Early screening, improved lifestyles and awareness campaigns stemming diabetes from among Rwandans

Residents lining up for screening BY LYDIA ATIENO Diogene Abarihamwe,56, heard about the diabetes campaign which was being launched near his village area, as Rwanda was marking International Diabetes Day, at Cyabingo Health Center, in Gakenke District. He attended the launch. After the event, he was advised to go for screening which he, albeit reluctantly, did. “In my mind the last thing I could think of is having diabetes or any other non communicable diseases. Most of the time those who suffer from such diseases are people from the city because of the lifestyle they are exposed to,” he says. To his surprise, after screening he was informed that he has diabetes. It was a shock. However, with the help of experts at the event, he was advised on what to do so that he learns how to manage it. He was also advised to visit a health center where they would conduct several medical checks and, accordingly, advise on the right diet and correct medication. Celebrating world diabetes day Globally, Diabetes Day is marked annually on 14th November, to unite the global diabetes community to create a powerful voice for diabetes awareness and advocacy, engaging governments, individuals and communities to bring the diabetes epidemic into the public spotlight and on national agenda. In Rwanda, events to mark the day were held at Cyabingo Health Center, Gakenke District, in Northern Province, where the campaign on fighting diabetes was launched. The residents had a chance of getting tested, screened and being educated on diabetes in general free of charge. The Ministry of Health through RBC always organizes the day in Kigali where screening is done among the willing population. But this time, the Ministry took it to the grassroots with the aim of educating masses in rural areas that diabetes can, as well, affect any person regardless of where they reside. According to RBC officials, a two-week awareness campaign on diabetes is on going across the country under the theme, ‘role of families and communities in fighting diabetes’. The campaign is expected to ensure that the number of those living with diabetes doesn’t continue going up. This will be achieved through screening taking place all over the country together with education to the population on how to keep the disease at bay. According to statistics from the Ministry of Health, in Rwanda 187,280 people are living with diabetes; at least one person in twenty people has diabetes. A health worker assists a resident in measuring height andweight, to determine her Body Mass Index (BMI) Diabetes can lead to complications in many parts of the body such as stroke, blindness, heart attack, kidney failure and increasing premature death risks. Activities Simon Pierre Niyonsenga, the Director of Diabetes and other Metabolic Diseases (Non-Communicable Diseases) at RBC, says the campaign will be extensively dedicated to screening and educating people on how to stay healthy. More than 500 health centres in the country will be involved in these activities. He says they are targeting to screen at least 300 people at every health facility by the end of the campaign, adding that equipment had been deployed in all centres to ensure a smooth process. Another aspect, Niyonsenga points out that there have been awareness campaigns at community levels where people have been trained to avoid NCDs which also includes diabetes, by sticking to a balanced diet as well as go for screening as well as advice on how to manage the disease. “There is another linkage of community health workers and home-based care practitioners, who are people within the community that help sensitize others to go screening for NCDs, including diabetes,” says Niyonsenga. He adds that the campaign will also be conducted through the media and other channels, including monthly community-based voluntary work, Umuganda, to help pass preventive message to more people. “Fighting diabetes is not only the role of the Ministry of Health; everyone has a role in this. This will help us as a country move forward in ensuring good health to each and everyone,” he says. Dr Jean Baptise Mazarrath, Head of Biomedical services Department at RBC says, they want to ensure that People are not dying of diabetes anymore when the disease can be prevented. He points out that apart from those cases where one can contract diabetes due to inheritance, it’s their obligation to ensure that other types of diabetes are prevented. “These always come as a result of the lifestyle of people. I believe by creating awareness on what should be done will help a lot in keeping the population safe from diabetes. “Lifestyle matters in fighting diabetes; that’s why screening is required and education to the entire population on what to do and not to. From city to rural areas, it means that this is to focus on each and every individual,” he says. Mazarath says early screening, paying attention to nutrition and being active in sports can help in prevent the disease. Chrispin Gishoma, Director of Rwanda Diabetes Association says it’s also a great opportunity for rural people to get access to free medical checkups. Residents register for the screening Malnutrition linked to diabetes Gishoma says most of the people with diabetes from rural settings are associated to malnutrition. Another likely cause for developing diabetes is associated with age. “Older people are at a high risk of developing type 2 diabetes because of the combined effects of increasing insulin resistance and impaired pancreatic function with aging,” he says. The only thing that can be done, he says, people should start adopting a balanced diet and physical activities early in their life so that they can keep diabetes away even in old age. Women taking a lead role He notes that this campaign is also focusing on women to play a big role in changing the lifestyle their families are exposed to. Gishoma explains that women are major decision makers of when and what time their families are supposed to take which meals, including monitoring of what the children and adults eat. “As a woman, making sure that your children get meals three times per day with plenty of fruits and vegetables is important as it helps them maintain a balanced diet and keeping diabetes away,” he says. Women should play a good role in the community by passing the same information to their neighbors. As a multi–disciplinary approach, Niyonsenga says they would like to work with all the ministries so that they help fight the disease together. Going forward Rwanda adopted the NCDs clinic model at health center to improve access to care among patients living with diabetes. Since 2016, Rwanda Ministry of Health has responded to the double burden of the increase of Non Communicable Diseases (NCDs) and shortage of health care providers. This led to the shifting of some of the responsibility to trained nurses to manage hypertension, diabetes and asthma under the supervision of Medical Doctors at primary health care level (health centers). Niyonsenga says patients with chronic conditions such as diabetes need regular follow-up by trained health care providers. Improved access to treatment at health center level will decrease on the time and expenses due to the long distances patients used to walk to seek care at district hospitals. He says all hospitals and health centers have been equipped with necessary tools to properly manage diabetes and this will enable patients that have been visiting district hospitals to seek care near their homes. Blood test was among the excercises carried out that day

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Early screening, improved lifestyles and awareness campaigns stemming diabetes from among Rwandans