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Burden of diabetes in childhood

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Imagine you have a 14-year old daughter and she has diabetes. She constantly needs insulin and expensive medical health care it is not easy to manage her case.

This is the experience of parents from poor backgrounds across the country.

The World Health Organization (WHO) defines obesity and overweight as abnormal or excessive fat accumulation that may impair health.

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Although there is scarcity of information on childhood diabetes or Type 1 diabetes in Malawi, available statistics show that diabetes in children is on the rise and threatening lives of children and the future of the country.

Type 1 diabetes is when the pancreas, a gland in the human body which produces insulin, totally fails and the body has to rely on artificial insulin to be able to regulate glucose in the body.

Marianne Kasiya, a project assistant officer based at the College of Medicine in Blantyre, says childhood diabetes is a serious health challenge because most parents cannot afford the cost of insulin to give their children.

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“Type 1 diabetes needs insulin and not tablets and insulin is not cheap. Many parents cannot manage to buy insulin and it means lives of children are at huge risk,” Kasiya notes.

She adds that at the Queen Elizabeth Central Hospital, there are 60 children under the age of 16 registered with Type 1 diabetes which is also referred to as childhood diabetes.

“Just one bottle of insulin costs about K14,000, one needs 2 bottles a month which translates to K28,000. Now how many parents can afford that?” She wonders.

This roughly means that in a year, a parent needs K336, 000 only for insulin, on top of other costs of Glucometres and their strips.

From a glance it is clear that this is a matter of urgency.

During the 2014 World Diabetes Day commemoration in the Mzuzu, German Child Life, an NGO working on paediatrics and childhood diabetes called for the need for Malawi government to invest in the health care system and ensure that children with Type 1 diabetes are given the treatment they deserve.

As if this is not enough, the present situation of children lacking access to diabetes treatment is a serious violation of child rights.

Ann Herst of German Child Life notes that countries such a s Malawi need to ensure that diabetes in children is dealt with and that failure to provide treatment is a violation of the right of children to good health.

Unicef, the UN agency responsible for children issues, stresses that governments have a responsibility to take all available measures to make sure children’s rights are respected, protected and fulfilled.

It says when countries ratify conventions on children’s rights, they agree to review their laws relating to children.

“This involves assessing their social services, legal, health and educational systems, as well as levels of funding for these services. Governments are then obliged to take all necessary steps to ensure that the minimum standards set by the Convention in these areas are being met,” reads in part the summary of the Child Rights Convention (CRC).

President of Diabetes Association in Malawi, Timothy Ntambalika, bemoans the lack of support from the private sector in Malawi in tackling the burden of diabetes.

He calls upon companies to invest in the response against diabetes.

“Always, we have to write dozens of letters to the private sector to help us in tackling diabetes, but we are shocked that none of these companies who make millions of kwachas in the country have come forward to assist us. I think we are now tired, to be honest,” complains Ntambalika.

Experts attributed the problem of diabetes in part to obesity and overweight condition. The two conditions are said to be risk factors for the development of Type 2 diabetes. It is said obese and overweight children have a high risk of developing Type 2 diabetes when they are growing up, which suggests the need for parents have to watch their children are eating.

In 2013, WHO estimated that 42 million children under the age of 5 were overweight or obese. Once considered a high-income country problem, overweight and obesity are now on the rise in low-and middle-income countries, particularly in urban settings.

In developing countries with emerging economies (classified by the World Bank as lower- and middle-income countries) the rate of increase of childhood overweight and obesity has been more than 30 percent higher than that of developed countries.

The fundamental cause of obesity and overweight is an energy imbalance between calories consumed and calories expended.

Globally, there has been an increased intake of energy-dense foods that are high in fat; and an increase in physical inactivity due to the increasingly sedentary nature of many forms of work, changing modes of transportation and increasing urbanisation.

That is, besides the economic hardships in the country, it is now clear that childhood diabetes has finally arrived on our doorsteps. It is time to act.

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