On January 12, 2010, an earthquake measuring 7.0 on the Richter scale devastated the Haitian capital, Port-au-Prince, and its surrounding areas. Estimates say over two hundred thousand people died, and more than 1.5 million were left homeless in the immediate aftermath of the quake. I heard first-hand about the devastation in Haiti after my uncle, Dr. Barry Koffler, an orthopedic surgeon, flew there to help with the relief efforts. Dr. Koffler said, “The devastation was indescribable. There were people on the clinic floor with broken legs, broken arms and amputations. Within the first two hours after arrival I had reduced and casted two children, one with a femur fracture and one with a tibia fracture. Their pain was gut wrenching but after getting them immobilized, the smiles were equally poignant.”
More recently Haiti has been in international headlines because of the cholera outbreak. But the news we haven’t heard very much about is the situation of the diabetics in Haiti, so we spoke to Dr. Nancy Charles Larco of FHADIMAC, the only institution in Haiti dedicated to serving people with diabetes and hypertension, to find out what happened to the diabetics in the aftermath of the quake, and what the situation is like today.
How many people with diabetes live in Haiti?
According to a survey made by FHADIMAC and published in the December 2006 issue of Diabetes and Metabolism Journal, there are approximately 300,000 diabetics in Haiti (age 20 and over) with 70.000 living in the Port-au-Prince metropolitan area. Type 2 diabetes comprises 90% of Haiti’s diabetes population, and for a poor country like Haiti, type 2 diabetes constitutes a very big socioeconomic problem.
In the aftermath of the quake, large amounts of emergency medical equipment were sent to Haiti. Did this include treatment for chronic diseases like diabetes — insulin, glucometers, test strips, syringes, lancets? Did trained medical staff arrive to help?
During the earthquake, 90 percent of diabetes patients lost their medication. However, under the leadership of International Diabetes Federation (IDF) and diabetes associations worldwide like: Children’s Diabetes Foundation (Barbara Davis), Insulin for Life from Australia (Ron Raab), Life For A Child, Novo Nordisk, Dr. Comfort (shoes), and some agencies in Haiti such as Prophalab, we were provided with all essential drugs we needed- insulin, oral antidiabetic and hypertensive drugs, material for glucose control, shoes, and more. We were able to give them to diabetics at the clinic. Since January 2010, public and private centers have received free insulin from FHADIMAC.
Did medical staff trained in diabetes arrive to help?
No medical staff trained in diabetes arrived to help. Only one Haitiano-American diabetes educator contacted by Fhadimac came to have the medical staff of a few institutions trained.
Did the supplies reach the people with diabetes?
The supplies reached people with diabetes who came to the clinics of FHADIMAC at its local and its mobile clinics. Insulin was given free to private and public centers and was also distributed to needy diabetics.
Would you share some patients’ stories with us?
I can tell you about two sisters aged 45 and 47 and their 75-year-old mother. They lost everything during the earthquake and were living in the streets under a tent. Their blood sugar levels were respectively 400mg, 360mg and 280mg and their blood pressures were above 160/100. Fortunately, FHADIMAC had just received a stock of insulin. They were given insulin and hypotensive drugs free of charge. They came back several times to the clinic. After two weeks, their blood glucose levels and blood pressure were normal. I can also tell you about Junior Jean, a 15-year-old boy, who lost his mother during the earthquake and was in charge of his two young brothers. Fortunately, neighbors were helping them. His blood sugar was 320mg when be came to FHADIMAC. With proper insulin therapy, his diabetes has been controlled. Unfortunately not all of our stories have happy endings. Marie J., 60-years-old had been admitted to the emergency room of a private hospital with a blood sugar of 600mg. She did not survive because of lack of medication (insulin and IV fluids) and care. In the days after the earthquake, others did not survive because of shortage of insulin in the emergency rooms of public hospitals and lack of trained physicians.
Is there still a shortage of basic care for diabetics now?
Do you feel the situation is under control?
The situation is under control for people with diabetes who come to FHADIMAC. Because of logistical problems, we cannot reach people outside of Port-au-Prince areas.
How can people contribute to help diabetes care in Haiti?
You can visit the International Diabetes Federation, where you can make a donation online to the Diabetes Trust Funds for Haiti.
For more information about Haiti’s diabetics in the aftermath of the earthquake see the June issue of Diabetes Voices (journal of IDF), Solidarity with Haiti: the global diabetes response.