In July 2011, the AYUDA team travelled to Quito, Ecuador to work in conjunction with AYUDA's local partner organization the Fundacion Diabetes Juvenil Ecuador (FDJE), in preparation for Campo Amigo Ecuador, a diabetes education and training program for children and youth with Type 1 diabetes. The first few days the volunteers engaged in practical sessions with the local youth leaders and built on their previous training. They practiced how to test and read blood sugars, draw and mix insulin and how to inject. In addition, the volunteers were taught multiple ice-breakers and how to play some of the local children’s games so that they would be familiar with them in advance of camp.
The volunteers met daily at the local foundation to review and discuss the initial plans for pre-camp training, diabetes camp and camp activities that had been outlined by the local youth leaders and FDJE staff members. The volunteers were able to offer feedback and suggestions about how to improve the activities from physical education to nutrition. Multiple themes were chosen and tasks were delegated according to skill-sets.
In addition to the planning activities for pre-camp training and for camp itself, the second week included home visits to children living with diabetes and their parents in the Quito and Pichincha areas. All teams were led by local youth leaders and each team visited on average three separate homes. The goal was to allow the first-time campers the opportunity to meet the volunteers prior to the camp and also for parents to discuss any questions and concerns about their child staying overnight for the first time. It was also a key learning opportunity for many of the volunteers since it provided an insight into the everyday lives of some of the children and youth they would be working with at camp. Many of the children were from low-income backgrounds and were supported by the FDJE sponsorship program. Overall, 100% of volunteers felt that these visits positively contributed to their experience at camp itself. Feedback from the FDJE staff was positive and agreed this was an area for increased support in the future, in particular since the home visits helped to develop the leadership skills of their own young leaders.
The weekend prior to camp, the AYUDA team accompanied the FDJE staff members and local youth leaders to the campsite in the valley of Cumbaya, in the outskirts of Quito. Several counselors-in-training also participated in the pre-camp activities. The focus of pre-camp was to review safety and diabetes protocols as well as to prepare the site for the program. It also provided an opportunity for all youth leaders, new and rising, to engage with the AYUDA team and designate roles for camp. Following pre-camp, the group returned to Quito to prepare for the arrival and registration process of the campers the following day, Sunday 31st July. A team of 5 people remained at camp to prepare the campsite for camp.
A total of 43 children and youth between the ages of 5 and 18 participated in Campo Amigo Ecuador which was held from July 31st to August 4th in Cumbaya. The campers were led by 19 local youth leaders and counselors in training in addition to the FDJE’s technical staff and AYUDA team. Two Ecuadorian endocrinologists and one local pediatrician lead the medical team which was supported by local medical students in each group. The children and youth were divided into 6 groups according to age and gender. The groups participated in education, nutrition, sports and arts activities on a daily basis. Meal times also served as key learning opportunities with discussions encouraged at each table around portion size and carbohydrate counting. The days were interspersed with many dynamic entertainment activities including a color war, a camp-wide treasure hunt and a camp rally.
During the program, all participants were able to have their HbA1c levels tested as well as receive a full foot examination. (HbA1c tests reflect average blood sugar levels over a period of approximately 90 days and are considered a standard measure for blood sugar control). HbA1c results varied between 6.9% and 14.24% with the average result of 9. 47%. Those campers who had not measured their HbA1cs in many months typically had higher results, reflecting poorer control.
Campo Amigo Ecuador was the first and only time many of the campers had seen a podiatrist (footcare is an important element of diabetes self-care). While the feet of most campers were free from diabetes-related complications the examination enabled participants to learn about appropriate and essential foot care and was intended to encourage them to be active in their own self-care. Each group also received a session with a local psychologist who himself had Type 1 diabetes and proved to be very popular with the children and youth. The issues for discussion were selected in advance and were age-appropriate.
In the evaluation of the program with the FDJE technical team, the staff felt that the size and location were more manageable compared to previous programs. An unanticipated result was that the reduced numbers and the facility’s spacing allowed for greater integration between the different age groups and enabled increased opportunities for leadership from the older groups. Furthermore, the FDJE felt that the AYUDA and FDJE were well integrated and worked well together. The education and nutrition sessions were considered to be the most interactive and successful to date. Plans are currently in progress for 2012 programs. The next local sessions are to be lead by the FDJE in Quito in November 2011 and additional provincial programs in March 2012.
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