Re: Traditional healers and diabetes in Cameroon (3)
(3)
This is shocking! I really enjoy and appreciate various messages sent to me. I entreat the indidenes of India to be focused on the various preventive measures in relation to Type-2 DM. Mass education is urgently needed to solve this menace. I would say Bravo to the Procor team for their initiative.
All the best.
----------
(2)
Dear Procor Readers:
According to WHO estimate, India ranks number one in the list of countries with Type-2 Diabetes. To create awareness, develop educational and preventive programs, we and other proactive members, started a professional society (SASAT: www.sasat.org). We have been organizing educational programs in India, for the last two decades. Having said that, I cannot say that we have reached anywhere closer to what Cameroon has done, to integrate the health care delivery. I am impressed to learn from the studies reported, that 70% of the population in Cameroon, use traditional healers. I do not know the numbers in India. In India we have at least more than five different stake holders in health care; Ayurveda, Unani, Siddha, Homeopathy, Allopathy and other Traditional Healers. No single group can provide the total health care for all, in a country like India. How do we provide affordable health care for all, is a big question in the minds of many, who are working in this area. I was delighted to know that the Cameroon Burden of Diabetes Project was aimed at training traditional healers, in prevention strategies of diabetes. I am pleasantly surprised, to learn that the traditional healers rapidly absorbed the strategies, collaborated with the professional health providers and integrated the prevention program into their way of healing modalities. If Cameroon can do it, why not other countries with high disease burden adapt this way?
In a country like India, we need well resourced intervention program, we need the political will and sustainable government support, we need effective coordination between all levels of service providers, health care agencies, multidisciplinary health care team, professional organizations and patient advocacy groups. We have been advocating the establishment of a national platform for Diabetes Prevention and development of appropriate proactive prevention plans for over a decade. Intervention is needed today. In the State of Karnataka (e-governance) there is an initiative to develop a service platform in the form of a "Kiosk" . This pilot project will be developed by a consortium of IT-Giants of Bangalore, under the leadership of a Professor from the Indian Institute of Management. These "Kiosks" will be developed at the Gram Panchyath (Village administrative platform) level to provide basic essential services, so that the common man/woman can operate day-to-day transactions without leaving the village. Once such infrastructure is developed and the capacity building is initiated, we would like to bring in a "health booth" to this "Kiosk" which will offer services from all the available health care providers (Ayurveda, Unani, Siddha, Homeopathy, Allopathy and other Traditional Healers). Although the idea seems a good one, we still have to figure out, as how to provide affordable and acceptable health care to all, in a country like India. I welcome comments, criticism and suggestions from your esteemed readers.
Gundu H. R. Rao,
Professor
Lillehei Heart Institute
University of Minnesota
----------
(1)
With the impending endemic of type-2DM all means available should be put to use, tradition healers should be trained in life style management programs that will help the IGT. prediabetics,obese DM and prevent the progress of hypertension and CVD
regards
Shaheena banu MD.PhD
dept of Biochemistry
SJICR, Bangalore
----------
(Original message)
Title: Traditional healers and diabetes: results from a pilot project to train traditional healers to provide health education and appropriate health care practices for diabetes patients in Cameroon
Authors: G Mbeh, R Edwards, G Ngufor, F Assah, et al.
Reference: Global Health Promotion 2010; 17(2): 17-26 (open access) http://bit.ly/bc19LG
Reviewer: Carlos Mendoza Montano, PhD, ProCor contributing editor; President, Guatemalan Association for the Prevention of Heart Diseases (APRECOR), Guatemala City, Guatemala
Reviewer comments: In sub-Saharan Africa, there is a parallel traditional health care system to the biomedical health system in the form of traditional healers. Such healers are used by up to 70% of the population for conditions such as sexually transmitted diseases, minor ailments, and mental illnesses. There is growing interest in the possible complementary roles traditional healers could play within the biomedical health system, including the role in prevention and control of chronic diseases. The training of traditional healers on health education and health care for diabetes was incorporated in the Cameroon Burden of Diabetes (CAMBoD) project. The current article shows that traditional healers could learn prevention strategies of diabetes relatively rapidly and collaborate in health promotion.
Purpose of study: To describe the results of a pilot intervention to evaluate the feasibility and effectiveness of training traditional healers to support the delivery of health education and prevention for diabetes.
Location of study: Cameroon
Study design: The CAMBoD project was initiated in four sentinel sites. The intervention consisted in a two-day training seminar per site incorporating a quantitative pretest/post-test evaluation, plenary lectures, and group discussions. There were 106 healers trained in a range of topics and practices relating to diabetes prevention and care. The impact of the intervention on knowledge and practice was evaluated through pre-post training questionnaires and at eight months after the training through semi-structured qualitative interviews and direct field observations of the practice of selected participating traditional healers.
Results: Eight months after the conclusion of the intervention, the investigators carried out a field evaluation with 36 of the previously trained healers using in-depth semi-structured interviews and direct observation methods to find out if they remembered and applied the learning from the training. Most healers recalled and were applying some of the lessons learnt, including referral of patients for blood glucose tests at biomedical health facilities, desisting from scarifying patients with diabetes, and educating their patients, peers, and other people in their communities about diabetes. Healers were enthusiastic about collaboration with the diabetes control program.
Additional References: D Whiting, L Hayes, N Unwin. Diabetes in Africa: challenges to health care for diabetes in Africa. Journal of Cardiovascular Risk 2003; 10(2): 103-10 (open access) http://bit.ly/cONk0B
J Mbanya, A Kengne, F Assah. Diabetes care in Africa. The Lancet 2006; 368(9548): 1628-1629 http://bit.ly/dutPXl
This is shocking! I really enjoy and appreciate various messages sent to me. I entreat the indidenes of India to be focused on the various preventive measures in relation to Type-2 DM. Mass education is urgently needed to solve this menace. I would say Bravo to the Procor team for their initiative.
All the best.
----------
(2)
Dear Procor Readers:
According to WHO estimate, India ranks number one in the list of countries with Type-2 Diabetes. To create awareness, develop educational and preventive programs, we and other proactive members, started a professional society (SASAT: www.sasat.org). We have been organizing educational programs in India, for the last two decades. Having said that, I cannot say that we have reached anywhere closer to what Cameroon has done, to integrate the health care delivery. I am impressed to learn from the studies reported, that 70% of the population in Cameroon, use traditional healers. I do not know the numbers in India. In India we have at least more than five different stake holders in health care; Ayurveda, Unani, Siddha, Homeopathy, Allopathy and other Traditional Healers. No single group can provide the total health care for all, in a country like India. How do we provide affordable health care for all, is a big question in the minds of many, who are working in this area. I was delighted to know that the Cameroon Burden of Diabetes Project was aimed at training traditional healers, in prevention strategies of diabetes. I am pleasantly surprised, to learn that the traditional healers rapidly absorbed the strategies, collaborated with the professional health providers and integrated the prevention program into their way of healing modalities. If Cameroon can do it, why not other countries with high disease burden adapt this way?
In a country like India, we need well resourced intervention program, we need the political will and sustainable government support, we need effective coordination between all levels of service providers, health care agencies, multidisciplinary health care team, professional organizations and patient advocacy groups. We have been advocating the establishment of a national platform for Diabetes Prevention and development of appropriate proactive prevention plans for over a decade. Intervention is needed today. In the State of Karnataka (e-governance) there is an initiative to develop a service platform in the form of a "Kiosk" . This pilot project will be developed by a consortium of IT-Giants of Bangalore, under the leadership of a Professor from the Indian Institute of Management. These "Kiosks" will be developed at the Gram Panchyath (Village administrative platform) level to provide basic essential services, so that the common man/woman can operate day-to-day transactions without leaving the village. Once such infrastructure is developed and the capacity building is initiated, we would like to bring in a "health booth" to this "Kiosk" which will offer services from all the available health care providers (Ayurveda, Unani, Siddha, Homeopathy, Allopathy and other Traditional Healers). Although the idea seems a good one, we still have to figure out, as how to provide affordable and acceptable health care to all, in a country like India. I welcome comments, criticism and suggestions from your esteemed readers.
Gundu H. R. Rao,
Professor
Lillehei Heart Institute
University of Minnesota
----------
(1)
With the impending endemic of type-2DM all means available should be put to use, tradition healers should be trained in life style management programs that will help the IGT. prediabetics,obese DM and prevent the progress of hypertension and CVD
regards
Shaheena banu MD.PhD
dept of Biochemistry
SJICR, Bangalore
----------
(Original message)
Title: Traditional healers and diabetes: results from a pilot project to train traditional healers to provide health education and appropriate health care practices for diabetes patients in Cameroon
Authors: G Mbeh, R Edwards, G Ngufor, F Assah, et al.
Reference: Global Health Promotion 2010; 17(2): 17-26 (open access) http://bit.ly/bc19LG
Reviewer: Carlos Mendoza Montano, PhD, ProCor contributing editor; President, Guatemalan Association for the Prevention of Heart Diseases (APRECOR), Guatemala City, Guatemala
Reviewer comments: In sub-Saharan Africa, there is a parallel traditional health care system to the biomedical health system in the form of traditional healers. Such healers are used by up to 70% of the population for conditions such as sexually transmitted diseases, minor ailments, and mental illnesses. There is growing interest in the possible complementary roles traditional healers could play within the biomedical health system, including the role in prevention and control of chronic diseases. The training of traditional healers on health education and health care for diabetes was incorporated in the Cameroon Burden of Diabetes (CAMBoD) project. The current article shows that traditional healers could learn prevention strategies of diabetes relatively rapidly and collaborate in health promotion.
Purpose of study: To describe the results of a pilot intervention to evaluate the feasibility and effectiveness of training traditional healers to support the delivery of health education and prevention for diabetes.
Location of study: Cameroon
Study design: The CAMBoD project was initiated in four sentinel sites. The intervention consisted in a two-day training seminar per site incorporating a quantitative pretest/post-test evaluation, plenary lectures, and group discussions. There were 106 healers trained in a range of topics and practices relating to diabetes prevention and care. The impact of the intervention on knowledge and practice was evaluated through pre-post training questionnaires and at eight months after the training through semi-structured qualitative interviews and direct field observations of the practice of selected participating traditional healers.
Results: Eight months after the conclusion of the intervention, the investigators carried out a field evaluation with 36 of the previously trained healers using in-depth semi-structured interviews and direct observation methods to find out if they remembered and applied the learning from the training. Most healers recalled and were applying some of the lessons learnt, including referral of patients for blood glucose tests at biomedical health facilities, desisting from scarifying patients with diabetes, and educating their patients, peers, and other people in their communities about diabetes. Healers were enthusiastic about collaboration with the diabetes control program.
Additional References: D Whiting, L Hayes, N Unwin. Diabetes in Africa: challenges to health care for diabetes in Africa. Journal of Cardiovascular Risk 2003; 10(2): 103-10 (open access) http://bit.ly/cONk0B
J Mbanya, A Kengne, F Assah. Diabetes care in Africa. The Lancet 2006; 368(9548): 1628-1629 http://bit.ly/dutPXl
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