As critical as Diabetes is, many still find it unnecessary to go for a test at will, until complications set in. Research has shown that 1 out of 10 people have diabetes and sadly only 50% of people suffering from diabetes, know they have the disease. A lot of people don’t carry out tests, until irreversible complications set in. It was against this backdrop that the Association of People Living with Diabetes in Cross River State and Lions Club International, decided to keep their mantra at the peak of raising alarm and carrying out projects to help reduce and help Diabetic patients in the state, with emphasis to southern Cross River, to ascertain the prevalence, encourage early detection and fight Diabetes.
–A report carried out by Amarachi Deborah Ugwu (Sparkling 92.3 FM Calabar)
Cross River state is a coastal state in South South Nigeria. According to the 2006 national census figures, Cross River has a total population of 2,888,966 with 1,492,465 males and 1,396,501 females. The state is divided into three senatorial districts, namely Southern, Central, and Northern districts. The Southern District comprises seven local government areas (LGAs), namely Calabar Municipality, Calabar South, Akamkpa, Akpabuyo, Bakassi, Odukpani and Biase. The state is basically an agrarian society with the civil service being the other major employer of labour.
Following a research carried out by a group of individuals (Akaninyene Otu, Margaret Akpan, Emmanuel Effa, Victor Umoh, Ofem Enang), in 2018 on the prevalence of type 2 diabetes mellitus in Southern Cross River, the prevalence of diabetes among adult males and females in the southern region of Cross River state was found to be 6.9%. This is an alarmingly high prevalence rate which buttressed the fact that diabetes is emerging as a major public health problem in Cross River state in particular and Nigeria at large.
This result was achieved using a multistage sampling method, selecting 1,200 participants randomly from four LGAs namely Akamkpa, Akpabuyo, Biase, and Calabar Municipality from the seven LGAs in the Southern District of Cross River State.
It was discovered that there has been quite low literacy about diabetes as a major public health concern, leading to false attribution of death cause to other health problems like high blood pressure, stroke etc, forgetting Diabetes which most cases form the underlying factor of all other health issues.
For a long time now, there has been little or no attention given to diabetes by state health sector or state government, however Association of People living with Diabetes in Cross River State, in collaboration with Lion’s Club International has been able to help sensitize the public by organising outreaches to remote communities like Nasarawa in Calabar, and other communities. Giving free screening, consultation services, collaborating with pharmacies and medical outlets to give free test kits to Cross Riverians and recommending special treatments for special cases.
According to Bernard Enyia, Chairman, Persons Living with Diabetes in Cross River State, the organisation knows the pain of a Diabetic patient, because it is made up of Diabetic patients, medical practitioners, and health workers, who are by extension trained by the organisation, to properly educate and counsel Diabetic patients. As it is their core goal to help achieve good health for persons living with Diabetes. In his words “living with Diabetes in a state where there is little or nothing done to support the patients, can be frustrating and in a system where the health sector is always on strike can be more deadly”. He went on to narrate how Covid 19 really affected them as Diabetic patients and now having to take the fact that doctors are on strike is another big challenge for them.
“It’s been a tough year for people living with diabetes as COVID-19 disease and lock down led to increase mortality, as persons with diabetes were most vulnerable and affected. Now that resident doctors are on strike, it’s even worse as Diabetic patients die in their numbers and some hopelessly discharged from the hospital. Furthermore the cost of buying insulin and drugs has skyrocketed, hence making it difficult for some to cope, However there is hope as their organisation will not rest until at least something tangible and positive is done and they have to take the step to starting the positive work with the ones they can do as an organisation”.
The 2020 world Diabetes day, had the organisation partnering with agencies and pharmaceuticals to carry out outreaches in communities in Cross River State. That of the outreach in Nasarawa, Calabar (an Hausa Community which has a high number of Diabetic patients, had them conducting free screenings, consultation, enlightenment programmes, and sharing free test kits. Hadiza Moodi who benefitted from the outreach, said she has been living with Diabetes for over 15 years, but was given free screening, drugs and advised to always visit the unit at University of Calabar teaching hospital (UCTH) for further tests. According to Hadiza, they were taught special diets to take and encouraged to do more exercise. Chinaza Ịta who also benefitted from one of their outreaches, acknowledged that they were screened for free, and given test kits, also a transportation fare of 2000 Naira.
The UCTH Calabar is a very big one, however with no special Diabetic unit, hence making it difficult to give Diabetic patients the special attention they need. Some of them who travel from really far places like Ogoja, Biase, etc, find it hard to stand and wait for their turn to see the doctors, hence being discourage from coming to the hospital and following up their treatment.
However, this issue was sorted out as Lions club International, working together with Association of Person’s living with Diabetes, built a monumental centre for Diabetic patient at UCTH.
The lions club International is an organisation which has done so much to see to the sound health of citizens in different states. According to the former District governor of Lions Club international in Nigeria, Lion Sunday Elom, the club which under the Humanitarian services Provision of international Association of Lions club, addresses health issues on Sight and Diabetes across the nation. However in Calabar from 2017, there was need to make Diabetes their focal point, hence handled by a subset of Lion club in Cross River State. But in 2008/2009 service year, under the then district governor Kwa Idimitu, the organisation built the diabetes Centre at UCTH, to cater for the immediate needs of Diabetic patients.
The building which was specifically for Diabetic patients, is a separate building from the main hospital building, though situated inside the hospital compound, was facilitated in partnership with UCTH. It has a consultation room for patients to see doctors, a mini hall with plastic chairs for diabetes education and counselling purposes, it also has a laboratory for screening, after which a person diagnosed with critical condition, is given a bed in the main hospital ward. The doctors and educators in the Diabetic unit are under the employment role of UCTH, hence are same doctors working at UCTH.
The Unit is always open with the head of unit who is an educator or health worker, always on standby to attend to patients. However, they do have their clinical days on Wednesdays and Saturdays. On the clinical days, Medical practitioners (Doctors and nurses) move down to the Diabetes building for special counselling, screening and consultations and people with critical conditions are immediately given bed in the ward. These treatments are not free of charge, as the patients would have to obtain cards for the drugs. It primarily eases the accessibility of doctors and counsellors.
The association of people living with Diabetes in Nigeria, Cross River state chapter, made up of Diabetic patients, Doctors and Educators, made it a point of duty on the clinical days to teach, screen, and have conversations with Diabetic patients, both in the hospital ward, unit and even take it out of the hospital.
Following a statement by the chairman, they go as a far as visiting other hospitals, assembling Diabetic patients, teaching them about diabetes, forming support groups, as most of them would refuse to give them attention, but would yield when they see other people with the same ailment. In his words “the diabetic patients we met in other hospitals already have critical conditions, some don’t even have funds to test their wounds, some stay very far away that they don’t follow up their treatment, hence some of the support groups created didn’t last, as they couldn’t follow up”.
“Also, the strike embarked on by resident doctors, dropped their efforts, and caused serious harm to Diabetic patients in the state. So many patients stopped going to the unit, some were discharged even when they were still critical, some died at the course of the strike because there were no doctors to attend to them. But amidst all the crises, the educators were still there and some other health workers, attending to some patients, especially ones with no major case,” according to Chinaza.
The former district governor of Lion’s club intl, further explained how an app was developed in 2020 during Covid-19, to enable people get tested or screened to know if they are exposed to diabetes. “during the Covid lock down, we developed an app which people used at the comfort of their zone to screen and know if they have been exposed to diabetes, by answering questions on the app and getting their status. The outcome was positive as it was shared on WhatsApp and social media, a lot of persons after using the app realised they have the disease and started taking precautions on changing the narrative, because early detection can help in the cure of diabetes”.
The beautiful thing about these projects according to former chairman of lions club was that it got the support of the government as the commissioner for health in Cross River State, Dr Betta Edu showed support, as a lion too, and just 3 weeks ago, The Lions club commissioned the foundation of an ultra modern Diabetes Centre in Ogoja, which will be completed in no time.
These projects weren’t totally successful, as there is no much fund to follow up and be consistent with the outreaches and help those who couldn’t afford the hospital bills, also a major challenge that was faced was inability to get medical doctors who are Diabetic specialists, as some of the doctors only know little about diabetes, but not core Diabetic specialists. On the part of the patients, some didn’t follow instructions on diet, refused coming for check ups, and stopped taking their drugs after so much effort to get them.
However, Association of Persons Living with Diabetes and Lion Club International, has said not to relent in their course, until there is total eradication of diabetes in the state. The lions club hinted that their November 2021 outreach, hopes to reach out to 500,000 persons, testing and giving relief materials too. Hence, calling on the government, organisations and individuals to take responsibility when it comes to testing and following up with the disease, and helping sponsor projects that can help eradicate the disease and help people living with Diabetes.
