As the number of people with diabetes rises across the world, nurses are becoming increasingly important in managing its impact. The quality of their initial assessment, care and treatment is vital.
So it is fitting that the International Diabetes Federation has nurses in focus this November 14. WDF knows the power of nurses first-hand: WDF-funded projects have trained more than 100,000 nurses worldwide, and the Foundation counts many of them among its trusted partners worldwide.
Earlier this week, we spoke with Emmanuel Kpon Saye from Liberia. Today, we introduce:
Maja Zaplan, the Philippines
Maja was born in 1986, and her childhood in Cainta, east of Manila, was a happy one.
“I had no idea what to do when I grew up – and no interest in the healthcare sector,” she says with a laugh. At age 18, on her mother’s advice, she enrolled in nursing school. The experience opened her eyes to a whole new world.
“I was really surprised by what is needed,” she says. “You have to study really hard, elevate your knowledge and then keep it updated – there is always something new. As a nurse, you don’t have the right to be lazy. If you're lazy, your patients will suffer.”
She graduated from St. Rita Hospital College of Nursing and Midwifery in 2007, and started her nursing career at Pasig City General Hospital three years later. Her first fulltime position was in the geriatrics department, where she saw the effects of diabetes and hypertension first hand.
Then, in 2017, an opportunity arose: she was invited to attend a seminar arranged by the project Accessing Gestational Diabetes Care, WDF16-1349. The project was funded by WDF and implemented by the Institute for Reproductive Health Philippines. Its goal was to improve gestational diabetes (GDM) care in the Metro Manila area – an area where diabetes prevalence is increasing with frightening speed.
Maja learned about how diabetes can develop during pregnancy, gained new skills to detect and treat gestational diabetes, and met other nurses working in the area. Soon after, she was transferred to the hospital’s maternity ward. She had found her calling.
“I really enjoy talking to pregnant women. They are not stressful to talk to, they are not sick. It mades me feel happy, because I know I can make an impact in their lives,” she says.
Absorbing the messages
Today, Maja sees women newly diagnosed with GDM and provides them with glucometers, strips, information and encouragement. She helped to roll out the Accessing Gestational Diabetes Care project, which successfully completed in August.
There is a lot of fear surrounding gestational diabetes, Maja notes. The potential harm to both mother and child is serious, and the patients need to understand what is at stake. But after meeting with the doctor and dietician, many patients arrive at her door frightened.
“I don’t want to scare them – about the risk of preeclampsia, for example – so I try to explain that not all mothers affected by GDM have problems,” she says. “I also tell them they can use what they learned after pregnancy, to help their own families and other pregnant women. I really see them absorbing the project’s messages.
“Honestly, when I learned about side effects of gestational diabetes, I feared the worst,” she adds. “But the babies we’re seeing in this programme are good, healthy. This project makes me feel like I’m doing my job well.”
Maja with patients after an informational seminar on gestational diabetes.
A tough profession
Globally nurses are often the first - and sometimes the only - health professional that a person interacts with. Asked if this is the case in the Philippines as well, Maja says “Yes - this is true!”
Pasig City General and other public hospitals just don’t have enough doctors, she explains. The doctors in her unit are busy and often exhausted after surgeries and complex deliveries … yet the the patients “ask a lot of questions, and if you’re the one there, you need to answer,” she says.
“They see me, say Doctor, Doctor! So I tell them I am a nurse, but they still insist, they still have their questions. When the waiting time for patients is very long, sometimes they are shouting at us.”
To make matters worse, the Philippines also suffers from a lack of nurses, especially in the public sector. It is not alone – according to the WHO there was a global shortage of 5.9 million nurses in 2018, with nearly 90% of that shortage concentrated in low- and middle-income countries.
This shortage is exacerbated by the tradition of Filipino healthcare professionals emigrating in search of better wages and opportunities abroad. Maja says she does not blame colleagues who chose to leave – but wishes that conditions were better for those who stay behind.
“Nursing is a tough profession here in the Philippines,” she says. “You meet patients who have been abused, and you absorb it. Sometimes I forget my family, and myself, thinking about my patients.”
Crises such as the COVID-19 pandemic are making the current moment especially difficult, she says. Strips and insulin are now in short supply. Maja also lacks glucometers, because the patients she has lent them to are unable to return them.
The challenges are many – and nurses deserve more recognition for their hard work, she says. But the job brings many rewards as well.
“Seeing patients get well and say ‘thank you’ to us for making their lives better, seeing the newborn babies healthy, mothers alive after giving birth – it makes me feel that as a nurse, I was able to make a difference, and this is something that no amount of money can replace.”