Rwanda joined the rest of the world to celebrate world diabetes day with patients sharing their struggles and challenges of living with the non-communicable disease.
The celebrations that revolved around the theme Know More about Diabetes were held at Muhima Hospital in Kigali, November 23, 2023 with a call to fight type one diabete among children.
Type 1 Diabetes Mellitus(T1DM) is the most common endocrine disorder in childhood whose incidence predominantly occurs during early adolescence. It is characterized by lack of insulin caused by autoimmune damage of Beta cells of Angels.
Normally, a diabetic is required to have sugar-free foods (vegetables, fruits, rice, cocoyam, bananas- ‘matooke’ etc.) Before they eat the first meal, they must take a sugar level test and inject insulin according to the sugar levels generated in the body.
After eating, the sugar levels go high and that means a diabetic has to take the sugar level measures two hours after the meal. The second insulin injection which works in long periods is taken at night.
Innocent Mugabo, a father of two diabetic girls says the routine is much easier to follow up on children at home but not in boarding school, where they have to eat the same foods (maize flour and beans) every now and then unlike in day school where they can get special foods delivered (at midday).
Mugabo said that it has been a struggle to keep his children in boarding school. His first born had to drop out of school while in primary school until this year when a christian school which is mindful of these cases enrolled her.
Mugabo says that if public and government aided schools openly consider diabetic cases in school this can reduce parents’ burden.
A research paper by Immaculée Mukamarara from University of Rwanda, College of Medicine and Health Sciences indicates that adolescents with T1DM face many challenges, like inadequate knowledge of self-management and stigma.
A 10-year-old pupil in Kigali who shared her testimony said that her teachers know her medical condition and she, like some few pupils with similar conditions, are allowed to get food from home.
However, she struggles with the stigma of being diabetic, reason why she takes insulin in hiding.
“I skipped school to come to these celebrations but if pupils ask me where I was, I will not have a response, maybe I will have to lie,” she said.
Her mother Olive Uwaruyenzi said that stigma is still a big challenge among the diabetic patients.
“If all schools, and communities were aware of diabetes as a ‘normal’ disease, this would help deal with its stigma. I literally have to build her confidence to have her stay in school,” she said.
Currently the community based health insurance covers the diabetes medication (insulin syringe) but test strips, blood glucose meters (to measure sugar levels) and other supplies are not covered.
Through donations from the Rwanda diabetes association and partners, diabetic adolescents have received glucometers and many still use the bottle and syringe insulin method, but are not aware and have never used the other methods such as the insulin pens, insulin pumps, and insulin jets.
“The last insulin pens were donated once and that was two year ago. Most of the glucometers are broken and some of us take insulin without testing sugar levels,” Mushimiyimana said.