My Personal Journey Into Osteoporosis Care and Raising Awareness in Underserved Communities
By Dr. Tasneem Hassan
My name is Dr. Tasneem Hassan, and I work as a general practitioner in Nairobi, Kenya. After earning my degree in 2019, I began working at a public hospital in Nairobi.
Later on, I joined Rayhaan Healthcare where I met Dr. Mustafa Bhaiji, a consultant radiologist with a particular interest in osteoporosis. I also learned about the DXA technology, which further piqued my interest in osteoporosis. As I learned more about my family's history and observed many people with poor bone mass, I began to pay greater attention to it.
This is the story of my grandma, who fell a few years ago and broke her hip, requiring hip replacement surgery and leaving her bedridden for a while. All of these difficulties contributed to her death. To begin, we know she had low bone mass, but due to a lack of a bone DXA scan in Mombasa, Kenya, early diagnosis and treatment were delayed. She also had dementia, and her recuperation was difficult. In addition, there is a dearth of awareness about osteopenia and osteoporosis in our system, which impedes early diagnosis and prevention. If our thinking on osteoporosis had advanced significantly sooner back then, she might not have died from the comorbidities associated with the fracture.
Another interaction I had was with my mother, who had already suffered a fracture. She is currently in menopause, and a few months ago she fractured her foot as a result of a tumble. This could be a stress fracture. However, given her age and menopause, greater risk of falling, and past two fractures, I would not be shocked if she has poor bone mass, and so osteopenia. Individualizing care is easy; we do it all the time. We shouldn't allow folks to wander around with untreated osteoporosis since they will eventually stop walking. It is no longer the 1900s.
Osteoporosis is a disease that causes roughly 8.9 million fractures every year, culminating in one osteoporosis fracture every 3 seconds. One in every three women and one in every five men aged 50 and over will experience an osteoporotic fracture. Osteoporosis causes bones to become weak and fragile, allowing them to break easily - even from a little fall, a bump, a sneeze, or a rapid movement. I've seen people who have fractures that damage them not only physically, but also emotionally. It decreases their overall quality of life, sometimes resulting in despair and isolation as people reduce social connection or are no longer able to do the activities they used to do. Long-term loss of freedom and movement has imposed physical, emotional, and financial hardship on patients as well as their relatives and friends.
80% of those who have had at least one osteoporotic fracture are not diagnosed or treated for osteoporosis.
As a general practitioner, I endeavored to read as much as I could after recovering from my pity party, which I believe was tragically avoidable. Over the last few weeks, I have focused on doing a study on the prevalence of osteoporosis in our organization, particularly in connection to ethnicity, age, menopause, and risk factors.
Many women experience reduced bone mass after menopause and aging. I've taken a keen interest in following up with this group of patients and directing them to the best available care. We are also undertaking research based on the few DXA scans that we have completed in order to assist future generations.
It is also overlooked as a health concern in Africa for a variety of reasons, including:
Overburdened by communicable diseases like tuberculosis (TB) and human immunodeficiency virus (HIV).
Not long ago, there was a widespread belief that osteoporosis and the resulting fragility fractures were uncommon among Black Africans, but this is no longer the case.
We have encountered many people of all races impacted by osteopenia. However, the problem remains that there is no African-based research. This puts the FRAX scoring guideline in conflict because it does not take the African race into account.
In our region Healthcare professionals also lack insights on osteoporosis.
Despite advances in scientific study and available therapies and diagnostic techniques, osteoporosis continues to be a global health issue with potentially disastrous implications for patients and huge costs for health-care systems.
With this context, we can probably all agree that we need to improve osteoporosis treatment and raise awareness in underserved communities.
My aim is that more doctors will be informed on the subject and that this disease will be prioritized alongside other chronic conditions.
This story is part of a support initiative of the Bone Health and Osteoporosis Foundation called Voices of Osteoporosis: Stories of Hope and Inspiration. If you have experienced osteoporosis as a patient or caregiver, we invite you to share your story. Your story could inspire others to learn how to protect their ability to live their best life and stay bone strong. Click here to learn more.