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Tuesday, October 20, 2009

Diabetes, Belize's #1 Killer

Diabetes, Belize’s #1 killer
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Posted: 20/10/2009 - 10:29 AM
Author: Adele Ramos -

103 murders in 2008 – 103 diabetes deaths

Over 40,000 Belizeans are said to be diabetic (roughly 13% of the population)

Another Belizean succumbed last week after battling 29 years with the silent killer, diabetes (locally dubbed “sugar”), complicated almost two years ago by the loss of her kidneys, which a close relative told Amandala had gotten infected after the patient underwent a hysterectomy, having suffered fibroids on her womb.

From anecdotal accounts, we know that fibroids afflict many Belizean women, and diabetes remains the leading cause of death in Belize, as confirmed by statistics we obtained today from the Ministry of Health (See chart).

Despite the double whammy that hit a More Tomorrow woman, Melva Sutherland, whose story we introduced above, she fought long and hard to stay alive. (The name of her village, More Tomorrow, seems intriguingly symbolic.)

Sutherland’s story is lived by many other Belizeans—some of whom are not as fortunate as she was to have gotten on the shortlist of 20 patients receiving subsidized dialysis treatment at Belize Healthcare Partners Limited (BHPL), a private hospital. Her death is a tragic way for someone else to ascend to that limited list of privileged few.

According to her daughter, Marilyn, her mother had been on dialysis, having lost her two kidneys, for a year and four months, and she had to battle with side-effects and complications, including infection of the catheter that was in her chest, which got infected every three months, and low blood levels at times, said Marilyn.

Last Wednesday morning, Melva Sutherland was rushed to the Karl Heusner Memorial Hospital, where she died at about 9:00. Marilyn said that her mother had had dialysis the day before, and held on for as long “as God wanted her here”. The daughter, grateful for the care her mother received, harbors no ill feelings over her mom’s passing.

In fact, she told us that the nurses at BHPL, who attended to her mom when she visited for dialysis on Mondays and Thursdays, took exceptional care of her and wept when they heard that she had passed.

According to family friend, Lizbeth Ayuso of the Reporter newspaper, they had to fight to get Melva on the Government’s dialysis program at BHPL. One man told us that because the cost of dialysis treatment is so high, he, too, had had to chip in when Ms. Sutherland was not receiving help from the government.

Marilyn said—underscoring the importance of treatment—that if it were not for her mom receiving the dialysis, “she would have died 10 times earlier.”

Melva Sutherland, 62, was laid to rest in her village of More Tomorrow on Saturday, her daughter told us.

Asked if anyone else in her family suffers similar challenges with diabetes, Marilyn said that one of her sisters, now 39, has been having problems with her “sugar” (blood glucose) level for the past three years.

Her sugar level has gone as high as 600 (four times the normal limit) and whenever it spikes, she has to be hospitalized for treatment. Her condition is debilitating and may eventually require that she, too, start a dialysis regimen.

Last reports to our newspaper are that 84 Belizeans require dialysis treatment for diabetes and other conditions that have caused their kidneys to stop working.

That is why a group of Belizeans are adamantly advocating for the immediate implementation of a dialysis program proposed by the World Organization for Renal Therapies (WORTH), which has pledged 10 dialysis machines and technical support for two centers to be set up at the Karl Heusner Memorial Hospital (KHMH) in Belize City (the country’s tertiary, public sector hospital) and La Loma Luz Hospital (a private Seventh Day Adventist hospital) in San Ignacio.

Belize Association for Renal Therapy (BART) representative, Jose Cruz, told Amandala last week that the program—which he said would provide dialysis for as low as $8 a pop as well as additional and much needed care from a dedicated nephrologist and dietician—is a blessing, especially to those who currently need treatment and simply cannot afford it.

Cruz has been publicly lobbying for Government to speed up on its end, because WORTH, frustrated over missed deadlines and extensions to those deadlines, has threatened to pull back the KHMH portion of the project.

We know that partners in Belize met last Thursday to finalize the memorandum of understanding for the project, due back in September. When we called Director of Health Services, Dr. Michael Pitts, for an update today, Pitts told us that he could not yet update us, though he promised to get back to us later.

Unlike street violence, diabetes is called a silent killer, because we don’t hear many lamentations about Belizeans losing their lives to diabetes. Many will be surprised to learn that diabetes is on equal footing with murders in Belize, even though women fall prey more often to diabetes and men more often to violent crimes and traffic accidents. Furthermore, diabetes is at least 8 times more pervasive here than HIV/AIDS. Yet the attention given to diabetes is vastly overshadowed by the gleaming national spotlight given to crime and HIV/AIDS.

Official Police stats say the 2008 murder count reached 103; Ministry of Health stats say diabetes equally claimed 103 lives (40 men and 63 women), whereas HIV/AIDS was blamed for 62 deaths.

At last report, the count for Belizeans having contracted HIV was roughly 5,000 (1.6% of the total population). By contrast, over 40,000 Belizeans are said to be diabetic (that’s roughly 13% of the population), according to Minister of Health, Pablo Marin, who quoted the figure to us back in September 2008.

He also reported that the obesity rate—one of the key risk factors for developing diabetes—was 60%; meaning nearly 200,000 Belizeans are overweight. Meanwhile 30%—over 90,000 Belizeans—are reported to be hypertensive, suffering high blood pressure.

Hypertensive diseases, locally called “pressure,” killed 51 people in 2008, according to the Ministry of Health, and are listed as the 8th leading cause of death.

In 2004, 89 deaths were attributed to diabetes. In 2006, there were nearly 50% more or 131 deaths reported.

Despite the pervasiveness of diabetes, there are currently no dialysis machines in public hospitals and the only place where Belizeans can get treated without having to leave the country is at BHPL, a private hospital.

Director of Health Services, Dr. Michael Pitts, told Amandala in a conversation tonight that he only learned today of a new case of a 34-year-old mother who needs dialysis. Pitts restated his commitment to the WORTH program, of which an update is expected at a Ministry of Health press conference tomorrow evening, Tuesday.

(Author’s Note: The Ministry of Health separates violent deaths (for which they are not certain if the injury was purposely afflicted) from clear homicides or deaths purposefully caused; therefore, the discrepancy in numbers.)

What is Diabetes?

Diabetes is a condition that arises when the pancreas does not produce enough insulin, or when the body cannot effectively use the insulin produced. Insulin is a hormone that is produced in the pancreas, to regulate the amount of glucose (sugar) in the blood.

Symptoms of Diabetes
· Increased thirst
· Frequent urination
· Blurred vision
· Feeling tired most of the time
· Losing weight
· Having sores and cuts that are slow to heal
· Numbness and tingling in hands and feet
· Frequent infection (urinary tract and vaginal infections, boils, etc).
Manage Your Diabetes
· Exercise regularly
· Eat a healthy diet
· Wear appropriate shoes
· Take medication, prescribed by your doctor
· If overweight, lose weight
· Monitor blood sugar
Risk for Diabetes
· Family history
· Overweight
· Physical inactivity
· Smoking
· History of gestational diabetes
· Belonging to a high risk or ethnic group

(Summary information courtesy Belize Diabetes Association)

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