Challenges of the diabetic in Malawi

Grieves Mang’anda is a youthful medical doctor, yet it took him long to realise he had diabetes, a non-communicable disease (NCD).

Mang’anda never suspected he had diabetes, not even when it started affecting his dietary intake. However, strained by the growing complaints over his health, his relatives encouraged him to go for a medical check-up.

“I would feel unusually thirsty. Most times, after taking soft drinks such as Coke or Fanta, it would just be a matter of seconds before I called for another one,” he said, adding: “My appetite for more drinks or sweet foodstuffs puzzled my relations who felt I might be suffering from diabetes, as some of them were also suffering from the disease.”

Increased thirst is one of the symptoms of diabetes. Other symptoms include frequent urination, constant hunger, extreme tiredness, feeling tired or ill, weight loss, blurred vision, frequent infections, slow healing of sores, having dry itchy skin, losing feeling in the feet or having tingling in the feet.

Mang’anda eventually took his relations’ advice sought medical attention. Following his diagnosis, his condition drastically changed for the better.

Mang’anda says the scarcity of drugs is a critical issue among diabetic patients, who have to walk long distances to access medicines in the Southern Region, especially at Queen Elizabeth Central Hospital.

The shortage of diabetes drugs has been in the spotlight following lack of adequate funding to procure them and other medical equipment.

“Drugs are very scarce and we have to walk long distances to access medicines for diabetes,” Eunice M’bwana, another diabetic patient.

According to the International Diabetes Federation (IDF), diabetes kills one person every eight seconds globally.

A 2009 World Health Organisation survey shows that Malawi has a 5.6 percent prevalence rate of diabetes, with more cases arising on a daily basis, thereby creating huge demand for services while the health infrastructure is struggling to cope with the disease.

Osman Gani, a Blantyre-based diabetic patient says:  “Doctors come to the clinic in the afternoon and they are not government medics, most of them are student clinicians from College of Medicine; hence they cannot manage to treat the huge number of diabetic patients. We would also appreciate if the clinic hours were extended from morning to the afternoon and not only in the afternoon.”

Members of the Diabetes Association of Malawi now call for more awareness campaigns to help reduce the plight of people suffering from the disease.

Awareness of the disease would also make it easier for patients to manage the disease better.

According to IDF, the goal of diabetes management is to keep blood glucose levels as close to the normal range as safely possible.

IDF further recommends that people with diabetes need to be treated by a doctor who monitors their diabetes control and checks for complications.

However, this is proving to be difficult in Malawi, where there is a chronic shortage of health workers, with only 252 doctors for the entire 13 million population, according to the World Association of Diabetes (WAD)

Moses Phiri, educator for the Diabetes Association of Malawi says government must start to mobilise communities in villages and towns because there is a large proportion of people who have diabetes.

The media is also urged to partner NGOs to disseminate information on diabetes.

“It is important to strengthen awareness on diabetes prevention, why ignore diabetes? Imagine people living with HIV and Aids have clinicians, but why not with diabetics? I think non-communicable diseases are not getting enough attention,” he complains.

But spokesperson of the Ministry of Health Henry Chimbali says government has put in place mechanisms to assist diabetic patients by ensuring that insulin is found in hospitals.

“We understand their problems but what I know is that dialysis machines are operational, targeting them. We are also trying to ensure that insulin is available at all times,” he explains.

Meanwhile, Chimbali says the ministry is partnering with various health organisations to create a disease-free society

Realising the need for other players to support government’s efforts to deal with the disease, Galaxy Pharmaceutical and Surgical, a newly established company in Blantyre whose focus is to manufacture herbal drugs to treat non-communicable disease such as diabetes.

Managing director of the company Jayant Makhecha says, they encourage people to use herbal drugs so they are free from diseases such as diabetes, heart attack and blood pressure.

“People suffer from these diseases, yet we have green vegetation from which we make these products. Our company will look at ways of introducing herbs on the market,” he said.

During a recent study tour to Mangochi and Blantyre, JournAIDS in collaboration with College of Medicine and the Diabetes Association of Malawi hosted a study visit for selected civil society organisations and media institutions.

JournAIDS is implementing a primary diabetes prevention project in Malawi with financial and technical support from the World Diabetes Foundation (WDF) in Denmark. The three-year project, called ‘Enhanced Support to Primary Diabetes Prevention’, is  built on the need to enhance capacity and advocacy for the country to positively respond to the worrying epidemic of diabetes and other non-communicable diseases such as hypertension and cancer.

President of the Diabetes Association of Malawi, Timothy Ntambalika has since said that it is vital that government of Malawi through the Ministry of Health and the desk responsible for NCDs continue working together with the organisation.

With budget consultations underway, Malawians expect no much more but medical care towards diabetic patients.