A considerable achievement given the fact that only a decade ago there were but a handful of diabetes clinic for the estimated 275,000 people that had diabetes at that time.
“Awareness of the disease was almost non-existent and the supply of insulin was insufficient for those diagnosed with the disease,” Dr Ramaiya Kaushik recalled during the third East African Diabetes Study Group Congress last week in Dar es Salaam.
“Tanzania is the one of the poorest countries in the world with the more than a third of its 47 million inhabitants living below the World Bank national poverty line...the country has low human development that suffers an average life expectancy of 58.2 years,” he added.
A decade of development
Dr. Kaushik also noted that, the first project supported by World Diabetes Foundation in Tanzania was to establish diabetes clinics at four region hospitals which had no access at all to diabetes services.
“This proved so successful that all the remaining regional hospitals and four referrals were subsequently included in the project,” he recalls and went on to highlight that by the end of the first project in 2006, diabetes care at the regional level had been significantly strengthened and an important base was laid for expanding care down at the primary level in the districts.
In addition, he said to raise awareness of diabetes and improve prevention and access to diabetes care, another project was conducted supported by WDFT and it focused on reducing the number of amputations by improving foot care or by training orthopedic surgeons to perform limb saving surgery instead of amputations.
Improving access to health care
Speaking at the same event, Tanzania Diabetes Association (TDA) Vice chairperson Dr. Ramadhani Mongi said the result from all 13 projects conducted in the country have been encouraging citing that a total of 290 diabetes have been established across Tanzania with the support from WDF along with other donors.
“Together with the establishment of clinics, health care professionals including doctors, nurses, ophthalmologist and surgeons have received training as well as teachers and the people living with diabetes and along their families have been educated about the disease, nutrition and how cope,” he detailed.
Dr. Mongi seized the moment to highlight that the World Diabetes Foundation (WDF) has committed its support for the implementation of the diabetes component in the national strategy for Non Communicable Diseases (NCDs) that will bring about a greater focus on prevention.
“I believe about 50 per cent of people with diabetes have other NDC complications such as hypertension, dyslipidaemia, stroke, cancer and cardiovascular disease. The next round of training we conduct for health care professionals will focus in these areas,” Dr. Mongi said
Nurturing the momentum
Tanzania is a good example of how WDF works to improve access to diabetes care in a sustainable and replicable way.
“The success of the first few projects has created greater confidence and willingness to take on bigger projects, attracted other sources of funding and encouraged more projects involving more local agencies,” Dr. Mongi went on to elaborate.
He noted that the projects have now attracted government attention and support which ultimately motivated the Ministry of Health and Social welfare to establish a national diabetes programme.
He nonetheless acknowledged a number of challenges that still need to be addressed such as sustainability of the training. Despite the challenges, he said after 2-3 years of training, about 50 per cent of the staff have graduated into the full practice.
“We also need to ensure health care professionals are trained in antenatal clinics to educate expectant mothers about gestational diabetes,” he said
Another challenge is the question of co-morbidity such as TB, HIV and AIDS which have only been linked to diabetes in recent years.
Then there is the issue of medical supply; “because there is little benefit to the patient if they have diabetes clinic but an inadequate amount of glucose monitors, oral hypoglycemic and insulin available to treat them,” said the expert.
Summing up, Dr. Mongi urged the WDF to support projects that improve access to care in Tanzania and therefore the lives of people living with diabetes.
Diabetes in Tanzania
Every six seconds a person dies of diabetes (WHO) if it takes you 30 minutes to read this article, 300 people will have died by the time you are done.
African countries that have the highest numbers of people with diabetes are South Africa (2.3 million), Democratic Republic of Congo (1.8 million), Nigeria (1.6 million) and Ethiopia (1.3 million).
According to the International Diabetes Foundation (IDF) last year alone, there were over 822,800 cases of diabetes in Tanzania.
According to the latest WHO data published in May 2014, Diabetes Mellitus Deaths in Tanzania reached 9,257 or 2.59 percent of total deaths. The age adjusted Death Rate is 45.18 per 100,000 of population and Tanzania ranks number 34 in the world.
Many people in Tanzania are at risk of getting diabetes and high blood pressure due to several reasons such as urbanization, unhealthy diet and reduced levels of physical activity.
Non-communicable diseases, such as diabetes type 2 primarily affect those living in urban areas and increasingly the poor are facing the brunt due to lack of awareness and a health care system not geared to deal with chronic diseases says the World Diabetes Foundation.
It also points out that the rapid rise in NCDs is now acknowledged by the Ministry of Health in Tanzania and has resulted in the development and initiation of a National Strategy for Non-communicable Diseases in the recognition of the emerging importance and severity of this disease burden.
In Tanzania, around 1 million people have diabetes. 33 percent of patients admitted for diabetic foot ulcers undergo amputation with a 54percent mortality rate in patients who present late.-world diabetes foundation
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