Afghan children saved by diabetes clinics

On 17 April, the children’s diabetes centre in Indira Gandhi Hospital in Kabul was inaugurated. The next day, a man entered the clinic carrying his seven year old daughter on his shoulders. Anita was diagnosed with type 1 diabetes and received immediately insulin treatment.   Since April, Anita visits the clinic regularly for medical check ups and to receive more, free, insulin. Her blood glucose levels have dropped to normal and her weight has gone from a slim 14 kilos to a healthy 17 kilos. Today, the girl from the poor Afghan family doesn’t need to be carried on her father’s shoulders. She walks to the clinic herself. Making an effort on all levels Anita is only one of the hundreds of children who since April have been saved by the presence of four diabetes clinics in Kabul. Numbers from November 2005 show that 4300 patients have been registered and treated at the four clinics established by funds through a project funded by the World Diabetes Foundation. The project funding has also paid for training of Health care personnel in Karachi, Pakistan, while the healthcare company Novo Nordisk has funded a customized database which collects critical data on the diabetes population for the Ministry of Health to rollout a National Diabetes Program in 2006. The Afghan Medical Relief Foundation (AMRF) funds the supply of insulin, which means that the children and adults visiting the clinics receive free treatment and medication. Success on all levels demands a new way of thinking “We have a tremendous cooperation with the Ministry of Public health and they are extremely supportive,” says Ken Belanger, one of the responsible for the project operation, and working at the Novo Nordisk Near East Office. “The problems turn up when we talk implementation. For example, in the middle management in the clinics we feel that there are some difficulties in how to implement the agreed plans and goals.” Ken Belanger and Sardar Isaqzai are the main forces behind the project in Kabul. Sardar has taken it upon himself to help the hospitals with a lot of practical solutions, i.e. the lay out of a clinic and advice on which materials are necessary to run a clinic. Sardar and Dr. Kabir Ahmad Faiz, Novo Nordisk Medical Advisor in Kabul, supply the clinics with educational material and conduct small seminars, which supplement the three week training program the health care personnel received in Karachi. Trying to find an explanation to some of the difficulties the team encounters, Ken Belanger suggests that;”the main challenge is to get the people to think differently. They have lived in 30 years of civil war, and are used to thinking in short term solutions for survival. Now we would like them to think in longer term perspectives in order to prevent and to establish systems that eventually will pay off in the long run. It’s a new way of thinking for them.” Working - and walking - to combat diabetes Sardar  M. Isaqzai , Dr. M. Amin Fatemie (Minister of Public Health), Dr. Moqim Rahmanzai  (President of AMRF)  and other key people from The Ministry of Public Health, The Ministry of Higher Education, Kabul Medical University and school children were among the group of 1100 people in Kabul, who joined the Global Diabetes Walk 2005. The walk created greater awareness of diabetes. In addition, the Ministry of Public Health has initiated general awareness campaigns on radio and television, so the project team feels very confident that the authorities have the will to combat the diabetes problem, although the road may be long. Seeing the long perspective It may take a long time to change the way of thinking in Afghanistan, but some things have already changed. Anita and thousands of other people in Kabul are receiving treatment for a disease they would otherwise die from. Ken Belanger reminds himself; “We spend a lot of time worrying about the obstacles we meet when trying to establish a system for prevention, diagnosis and treatment of diabetes, but then again we think of the 4300 people we are presently helping , and the 4300 families whose lives we have impacted  – it makes it totally worth the effort.”