In 2012, as pre-clinical medical students and faced with the lapses in diabetes prevention and care in Nigeria and the African continent. My friends and I decided to create a platform for social peer support for people living with diabetes in Nigeria that is inexpensive and will have an optimal impact in the lives of people who erstwhile seem not to have that voice.
Thus, in March of 2012 we launched The Nigeria Diabetes Online Community (NGDoc). Mentored by our school professors, we started NGdoc at a time when social media health advocacy was not popular; we were immediately accepted by the global diabetes online community despite we ourselves not living with diabetes.
A huge thanks to Cherise, Kim, Bastian, Mike, Manny, Renza, Elizabeth, Erin, Paul and many others space won’t permit me to mention; the new organization grew into one of the biggest platform and loudest voice for people with diabetes in Nigeria and by extension the continent. We silently fought the odds of running a non profit and studying to becoming doctors, we endured the challenges of advocacy – the issues from the social system at that time and overcame a little bit of the social stigmatization that made it difficult for people living with diabetes to go public. Thankful to God we came out victorious, some of us not without scars – but learnt from them.
It has been an amazing 7 years. From the outset it was our intention to eventually build NGdoc to a stage where people living with diabetes can run the platform and at that point we would eventually hand its administration over to a team living with diabetes in the spirit of ‘nothing about us without us’.
I thereby use this medium to extend my official stepping down from the administrative affairs of The Nigeria Diabetes Online Community to focus on personal matters. This process of transition has been on in the background for about a year and I am glad to announce Ms Bunmi Deborah as the new coordinator of The Nigeria Diabetes Online Community.
Ms Bunmi who will take the mantle of leadership of this organization has been handling the affairs of the group in an unofficial capacity over a year and officially for about a year. She has been living with type 1 diabetes for about 19 years. She is no doubt very passionate, efficient, humble and committed to the care of people living with diabetes in Nigeria.
Her erstwhile experience of working with people living with diabetes for over 10 yrs on how to create balance between living with diabetes and having a healthy life through diet and self love is a great resource to harness in helping Nigerians living with diabetes. Ms Bunmi also advocates for universal access to insulin for Nigerians. I am convinced the organization is in great hands.
To my friends and executive board members – Drs Halimat Odewale, Bolaji Dauda and Kola Rosiji cheers to all the sleepless nights, trips across the African continent and sacrifices to make this day a reality. I Love you from the bottom of my heart.
To our partners, I say thank you for your support through this past 7 years to me personally and to the organization. To our executive board and volunteers who have sacrificed a lot in the past 7 years to make NGdoc what it is today I say a huge thank you and God bless you in your future endeavors.
The other members of the team and I still will be around in advisory capacity to the incoming Team of executives and volunteers Ms Bunmi is working on to be unveiled soon. I know I can always count on your continual support for her and her team as she takes over full responsibilities in the coming weeks and years to come.
Many thanks once again and thank you all for your continual support as I signed out.
Sarah Akalugo will be representing NGdoc at the forthcoming Pamoja Advocacy Training in SouthAfrica
We are excited to announce the selection of Sarah Akalugo to represent The Nigeria Diabetes Online Community at the forthcoming Pamojan Advocacy conference in South Africa.
This Pamojan advocacy training is organized by T1International – a UK based NGO and Sonia Nabeta Foundation – a US Based non profit with the aim to train Type 1 diabetes Africans across Africa on advocacy, strategies and policies approaches to diabetes care within the continent.
The training will bring together Type 1 from across the continent to build a cohesive force towards creating awareness about diabetes and combating the social stigma associated with living with diabetes in the continent.
Sarah who is a member of The Nigeria Diabetes Online Commmunity and also a community diabetes advocate looks forward to maximizing this opportunity.
We wish Sarah the best and look forward to her representing Nigeria well at the training and translate the knowledge acquired into awareness and advocacy strategies in Nigeria.
For more information on the Pamojan Advocates visit here
Last year our co-founder launched an appeal to sponsor a child living with diabetes get essential medicine and consumables. Thanks to our donors we were able to sponsor 5 children living with diabetes at the Olabisi Onabanjo University Teaching Hospital, Sagamu, Ogun State, Nigeria for the year 2018.
With your help we were not just only able to sponsor these kids and ensuring steady supply of insulin throughout the year but we also have insulin dedicated to the children emergency, so no life will be lost as a result of inability to buy insulin at the Children Emergency Room. Steady strips were also made available to avail them the opportunity for continuous monitoring of their blood glucose.
On behalf of Barnabas Michelle, Bello Aminat, Nana Amisu, Daniel Timilehin and Racheal Favor we say a big thank you to those who supported this laudable cause and also anticipate their steady commitment for the coming year. If you wish to be a part of this project kindly send us an email on thengdoc(at)gmail(dot)com. Thank you
Social Media Platforms have always been a good opportunity for social peer support and for children living with diabetes it will prove much more.
Twitter chats centered around #diabetes has been around for years but sadly the NGdoc chat has always been frequently interfered by internet business marketers selling cure and even health care providers that seem to provide text based preferences rather than allowing the narratives of people living with diabetes prevail as a potent source of peer support to help, guide and even vent out the frustration of living with diabetes.
Above all is the misinformation and mixing up of the various types of diabetes under the broad umbrella of diabetes.
This we agree can be frustrating, and might add to the social stigma already faced by people living with diabetes. Turning major stakeholders in the running of diabetes into stalkers in their own program.
This has accounted for the on and off of the NGdoc Chat which has always been dear to our heart at The Nigeria Diabetes Online Community.
However, The Diabetes Youth Care of Ghana has demonstrated a good use of WhatsApp as a great tool to counteract all these challenges and build a network of diabetes warriors. I have been an invited guest in one of their hot seats and it was an awesome hangout.
This was why when one of our members suggested the use of WhatsApp chat for such interaction we were more than pleased to utilize our existing WhatsApp group for this purpose.
Our first guest on the 16th of Feb, 2019 is Yaa Bimpe from Ghana. She is a nurse and has been living with diabetes. An inspiration to many and a well respected diabetes advocate.
If you are a child living with type 1 diabetes and you have questions regarding living with diabetes, be rest assured that you are not alone.
Please do join the New NGdoc WhatsApp group discussion anchored by Ms Deborah Bunmi and Omolade Onafowokan and be a part this great chat.
Send us an email on thengdoc@gmail.com or contact us on any of our platforms on Twitter, Facebook or Instagram.
Talented Dr Ibe Chiemezie decided to hit the studio to drop some bars about Awareness on prevention and care for Type 2 diabetes.
We love this wonderful concept and requested for a feature on our blog.
Do enjoy the song.
Diabetes Mellitus
Diabetes mellitus aka D.M is a syndrome characterised by excessive blood sugar as a result of insulin deficiency or the body’s resistance to insulin.
There 4 types of DM:
Type 1 DM
Type 2 DM: Studies have shown that Type 2 diabetes mellitus is associated with over-eating and under activity
Gestational diabetes mellitus (GDM)
Other types of DM
Insulin Is the body’s hormone that keeps the blood sugar low and within normal and in its absence it rises beyond control
Common SYMPTOMS are
Excessive eating (polyphagia)
Excessive thirst/drinking of water (polydipsia)
Increased frequency and volume of urine
Weakness
Weight loss
Susceptibility to infection
COMPLICATIONS
Blindness
Numbness
Coma (Unconsciousness)
Kidney failure
Heart failure
Foot ulcer
Erectile dysfunction
Stroke
Death
Risk factors
Family History
Obesity
Alcohol
Pregnancy
Cigarette smoking
PREVENTION
Get regular check of your blood sugar at least 3monthly
Normal Fasting blood glucose levels 80-120mg/dl
Normal Random blood glucose levels 90-180mg/dl
During pregnancy register for antenatal care and get regular blood sugar check
Exercise
Eat balanced diet and fruits
Avoid Alcohol and cigarettes
See your doctor
Note : Medication : Avoid self medication, see your doctor regularly at least 3monthly and take medication as prescribed
Diet:Avoid junk food and reduce soda consumption High fat foods consumed in excess may increase free fatty acids and excercebate insulin resistance. Sweetfoods rich in refined carbohydrates e.g junk food and soft drinks consumed frequently may increase demand for insulin secretion
“#Insulin rationing is a crime against humanity. It shouldn’t happen. It is like a genocide; you’re not using machetes but you are systematically killing people”
These were the words from my mouth as i sit as a panelist in the Insulin4all panel of The Affordable Medicines Now Conference in Washignton D.C.
The Affordable Medicines Now is a training conference designed to build skills, knowledge and community among the activists (advocates) who power the movement for affordable medicines at the state, federal and international levels.
Hosted by O’NEILL INSTITUTE FOR NATIONAL AND GLOBAL HEALTH LAW and PUBLICCITIZEN with partnership from various local and international orgaisations; the objective was clear “Medications must be affordable” and its absolutely essential for us all to hold all stakeholders responsible.
From Rep Ro Khanna to Rep Peter Welch to Senators Cory Booker, Tina Schakowsky the messages were clear:
Medical innovations are from universities, public institutes of health (supported with tax payers money); while most of the medical innovators are not after the billions, their innovations are branded by MBA guys and profiteered.
Prescription drugs should be affordable.
The loopholes in governance that allows massive profiteering must be blocked and congress and governments must work in unison to ensure affordable health is for all.
In the midst of the well organized, highly educative meetup is my meeting Ola Ojewunmi a nigerian american disabled activist, founder @ProjectASCEND,cancer and 2 organ transplant survivor who spoke on the intersectionality (I was awed at the strength and resilience of Ola and i believe a lot of african feminist have a lot to learn from her view on intersectionality)
More about the event can be found below
INSULIN4ALL AND HOW IT AFFECTS AFRICA
Africa although experiencing significant economic changes faces an epidemic of chronic non-communicable diseases (NCDs) including diabetes.
Some 425 million people worldwide, or 8.8% of adults 20-79 years, are estimated to have diabetes.
About 79% live in low and middle income countries. The number of people with diabetes increases to 451 million if the age is expanded to 18-99 years.
In Africa, an estimated 15.5 (9.8-27.8) million adults aged 20-79 years have diabetes, representing a regional prevalence of 2.1 (6%).
Africa also has the highest proportion of undiagnosed diabetes; over two-thirds (69.2%) of people with diabetes are unaware they have the disease and almost a third of them need insulin – both insulin-dependent type 1 children living with diabetes and people living with type 2 diabetes who need to take insulin.
An estimated 50,600 children and adolescents under the age of 20 are living with type 1 diabetes with nigeria being the 9th largest country with children living with diabetes worldwide.
INSULIN PRICING AND ITS TOLL ON AFRICA
Availability of insulin:
The inconvenience and additional travel costs as a result of unavailability of insulin in some localities will definitely lead to disrupted treatment and eventual poor management of blood glucose and eventually lead to complications.
Affordability of insulin
The pricing cost of insulin is high which makes it unaffordable.
In Nigeria, for instance it costs about 12usd to get a vial of insulin which may look relatively cheap as compared to a country like The United State of America; however for a country like nigeria where 92.1% live in poverty this is equivalent to a 10 working day wages.
Policy implications
The out of pocket cost of hospital visits, insulin and other consumables makes it difficult for People living with diabetes to maintain their blood glucose and also visit hospitals regularly for checkups.
Lack of healthcare workers and facilities factor in the lack of adequate care for example in countries like uganda, sierra leon,the gambia to mention a few.
Only 11 countries of the 58 countries in africa has universal health coverage.
Religion and Culture
A major issue affecting diabetes care especially with children living with diabetes is the tendency of parents and caregivers to quickly fall back to alternatives in cases of inability to buy insulin or visit hospitals.
Top of the list of alternatives are the religious and traditional centers.
Major setback to these care is the limited understanding and unwillingness to refer peopele to hospitals for adequate care.
This most often leads to complications and in some cases death.
It is to this end that it is important for us all as individuals to demand for action from the executive and legislative arms of government into ensuring
Insulin access being a high priority for government
Diabetes programmes must be integrated and evidence based, highlighting the scale of the problem and areas for effective intervention
1)Reduction in the purchase price of insulin and medical devices
2)Improving geographical access to insuilin by ensuring NCD clinics are available at primary care health centers closer to people in rural areas
3)Incorporate Insulin into healthcare coverage schemes
I was engaging my followers on the need for constructive methods of essential medicine financing when Pharmacist Bukola Fabiyi mentioned “Drug Revolving Funds” as a potent and strategic means of ensuring people do not die due to live saving medications like insulin.
So i pleaded with her to submit an article about this which she did and i hope our readers can begin to task the government at local, state and federal level into making sure the right things are done towards ensuring essential medicines are made available, affordable and accessible to everyone irrespective of the social status.
Drug Revolving Fund (DRF)
The Bamako Initiative (BI) was introduced by WHO/UNICEF in the late 1980’s to improve access to essential drugs for the most vulnerable in the society and thus improve the health outcomes (Chukwuani et al., 2006).
Essential medicines, as defined by the World Health Organization (WHO), are themedicinesthat “satisfy the priority health care needs of the population”. These are themedicationsto which people should have access at all times in sufficient amounts.
Essential medicines selected for diabetes are “Insulins and analogues” and “Oral blood glucose lowering medicines”
The DRF is a method of financing medicine in which, after an initial capital investment, drug supplies are replenished with monies collected from the sales of drugs according to the world health organization. It is an effective strategy for ensuring regular drug supply in the healthcare delivery system.
This scheme according to the research conducted by ogbonna however has not been successful due to the following reasons:
Poor management
Mis-application of the Fund
Purchasing of drugs at exorbitant prices
Lumping of the proceeds of the fund into a general account
Non-reimbursement of the cost of drugs for exempted patients.
According to Gazelle News, May 14, 2013, it stated that 17 states went to understudy and adopt Ekiti’s unified DRF.
A case study was also carried out and evaluated on the efficiency in the drug supply system in Kano state in 2013. Kano state was able to increase their procurement significantly from N133 million in 2008 to N1 billion in 2013 without additional financial support. This was managed and supported by key institutions.
To ensure the success of DRF, quality medicines must be identified, the medicine must be affordable and the monitoring and evaluation of the DRF facility must be achieved in accordance to the set performance targets (Ogbonna and Nwako, 2016).
The Central medical stores in Lagos was renovated in 2013 through funding from Non-Governmental Organisation and Federal Ministry of Health (NGO/FMOH). The Lagos state ministry of health has gone into collaboration with PATHS (Partnership for Transforming Health Systems) and private suppliers of medicines to enhance the operation of sustainable DRF system.
References:
Ogbonna, B. O., and Nwako, C. N. (2016) Essential Drug Revolving Fund Scheme in Nigeria, from the Edge of a Precipice towards Sustainability. Journal of Advances in medical and Pharmaceutical Sciences. Vol 8(2), Pp1-8.
WHO (2009) How to establish a successful revolving drug fund: the experience of Khartoum state in the Sudan. Available [online] from here
I had the opportunity of attending an advocacy program on the 22nd – 26th of August 2018. I went as a representative of my country Nigeria (The Nigeria Diabetes Online Community). The venue of the program was at the University of Ghana, Yiri lodge, Accra.
The advocacy program was organized by the SONIA NABETA FOUNDATION, DIABETES YOUTH CARE and Sponsored by T1 INTERNATIONAL, there were also many invited advocates from different country.
At exactly 9am on the 23rd of august the founder of T1 INTERNATIONAL, Elizabeth , open with the following contents. “The meaning of diabetes advocacy, T1 diabetes aim, Importance of diabetes awareness, advocacy plan, advocacy goal.”
After this inspiring step and perfect explanation of what she meant, she gave every advocate an assignment to do in his/her country. It was the most orderly and systematic arrangement I have experienced.
I learnt about ways of improving public awareness through diabetes education, because not all people that are diagnosed of diabetes accept the condition and the fact that they don’t accept means they are not willing to learn about diabetes.
Also, I also learnt about diabetes advocacy aim which helps to raise public awareness round the world in terms of access to insulin, test strip, supporting people with diabetes, organizing diabetes resources and campaigning for world diabetes day. I learnt about the means of taking action to achieve a specific change in policy practice that could benefit people with diabetes based on good advocacy.
I learnt about speaking on what is important to us, by ensuring that voices of people living with diabetes are heard and by making a difference, standing up for our health right. It is a way of fighting for long term change so more people can have a better life with diabetes.
In numerous ways, I benefited from the experience. First, it paved way for me to know how my goal could be achieved based on advocacy’s key message. Second, the lecture enables me find a remedy to any advocacy issue I may encounter. Finally, the experience I had was that I was able to gather a first – hand information on how my goal could be easily achieved.
My action plan is to organize a diabetes education program at school in November period, giving them information on what diabetes entails, because misconception about diabetes is one of the health challenges we face in our community and this brings about mismanagement of diabetes. “EDUCATION IS KEY”.
My goal is to make sure students are able to understand the facts and initiative about diabetes.
A Bad Case is an original comedy series about four friends and what happens when diabetes shows up at the worst possible moment. It is a message of hope to the world. It’s comedy about when diabetes goes all wrong and easily relatable.
According to Erin Spinento who also directed the movie:
Hollywood has consistently gotten our story wrong. They have used diabetes as a handy plot tool to raise the stakes for a story. From minor mistakes to huge blunders, they are sharing an inaccurate story of what it means to live with diabetes.
It is time to change that narrative. It is time to have our stories told accurately and in depth. A Bad Case is the story of four friends who handle their diabetes very differently. There is a good chance you will see yourself in at least one of the characters on screen. For the first time, a viewer might be able to relate to someone just like her, who has the same outlook or quirks, who has developed the same strategies for dealing.
Knowing how crucial a positive outlook is on doing a good job of taking care of diabetes, a series that focuses on diabetes and humor could have an incredible impact on those who are struggling with the difficulty of this condition.
Personally, the only way I can deal with such a long-term and difficult situation is to find the humor, even if it is a sort of gallows humor. When we can come to a point of laughing at the absurd difficulty, we gain perspective and a renewed sense of strength to keep on fighting.
I want to produce this series to explore a new medium for pursuing the same mission I have always had when it comes to interacting with the diabetes community; to empower people to take amazing care of their diabetes.
You can watch, follow the series and support the project here
The Diabetes Youth Care of Ghana, Sonia Nabeta Foundation of Uganda and the Global Advocacy organization T1International organized a diabetes camp and advocacy training for children living with diabetes in Africa.
Thanks to the generous support of T1International.
Omolade Onafowokan represented The Nigeria Diabetes Online Community (NGDoc) on an all expense paid trip to Accra Ghana courtesy T1International and domestic support from NGdoc.
The diabetes advocacy training has already been yeilding results as Omolade has embarked on a project which aims at creating diabetes awareness among young school children “Catch them young”
According to an article sent to us by Omolade:
Many people lack knowledge about diabetes in Nigeria and awareness through diabetes education can reduce discrimination among peers and other people in Nigeria.
After the diabetes advocacy training that took place at Ghana, I went to schools in my community to give a health talk about diabetes education. I realized that diabetes is easier to ignore, if you don’t have first hand fact and initiative. Some people lack diabetes education and this brings about misconception about diabetes.
Increase diabetes awareness and education will undoubtedly help to reduce the health complication; Diabetes education program can enlighten and motivate a community as a whole.
On the 21, September 2018. I visited schools in my locality to talk to the students and staff about diabetes because I personally saw diabetes education as a way of helping individuals with diabetes, pre-diabetes to understand the importance of blood sugar, sign and symptoms of hypoglycemia management of diabetes, healthy eating habits life style etc.
I also observed that diabetes education is a means of setting solid foundation for better diabetes care, it is designed to provides individual with necessary skills and knowledge for successful diabetes management into their daily life because the ailment goes beyond families.
In addition, it allows people to engage in their own health as a means of putting what they have learnt into action.
In conclusion, diabetes education among student will help to reduce misconception discrimination among peers and it will give maximum effectiveness.
Omolade Onakowokan
We wish Omolade the very best in her endeavors and we wish to specially thank TiInternational who made her flight, accommodation and training possible.
Are you a young Nigerian child living with diabetes and you wish to reach out to us. Follow us on our social media platforms Twitter and Instagram: @theNGdoc; Click to join our Facebook and whatsapp groups
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