Opinion article by Tshepiso Lekanyane, an Honours graduate in Sociology, and Dr Sello Sele, Lecturer, Department Sociology, University of the Free State

Academic success is a desirable outcome for students as well as the entire university community. However, it becomes a major challenge when illness, ailments and diseases become an unexpected threat to academic success. At times South African students battle with financial challenges, deadlines, and threats of academic exclusion. Thus, the last thing they want to deal with is something they have no control over, such as a chronic illness, which may interfere with their academic progress. For many students, chronic illness can manifest as fatigue, constant pain, or regular hospital visits. This is a daily battle of their reality. Chronic illnesses significantly affect students’ academic success in higher education. As such, institutions should go above and beyond to accommodate and support such students.

Understanding chronic health conditions

According to the World Health Organization, chronic diseases, also called noncommunicable diseases (NCDs), are long-lasting and caused by a combination of genetic, physiological, environmental, and behavioural factors. Common types of NCDs include heart problems, such as heart attacks and strokes, cancer, and long-term lung diseases, such as asthma and diabetes. These illnesses are common in poorer countries, where approximately 75% of all NCD-related deaths, around 32 million, occur. Some students enter higher education with chronic conditions, and their struggles often go unnoticed, with many students avoiding disclosing their illness due to fear of discrimination or being perceived as “lazy”. A study by Thongseiratch and Chandeying shows that long-term health problems can affect a student’s learning in different ways. They have a direct impact on academic performance and can also lead to social and psychological challenges. Common conditions such as epilepsy, asthma, diabetes, cancer, heart defects, and HIV can make it difficult for students to maintain sharpness and perform optimally in their studies.

Academic repercussions due to chronic illnesses

It is easy to judge other students if they are frequently absent, always look tired or miss deadlines. However, one ceases to be judgmental if they, a family member, or a friend falls ill. With that said, there are academic repercussions that students with chronic illness face. For example, there is frequent absenteeism due to overwhelming episodes of illness or medical appointments, which leads to missed lectures and reduced engagement during class. Furthermore, cognitive load can be increased by pain, fatigue, and medication side effects, which can impair concentration, memory, and executive functioning. Lastly, there is performance pressure where deadlines and exams become daunting when health is unpredictable, often resulting in lower grades or incomplete coursework.

Chronic illness often coexists with psychological issues such as anxiety and depression, combined with academic challenges. Socially, students may feel isolated from their peers, especially when they are unable to participate in campus life or activities. According to Shiu, missing classes could be a sign that a student is struggling socially or may show early signs of depression.

For students with NCDs, attending classes can be just as important for their emotional well-being as medical care is for their physical health.  A classroom setting might be the only place where these students are seen as regular people and not just patients. Even though it is difficult to show up for classes when they feel down, being on campus can bring a bit of structure and normalcy to the abnormality they may feel.

A clarion call for university support

Support from educational institutions is necessary because students are an integral part of these institutions. Many universities lack flexible policies or fail to effectively implement them to accommodate the various needs of students. In this context, student support services such as counselling, disability offices, and academic advisors must be better equipped to handle cases involving chronic illness. Furthermore, universities should adopt inclusive practices such as flexible deadlines, hybrid learning, and medical leave policies that recognise fluctuating student health. Hamilton et al., study shows that some students felt less important than others because their university did not focus on their health needs. Other students mentioned that when academic staff strictly enforce generic rules and policies, it can negatively affect students with disabilities and those with NCDs. This shows that academics and leadership may lack full comprehension of the impact of chronic illnesses on students and might be unwilling to adjust rules to meet the needs of vulnerable students with disabilities or those suffering from NCDs.