How asthma is affecting Africa
10:32 Share

This BBC podcast is supported by ads outside the UK. Coughing, wheezing, difficulty breathing, that tightness in your chest. These are some of the symptoms of an asthma attack. It can come on because of stress, bad air quality, exercise or breathing in smoke. And people often have to use an inhaler to get their breath back.

Almost half of all the asthma sufferers in the world are estimated to be in Africa. And a new study has found a huge number of teenagers on the continent have undiagnosed asthma. In rare cases, it can lead to death. So why does Africa have such high rates of asthma and why isn't it being diagnosed? I'm Hannah Gelbart and you're listening to What in the World from the BBC World Service.

First of all, let's hear what the air is like in Africa's most popular city, Lagos. Doyin Ogunye is a campaigner for better air quality there and she sent us this voice note. The air quality in Lagos, Nigeria is terrible.

There's so much dust right now because of the environment and because of the climate. We're in the Hamatan season right now and there's a lot of work going on, especially where I live. So the air quality is really bad. But thankfully, I live very close to the beach, so I'm able to get a little bit of good air quality there.

sometimes in the day but generally the the drainages are clogged it's it smells a lot in in Lagos and um it's very unhealthy air a lot of people are complaining of chest pain severe cough

A lot of things are affecting people, especially their lungs. So we encourage people right now to cover up and stay indoors, especially young children and people that have diseases or they have issues with their lungs. We encourage them to stay at home and close all doors and windows.

I remember the air pollution and the traffic when What in the World was in Lagos earlier this year. So let's find out what is causing it and how it's affecting people across the continent. I'm speaking to Dorcas Wangira, the BBC's Africa health correspondent in Nairobi, Kenya. Hi, Dorcas.

Hi, Hannah. Is there an estimate of how many people across Africa have it? Data in Africa isn't easy to come by. It's very expensive, very time-consuming to get this data to collect it, especially where it's not diagnosed properly. However, there have been some studies done by the US National Library of Medicine, but this one in 2013 did estimate that

there were around 119 million people suffering from asthma in Africa. So if we take the WHO figure of 262 million, it's almost half, just about half. So when you think about it, but the worrying thing is that the cases are continuing to increase, and that is where the problem is.

The cases are going up and this new study has found that a huge number of undiagnosed cases of asthma are also in people on the continent. Can you tell me a bit about this study? This is an interesting study looking at when it was done. It was done between 2018 and 2021 and it focused on 20,000 children aged between 12 and

and 14 in schools in Malawi, South Africa, Zimbabwe, Uganda, Ghana, and in Nigeria. So over this period, the scientists or the researchers rather, they did look at 27,000 pupils, and they did find that one in every nine, so from 27,000, they found more than 3,000 had asthma symptoms, but

only 600 had been diagnosed properly. Even growing up, this is very common. You know, if you're not having an attack, people are like, OK, maybe you don't have asthma, you're just struggling to breathe. So what is concerning is not even just the numbers, the fact that so many did not get a formal diagnosis. However, so many still had the symptoms. Why do you think there were so many without a formal diagnosis? Yeah, so sometimes it's just the symptoms. You know, when maybe you're wheezing,

or you're having tightness in your chest. When we were growing up, we'd be told, "Be tough, be tough if you're boys." So if you start coughing and guys are like, "Oh, you're a softie," it'll get over. So when you have symptoms that people don't really take seriously, and then you have the formal tests aren't as much as you would like them to be. There's really no gold standard. For instance, when you think about other diseases where you have a PCR test,

the polymerase chain reaction for asthma there isn't really a standard in the continent and then when you look at the under reporting I may have symptoms and when I'm trying I'm trying to imagine if I was an adolescent I grew up in a boarding school and there are times when you would be sick but you would not tell anyone about it you would just suck it up and you would get on with your with your life or with your studies and

And then also when you look at the socioeconomic status of some of these people, like in a country like Malawi, for instance, where many people live below the poverty line,

You know, you tell a parent I'm sick and they're like, OK, we don't have money to take you to a hospital. So you just suffer with the symptoms. It's not diagnosed. And it only becomes an emergency when you develop a severe attack. And perhaps for some children, it's already too late. Would you call it an asthma epidemic? What's causing these rates to be so high? Well, in the words of some health experts who took part in the study and others, it's a silent epidemic, right?

And that's where the problem is. It's not like these other diseases where we've seen the symptoms which I can easily see. For instance, MPOCs, you could see a rash and be like, okay, this is something we probably know. If the child isn't having an attack, you probably wouldn't know, or if a young adult was having, you probably wouldn't know that they had asthma unless I tell you.

or if you saw someone pulling out their inhaler. And also when you think about this, Africa is experiencing what we've been calling a youthquake, where you're having a whole demographic dividend, you're having more young people in countries like Uganda. So if you're having a population of young people who many of them are getting sick, they're developing this, and they're transitioning as young adults with this condition, that's where the problem is. And I don't think

There's anything we could do without breathing. That's where the problem is. So it has been described as an epidemic, but a silent one. What is causing the rates to be so high? And are there any countries in particular that have...

higher rates. So what the researchers and also what other health experts have been observing is that there is increasing urbanization. Cities are growing. More than two-thirds, at least two-thirds of the world's population is now living in cities.

And what is the quality of life in the cities, buildings everywhere, vehicles everywhere. When I was growing up, where I grew up, I was born in the capital, Nairobi. But I remember where I grew up, we had ponds, we had trees, we had open spaces. When I went back just a few months ago to where I grew up, I couldn't recognize it. There were buildings everywhere.

Then you're looking at the pollution. Think about the particles that are in the air. In a country like Kenya, there have been robust laws against smoking in public spaces because when you inhale second-hand smoke, it's even more dangerous for you. But when you have a lot of dusty areas, some health experts...

may posit that climate change also is contributing to this, but that is debatable because one of the scientists from the Queen Mary University of London who took part in the study said that asthma was made worse by exposure to small particles of pollutants

with the impact of the climate crisis yet to become clear. So this part of the sub-Saharan Africa, we have mostly pollution, urbanization, climate change. And lastly, some health experts also believe poor diets, when you have a lot of people eating foods that are high in refined grains, low in fruit and vegetables, could be associated with asthma.

There are no signs that the growth of cities and also the population in Africa is slowing down. So is this expected to get worse? Yes, demographers have shown that we're having population booms. I always used to hear this from my parents that there was such a big boom of population in Kenya in the 80s.

So you're seeing like now where you'd have houses like one story, now you're seeing 10 stories come up, 12 story buildings come up because you're having people are having better health care outcomes with vaccines. So your population is steady. However, when you look at the other diseases that are

are resulting because of this urbanization it's also a concern so this particular study looked at cities like Blantyre in Malawi there was Durban in South Africa which is well known as a very cosmopolitan metropolis there was Harare in Zimbabwe Kampala

So Durban, which is known to have a very well-developed city, had the highest number of people with asthma. Blantyre, which is a developed city in Malawi, yes, but it had the lowest number of people with asthma. So it's telling you something. The cities that are growing are more likely to have children, adolescents, young adults with asthma compared to the ones that are growing at a much slower pace. Dorcas, thank you so much for speaking to us. Thank you, Hannah.

We've talked about air pollution on the podcast before in places like Jakarta, Cairo and Delhi. Now, Delhi is often described as the most polluted city in the world, and it's trying to tackle the problem by addressing pollution from coal, cars and cooking fuels. And if you want to hear more about what Delhi is doing, you can find that and all of our other episodes wherever you get your BBC podcasts. And if you think you might have asthma yourself, it is worth chatting to your doctor.

That is it for today. Thank you for listening to this episode of What in the World from the BBC World Service. I'm Hannah Gelbott and I'll be back with another one soon. Bye. Yoga is more than just exercise. It's the spiritual practice that millions swear by.

And in 2017, Miranda, a university tutor from London, joins a yoga school that promises profound transformation. It felt a really safe and welcoming space. After the yoga classes, I felt amazing. But soon, that calm, welcoming atmosphere leads to something far darker, a journey that leads to allegations of grooming, trafficking and exploitation across international borders. ♪

I don't have my passport, I don't have my phone, I don't have my bank cards, I have nothing. The passport being taken, the being in a house and not feeling like they can leave.

You just get sucked in so gradually.

And it's done so skillfully that you don't realize. And it's like this, the secret that's there. I wanted to believe that, you know, that...

Whatever they were doing, even if it seemed gross to me, was for some spiritual reason that I couldn't yet understand. Revealing the hidden secrets of a global yoga network. I feel that I have no other choice. The only thing I can do is to speak about this and to put my reputation and everything else on the line. I want truth and justice.

And for other people to not be hurt, for things to be different in the future. To bring it into the light and almost alchemise some of that evil stuff that went on and take back the power. World of Secrets, Season 6, The Bad Guru. Listen wherever you get your podcasts.