Treating Patients Without Tools: Haiti's Diabetes Crisis Day 2

Published on
February 26, 2011

Today I lectured at the medical school. It is on a hill in a UNICEF tent. It was over 100 degrees in the "tent classroom" while I was lecturing. The students took handwritten notes and copied down every word I said from my French-translated slides. They were fourth-year students in the European system, equivalent to first or second-year stuents in the States, but they had no idea what caused diabetes or what insulin did.

When they asked a question, they stood up. There were no books. The dean was housed in a small container nearby. They graciously served us coke -- with ice -- so we couldnt' drink it. The medical school looked to be as lacking in resources as the rest of Haiti. But despite the absence of any basic amenities, they go on.

Evelyne, the nurse practitioner traveling with us, teaches every day and has now trained hundreds of nurses, pharmacists, social workers and other health workers. She also is training health professionals to serve as trainers themselves so they can continue to educate other health workers and patients in diabetes care. She is tireless and a star.

We had a meeting with about 40 doctors later in the day. The discussion revolved around inpatient diabetes care. The main problem discussed: doctors' inability to check blood sugar. They clamored to have a glucose meter and strips at least in every hospital. The next goal would be a meter on every ward of the hospital. Most importantly they want meters and strips available during surgery.

Without such basics, they have adjusted by learning how to give insulin based upon urine results and symptoms. Or more often, providers don't provide any therapy at all. They estimate there are 300,000 to 400,000 people with diabetes in Haiti. There is not enough insulin. There are almost no glucose meters. Glucose strips are the final frontier.

Francine Kaufman, M.D., is sending updates from her Blackberry during her visit to Haiti with a relief mission. Here are links to her other updates:

Day 1

Day 3

Day 4