Managing diabetes at grass roots
Voltaire says: “The art of medicine consists in amusing the patient while nature cures the disease.”
Non-communicable diseases (NCDs) are the best examples of diseases that require more than medication for a cure.
The World Health Organisation (WHO) in 2005 emphasised that preventing and treating diabetes is effective and cost-effective. This was a reflection of a condition that is posing great risks to people’s health globally.
In Malawi, diabetes used to be thought of as a disease of the rich but today the disease has not spared anyone.
According to WHO, diabetes is at crisis levels and most people die of diabetes and hypertension without healthy officials knowing the cause of death. In fact, in many circumstances, people have been accused of witchcraft after failing to understand the cause of the death of a relative.
Globally, healthcare expenditure for diabetes totalled $465 billion in 2010, which is equivalent to 11 percent of the total healthcare spending. WHO warns that without investments in widely availing people with effective preventative diabetes complications, the expenditure on treatment is predicted to rise to $595 billion by 2030.
On the contrary, diabetes and, indeed, other NCDs are not adequately funded in the Ministry of Health budget allocation.
Malawi Health Equity Network Executive Director, George Jobe, recently lamented lack of implementing of the Abuja Declaration that calls on member states to allocate 15 percent of the national budget to health sector.
“The health budget is small and cannot adequately accommodate non-communicable diseases and much attention is given to HIV and Aids,” Jobe said.
With such lack of financial commitment to provide adequate resources towards this emerging chronic disease, most patients are unable to access medication, supplementary food and counselling at the right time, as their locations are far away from health centres.
“We are finding it hard to get the right medication due to long distances to reach Kamuzu Central Hospital, where diabetes is ably treated. This disease deteriorates health and we need frequent check-ups,” says Catherine Maulana of Mtandire Township in Lilongwe. She was diagnosed with diabetes and hypertension in 2010.
The current challenges facing diabetic patients compelled Olive Kadzakumanja, a retired nurse/midwife, to establish a community non-governmental organisation called Community against Diabetes and Hypertension (CADH) in 2015. The organisation serves local communities in raising awareness in the prevention and treatment of diabetes and hypertension.
Kadzakumanja defied retirement and her passion on diabetes and hypertension has been using peer supporting groups to raise awareness and counsel patients on lifestyle as diabetes demands total change of lifestyle.
Using her retirement package, she has been visiting the peer groups and establishing more to serve her passion.
“I have always believed that peer supporting groups are a better model in preventing and treating diabetes and other non-communicable diseases. We need stakeholders that can help us in implementing this model throughout the country,” Kadzakumanja says.
Since 2015, CADH has seen the growth of diabetes peer support groups from 17 to 30 in Lilongwe with about 1,200 patients.
Matapira Peer Support Group in Traditional Authority Mazengera in the district testifies to CADH’s impact with over 163 members from 26 in 2015.
Kadzakumanja says CADH’s establishment of peer support groups has made other people inquire of diabetes and hypertension. However, the peer groups face challenges of lack of drugs and screen machines such as Glucometers and BP machines.
On drugs and medical equipment, Kadzakumanja appeals to organisations in the health sector to support CADH as it champions diabetes and hypertension awareness.
“CADH has passion but not resources and it is hard to source funds since many stakeholders do not realise the extent to which diabetes is affecting communities. We always empower communities with knowledge and skills so that they will be able to prevent a number of diseases and live healthily while contributing to the household and country’s development,” Kadzakumanja says.
Parliamentary Committee on Health Chairperson, Juliana Lunguzi, who officially opened CADH’s Diabetes Counselling Centre in Lilongwe, commends the organisation for the initiative and challenges the authorities to support such efforts with the required resources.
“Our committee in Parliament will continue to lobby for more funding on NCDs, which include diabetes, and that such funds should reach community initiatives such as that of CADH,” Lunguzi says.
The establishment of CADH comes when most Malawians do not know about diabetes, the disease which is claiming many lives.
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