Regional effort to improve diabetes care for indigenous peoples begins

In July 2019, a group of local women gathered in a shaded, dusty clearing in Tarabuco, Bolivia to learn about plants. Special plants: Bromeliad guzmania, aloe vera, pomegranate, lemon, orange – two with powers to heal, and three that both heal and feed. After two traditional doctors explained the plants’ benefits and care, the women lined up to receive seedlings of their own, wrapping them carefully in alpaca blankets for safe passage to their homes and gardens.

The event was part of a pilot project to prevent and control diabetes in indigenous peoples in Bolivia. In addition to re-introducing traditional knowledge and practices about medicinal plants, it raised diabetes awareness among thousands of residents and trained doctors – both Western-trained, and traditional - in diabetes care.

In July 2020, a new project began that takes the learnings from this pilot and extends them across the region. The project, Prevention and Control of Diabetes in Indigenous Populations in Bolivia, Guatemala and Nicaragua, is the first larger scale intervention by WDF specifically targeting indigenous peoples. 

Still not being seen

WDF has worked to improve diabetes prevention and care among the world’s indigenous peoples since its founding in 2002. 

“WDF’s Mission states Our priority is to support the poorest of the poor,” says Ida Nicolaisen, a cultural anthropologist and expert on socio-economic challenges facing developing countries. “In that category one finds many of the world’s 476 million indigenous people.”

In the early 2000’s, the devastating impact of diabetes on indigenous populations was becoming clear. This prompted Ms Nicolaisen to join the Board of the World Diabetes Foundation and raise the issue. 

“The Board saw this as a serious human rights issue, and we decided to reach out in a number of ways,” she says. “For example, we tried to ensure that our partners include indigenous populations in their projects, and we initiated projects specifically targeting them.”

WDF’s advocacy on behalf of indigenous peoples took a major step forward in 2012, with the Expert Meeting on Indigenous Peoples, Diabetes and Development in Copenhagen. The meeting attracted experts from 15 countries and generated a Call to Action. The following year, representatives from the UN Permanent Forum on Indigenous Issues, (of which Ms Nicolaisen was a former co-chair), UN agencies, Member States and indigenous experts and leaders agreed to support landmark policy recommendations for indigenous peoples’ health and diabetes at the UN headquarters in New York. 

“The Expert meeting was a milestone,” she says. “It was a catalyst for the UN recommendations the following year – as it underscored how indigenous peoples remain politically and geographically isolated.”

In 2019, the WDF Board of Directors took stock of its efforts to support indigenous peoples to date and approved a new approach. Going forward, the Foundation would focus on access to care, increase sensitivity to cultural and political issues, and seek collaborations with leading indigenous and other organisations in the area. 

As Ms Nicolaisen explains: “Indigenous peoples are still not being seen – we need the clout of international organisations to change this.” 

The right direction

WDF’s new partnership works with just such an organisation: El Fondo para el Desarrollo de los Pueblos Indígenas de América Latina y El Caribe (FILAC), which supports the rights of the indigenous peoples, communities and organisations of Latin America and the Caribbean. In addition to FILAC, project partners include a variety of ministries and NGOs in all three countries. 

The project targets about 400,000 people in the three countries and will pursue three tracks: advocacy and knowledge generation, health system strengthening, and awareness raising/healthy lifestyle promotion. Learnings and tools from the Bolivian pilot provide an important foundation, says Amparo Morales, FILAC Cabinet Chief and WDF’s project partner. 

“We need to provide differentiated care to indigenous peoples, taking into account their worldview and customs,” she says. “The pilot gave us experience with how to do this. For example, it established the need for a network approach to care and the importance of local community organisation.”

The project will work with traditional doctors, indigenous peoples’ patient organisations and other relevant groups. The care model it develops will be captured in a Technical Guide that will be produced in each country, compiling the project’s learnings and experiences.

Promoting healthy lifestyles is also a priority. This is where outreach like the plant donation event in Bolivia comes in. “The rescue and promotion of good practices among indigenous peoples is one of the measures we can take to confront type 2 diabetes,” Ms Morales says.

WDF’s new approach and first comprehensive project targeting indigenous peoples are important steps in the right direction, Ms Nicolaisen says. 

“Indigenous peoples around the world are under the radar for political reasons, and because they often exist in remote areas. There is so much that needs to be done – but I believe that, working with FILAC and other strong partners, that we can make a difference.”