Awareness for diabetes in Madagascar

Madagascan Diabetes Association have sent health experts to provinces to raise awareness for diabetes.

Madagascar.

TAMATAVE - An estimated 1 million people in Madagascar are diabetic, but only about half of them know it.

Finding the other half presents a major challenge for this large, island nation in which 80 percent of the population live in rural areas where few people have ever heard of this chronic and potentially deadly disease.

With the country's underfunded public health sector barely functioning, this task has mainly fallen to the Madagascan Diabetes Association (A.MA.DIA.) which dispatches its doctors and nurses to the provinces to conduct blood sugar tests and raise awareness at fairs, schools and health centres.

"We have done this work for over five years now, and people are slowly starting to know more about the illness," said Jean Marie Andriamanonga, coordinator of A.MA.DIA.

"Malagasy people think that diabetes is not a problem in this country, because they don't drink Coke and don't eat cakes, like Westerners. But there are many components in the traditional diet that can cause the illness," Andriamanonga told IRIN.

"In the countryside, for instance, people drink local rum made of sugar cane. They also like to eat fatty meat and plates full of rice. In the cities, people are starting to eat Western foods and they don't move as much as they used to."

Based on the tests that A.MA.DIA. has conducted, Andriamanonga estimates that 5-6 percent of Madagascar's population of 20 million has diabetes, while only about 3 percent have received a diagnosis.

"In the bush, people really die of this illness," he said. "We have seen cases where people's limbs were amputated. People often complain about vision problems, high blood pressure or wounds that don't heal well.

"We used to only find cases among the elderly, but now it is spreading among the young also."

If finding diabetes patients presents a challenge, treating them is even more difficult. Moussa Bako, a 69-year-old farmer who lives 160km north of Tamatave, a port town on the east coast of the island - which is also known as Toamasina, was diagnosed with diabetes three years ago after complaining of chronic fatigue.

At the time, the doctor at the public health centre in his region gave him some advice on diet and treatment and administered one dose of insulin. "I felt better after this, but never had the opportunity to go back," said Bako, who thought one treatment would cure him; he lived too far from the clinic to return for regular check-ups.