In these monthly articles I have tried to highlight certain health problems occurring in the Kurdistan region and offering solutions to the prevention and elimination of the problem in the region. However, this month I will be writing about allergies in relation to Kurdistan’s population and climate, although, it is not necessarily a major health problem in the society at this present time.
The immune system is a complex network of cells and proteins that defends the body against infection. Under-activity of the immune system, also called immunodeficiency, can be inherited or acquired as a result of medical treatment or caused by another disease. Immunodeficiency predisposes people to infections. Over-activity of the immune system can take many forms, including allergic diseases, where the immune system makes an excessive response to proteins in substances (known as allergens) and autoimmune diseases, where the immune system mounts a response against normal components of the body. Allergic diseases are extremely common. These include food, drug or stinging insect allergy, anaphylaxis (life-threatening allergy), hay fever (allergic rhinitis), sinus disease, asthma, hives (urticaria), dermatitis and eczema (skin allergies).
An allergy is commonly defined as a hypersensitivity disorder of the immune system and allergic reactions occur due to the reaction of the immune system to substances or changes in the environment which are normally harmless. Although once diagnosed allergies can be predictable, they are also rapid and can be fatal depending on the seriousness of the allergic reaction which can occur. On a more medical and scientific level allergic reactions are excessively activate white blood cells by the name of mast cells and basophils by a type of antibody called Immunoglobulin E (IgE). This cases an inflammatory response which can potentially be a serious health concern.
More common and mild forms of allergies include hey-fever red eyes, itching and skin irritation, runny nose, eczema, hives or asthma attacks which usually occur in reaction to substances in the environment. Asthma suffers are at a greater risk of potentially dangerous allergic reactions as it can irritate their condition. Some of the more severe allergic reactions arise from food allergies, and reactions to the venom of stinging insects such as wasps and bees.
Severe allergies to environmental or dietary allergens or to medication may result in a life-threatening reaction called anaphylaxis. Anaphylaxis is a serious allergic reaction that is rapid in onset and can be fatal. It typically causes a number of symptoms including an itchy rash, throat swelling, and low blood pressure. Worldwide 0.05–2% of people are estimated to have anaphylaxis at some point in their lives and rates appear to be increasing. As a side note and interestingly the term comes from the Greek anaphylaxis words ἀνά ana, against, and φύλαξις phylaxis, protection.
International wide studies have demonstrated that allergic diseases are more common in industrialized countries than in countries that are more traditional or agricultural, and there is a higher rate of allergic disease in urban populations versus rural populations. Kurdistan being a traditionally agricultural region and rapidly becoming industrialised due to the major exploitation of its oil fields and constantly advancing economy, urban regions of the country are in great risk of acquiring allergic diseases.
Currently in Kurdistan there are no statistics which exist for the rates of allergic diseases prevalent among the population. There was no response from the health ministry of the KRG on the issue when contacted and most doctors working in the region were unsure of the prevalence of the problem. One doctor whom works and resides in Slemani, Dr Rebeen Saeed, spoke to me about his observations as a professional in the field and the region. Dr Saeed who works in the emergency department believes he observes quite a few cases of allergies whilst on duty, however points out that many visit the immunological clinics instead and therefore he cannot comment on the population as a whole.
Dr Saeed says one of the worst cases they see is an allergic reaction to antibiotics or other medicinal drugs, he states “a few cases have been fatal before even reaching a hospital in the last few years due to anaphylaxis as there is not a solid system preventing Intravenous antibiotic usage outside hospitals especially those who receive the drug for the first time.” He reiterates that although the Ministry of Health has banned the use of Intravenous antibiotics or even intramuscular drugs outside of a hospital and if given must be under close observation of doctors especially those who have a history of allergies, cases are still seen due to the lack of control. He went on to also describe the allergies seen to foods such as berries, nuts (a common allergy among children globally) and meat, just to name a few, in the form of itching or even anaphylaxis in the worst case scenarios.
Dr Saeed also pointed out a less common allergic reaction seen in developed countries, he states that, “there are a lot of detergent inhalation cases every day by females who present with shortness of breath and features of bronchospasm, this is quite common we see it on daily basis.” He also spoke about a large number of Asthma cases for which many cases are not controlled or under constant medical supervision and therefore are frequently admitted for treatment of their symptoms. A high prevalence of asthma in the region would not be surprising due to the history of war and chemical warfare in the region and due to the now much industrialised environment of the region. The large exploitation of the rich oil fields and modernisation of an economy taking over the Middle East under a recovering health system will consequently result in high numbers of untreated long term allergy diseases.
Most concerning is the need for a standard procedure of treatment for different cases of allergic diseases in Kurdistan, across all hospitals and clinics, be it private or governmental, which seems to be absent. Especially for long term suffers like asthma victims and food allergies. Treatments plans must be in place to insure they remain healthy and prevent or treat any reactions as per symptoms. I will repeat once again, as I have done so in every article, that the public education on such health issues will be the greatest prevention. The knowledge of nut diseases for example could save a child’s life. A much greater need for resources of research into these kinds of health issues is direly needed so that the problem can be put into perspective against the population in the region. Action plans can and will be much more effective once this has been achieved.