Saving children in Sudan

Dr. Mohamed Elhassan Abdalla (in the middle) is responsible for a project in Sudan helping children who suffer from diabetes. In Sudan, a general lack of consensus on management of diabetes among health care professionals as well as correct knowledge about diabetes amongst parents and school teachers results in poor diabetes control in children suffering from diabetes.   These circumstances entail that many children are admitted to hospital in a state of keto-acidosis; a serious consequence of high glucose levels in the blood. Many of the admitted children are in a state where the hospital is unable to save their lives; others struggle with poor control affecting their health seriously. Involving family and school A project supported by the World Diabetes Foundation in Sudan, the “Integrated management of diabetes in children”  seeks to improve care given to children with type 1 diabetes through their schools and families and the health care system in order to decrease the high number of children admitted to hospitals with keto-acidosis. Project manager and paediatrician Dr. Mohamed Elhassan Abdalla, Faculty of Medicine at the University of Gezira, Wad Medani, explains that one diabetic girl gave him and the team at the Wad Medani Paediatrics teaching hospital the idea to establish a programme for children with diabetes. Sabrin’s case Sabrin was five years old when her diabetes was discovered, and she has been a regular hospital visitor at the local paediatrics unit since she was nine. Today she is 14: “At one point she was more in the hospital than in her home, and the staff became aware of the poor situation of children with diabetes”. “Her problem was difficulty in controlling her diabetes resulting in repeated incidents of keto-acidosis leading to admissions. Sabrin also suffered from depression. It seemed as if no one took care of her daily treatment; the ignorance and lack of interest from her family, alarmed us and made us aware to the many problems facing children with diabetes”. During a tutorial about keto-acidosis, Dr. Abdalla and the team at the Wad Medani Paediatrics teaching hospital discussed the situation of children with diabetes and the possible solutions and we decided to write the proposal to establish a clinic. Their project has run since January and will be completed in 2009. It is expected that 200 school teachers, 100 health care providers will be trained and 1,500 children will receive better quality diabetes care, while 1,500 mothers/care takers of children with type 1 diabetes will be trained in diabetes management. Finding the root of the problems When the project was established, a psychologist worked with Sabrin, and the team came to know that her parents were divorced and she was living between the new families and their children. This psychological disturbance affected her treatment; she omitted taking insulin and some time meals and she preferred to be in the hospital. Besides working with her both clinically and psychologically the team decided to have a visit to her mother's home to discuss her condition and their role in the diabetes management, as well as discussing her condition with her school. Today Sabrin’s condition is improving. The support from the diabetes clinic staff has enabled her get better control over her diabetes; it has been three months since her last admission, which in her case is a very long period of absence and is due to her newly gained psychosocial stability. But Sabrin still needs all the support she can get; her stunted growth, delayed puberty and poor wound healing have left marks that she lives with today. “If the clinic and the project were not started, I think the future for her was not good, for the simple reason that she and her family are not well educated about her condition and the management of the disease”, Dr. Abdalla concludes. Conflicts increase the problems of diabetes treatment Ms Tilde Frøyr, programme coordinator for WDF, visited Sudan in May 2006 and encouraged Dr Abdallah to initiate “Integrated management of diabetes in children” –project, during her field visit. “Years of conflict have paralysed the preventive and curative health services in Sudan. The programme staff are hard working and a dedicated group of health care professionals who have secured the sustainability of the programme and are thereby truly making a difference for the families and their children”, explains Ms Tilde Frøyr. According to Dr. Abdalla, the main problems facing children are poverty, induced by the history of conflicts of the country, lack of sustained insulin supply and storage facilities and distances from the health facilities.   Read more about the project

Link Visit the projects own website: imdcsudan.org