlou, recalls that day: “Even though she would go to a private doctor whenever she felt some pain in her body, she did not know she had high blood pressure all along.”
Ncesh manages her health well, maintaining normal blood pressure levels through regular check-ups, healthy diet and with the use of Lipogen 40 Atorvastatin and Carloc 6.25 mg Carvedilol pills collected monthly at Helen Joseph Hospital.
Her story is not unique in South Africa. The National Health Department says that one in three adults in the country lives with hypertension. This condition contributes to one in every two strokes and two in every five heart attacks. Hypertension is cited as the second leading cause of death and disability.
The Gauteng Health department launched its ‘Corner to Corner’ campaign on October 11, this year, paving the way to prevent experiences like Ncesh’s in the future.
The Corner-to-Corner campaign will bring healthcare services directly to street corners and undeserved communities and to provide screenings, health education, and referrals to nearby clinics, creating accessible, community-based health hubs.
In an interview, department spokesperson Motalatale Modiba explains that the campaign offers services including diabetes and hypertension screenings in response to the rising prevalence of these conditions. “The province (Gauteng) has recorded a diabetes prevalence of 11.3 percent, while hypertension has sharply risen—from 29 percent to 49 percent in men and from 34 percent to 51 percent in women between 1998 and 2016,” Modiba says.
The Health Department further says the campaign aligns with the National Strategic Plan’s goal of ensuring that 90 percent of adults are aware of their blood pressure and glucose levels, 60 percent of those diagnosed receive treatment, and 50 percent of those treated achieve control. In the 2023/24 financial year, Gauteng hospitals recorded 7,991 new stroke cases, attributed to the alarming increase in hypertension.
Data from Statistics South Africa indicates that non-communicable diseases and mortality levels are most prevalent in KwaZulu-Natal, Gauteng, Western Cape, and Eastern Cape provinces
Motalatale further highlighted that “this alarming trend” was driven by unhealthy diets, physical inactivity, smoking, and excessive alcohol consumption, and stressed that prevention, early detection, and effective management are essential to addressing these conditions.
The department says early detection of non-communicable diseases, particularly hypertension and diabetes, is significant. This has led to the rollout of community-based screening campaigns through Community Health Workers (CHWs).
Looming Health Crisis
Statistics South Africa’s October 2023 report described the “upsurge” in non-communicable diseases as a “looming crisis.” Stats SA reported that deaths from major non-communicable diseases (NCDs) — such as cardiovascular diseases, diabetes, and chronic lower respiratory diseases — increased by 58.7 percent over 20 years, from 103,428 in 1997 to 164,205 in 2018.
The report further stated that deaths due to cardiovascular diseases (CVD) had increased to 17.6 percent in 2018 from 12 percent in 2008. It also noted that mortality from diabetes rose by 36.5 percent, from 19,692 in 2008 to 26,880 in 2018.
“The increasing number of people living with NCDs necessitates more extensive and efficient healthcare services, posing financial and organisational challenges for health systems,” the SA report noted. Link
The impact of non-communicable diseases places a heavy burden on public healthcare and has a severe impact on communities and individual livelihoods, particularly affecting women, who often shoulder the responsibilities of caregiving.
When asked how it is strengthening primary healthcare (HPC) for early detection and screening of non-communicable diseases, National Health Department spokesperson Foster Mohale says it was using “integrated care models that prioritize early screening and management of NCDs.
“We are integrating screening for hypertension, diabetes, specific cancers, and mental health into routine PHC visits. The PHC facilities are equipped to conduct regular screening, enabling early identification and management of hypertension and other NCDs to provide a comprehensive service,” Mohale says.
When asked about community-based measures to address the rise of non-communicable diseases, the Health Department said these include deploying community healthcare workers and focusing on screening. “Community health workers are trained to conduct household visits, educate about hypertension prevention, provide screening on hypertension and diabetes, and link patients to PHC facilities,” Mohale says.
Mohale notes the training of community healthcare workers, and the training had been extended to traditional health practitioners.
He further states that in communities, health education campaigns are being conducted to raise public awareness about hypertension, promoting lifestyle changes such as reducing salt intake, increasing physical activity, and adhering to treatment.
The Health Department implemented regulations, like the 2013 sodium reduction law, to lower salt intake and reduce hypertension. “South Africa is the first country in the world to legislate salt levels to help reduce the amount of salt that the public takes in from processed foods.” Enditem
Sources: Graph Statistics SA and Pic from Unicef South Africa.
