RAGDiabetes Winter 2010 Newsletter
Message from the President
C. Wayne Edwards |
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Through Rotary’s efforts, the awareness of diabetes as a worldwide epidemic is increasing.
Recent articles in the Rotarian; presentations at RI Zone Institutes, District Conferences, Clubs, and medical meetings; and representation at the World Diabetes Congress have been instrumental in making Rotarians aware.
As you will see in this newsletter, projects by Rotary Clubs highlighting Rotary’s leadership have increased significantly. From the clinic and diabetes camp in India, to the initiation of the 6 clinics in the Cameroon, to the awareness walk in Texas, Rotary is illustrating “Service Above Self” in diabetes related areas.
The Rotarian Action Group for Diabetes (RAGD) can be a significant factor in increasing awareness and promoting service projects in diabetes related programs. With an increased membership, the RAGD can do more in communicating and coordinating the opportunities for Rotary service. Please encourage your fellow Rotarians to join us at www.ragdiabetes.org.
The RAGD will sponsor a booth in the House of Friendship at the Rotary International Convention in Montreal, June 19 – 23, 2010. Also, our initial Annual Meeting will be held Monday, June 21, 2010 at the convention. Please plan on joining us.
Thanks for all you do for Rotary and for your interest and participation in RAGD.
In Rotary,
Wayne
C. Wayne Edwards,
President
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DAY Society
Founded by Dr.Ch.Vasanth Kumar |
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DAYS, Diabetes and You Society, was founded by Dr.Ch.Vasanth Kumar in 1999 in Hyderabad, India to enable economically and socially deprived children and adults to avail affordable or free treatment and counseling support in the management of diabetes. The role of DAYS is to reach out to every underprivileged child who has diabetes and who is not able to manage it due to economic conditions. The emphasis of DAYS is to disseminate information to help prevent and/or to manage diabetes -- For more information about DAYS, please go to www.daysociety.com.
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Making a Difference to Global Diabetes
By Jean Claude Mbanya |
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The numbers are alarming. We appear to be on the cusp of losing the battle to contain diabetes. In the coming year, diabetes will kill more than 10,000 people every day – a staggering 4 million lives lost to diabetes in 12 months. The new edition of the IDF Diabetes Atlas – released recently at the World Diabetes Congress in Montreal – gave us the dismal news that 285 million people are currently living with diabetes.
Low-and middle-income countries continue to bear the brunt of the disease. Soon, four out of every five people with diabetes will live in developing countries. And the men and women most affected are of working age – the breadwinners of their families. In two decades, the total number of people with diabetes is likely to swell to nearly 440 million – more people than the population of Mexico, the United States and Canada put together.
Throughout the developing world, increasing huge numbers of newly diagnosed people with diabetes find themselves alone on a path that can lead to crippling complications, depression, poor mental health, and early death.
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As the sole global representative of all people with diabetes, IDF has a de facto mandate to step up its response in order to protect these vulnerable populations. We need to increase awareness and deliver health education to make sure that diabetes is detected early, and to make sure that those who are newly diagnosed are guided along a course of chronic disease management and informed self-care that empowers them to avoid or delay the potentially devastating consequences of the disease. We need to provide guidance that will help to alleviate the stress of dealing with diabetes, and help people to develop the coping skills they need to make their diabetes journey in absolute safety – and we need to let them know that they are not alone. We need to make sure that appropriate care is available to all people with diabetes. And we need to make sure that more evidence-based diabetes education is available so that people with diabetes can play an informed and central role in their own care. And IDF needs to do more. We need to expand our remit to the area of health promotion.
With millions more people developing diabetes, and with no guarantee that the total funding available for global health will be expanded sufficiently to meet the growing need, we have to be more active in prevention. This is a huge challenge. Engendering the required behavioral change and creating healthy environments will require unparalleled cross-sector collaboration. To do this, we need to overcome powerful social, cultural and market forces to make sure that healthy life choices are available and affordable. Moreover, we need to break through the paradox that leaves many of us knowing what the healthy choice should be, but making the less healthy choice regardless. The marketing machine that is driving the epidemic of type 2 diabetes and other non-communicable diseases is committed to a full frontal assault on all our senses. Compelling images of consumerism are a constant attraction; advertising jingles make up the soundtrack to our lives. Indeed, it often seems that the marketers of calorific excess have all the best tunes and have learned to speak in a seductive voice that promises fun and attainable freedom.
‘Unhealthy’ is delivered well-packaged, straight to your living room, at a price that you can afford. But there is a huge hidden cost. Treatment and technology currently exist for people with diabetes to manage their disease successfully and enable them to lead full, productive lives. Yet for millions of people with diabetes, modern treatment and technology is just a dream, and the right to live a full life is denied through ignorance, lack of resources and education, and inadequate health infrastructure. With odds like these stacked against us, it will not be easy to defeat diabetes. But this is a battle that we can ill-afford to lose – and one that we will all have to fight.
Jean Claude Mbanya is IDF president for the period 2009 to 2012. He is professor of endocrinology at the University of Yaounde, Cameroon, and chief of the Endocrinology and Metabolic Diseases Unit at the Hospital Central in Yaounde.
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IDF and Rotary – Reaching Out to Fight Diabetes from the Grassroots
By Larry Deeb, Martin Silink, Massimo Massi Benedetti, Wayne Edwards |
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Rotary has a long history of cooperation with other organizations in the
delivery of programmers. Recognition of need is often best accomplished at the local community level; solutions are best delivered locally by committed community members. Rotary has long capitalized on these facts. A donor club or district and a recipient club or district recognizes a need. Individual Rotarians as members of clubs raise the funds that are donated to support activities. Individual Rotarians are the ones who deliver the programs, often in collaboration with community organizations.
Historically, Rotarians have been dedicated to health causes. Clean water, aid with clinics and other health projects are a focus of Rotary and its Foundation. Every Rotarian is urged to donate 100 USD every year. Many donate much more. In the last fiscal year, Rotarians donated more than 100 million USD. The largest philanthropic activity to date has been the Polio Plus campaign. This campaign has raised more than 600 million USD, and was recently endowed with more than 250 million USD by the Bill and Melinda Gates Foundation. However, even this campaign relies on local Rotarians. An example is the 100 million-plus child immunization campaigns in India. Such a campaign could not be accomplished without the dedicated support of thousands of individual Rotarians. It also demonstrated the power of committed individuals.
It should be of no surprise, therefore, that Rotary has been involved in the fight against the worldwide epidemic of diabetes. Some members and officers of IDF are long-term Rotarians who have helped introduce diabetes programs to Rotary.
Beginning in 1999, Rotarians in Florida, USA, expressed an interest in diabetes. After the creation of the Life for a Child Program in 2000, Rotary clubs decided to participate. In 2002 the Rotary District of North Florida, USA, partnered with the Rotary Club of Quillicola, Bolivia. Together, along with the Rotary Foundation’s matching-grant program, more than 100,000 USD was dedicated to providing insulin and testing equipment to needy children in Bolivia. Today, there are eight clinics all over Bolivia and, with the support of the Insulin for Life Program, many needy children with diabetes in Bolivia continue to receive insulin.
Shortly thereafter, at the 2003 World Diabetes Congress in Paris, this Bolivian model was introduced at an IDF press conference on Life for a Child. The first country to benefit was Sri Lanka. Contributions from the Rotary Club of Lane Cove in Sydney were matched by a contribution from LifeScan, and this total was in turn matched by the Eli Lilly Foundation. The Lane Cove Club also provided funds so that the Life for a Child Program could commence support in Nepal.
The managing director of the Rotary Foundation met with the chief executive officers of the American and Canadian Diabetes Associations. Shortly thereafter, a 3-year project for Nigeria was approved. This was among the first multiyear grants from the Rotary Foundation.
Based on this success, Massimo Massi Benedetti convinced the Rotary districts from all over Italy to participate in a major 5-year matching-grant effort. This was coordinated with the Ministry of Health in Cameroon, where five clinics were established for children with diabetes. If successful, the Cameroon Minister of Health proposed to make them part of the healthcare establishment. This program was initiated at the Italian Senate in Rome with the Ambassador for Cameroon in attendance.
Children with diabetes have not been the only focus. Rotarians from Ledbury, UK, have
developed a remarkable foot care project in the Caribbean. Starting in Trinidad and Tobago, they demonstrated a 70% reduction in amputations. This was so successful that the Ministry of Health has formally adopted the program within the healthcare structure. These accomplishments encouraged the interest of others, and clubs in other parts of the UK have cooperated with other islands. IDF began collaborating under the direction of Karel Bakker, and the project has adopted successful IDF models of foot care as their standard of care. A similar program in the Philippines has also demonstrated a dramatic reduction in amputations.
These two successful Rotary/IDF collaborations – Life for a Child and the Foot Care Program – are just the beginning of potential collaborations between IDF and Rotary. As Rotarians discovered the interest in diabetes, a logical expansion of the Rotary efforts was the creation of a Rotarian Action Group. Such Action Groups, approved by the Rotary International Board, are charged with making a difference.
Members are joining from around the world. The Action Group was present at the 100th Rotary Convention in Birmingham, UK, in June 2009, where over 1000 individuals received related information packs. The Action Group also offered information at the 2009 World Diabetes Congress in Montreal. There, the audience comprised Rotarians who are active in diabetes as well as individuals who might either become Rotarians or engage Rotarians for service in diabetes in their home country. In addition, we wish to reach out to individuals who know Rotarians. We need to raise diabetes awareness worldwide and further involve Rotary in the diabetes cause.
Rotary and IDF are grassroots organizations. The historical willingness of Rotarians to embrace healthcare causes along with the enormity of the diabetes epidemic makes this a logical place for increased Rotary involvement. We hope to inform Diabetes Voice readers so that you will reach out to Rotarians in your country and your community to involve them with us in this fight against diabetes. We welcome enquiries at our website www.ragdiabetes.org.
Larry Deeb, Martin Silink, Massimo Massi Benedetti,
Wayne Edwards
Larry Deeb is a member of the Rotary Club of Tallahassee,
Florida, USA. He is past-president of the American Diabetes
Association, current chair of the IDF Task Force for Insulin
and other Diabetes Supplies, and treasurer of the Rotarian
Action Group for Diabetes.
Martin Silink is a member of the Rotary Club of Lane Cove
Australia. He is immediate past-president of IDF and secretary
of the Rotarian Action Group for Diabetes.
Massimo Massi Benedetti is a past district governor and a
member of the Rotary Club of Foligno, Italy. He is a past
vice-president of IDF and current vice-president of the Rotarian
Action Group for Diabetes.
Wayne Edwards is a past district governor and member of the
Rotary Club of Tallahassee, Florida, USA. He is president of the
Rotarian Action Group for Diabetes.
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StepOut - Walk to Fight Diabetes
By Seabrook Rotary Club |
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On November 7, 2009 The Seabrook Rotary Club in Texas hosted a walk to raise money for the American Diabetes Association’s efforts to fund diabetes research, education and advocacy. The Step Out: Walk to Fight Diabetes is the American Diabetes Association’s largest annual fundraising campaign in the Houston area. Every fall, thousands of people all over the country join in the fight against diabetes by walking and running in the family friendly non-competitive 3 K walk and run.
The annual walk in Seabrook was started because over 23 million children and adults in the U.S. have diabetes – and 1/3 of them don’t know it. Every 21 seconds someone in this country is diagnosed with diabetes. If current trends continue, 1 in 3 children born today will develop this chronic disease in their lifetime
Thanks to the Seabrook Rotary Club, this year over $6,350 was raised and more than 200 people participated. It is hoped that as people become aware of how prevalent diabetes has become, not only in our society, but throughout the world, this walk will continue to grow in an effort to contribute much needed funds for diabetes research and awareness.
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Diabetes Program Complete
By Dr. Larry Deeb |
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The Rotary Club of Tallahassee, District 6940, and District 9110 (Nigeria) announced the successful completion of a program to provide treatment and supplies to children with diabetes in Lagos, Nigeria. Funds were provided by a matching grant from the Rotary Foundation, funds from the Club and host/international Districts, and funds from the Eli Lilly Foundation. The program takes place at the Lagos Diabetes Center, Lagos University Teaching Hospital, Lagos, and was coordinated with the International Diabetes Federation.
The project was another example of the “Bolivian Model” first established in 2003 by Rotarians Dr. Larry Deeb and PDG Wayne Edwards in Bolivia. This Model illustrates the partnership of Rotary and the International Diabetes Federation (IDF) to provide treatment and supplies to children with diabetes in developing countries.
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The International Diabetes Foundation (IDF) Life for a Child/ Rotary International Program in Lagos, Nigeria.
By Dr A.O. Oduwole Medical Coordinator |
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This is the third year for The International Diabetes Foundation (IDF) Life for a Child/ Rotary International Program in Lagos, Nigeria. It has achieved all that it was intended to do, which was to provide quality of life for children and adolescents with diabetes through the provision of free:
- Insulin syringes and needles;
- Insulin;
- Blood sugar monitoring devices and reagent strips;
- Lancets;
- Urine Ketone testing reagent strips; and Regular estimation of HBA1C
Rotarians manage and oversee this project by assisting in identifying patients and monitoring their progress. They visit the Diabetes Center on a regular basis and speak with the children extensively.
The children now have regular and uninterrupted supplies of insulin; they use appropriate insulin
syringes; they check their blood sugar levels every day; and they check ketones as needed. Attendance at clinics has improved, and the financial and physiological burdens to the parents have been greatly reduced. As a result, we expect a good quality of life for these children as well as a reduced rate of complications from diabetes mellitus, which, oftentimes, can be life threatening.
From the initial 15 patients, the number has increased to 34. This doubling of patients has shown that diabetes is a growing and worrisome problem, and suggests that there are many more children out there who need our help. More than 60% of the patients come from the low income class.
Lagos University Teaching hospital, where the center is situated, has dedicated a whole floor to the children’s diabetic center in a newly built building. It is hoped that Rotary International will help to equip the center.
Very sadly, during the year, three children died due to poor knowledge of diabetes management in other health facilities. This has brought to the forefront the importance of organizing diabetic education seminars to impart knowledge to caregivers. Limited financial resources are to blame for the lack of diabetes education and awareness.
On the brighter side, many patients have benefited greatly from the IDF/Rotary International. We are the envy of other centers in the country!
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Rotary Club of Ledbury Caribbean Diabetic Footcare Project
By Andrew Perry - Rotary Club of Ledbury |
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2009 has been a very busy year for the Footcare Project. With Diabetic Foot Care projects in Barbados, St Lucia, the British Virgin Islands, Sint Maarten, Montserrat and Nevis. Restrictions on approvals for The Rotary Foundation Matching Grants meant that only one of our matching grant applications were successful. MG #69770 managed by RC Gloucester Severn in association with the International Diabetes Federation “Step by Step” programme has placed the first of a two year project on the islands of Sint Maarten (RC St Martin Sunrise) and BVI (RC Road Town). The Footcare Team helped staff the RAG Diabetes stand at the Rotary International Conference Birmingham UK in June, Ledbury Rotarian Martin Perry gave a presentation at the very well attended Diabetes “Break Out” session on the Footcare Project.
The visit to the Caribbean earlier in the year by Dr Karel Bakker (Chair, International Working Group on the Diabetic Foot and Step by Step) and Ledbury Rotarian John Greedy had identified Barbados and St Lucia as being in real need of diabetic foot care training. Dr Bakker managed to obtain funding from the World Diabetes Foundation to place a Step by Step program on Barbados (RC Barbados South) and St Lucia (RC Gros Islet) albeit on a reduced budget. Rotary Clubs in the UK and in the Caribbean have all contributed to help run this programme and are continuing to do so. We are very grateful for their help.
From St Lucia we have heard that since the initial session in July/August 2009 more Community Health Nurses have been trained. With more health care professionals now equipped with advanced information and skills the care of the diabetic foot should improve immensely. Podiatry equipment given by the project have been used for training and some out in the clinics. The Ministry of Health is helping to fund further podiatry equipment. Further outreach training has been helped by funding from the Pan American Health Organization (PAHO). Most importantly the reports from the clinics are being made by the Community Nursing Department of the Ministry of Health as an aid to measure the success of the project.
The Canadian Podiatry Team, Sole Savers International (SSI), Melanie Atkinson and Tracy Oliver, completed the second phase of the Diabetic Footcare Project on the islands of Monserrat (MG #67148 and the RC West Ottawa), Nevis has been financed largely by RC Ledbury.
The purpose of this second visit by SSI was to teach more advanced practical skills, discuss the implementation of the Diabetic Footcare programme on Montserrat and Nevis and address any difficulties in implementing what had been learned on the first phase of the programme in 2008. Thirtyfive frontline health care workers have been trained over the two years of the project.
Fiftyseven patients were examined and treated by SSI over the course of these secondary visits. Most importantly some patients who had active ulcers during the first visit by SSI were re-examined, they presented no signs ulcers on this visit. Regular care by the trainee participants of the Diabetic Footcare project has helped the original ulcers to heal. The number of patients seen requiring clinical intervention was significantly reduced on this second visit probably as a result of health care workers advising their known patients with problems to attend the Diabetic Footcare Clinics and receive treatment.
The Rotary Club of Ledbury were also pleased to apply for and receive grant funding from Rotary District 1100 for the Diabetic Awareness Programme on the Island of Tobago where the initial Footcare program started in 2002. The funding will be aimed specifically at Diabetic Retinopathy. RC West Ottawa and RC Ledbury have also supplied glucometers in response to a request from RC Tobago South West.
The Rotary Club of Ledbury are delighted with the success of these Diabetic Footcare programs. Reports coming from the Caribbean all are testimony to the value of the Diabetic Footcare training given in the Footcare programs.
Massive support has been received from Rotary Clubs worldwide. In excess of $211,000 has been raised by our International partnership with the combined support of the Rotary Foundation, the International Diabetes Federation, the World Diabetes Foundation, Rotary Clubs in the Caribbean, UK and Canada and numerous other organizations.
Lack of podiatry training makes so many diabetic patients vulnerable to ulcers which, if left untreated, can easily result in amputation.
Once in place our Caribbean Diabetes Footcare project are self sustaining programs aimed at lessening the huge social and medical costs associated with Diabetes. More projects are planned. As fellow Rotarians, can you help us as we plan new programs in the Caribbean?
Help us start the healing process.
“Rotary in Action”
Andrew Perry
Rotary Club of Ledbury
Caribbean Diabetic Footcare Project
www.ledbury.rotaryweb.org
January 2009
World Diabetes Day 2008
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