Health authorities in three districts of the Upper West Region are reporting increasing rate of hernia and goiter infection.Medical experts associated the two conditions to iodine deficiency and unclean water, but the high prevalence is prompting authorities to investigate for other potential causes.Out of 64 patients who underwent surgery by the APRIDEC Medical Outreach medical team, currently offering free care in the region, 36 were operated for hernia.Eighty out of 400 Out-Patient cases recorded daily at the hospitals across the region require surgery.Districts with high prevalence are the Sisala East and West as well as Nadowli-Kaleo.Two out of ten people who seek medical care daily at the Tumu District Hospital are diagnosed of hernia.Medical Superintendent at Tumu District Hospital, Dr. Zakari Bukari, is worried because most of the patients report late for treatment.He wants the Regional Health Directorate to lead the crusade to investigate the real cause of the diseases for appropriate action.“Under the surgical cases we have hernia as being the number one cause of OPD attendance or admission for surgery because most of them would come strangulated. For every ten case that comes for OPD, you have two having hernia. We haven’t sat as health managers in the area to find out why. This is something like prompting us. We would take that opportunity and find out why,” Dr. Zakari said.Despite the introduction of Health Insurance, residents in predominantly farming communities in the area do not report early at health centers, they wait till the diseases get to the advanced stage.Dr. Bukari who is also the District Director of Health for the Sisala West, emphasized on attitudinal change in order to overcome the challenge.“In fact, generally there is a delayed in coming to the hospital because we are not the final or the only system that provides help. There is family system where they (patients) have to consult someone first for permission. There is a family system where they have to go to somewhere first to sought for medication, there is a herbalist they have to [consult]and the women too there is this traditional birth attendant that must give order that ok at this time we cannot deliver you, go to hospital,” Dr Zakari explained.He also called for an end to what he calls complex health system in the area.“So there is a whole lot of complex system. And finally if they consult all other means of getting healing and it’s not possible, then they come to us”. Dr Zakari emphasized.