Diabetes, a life-long disease that increases sugar levels in the blood, affects over 366 million people worldwide. The NGO Project Hope, based in the U.S. state of Virginia, said in sub-Saharan Africa that diabetes, once a rarity for Africans, is now affecting over 12 million people. The organization said there is an urgent need to expand education about the disease in developing countries, and they recently opened a center in Johannesburg in partnership with the pharmaceutical company, Eli Lilly, that addresses the needs of patients at risk of developing diabetes, and those living with it.
Paul Madden, Project Hope’s senior advisor for non-communicable diseases, explained that diabetes is rapidly spreading throughout sub-Saharan Africa, and even other developing countries around the world, largely due to lifestyle changes. People generally are not as active as previous generations, and they are in jobs that require them to sit or stand for long periods of time. Another reason for the increase in the rate of diabetes is eating processed food.
“The way things are packaged, they’re often in bigger portion sizes than the body needs. So it’s the portion sizes, lack of activity. In some of the villages and towns and cities in Africa, it’s people are living longer, and as you live longer and get less active, and also taking in a few too many calories on some days, and if you do that over many years, you gain weight,” explained Madden.
In countries where there are food crises, Madden said you have a moral dilemma of having to feed people. Much of the foods donated from the international community are calorie-dense foods, and while making sure that hungry people are fed is vital, it is also important to educate people about food and nutrition, so they can properly take care of themselves.
Madden described Project Hope’s way of tackling this challenge.
“We see our peer group every day. We see family members every day, so we actually are going in and training community health workers," he said. "I think of our Hope Clinic in South Africa, just outside of Johannesburg, and in that program, yes, we have well-trained professionals who run the clinic. But we also are training not just the person who comes in with obesity, with diabetes, but we’re training family members too. And we invite them also to bring an important friend in to join us for the education.”
Madden said Project Hope plans to stay in the community for several years or more, so that the education process will be successful, “but at some point, we want the local leaders, the local medical teams, the local educators, role models, village leaders, to run those programs. And as you know . . . throughout Africa and the world there are so many groups that need some assistance right now.”
Madden said Type 2 diabetes is the form of the disease that is exploding in Africa right now.
“And Type 2 diabetes is the type that tends to develop when the waist line gets bigger. We get less active, too many calories on the plate or in the bottle, however we do it, drink it or eat it. So it’s that Type 2 diabetes that we often see developing a little later in life. And in a frightening way too, I’ve been in the business for 38 years now as a diabetes specialist. If you and I were talking 38 years ago, I would tell you that type 2 diabetes from too big a waist line, too many calories, too little activity, was virtually non-existent in Africa and the world,” he explained.
There are other factors that must also be considered when looking at causes of diabetes. For example, in some countries that are experiencing fighting and instability, parents are keeping their children indoors to keep them out of harm’s way.
“So sometimes it’s even a safety issue that these families are saying, we don’t want you going out. Well, it’s real hard to get more adequate physical activity when you live in a beautiful one room house that you share with four other people. So it gets very difficult to promote the activity sometimes,” said Madden.
Madden went on to say that diabetes is showing up in low numbers in children in Africa, but is exploding among the age group of 20- to 60-year-olds. He said this age group is where they are seeing the largest proportions of deaths occurring.
“Type 2 diabetes typically develops over several months to several years. And people often don’t know they have it. It’s not uncommon in some of the villages of Africa for people to not even know they have diabetes. And in the big cities of Johannesburg, you look at different statistics on Africa, and it says depending on what city or town or village you are in, we could have people living with diabetes, and 40 to 70 to 80 percent of them may not know they have it,” he explained.
Madden highlighted an experience of an African girl with diabetes who said she wished she had AIDS instead. When asked why, she said because there were so many deaths from diabetes, and her country provides drugs for AIDS, but none for diabetes. Madden said Project Hope is working to change this perspective. They are partnering with many groups and pharmaceutical companies to educate people and provide them with much-needed medicine to fight diabetes.