Autoimmune Diseases On The Spot

In light of International Autoimmune Disease Awareness Month which is observed throughout the entirety of March, Rheumatologist, Dr Rutendo Rukarwa of RheumaMed Clinic, discusses all things autoimmune diseases. These are a group of disorders in which the

Hello Dr Rukarwa. Thank you for making time for us. Tell us a bit about yourself and what inspired You to enter the field of rheumatology?

My name is Dr Rutendo Yvonne Rukarwa. I am a mother, a wife, as well as a highly career driven individual. I attained my Undergraduate Bachelor of Medicine and Surgery at the University of Zimbabwe, then upon immigrating to Botswana I did a Post Graduate Diploma in Family Medicine with the University of Stellenbosch. However my first love in medicine had always been Internal Medicine, and with the encouragement and support from my husband, I did my Post graduate studies at the University of the Witwatersrand, and attained a Master of Medicine (Internal Medicine) as well as became a Fellow of the Collage of Physicians (FCP) as a

Specialist Physician. During my training journey, I fell in love with Rheumatology, a branch of Internal Medicine, and then went on to subspecialize in Rheumatology. What inspired my choice to specialize in Rheumatology is multifactorial.

Firstly it’s a challenging field that requires one to have an excellent grasp of general Internal Medicine as the patients typically present with many systems of the body being involved.

Secondly there is a shortage of doctors trained in this field, especially in Africa, Botswana currently having only two of us, however the burden of diseases in the field is great. Lastly it is an ever evolving discipline, with lots of research dedicated to giving patients the best outcomes, so it’s never boring.

It seem in recent years more and more people around the world are suffering because their immune systems can no longer tell the difference between healthy cells and invading microorganisms. What do you think is driving this? The food we eat? Environment? Our lifestyles?

Indeed there has been a rise over the years in the incidence and prevalence of autoimmune diseases, by between 3-9% per year, and the reasons for this is multifactorial. Firstly there is usually a genetic component to developing these diseases and this is passed down from parents, however they can occur spontaneously. Gender also plays a role, as autoimmune conditions as a whole are 3 times more common in females than in males, indicating hormonal and genetic influences. Genetics alone however cannot explain the rise in autoimmune cases and therefore other factors play a role. These include a combination of lifestyle and environmental factors as well as infections that contribute to a genetically susceptible individual developing the disease. Obesity and a more sedentary lifestyle, and the chronic inflammation that results from it may trigger autoimmune diseases. Also with the dietary changes and the adoption of a Western diet that is rich in processed foods, additives, sugar, unhealthy fats, and fast foods, these contribute to a dysregulated immune system and have been implicated in the increases being seen especially in developing countries. Other lifestyle factors include cigarette smoking which known as an important trigger of autoimmune conditions, especially with Rheumatoid Arthritis. Stress has also been shown to trigger