© World Health Organization

Name: Malri Twalib. Age: 5. Country: United Republic of Tanzania. Diagnosis: Obesity.

Malri Twalib is a five-year old living in a poor rural area of the Kilimanjaro District of the United Republic of Tanzania. Health workers from a nearby medical centre spottedhis weight problem last year during a routine community outreach activity. The diagnosis was clear: childhood obesity.

One year later, Malri’s health condition hasn’t changed for the better and neither has his excessive consumption of porridge and animal fat. His fruit and vegetable intake also remains seriously insufficient – “it is just too hard to find reasonably priced products during the dry season, so I can’t manage his diet,” his mother Fadhila complains. The community health workers who recently visited Malri for a follow-up also noticed that he was holding the same flat football as before – the word “Health” stamped on it couldn’t pass unnoticed. Malri’s neighbourhood is littered with sharp and rusted construction debris and the courtyard is too small for him to be able to play ball games. In fact, he rarely plays outside. “It is simply too hazardous. He could get hurt,” his mother says.

Fadhila, who is herself obese, believes that there are no risks attached to her son’s obesity and that his weight will naturally go down one day. “Rounded forms run in the family and there’s no history of chronic diseases, so why make a big fuss of all this,” she argues with a smile on her face. In fact, Malri and Fadhila are at risk of developing a chronic disease as a result of their obesity.

Name: Menaka Seni. Age: 60. Country: India. Diagnosis: Heart disease and diabetes.

Menaka Seni had bypass surgery following a heart attack last year – exactly a year after her husband died from one – and survived the tsunami which devastated her neighbourhood in December 2004. Despite these ordeals, she has been able to “get back on track”, she says, and to make positive changes to her life. Shortly after her husband’s death, Menaka started taking daily walks to the temple, but was still eating unhealthily at the time of her heart attack.

“I may be one of the privileged who could seek the best medical treatment, but what really matters from now on is how I behave,” she argues. Menaka has been eating more fi sh, fruit and vegetables since the surgery. Related to her heart disease and diabetes, Menaka is overweight and suffers from high blood pressure.

“Taking medication for my heart and diabetes helps but it takes more than that. You also need to change behaviour to lower your health risks,” she explains. Menaka recently turned 60 and is successfully managing both her diet and daily physical activity. The medical staff who took care of her while she was recovering in hospital played a key role in convincing her of the benefi ts of eating well and exercising regularly.

Name: Faiz Mohammad. Age: 48. Country: Pakistan. Diagnosis: Diabetes.

For the past 20 years, Faiz Mohammad has been a victim of the misunderstandings surrounding his condition. He married two years after being diagnosed with diabetes, and remembers the difficulty he had in obtaining the blessing of his future parents-in-law. “They were quite reluctant to give their daughter to someone with diabetes. They didn’t trust me. They thought I couldn’t support a family,” Faiz explains.

A hard-working livestock keeper and a father of three boys, Faiz considers that at 48 he’s living a normal life. However, even after all this time, he still encounters all sorts of obstacles that he fi nds diffi cult to overcome. “People don’t understand why I suddenly became ill. They think I have done something wrong and that I’m being punished.”

Faiz himself has misunderstandings about his disease. He wrongly believes that diabetes is contagious and that he could transmit it sexually to his wife. “I’m afraid of contaminating her because people keep telling me that I will,” he says.

Faiz has a check-up and buys insulin every two months at a local clinic. He claims that he is not receiving clear information about his disease and wishes he knew where to fi nd answers to all his questions.

Source: World Health Organization (2005) Preventing Chronic Disease: A Vital Investment, Geneva.