Fighting diabetes: the Vietnam model
FOR MOST non-communicable diseases, awareness is the key to prevention.
Diabetes, characterised by high blood sugar levels when the body is unable to produce or utilise insulin, is not a shocker disease like HIV/AIDS or cancer.
It is rather a benign one, not really interfering with the patient's lifestyle until complications set in.
But once complications do set in, it could lead to loss of vision, amputation, renal failure, heart disease and stroke.
Major issue
The World Health Organisation predicts that diabetes will be a major health issue in the 21st century, with approximately 80 per cent of all new cases in developing countries.
At present, Asia has the world's largest diabetic populations — India is estimated to have 35 million people with diabetes, China: 23 million, Pakistan: 9 million, and Japan: 7 million.
Health problems
And these numbers are growing as urbanisation takes over Asia. One study in Vietnam shows that as the economy grows and people switch from bicycles to motorbikes, there has been an increase in inactivity-related health problems.
Recognising the problems that an increasing unhealthy population could pose, the Vietnamese Government in 2002 issued a national strategy for prevention and control of non-communicable diseases.
Though just 3 per cent of the Vietnamese people have diabetes, the Government prioritised it as a public health problem in 2001.
At a summit organised by the World Diabetes Foundation in Hanoi, the organisation showcased a pilot project it is running in collaboration with the Vietnam Ministry of Health and WHO in two provinces.
The project focuses on a community-based approach to creating awareness, improving counselling and diagnostic facilities, making medication available and, most importantly, trying to improve the quality of life in Thanh Hoa and Thai Bin provinces.
Dr. Trinh Hung Truong of the Endocrinology Department at the community hospital in Thanh Hoa province says about 60 per cent of the people in the area are now alert to the dangers of diabetes.
Before the programme was launched in January 2004, he says, people believed diabetes could not be managed, preferred herbal and alternative cures to insulin, and, often, did not understand the disease.
Awareness programmes
They are able to monitor and understand their disease better, as well as have professionals guide them."
Television and media campaigns, diabetes clubs and other public awareness programmes are the mainstay of the drive to educate people. The programme is to be rolled out across the country by the end of the year.
Community programmes
"The Vietnam model is not unique," says Dr. Gauden Galea, WHO's Regional Adviser for Non-Communicable Diseases.
"There are many community-level programmes in various regions but this effort has proved that lifestyle changes, quality care and dedicated interest from the authorities can make a difference.
It is just a common sense approach that can be followed anywhere in the world, which can lead to a reduction of complications and ultimately of incidence."
SHALINI UMACHANDRAN
recently in Hanoi, Vietnam
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