April 23, 2019
Laura Constable is a doctor from Melbourne, Australia and an associate of the non-profit Insulin for Life (IFL). IFL provides in-date diabetes supplies to diabetes clinics in resource-poor settings. It also supports local organisers in conducting diabetes youth camps. Laura travelled to Dhaal Kudahuvadhoo, Maldives to work with the DiabMaldives Youth Camp 2018. The 5-day program was organised by the Diabetes Society of the Maldives, in collaboration with Dhaal Atoll Hospital and International Diabetes Federation South-East Asia. Delegates were aged 13- 26 years with type I diabetes, and predominantly from the Maldives, but also from India, Bangladesh and Sri Lanka. For many camp attendees it was their first time at a diabetes camp, an experience much more than blood glucose testing. Today, Laura talks about her time in the Maldives and the campers she met with type 1 diabetes.
What surprised you most about the type 1 diabetes camp in the Maldives?
My immediate impression was the difference in expectations before and after I arrived. Before the trip, out team was briefed about IFL’s experience with youth at the camps: many usually do not achieve blood glucose targets and/or do not receive routine laboratory tests like HbA1c.
In contrast, the DiabMaldives participants have an extensive knowledge base. They have much more knowledge of diabetes than me at the end of my medical school studies! They know a great deal about treatment options and some campers are insulin pump users. Most participants have regular health screening tests. After my clinical examination and review of their recent results, the youth also have excellent diabetes management. These observations are similar to those I see in Australia. It showcases the strength of the Maldivian and South East Asian system in supporting young people with diabetes.
Please tell us about the campers (participants) you met?
The youth delegates involved in the camp were not just adolescents living with type I diabetes, but young leaders in their communities, educating and advocating for issues on youth related diabetes. Through interactive workshops, activities during the camp, and personal conversations, I was able to catch a glimpse into the lives of these youth. I and was awestruck by the talent and vast skill-set present. One delegate had completed Master level research into the biochemistry of type 1 diabetes. Another delegate runs a social media platform for raising support and awareness of type I diabetes. Others are undertaking university studies in a multitude of fields, with exceptional talents in dancing, painting, and jewelry-making on the side. Three girls shared stories of how they improved their HbA1c levels from 14-15% to 7.5% by having social support and connectedness during their adolescent years. I really do believe that these young leaders have the ability to empower their communities and be the change for the future of type I diabetes.
What were camp attendees most concerned with about type 1 diabetes?
Their resilience and what I heard in their stories was very powerful. Stigma still exists in many communities, and hearing stories of what they have overcome and continue to overcome day-to-day was very moving. Many said they still face stigma around injecting and insulin pumping. One delegate told of a youth in their community not wanting to disclose their diabetes to a potential husband’s family due to a negative impact on marriage prospects. There was a large focus on mental health and psychological support during the camp, with interactive workshops, and skills they can use to face stigma with resilience. For many participants this was their first time on a plane, in a new country, at a beach – and I watched their strength in this environment which was humbling.
What do you think are the most important aspects of attending the camp?
The connectivity and support were without a doubt two of the most invaluable aspects of the camp. The universality of type I diabetes was evident. Diabetes camp goes beyond culture, religion, language, and age. A place where participants and facilitators connect and share personal experiences around diabetes. One highlight was a night celebration, with a traditional Maldivian feast, dancing, singing and lots of entertainment. Among the myriad of memories, was the image of the participants packing onto local boats to an exotic sand break for a Maldivian picnic. There was a good deal of laughing, singing and dancing; enough selfies to last a lifetime.
Are you glad you were able to attend, too?
Yes! Thank you to the Diabetes Society of the Maldives and Dhaal Atoll Hospital staff for their endless warmth and generosity. I am humbled to have been part of the program and returned home with a new sense of connectedness, optimism for the future of diabetes and a goal to live, love and find a cure for type I diabetes.
Acknowledgements:
Diab Maldives participants
Diabetes Society of Maldives
Dhaal Atoll Hospital staff
Insulin for Life
