It was six years ago that I got diagnosed with Type 1 diabetes. That moment has proved to be the most consequential moment of my life. The disease has brought about many radical changes in my life. For instance, the lifestyle I had, my future career and personal plans, and mostly the way that I used to lead my social life have radically changed.
After a period of toil and personal problems, I believe I have overcome the hardships that I persistently faced. In this article, I would like to shine a light on some of the issues that people with diabetes face on a societal basis in Ethiopia. Issues that are discussed may not pertain to every diabetic, but are a very good representation according to my discussion with various healthcare experts.
Diabetes is the breakdown of one of the more important of the body’s autonomic mechanisms, and its breakdown throws many other self-regulating systems into imbalance. It is a very complex and strenuous disease ever to exist as it has been documented since the Greek and Roman civilizations. As of today, we are not closer to the remedy of this deadly disease; and its palpable complexity and adversity that it inflicts upon its patients inherently make it a very sophisticated issue in human society.
The Ethiopian society is one of the most pro-multicultural societies in the entire sphere. The history, culture, cuisine, and so forth speak for themselves. While the bondage in our society is strong, it still doesn’t address a very core query from diabetics: the issue of fully assimilating diabetics into the norms of society. Whilst diabetics are not thrown chagrin at them or cast to fire up on their discovery that their pancreas is not functioning, they still face various adversities due to the disease. To list all of the adversities in one article and expound on each one of them would be unjust for their experience, therefore, I will strive to address mainly three issues: the underwhelming comprehension of diabetes in our society and its effects, the unsaturated needs brought up due to absence of a comprehensive diabetes healthcare and the social norms and cultural values of Ethiopian society and their impact on diabetics.
The primary task that a cancer specialist does to a new patient is informing him/her that a deadly disease has consumed his/her body. As tough as it may be, informing an individual whose life could potentially be ravaged by 5 stages of a disease is as vital as applying a gamma ray or other sophisticated medication. In fact, a study published in the Journal of Clinical Oncology on October 5, 2015, reveals that patients with advanced cancer who discussed their prognosis with their physicians had more realistic expectations about life expectancy than patients who did not have such conversations. Moreover, these discussions did not damage the patients’ emotional well-being or compromise their relationships with physicians.
Just like cancer, the first thing that diabetics ought to do is that they have to voluntarily accept that they will have chance to live with the disease. This move is essential to them as the disease requires constant care and rapt attention daily. The society, on the other hand, doesn’t offer the same merits to diabetics. Due to the absence of grave symptoms that are normally expected from chronic illnesses and the endless treatment that is bestowed upon diabetics, society hardly accepts it as a serious issue, leading to negligent acts, particularly during social scenes or adjusting their perception of diabetics. After the painful acceptance of a potential life-lasting illness, diabetics are put between a rock and a hard place due to the aforementioned actions and inactions. The underestimation leads to a lack of support for diabetics, causing mental health issues to ensue gradually.
The first conjecture that is projected in anyone’s mind when the word disease is brought up is healthcare. Healthcare as the crux of treatment and well-being could be a make or break for any patient. And particularly in diabetics where the conceit of one-time treatment is transcended, it is vital. The process of caring for a patient entails a multitude of acts and perils. Firstly, diabetics should pay a regular visit to healthcare centers. For a timely diagnosis to occur, access to healthcare centers should have as few barriers as possible for diabetics, but in reality the antithesis rules. Approximately 18% of Ethiopians do not have access to a public healthcare facility within a two-hour walk (JGlob Health, 2023). This is a damning indictment of the healthcare system in our country and is a recipe for disaster for diabetics. As mentioned before, diabetes requires continuous regulation and checkups as the bodies of diabetics could face an immediate and radical alteration which in turn could ignite a chain of reactions within and result in possible complications or even death.
This may seem far-fetched, but a plethora of deaths are attributed to diabetics annually and it’s also difficult to quantify how many deaths diabetes causes as it’s mostly associated with other miscellaneous diseases like hypertension. Even when diabetics have access to a healthcare center, the cost of treatment: insulin, glucose monitors, and other essential supplies are prohibitively exorbitant. Granted, healthcare plans may have been introduced but they still don’t entirely saturate the needs of diabetics. In fact, it isn’t a bombshell anymore when a shortage of insulin is periodically mentioned. This kind of incident could have catastrophic results as scarcity of medical supplies can’t be accommodated by diabetics due to the nature of the disease. This further corroborates the conceit that the support that diabetics acquire from our healthcare leaves a lot to be desired.
The cultural and social norms in our society also greatly influence how diabetics navigate their daily lives. Dietary restrictions are one of them. Diabetics are required to follow a strict and meticulously designed meal plan on a daily basis. A slight diversion from that could have immediate (appearance of hypertension symptoms such as fever and thirst) and gradual (long-term complications) ramifications. In Ethiopia, social gatherings often revolve around food, which involves carbohydrate-rich aliment.
Diabetics may find it challenging to adhere to their dietary restrictions in these settings, leading to potential non-compliance with their treatment plan. Some people in our country may have limited access to diabetic-friendly foods. This lack of accessibility renders difficulty for diabetics to maintain a diet that goes in concert with their health needs. Repudiating food offered by a host at a social event is often seen as disrespectful in Ethiopian culture. Diabetics may feel pressured to consume foods that are inimical to their health to avoid offending others. It also does not help that many Ethiopians face economic challenges that limit their ability to purchase healthier food options, such as fresh vegetables and lean proteins, which are essential for managing diabetes effectively.
In addition to culinary norms, physical exercise is also vital for diabetes care and management. After eating food compared to non- diabetics, a higher elevation in blood sugar takes place. To mitigate this spike, physical exercise should be implemented by diabetics. Though one may think about how this relates to our society and how it may be affected by it, there are many layers in which our society could prove to be a hindrance. In some communities, cultural norms may restrict women’s participation in public physical activities, such as jogging. This can limit their ability to engage in regular exercise. In many areas, there may be a lack of safe or accessible spaces for exercise. This can discourage diabetics from engaging in social activities.
Despite these hurdles, we are now seeing some major infrastructures being enacted. Harmful traditional beliefs like “Exercise is only for younger people” can prevent diabetics from adopting a regular exercise routine. Lack of support from family and friends for engaging in physical activity can lead to a sedentary lifestyle, which is a con to managing diabetics. This is perfectly captured in a study that deduced that the overall magnitude of adequate social support was only found to be for half of the population. (The Magnitude, Types, and Roles of Social Support in Diabetes Management among Diabetics: a Multilevel, Multicenter Cross-Sectional Study).
To conclude, diabetics from the day they are communicated with the fact of their health status, face an enormous amount of challenges in their social life, specifically in healthcare, social activities, and religious acts. Different reasons can be attributed to these waves of acts that could bring acrimony to them. Lack of knowledge, misconceptions, and misinformation about the disease fueled by traditional and religious beliefs and wrapped by insufficient healthcare acts unveil an enigma that may take a lifetime to solve for diabetics. To mitigate these unfortunate, circumstances our society needs to heed advice from medical experts about this deadly disease and treat diabetics in a fair and compromised manner. This is essential for diabetics to live as normal civilians in our country. As diabetics could potentially not be separated from their illness, they would have to integrate diabetes into the fabric of their identity and their activities. Hence, our society has to assimilate them as normal people in every facet of community life.
BY FASIL YOSEPH (School of Information Science Student, AAU)
THE ETHIOPIAN HERALD SATURDAY 14 SEPTEMBER 2024
