Blog - Engage Africa Foundation

Home / Blog / The Double Burden

The Double Burden

Once upon a time, in the land of Frica there was a plague called “umthwalo double”, which means the double burden. Umthwalo double was the term used to describe the high prevalence of communicable and non-communicable diseases. Frica had experienced many challenges; Biafran war, Apartheid, Genocide, you name it, none of these could be likened to the umthwalo. Preparing for such was a luxury; the already weakened health care system slowly crumbled as it raised the white flag.

During the process of surrender, countless efforts were made to fight the giant. The strategy? Attack the most threatening and easily contractible diseases by providing medications and preventive materials. As easy as it seemed, the majority agreed that communicable diseases would be their victim. Little did they know about what was to come. The threat of non-communicable diseases caught them by surprise. As far as the decision-makers were concerned, life for Fricans was over. Their hope was to have the leaders of tomorrow provide a solution, but that in itself was ironic.

“While we wait for the future leaders, many more children and potential parents will die, so tell me, where are the future leaders?” a concerned citizen expressed.

Another said, “even if they are alive, the atmosphere of our motherland does not esteem health researchers as it should. What is causing more palava now is the brain drain! Our doctors and nurses are practicing in Urope and Merica.”

“But, why won't they?! Higher education is not interrupted by constant strikes, the law of the land is enforced, and students feel safe! Not to mention teachers' pay in those areas are almost always regular.”

For years arguments like this continued amongst the people.  While the decision-makers were focused on enhancing the health care system with more structures and facilities, Fricans raised key outside factors that perpetuated the umthwalo. Both sides were appropriately concerned, but the lack of collaboration, which reflected the relationship between the health workers and non-health workers, was about to lay them face down at the feet of the umthwalo double.

What they did not realize was the need of a common language between doctors, community members, police, engineers, artists etc. Collaboration between even the most unlikely groups was needed to fight the umthwalo double. Everybody had to be on board. The need to work together under the same conceptual framework was critical. Fricans needed a transdisciplinary approach to defeat the umthwalo, but each group was and is still focused on their own framework for achieving a healthy Frica, so sit back, it might take awhile or do something and end the umthwalo double.


To understand the difference between interdisciplinary, multidisciplinary, and transdisciplinary approach to health please visit:

Jadesola Giwa is a Bachelor of Health Sciences (Honors) with a major in Health and Society and concentration in psychology and a soon-to -be University of Calgary Graduate (June 2014). She is interested in improving the socioeconomic status of low and middle income countries by encouraging preventive care in oral health. She is also currently involved in developing health interventions that address health inequities by ensuring that women of all ethnic backgrounds receive health interventions in a way that increases knowledge and encourages preventive behaviours.


Our mission is to create narratives and inspire action that can put health and wellbeing at the center of Africa's development.

  Newsletter Subscription
  Contact Us
  Engage Africa Foundation
Business Hours: 9:00 AM to 6:00 PM