Insulin: A Luxury in Haiti

Diabetes Mellitus (DM type 1), known also as Insulino-Dependent Diabetes Mellitus (IDDM) or Juvenile Diabetes, is an auto-immune disease diagnosed most of the time during the adolescence years, and characterized by lack or no production of insulin by the pancreas. Insulin is the hormone responsible for entering glucose (end-product of sugar, carbohydrates, and starch) into cells and muscles. With a deficiency in the production of insulin, the body becomes unable to metabolize glucose, which results in having too much glucose in the blood. This accumulated glucose will damage cells and tissues, particularly in the eyes, kidneys, heart, etc.

As IDDM is due to a lack of insulin, the treatment for this disease is insulin (mostly synthetic human insulin). Whereas for the other, most frequent type of diabetes, DM type 2 or Non Insulino-Dependent Diabetes Mellitus (NIDDM), treatment may be done with drugs other than insulin.

In Haiti, insulin is very expensive, as are most medications in forms other than tablets. As a result, patients with IDDM have a hard time adhering to their insulin treatment. Yesterday, I’ve seen one of them, a 24 year old man, diagnosed with IDDM three years ago. He looked sick, weighted 97 lbs., and had an overactive skin condition. When asked about insulin, he told me that he had gone without it for the past three months, simply because he could not afford it. He is unemployed and has no financial support.

This young man’s situation is not unique. Many IDDM patients, living in Haiti, face the same ordeal to maintain their insulin treatment. One solution is to put together a national, coordinated network that will raise funds to buy insulin or seek donations of insulin from pharmaceutical companies. This network will enroll IDDM patients and provide them with insulin at reduced or no cost, depending on their financial situations.

Insulin is readily available in developed countries, but in poor countries, like Haiti, it’s a luxury. We need to make insulin accessible and affordable to all, so that our IDDM patients can continue to lead healthy and productive lives, and delay the heart, kidney, and eye complications associated with DM.

Solving problems once and for all

It feels so good to fix a problem once and for all. I dream one day that we’ll have electricity 24/7, paved roads all over the country, running water in all households, well-equipped ERs and hospitals in all cities and towns, and schools…How can we achieve those dreams? It will take one problem at a time, one solution at a time, one fix at a time. We have big problems, we need big solutions. Thirty months after the January 12th earthquake, where are the big solutions and the big projects? Instead, we have small projects that only make a dent to our problems.

Shifting from Relief to Preventive Care

It’s time to shift our focus and resources from relief to preventive care. In the aftermath of the January 12, 2010 earthquake, healthcare professionals from all over the world rushed to Haiti to bring urgent care. Because of crushed body parts from free-falling concrete walls and roofs, the needs for surgeons, orthopedics, anesthesiologists, and trauma specialists were huge. At the same time, people with chronic diseases and those with acute diseases associated with malnutrition and unsanitary living conditions need primary care. Before long, all this care was lumped into one concept: relief care.

Seven surgeries and more to come…

In Haiti, you’re blessed if you never have any serious disease or any condition that requires CT scan or MRI, or sophisticated surgeries. You’re blessed if you don’t have any serious neurological disease—we have only two or three neurologists in the entire country. You’re blessed if you don’t have any cancer, since chemotherapy, radiotherapy, and even surgery are most of the time unavailable and expensive. Patients with such diseases or conditions end up broke, have to travel far, even outside the country, and many times have to suffer in silence until death ends their misery.

Caring for Angels

Her arms and legs are covered with lesions; some nascent, bumps under the skin; some active with pus oozing from their open top; and others healed, living behind a black spot. Her head tilts to the side. But her lips part with a lasting smile. She sits on her mother’s lap, with no care in the world. She’s 13 months old, but has yet to crawl or stand on her own. How long has she had those lesions? I asked her mother. Not to embarrass her, but they were so many. Two weeks, she replied. No, I thought, they’ve been there much longer; four weeks, at least. Another case of delaying seeking care, so frequent among no or low income communities. Or is it a case of neglecting the little girl who can’t walk and play like the others. Don’t think so, Mom looks and acts like a caring type. She may have not been able to get sooner the 50 gourdes ($1.20) needed for the exam. In any case, she was here now, to get proper care for her child.

Summer in Haiti

The heat is on...It's really hot, here, in Port-au-Prince. Thanks God we have electricity, thus a fan to keep our bedroom temperature tolerable. Unfortunately, most people in Haiti either don't have electricity or don't have a fan. Think of the thousands who still live under tents. Imagine you were one of them. There you are, night in and night out, lying in the dark, sweating bullets, mosquitoes buzzing in your ears. Daytime is hard here, nighttime too. Not just for you, but for your children too, if you have any. They'll get sick, from the heat, from mosquitoes, from lice, and from life itself. You'll bring them to the clinics tomorrow morning, early, so they can have a chance to get some much-needed medications.

Tomorrow morning, I'm scheduled to be at the Repheka Clinic at Carrefour Feuilles, and I'll remember the scorching night we'd had all.