For Madam Samaai, 69, every breath is a struggle, reflecting a growing burden of chronic respiratory diseases across Africa driven by smoking, pollution and weak health systems.
Lying on her hospital bed at the Heideveld Community Day Clinic in Cape Town, South Africa, she speaks slowly, pausing often to catch her breath as the weight of illness shows in every word.
Diagnosed more than a decade ago with Chronic Obstructive Pulmonary Disease (COPD), a progressive lung condition, her health has steadily declined, turning once simple daily routines into exhausting tasks.
“I couldn’t breathe properly and the pain in my lung was very severe,” she told the Ghana News Agency, recalling the symptoms that have repeatedly brought her back to hospital.
Madam Samaai said the condition had worsened over time, leaving her unable to carry out basic activities independently.
“I get tired very quickly, I can’t do much for myself anymore,” she added.
Her illness, Madam Samaai believes, is linked to years of smoking, a habit she now regrets.
“I want to tell young people to stay away from smoking tobacco smoking is not good for your health, you don’t feel it when you are young but later it takes away your strength, your appetite everything,” she said.
Her experience mirrors a wider public health challenge.
According to the World Health Organization (WHO), COPD is the fourth leading cause of death globally, responsible for about 3.5 million deaths each year, with nearly 90 per cent occurring in low- and middle-income countries.
Health experts say the drivers extend beyond tobacco use to include air pollution, indoor smoke from cooking fuels and exposure to harmful substances.
Professor Richard van Zyl-Smit, Deputy Head of the Division of Pulmonology, Department of Medicine at the University of Cape Town and a pulmonologist at the Groote Schuur Hospital, said lung damage could result from repeated exposure to smoke from various sources.
“Any smoke is harmful to the lungs, whether it comes from wood, charcoal, grass or crop residue, breathing it repeatedly can cause long-term damage.”
Prof. Zyl-Smit explained that while asthma often begins in childhood, COPD develops gradually and leads to persistent breathing difficulties.
“Traditionally we thought COPD appeared later in life because it required years of smoking, but we now know there are many other factors including severe childhood infections, air pollution and drug exposure that can damage the lungs earlier,” he said.
Beyond the causes, health system gaps continue to worsen outcomes.
Professor of family medicine and primary care at Stellenbosch University, Prof Bob Mash, said many African primary healthcare systems were not adequately equipped to manage chronic respiratory diseases.
He estimated that about 20 per cent of adults over 40 in Cape Town could be affected, placing pressure on limited specialist services.
“Many bypass primary clinics entirely, travelling long distances to hospitals in search of medication sometimes paying significant costs out of pocket,” he said.
Prof. Mash noted that limited training and inadequate diagnostic tools often led to delayed or incorrect diagnoses.
“Patients are often left with little understanding of their illness, doctors give medication without really explaining what is happening in the lungs or what lifestyle changes might help,” Mash said.
At the Heideveld Community Day Clinic, the strain on the system is evident.
Ms Portia Williams, a senior medical officer, said chronic lung diseases accounted for nearly a third of monthly admissions.
“Many cases are linked not only to cigarette smoking but also to substance use, drugs such as heroin, cannabis and crystal methamphetamine which has devastating consequences for lung and heart health are widely used in some communities,” she said.
Ms. Williams noted a troubling trend of younger patients presenting with advanced disease.
At the policy level, there are calls for urgent action. Mr. José Luis Castro, WHO Special Envoy on Chronic Respiratory Diseases, said the condition had received insufficient global attention.
“COPD kills more than three and a half million people every year yet has remained largely invisible in global policy discussions.”
Mr. Castro urged governments to implement stronger measures to reduce exposure to risk factors and strengthen health systems.
“Taxing tobacco products and regulating polluting industries could both reduce exposure and generate revenue to strengthen healthcare systems,” he said.
Mr. Castro warned that second-hand smoke and indoor air pollution, particularly from cooking fuels, continued to endanger millions, especially women and children.
Rapid urbanisation and industrial activity, he said, were further worsening air quality in many cities.
Back on her hospital bed, Madam Samaai reflects on the toll of the disease; her voice faint but resolute.
“If you cannot breathe, you cannot function, you cannot work, you cannot study, you cannot even do the simplest daily tasks,” she said.
“You don’t feel the damage when you are young, but later, it comes.”
Dr Castro said cases such as Madam Samaai’s highlight the need to address chronic respiratory diseases in line with Sustainable Development Goal 3, which seeks to ensure healthy lives and promote well-being for all.
Health professionals have also emphasised the importance of early diagnosis, access to inhalers, improved training for primary healthcare workers, and public education to improve outcomes.
By Linda Naa Deide Aryeetey
Source: GNA
