Wednesday, July 28, 2010

A 12 month death sentence, for a 12 year old girl

Xoli (pronounced Koli) is just a girl. 12 years old and full of life. She laughs contagiously at Raven Symone on the Disney Channel, has posters of Miley Cyrus decorating her bedroom wall, herds stuffed animals on her twin-sized top bunk bed, and wears bright yellow sneakers and orange t-shirts. If she lived in one of South Africa's bordering countries, however, she would be none of this. She would have rather not made it to her 12th birthday.

Underneath Xoli's fuzzy corn rows and subtle smiles is a disease that 285 million live with throughout the world: diabetes. Unlike the rest of the world, however, this disease is most often fatal in the developing world. In neighboring Mozambique, a child who develops diabetes is likely to die within one year… A 12 month death sentence.

As unimaginable as this is to process, it's tragically the reality for millions. Unlike the more commonly known infectious diseases (HIV/AIDs, tuberculosis, malaria) diabetes is a noncommunicable disease (NCD) that has slowly snuck into the continent. Its prevalence is hovering around 3-5% in most African countries and is expected to grow to nearly 20% by 2030, as diets (read: more sugar) and lifestyles (read: less physical activity) of the poor continue to evolve. Ironically, this is one of the unpredicted consequences of the increased income and development that countries have enjoyed.

And to complicate things, health systems throughout the continent are completely unequipped to manage diabetes. Medical professionals aren't trained to diagnose the disease, let alone treat it. Equipment (e.g., meters, syringes, etc.) is scarcely available. And without government policies, diabetic drugs are beyond unaffordable  for example, a year's supply of unsubsidized insulin can cost almost $200, while the majority of the bottom of the pyramid makes less than $2 a day.

Fortunately, it appears as if progress is being made, as evidenced by the project that I supported during my two month assignment in South Africa: a pan African leadership forum focusing on diabetes and other NCDs. In collaboration with a major international pharmaceutical company, the South African Ministry of Health, and the International Diabetes Federation, Dalberg (my employer) is designing this first-of-its-kind conference with the aim of creating policy, raising donor funding, and stimulating general awareness for diabetes. If successful, a number of new diabetes/NCD programs will be catalyzed and funded throughout the continent, and governments will develop and implement national diabetes policies.

As for Xoli, she can continue to worry about her upcoming mathematics exam and spelling quiz  as she was when I first met her  instead of how she will make it to the hospital for treatment or afford insulin. She's found a home at Marang House, a nonprofit organisation that provides a stable home-environment to disadvantaged children suffering from diseases such as chronic renal failure and diabetes. Here, she is given the treatment she needs and makes daily trips to the hospital, while living in a comfortable and loving environment that is void of the traumatic culture faced in traditional hospitals.

Run by a friend of mine after his dad (and the founder) passed away, this home is truly providing "a ray of the sun that gives hope," as its Tswana name would suggest. The hope is that this same ray will begin to shine on the rest of Southern Africa and throughout the Continent. 

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