Since its inception, the Maya Health Alliance - Wuqu’ Kawoq diabetes program has been truly groundbreaking. Our cohort of approximately 150 diabetes patients is among the largest clinical diabetes programs described in the global health literature, and, as far as we know, Wuqu Kawoq’ may be the only organization in Guatemala providing free, truly comprehensive diabetes care. In addition, we always have maintained an unwavering commitment to Maya communities as roughly 80% of our patients with diabetes are monolingual in a Mayan language.
This year has brought many exciting developments to the Wuqu’ Kawoq diabetes program. First, although we have added approximately 25 new complex diabetics to our cohort since August 2013, we have maintained and even strengthened the high quality of our patient care. For example, in the six months since January 1, 2014, the percentage of our patients with “good” blood sugar control has improved from 41% to 53%, and the percentage of our patients with “very good” blood sugar control has risen from 21% to 32%. Much of this improvement stems from our successful efforts to persuade approximately 15 patients to intitiate insulin therapy. (This is no small feat; it took some patients more than three years to accept the necessity of insulin treatment to adequately control their diabetes!)
Second, we have recently hired a new diabetes nurse educator, Carol Teleguario, who makes regular home visits with complex patients as part of our new diabetes education study. Carol, a Kaqchikel speaker from Patzún, has been warmly embraced by our patients. We have not crunched the data yet, but based on what our patients are telling us, we think it is likely that diabetes education in home visits improves patients’ blood sugar control and program adherence.
Third, we have recently begun a pilot program to screen all patients for cardiac and kidney complications through the measurement of cholesterol and microalbuminuria, respectively. Such screening tests are standard-of-care in the U.S., but our program would be the first in the global health literature to offer such tests at no cost.
Finally, as we are always brainstorming ways to improve our program, we have other exciting diabetes program news in the “pipeline,” including news about drug procurement, eye care, and expansion of services into a new community. We look forward to sharing the news with you in the coming months!
Thank you for your continued, incredible support!
At times, life is difficult for all of us. There are days when we don't want to get out of bed or days we are not sure how to make the best of a difficult situation. We understand that, which enables our patients to confide in us and put their trust in us to help them get better. In rural Guatemala, our diabetic patients face extremely difficult sitautions, especially when diabetes is poorly understood by family members and friends. Often, they receive poor advice about diet and mediciation and when they are trying to following a good diabetic diet, often family are misinformed and make it difficult for the diabetic patient to eat the foods they should.
We have worked together with our patients to understand their most difficult problems while batteling diabetes. Most often, it comes down to education and access to medications. We are thrilled that we can help our patients with both of these facets.
One of our patients, a 62 year old woman named Paula, told me "I always try to eat the right thing. I have tried cutting out sugar in my coffee and I rarely eat fried plantains any more and in the afternoons I have been trying to cut out my sweet bread. However, the most difficult factor is my husband, he always wants me to sit with him and have sweet bread and he loves plantains in the morning. I know these aren't good for me, but with him and my children always wanting the foods I can't eat, well it's hard to make more than one meal every day 3 times a day."
We understand Paula's concerns and we are excited to be growing our education program. We have continued pilot testing our program and we believe we are going to be making some fundamental changes to our program. These changes will focus on home educational visits wtih the diabetic and the entire family in order to educate and hopefully prevent diabetes among other family members.
The majority of our patients are able to control their diabetes through diet and some medication. However, we have several diabetics who need a lot more care, some needing insulin and even dialysis.
Our patient Amada, has been an incredible warrior batteling diabetes and has been on dialysis for many years. She lives far away from a hospital that can dialysis, which made it difficult for her to work or take care of her young daugher. We wanted to change that! We helped Amada to do dialysis at home! Amada compelted dialysis training sessions and has been doing DIY at home dialysis for over a year now. It took time to find her a place to live, incuding the construction of a small room that was a dedicated space to do dialysis. But now she is doing fantastic.
Amada makes the best of an extremely difficult situation in life. Here is Amada visiting with our nurse, Sandy, and showing us how she does dalysis at home: http://vimeo.com/71350398
From DIY dialysis to educating the family, not only the patient, we are helping diabetics learn and live!
Our research with rural diabetic patients in Guatemala has demonstrated that patients strongly prefer education classes and materials in the indigenous langauges. For example, many patients have explained that they fail to understand explinations in Spanish about diabetes control and diet modification. Most often, they return home after the consult with no resolution.
In order to provide the best care possible to our patients, we added an education course that incorporates indigenous knowledge and culture. The course is also taught in the indigenous langauge. We recently graduated the first class of adult, Kaqchikel Maya participants. The course was extremely successful! Participants explained that they not only learned how to control their diabetes with diet and medication in their own langauge, but for the first time ever they have found a strong social support in order to make the diet and liefstyle changes that are necessary to manage their diabetes.
One class participant explained that she struggled to follow the diet she was taught by us during consult, at home because no one else in her household understood her specific diet or its importance. But since we made family, friends, and the class particpants part of the learning process and key to supporting her and keeping her healthy, she now feels that now has the support at home and in the community to make better dietary decisions.
We are excited with the outcome from the first class and we can't wait to start more in January! Stayed tuned for more updates.
Thank you so much for your support in 2013!
Dear Friends, this has been a really busy week for the diabetes program.
In previous months, I've hinted to you about the new educational initiative for diabetes patients that we are rolling out. Education, as you might expect, is a huge part of any diabetes program. Over the years, we've developed a number of educational materials for our patients, and our nurses and community health promoters also provided individualized, one-on-one education during regular home visits to patients and their families.
However, one big area that has been missing still is the creation of a sense of community among the diabetes patients themselves. For example, as we noted in a recent research publication (see the link below), many diabetics feel alone with their disease. They often also feel stressed by pressures within their own families that prevent them from making good health and dietary choices. To combat this, we are instituting peer support groups for our patients, which will meet regularly and will be facilitated by our health promotion staff. In the United States and other developed countries, this strategy has been very successful at improving patient satisfaction and also disease control, and we are looking forward to seeing what happens with our patients!
To make this program a success, we've brought on a new volunteer, who just arrived in Guatemala and will be working full time on this project over the coming year, helping our local staff get the program up to speed.
Thanks for your support!
This is just a really quick note to let you know about two things.
First, to tell you a quick story. The picture you are seeing here is of Dominga, one of our long-standing diabetes patients (she's given me permission to tell her story). Dominga has had diabetes for a long time, but she spent almost 10 years looking for a medical home before she found us. She has kidney problems as a result of her diabetes, and she has also had life-threatening foot infections. However, we've been able to help her through all of this, thanks to your help. This photo was taken just before a routine surgery for diabetes-induced cataracts. She's back home and seeing better than she has in 20 years. Thank you so much for making this program a possibility!
Second, I wanted to let you know that GlobalGiving is having a Matching Funds Campaign on June 12. Because we are a "Superstar" ranked organization, this means that all donations to any of our projects on June 12 will be matched 50%! You can see the list of all of our current projects here. Pass the link on to your friends and colleagues!
Thanks as always for your amazing support and interest in our work.
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