June 2024

MANAGING DIABETES AT THE ZAMBIA LUTHERAN RURAL HEALTH CENTRE

Diabetes has become a disease affecting many people in Zambia. In our area, we started with three patients in 2004. The number kept on increasing so much that we now have seen over one hundred diabetic patients in 2024. The increase is as a result of a change in lifestyle. The change of lifestyle has brought diseases like diabetes and hypertension. Many patients used to go to herbalists where they were not getting any help and patients used to wait a long time before coming to our clinic primarily due to a lack of knowledge.

Unfortunately, the government does not yet support rural care of chronic diseases like
diabetes and hypertension. All the support of these chronic diseases was and is still focused on bigger, urban hospitals. In an effort to find out why there is no support for these diseases in rural areas, I went to the Ministry of Health. I was told that because these diseases are still so new in rural Zambia, the support had already been put in the urban areas where they have more diagnosed patients. As a result some of our diabetic patients have to travel 85 km to Lusaka for services at the University Teaching Hospital (UTH). These patients are fortunate enough to have the money to travel for the services.

Patients who come to us with signs and symptoms of diabetes still need to be referred to
bigger hospitals such as UTH which is still a big problem in rural Zambia. This is because of money for transport. Patients with money are the only ones able to go. In an effort to help, the clinic staff decided to buy a glucometer with glucose test strips and have started testing for diabetes. In the first month, we tested twenty-five patients, of whom five had high readings of glucose. To start treatment, we referred them to UTH. Out of the five, only one managed to go for treatment. Four failed to go because they didn’t have money. As a result, the clinic staff called for a meeting with village headmen to discuss the problem. This was done because one diabetic patient out of the four who failed to go to UTH unfortunately passed away from his condition. The calling of Headmen was done in line with the policy of the Central Board of Health. Any change of a health program was to go through and be agreed by the community. All the Headmen voted in favor of starting the diabetes program and I was able to get training and start a program in Zambia.

The program has grown so much that we now have patients from different areas (inside and outside of our area). Because of the help we get from CAMM and the quality services we provide for diabetes, the program is going very well. Managing diabetes properly, has made the name of our clinic to go beyond our boundaries so much that we have diabetic patients coming from as far as Lusaka. Our community, patients and their relatives are happy with our diabetes programs. We are very grateful for the help in managing our diabetic patients. In the district, we are the only clinic involved in diabetes treatments. Some patients think our clinic is a mini hospital.

We have a diabetic clinic day once per month where we provide health education on
diabetes. We are also privileged to have a nutritionist who was sent to our clinic this year in January of 2024. She focuses more on diabetic diet and the importance of maintaining the diet low in carbohydrates.

May God, the Almighty bless you in helping the poor in Zambia.

In Christ Jesus,

Jackson Kalekwa
Clinical Officer In Charge.

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