The festivities of World Diabetes Day proves each year that the Type 1 diabetes community transcends geographic boundaries. Unfortunately, the needs of the community differ greatly from country to country. People living with diabetes in resource-poor parts of the world often face considerably more challenges.
Earlier this month, we shared three portraits from interviews of people with diabetes in the developing world. Here, we feature three additional excerpted interviews. They paint a picture of the challenges some individuals must face every day. They also present the opportunity for the diabetes community to work together to find sustainable solutions for the global T1D community.
Sana Ajmal is Young Leader President Elect of the International Diabetes Federation. Sana talked about challenges to diabetes care in Pakistan:
For Type 1 patients, the only insulin options available through public sector in Pakistan are premixed, regular and NPH. Analogues, due to the higher cost, are not available for free. Thus availability, affordability, poor prescribing practices, and patient adherence all play a huge role in lack of use of insulin for people with diabetes….Many Type 1 diabetics lose their life in the very early stages…due to self-medication or alternative medicines. Rural areas are a special problem, where due to lack of health facilities, education, and government initiatives, people might never even know what their child died of.
Ronaldo Wieselburg lives with Type 1 diabetes in Brazil. He discussed the challenges there:
In smaller cities, or in (rural) areas such as the Amazon forest, the Caatinga, or the Pantanal, life with Type 1 diabetes can be a huge problem. Sometimes, the nearest city with a doctor can be something like 12 hours by boat, and the doctor won’t be prepared to treat diabetes. In this case, some cases of diabetes will not be discovered until the patient develops DKA (diabetic ketoacidosis) or complications and is far away from the doctor. This leads to a higher mortality rate among people in these areas.
Lucy Laycockis the founder of the Pendsey Trust, a UK-based charity that works with a local organization called the DREAM Trust to provide education for children with Type 1 diabetes in Nagpur, India:
Beyond the obvious struggle of being able to afford insulin in the first place, this is a complex issue. For example, insulin needs to be stored at fridge temperature. Many of the kids in India don’t own a fridge (or even) have electricity in their villages. To make things worse, many of those I met live hours from a main city, and each time they have to travel to collect insulin, they or their parents must miss at least two days of work.
Stigma is also a huge problem; girls with diabetes are not considered fit for marriage. This is a huge shame upon their family in India. As a consequence many either hide their condition from their husbands, are abandoned, or are actually concealed away within their homes by their families altogether…There is hope, and establishments like the DREAM Trust are constantly working on innovative ways to overcome these problems.
Yemurai Machirori is a young woman with Type 1 diabetes from Zimbabwe who explained the injustices for people with diabetes in her country.
Access to medicine and diabetes care is definitely different across the country. The nurses in small towns sometimes have no education at all about diabetes. Some clinics in the small towns even lack…instruments such as glucometers and insulin, and people with diabetes have to travel to the big cities for these regular check-ups. The price of insulin and other diabetes supplies is (also) definitely a problem that needs to be adjusted in Zimbabwe….I think insulin prices must be made affordable to the general public and given for free to those that cannot afford it. In this day and age, I believe that no one must die because they cannot afford insulin.
In honor of Diabetes Awareness Month, you can work with others towards the goal of ensuring that everyone has the right to stay healthy with Type 1. You also can take action by submitting your photo in support of the insulin4all campaign at www.insulin4all.tumblr.com. The campaign, a partnership of The Pendsey Trust and T1International, aims to ensure that the entire world is remembered on World Diabetes Day.
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