From YALI with Hope & A Renewed Sense in Public Service

By Mercy Kyeng Tetuh* In Africa, we say that cancer is a disease of the rich and diabetes is a disease of affluence. Contrary to this perception, it is the poor that are most affected by these diseases – including those that become poor because of it. Non-communicable diseases like diabetes, cardiovascular disease, chronic respiratory disease, and cancer accounts for more than 38 million deaths or 60% of all annual deaths worldwide. In America, every 1 in 5 adults has high blood pressure as opposed to every 1 in 3 adults in Africa. Kidney failure and stoke is one of the most common outcomes of diabetes and high blood pressure respectively and both outcomes have significant economic impacts not only on the victims but the entire community and society at large. My work is in public health and epidemiology with special emphasis on reducing mortality and morbidity rates of non-communicable diseases in Cameroon. In Cameroon, my home, the effects of high blood pressure are forcing people below the poverty line. I recall attending a conference on kidney disease and a man from the North West region of Cameroon where I come from shared a story with me. This man was one of the highest paid classes of individuals in government and suffering from kidney failure.  Because of this disease and all of the management it required – the testing, treatment, missing work – this man of wealth had to beg his relatives to help him buy food. The tuition funds he might have once set aside for his children to acquire an education were no longer a possibility. Similarly, my own friend’s father was also on dialysis and he was forced to sell his organization in order to pay for his accumulating health bills. He is now incapacitated and depends solely on his family for survival; my friend foregoes school twice per week to wait at the dialysis center for her father’s turn to use one of a handful of dialysis machines that are used to treat hundreds. I’ve been forced to ask myself many questions like, “Why are there no policies in place to combat these conditions in Cameroon? Why is it that only 3% of global funds are allocated to non-communicable diseases?” I couldn’t find an answer and it was then that I realized I had to become an answer. That was when I organized a team of Cameroonian medical professionals and created Value Health Africa (VAHA), a nonprofit organization whose mission is to “add to the quality of life and promote sustainable community development in Cameroon by improving the health of the community.” [caption id="attachment_32131" align="alignright" width="300"] community screening by Value Health Africa[/caption] Since little support is available for addressing non-communicable disease in my country, we knew it was important to maximize local resources like the youth. Through the power and dedication of the youth, VAHA has been able to develop strong volunteer-led community forums in partnership with higher institutions. Through the community intervention programs, VAHA has succeeded to screen over 12 communities for non-communicable disease, revealing its true prevalence in Cameroon and the associated risk factors to locals. We share this information at health research forums in my country to raise awareness and bring this problem to lamplight. We have also succeeded in developing  a disease management structure for diabetes patients in partnership with rural health centers through a task shift approach policy meanwhile, we are also putting in place an early detection program where we conduct community health screenings and promote education and awareness campaigns, benefiting more than 12 communities already. We have had real success and it seems as if a pathway for change is being made… As I look at the progress we have made and what more we may be able to accomplish, I can’t help but to think about the challenges we face and cannot yet overcome. I see myself on a motor bike, traveling to an interior village as I have been notified of an advanced diabetic case (at stage 5 kidney disease). I am rushing to a clinic with my team to intervene and, upon arrival; I am told that he has died. This is not a terrible dream I awoke from; this actually happened. We do not have enough medical equipment to fully address the need hence, we are being outpaced. The challenge we face is huge and we are attempting to do things that have never been done before in my country. But this challenge has opened the door to opportunities. This year, I applied to the Mandela Washington Young African Leaders Institute (YALI) program. It is a well-known and highly competitive opportunity throughout all of Africa, with the chance to come to America to undergo trainings and acquire new knowledge and resources that can be taken back to our countries. Nearly 49,000 applied but only 1,000 were chosen with just 24places for Cameroon.  Other VAHA colleagues and I, were among the chosen and I was placed at Kansas state university for a 6-week civic leadership workshop with 23 other fellows from 14 different countries in Africa. I thought that, this experience would be limited to a professional workshop environment, but it was much more than I expected. This experience has changed my perspective, the goals for my organization, and my life. The Staley School of Leadership Studies taught us about the importance of community in our work and created a peer network that connected us with faculty and community members doing work similar to ours. With the help of Professor Fadi  Aramouni of the Food Science Institute at KSU, I have been able to analyze the composition of some of our local foods in Cameroon. This will help us to educate locals on better eating habits which will go a long way in improving health conditions in the community. I met Kolia Souza of the Center for Engagement and Community Development, whose work is also dedicated to creating stronger communities through healthy food access. From there, I was connected to Professor John Calvin of Johns Hopkins University, the Medical Society of Segwick County, the Kansas Health Foundation, Blue Cross Blue Shield of Kansas, the Kansas Department of Health and Environment, and even Imagining America. I now see everything with new eyes. I see the introduction of new technologies to revolutionize our food system. I see opportunities to partner with our local schools and their nurses to develop health promotion programs that teach children using both artistic and scientific methods. I see implementing more playgrounds to encourage physical activity, because the one we have for all of Cameroon is not enough. I see the opportunity for mentorship between the young and old. I have renewed vigor for engaging, teaching, and empowering our local citizens and government to reimagine Cameroon and devise how we can get there together. Furthermore, I want this to spread across all of Africa. Through YALI, I have learned about and shared in the struggle of my fellow Africans and we have all been inspired by the possibility for transformation, discovered during our time in America. [caption id="attachment_32133" align="alignright" width="300"] Value Health Africa staff at work[/caption] The burden of non-communicable diseases extends beyond just medical bills. It steals time from work, time with family, and years from peoples’ lives. It also extends beyond Cameroon, beyond Africa. This is a human struggle that requires a collaborative approach for greater impact to be made. We can encourage our educational institutions to incorporate healthy eating habits and physical exercise at the elementary school level. We can teach both young and old to care for their own health and their community’s health together. We can advocate for policies that create healthier environments and holistic health systems. We can engage with our local governments to build stronger health systems in our societies. We can also donate to support projects such as these in communities so as to make the vision of a healthy community a reality. Our struggle is your struggle. My community is your community. We can uplift one another. *MPH/Epidemiology ,CEO: Value Health Africa,Mandela YALI Fellow 2016 from Cameroon