The Silent Threat of Hypertension in West Africa
Every morning, before the first light of dawn, 65-year-old Malam Idris Bunun Fadan checks his blood pressure. Living several kilometers away from the nearest hospital, he relies on the support of community health volunteers to monitor his condition and stay healthy. These volunteers, known as Community Health Influencers, Promoters and Services (CHIPs), play a crucial role in ensuring that individuals like Idris can manage their health effectively.
Malam Idris recalls how he was diagnosed with hypertension and had to be on medications to regulate his blood pressure. “There was a time I hit my head on the door while going to the toilet. Fortunately, I was working with the Ministry of Health then, and the Permanent Secretary asked me to go to the hospital,” he said. Across West Africa, from Bauchi in northeastern Nigeria to Suhum in Ghana’s Eastern Region, men and women like Idris depend on local volunteers for their survival.
These grassroots health workers bring essential services straight to people’s homes — from blood pressure checks to health education and treatment referrals. However, despite their critical role, they often work under immense strain, facing little or no government support, misunderstanding from residents, and the daily challenges of unpaid labor.
Battling the Silent Killer in Bauchi
When 45-year-old Amina Abdullahi began experiencing dizziness and headaches, she assumed it was stress. It was not until some health volunteers visited her home in Misau that she discovered her blood pressure was dangerously high. “Yes, I used to feel dizzy and had frequent headaches. When they tested me, they confirmed that I had high blood pressure. It has been about a year now, and we are very grateful for their support,” she said.
Amina and Idris are among hundreds in Bauchi whose lives have been transformed by CHIPs volunteers. The prevalence of hypertension has become alarmingly high in the region. In January 2020, Governor Bala Mohammed revealed that about 150 people died in Azare — Katagum Local Government Area — within 30 days, from hypertension and related illnesses.
Dr. Ahmed Abdulrahman Mohammed, a Nigerian cardiologist, warned that hypertension has become the leading cause of death in Africa after road accidents. He emphasized the need for more trained experts in cardiology, citing the shortage of heart specialists and the frequent deaths of patients suffering from cardiovascular diseases.
The Role of Volunteers in Saving Lives
In Bauchi State, volunteers like Comrade Yusuf Aliyu Fada lead local health outreaches, visiting homes and checking people’s blood pressure for free. “We try our best to check BP for people around the PHC. Even without payment, we still help those in need,” he said. He recounted a case where his 50-year-old neighbor suffered constant headaches, and upon checking his BP, it was found to be dangerously high.
However, the work comes with challenges. Many people think the government pays the volunteers, but that is not true. Only one local government gives them a small allowance. Another volunteer, Abdullahi Muhammad Mubarak, noted that residents often misunderstand their mission. “Some people think we’re showing off, but we are farmers and small business owners. We just want to help our community,” he said.
Parallel Efforts in Ghana
Across the border in Suhum, Ghana, a similar story unfolds. The Youth Aid Initiative (YAI), founded in 2015 by two university graduates, leads volunteer-led campaigns against diseases such as tuberculosis, malaria, HIV, and neglected tropical skin infections. Volunteers identify potential cases and notify disease control officers at the nearest health centre, who then accompany them to examine the clients and collect samples for testing.
Founder Bright Owusu explained that using local volunteers helps build trust and reach communities where hospitals cannot. “We use local volunteers because they know the people and understand their language,” he said. However, sustaining the work is tough due to limited funds, volunteer fatigue, and logistical constraints.
Government Response in Bauchi
The Bauchi State Government has expanded its hypertension screening programme from 24 to 132 primary healthcare centres as part of efforts to curb the rising cases of the disease across the state. Deputy Director of Public Health, Umar Hassan Waziri, disclosed this in an interview, noting that hypertension remains a major health concern not only in Bauchi but across Nigeria.
According to Waziri, the state records a hypertension prevalence rate of about 23 to 24 per cent, prompting the need for an intensified response. The intervention by Population Services International (PSI) through its Healthy Heart Africa programme has been instrumental in improving screening and early detection. Between 2023 and now, 1,284,662 people have been screened, with 125,162 showing elevated blood pressure.
Waziri commended PSI for providing free services, drugs, and capacity-building for health workers, adding that proper training had long been overlooked in managing the condition. The government has now incorporated the programme into its Annual Operational Plan (AOP) to ensure sustainability beyond PSI’s presence.
A Region’s Lifeline
Whether it is volunteers like Yusuf Fada in Misau or Conne David in Suhum, one truth binds them — their unpaid service keeps hundreds alive. In places where hospitals are miles away and ambulances never come, they have become the first responders, counselors, and sometimes the only hope for patients battling chronic illnesses.
But the question remains: how long can goodwill sustain a service the state should guarantee? Until West African governments strengthen rural healthcare systems, these volunteers — unsung and unpaid — will continue walking dusty roads, carrying blood pressure cuffs, and saving lives one household at a time. As Idris said with a faint smile, “They are the reason many of us still wake up to see another day.”