According to the World Health Organization (WHO) about 422 million worldwide have diabetes. There are approximately 220, 000 Jamaicans with diabetes between the ages of 10 to 74 years. This translates to 13.6% of the population. The WHO states that the number of people with diabetes has almost quadrupled since 1980. Data provided by the WHO indicates that prevalence is increasing worldwide, particularly in low and middle income countries due in part to the increase in the number of people who are overweight. As societies develop and technology increases there is a corresponding tendency for many of us to become physically inactive, and this undoubtedly is an open invitation for non communicable diseases. This is troubling not only for the individuals and their families who must deal with this reality, but also for the country on a whole since diabetes usually strikes those in the prime of their lives who are the most productive. Sadly, many Jamaicans struggle to keep this life threatening disease under control. This is a result of the many complications which must be addressed in the life of a diabetic and which are often costly to treat. One area of concern is that of foot care in a diabetic. The health care provider or podiatrist who treats conditions of the feet is not readily available in the public health care system. Many persons who have diabetes cannot afford to seek private foot care medical intervention. Since diabetes has a deep penetration within the older population, usually many who are affected are pensioners. We must be reminded that many pensioners solely depend on their fixed pensions for survival. The services of a podiatrist in the private sector begin somewhere around $6,000, and depending on what the diabetic patient requires the cost goes up. We need to foster and sustain a culture in which we acknowledge that our feet must last us a lifetime, and one way to ensure this is by paying attention to them. Of course due to nerve damage of the feet in diabetics, foot care is more critical in the management of diabetes. There are many nail diseases which affect the diabetic such as Ingrown Toenails, in which the nails penetrate painfully into the soft tissues of nail grooves often causing irritation. I am aware of a young man who was diabetic and was unaware of his condition. He developed a bunion on the sole of his feet and in trying to remove it he eventually lost a toe then ultimately his leg which had to be amputated. It bares thought that foot care treatment cannot and should not be underestimated regarding the holistic treatment of diabetes. The Diabetes Association of Jamaica in Kingston provides this service on the last Thursday of each month. This is however unacceptable especially in light of the growing number of Jamaicans who are living with this disease.

The Way Forward

The government should look at the possibility of increasing the number of foot care specialists in order to satisfy the increase demand for such a service. The issue of diabetes is a national health care priority especially since almost 14% of the Jamaican population are affected and impacted by this disease. Perhaps, it would be useful to have public private partnership to offer such a service. It is evident that we need podiatrists in the public health care system along with other support staff in addressing the issues of the diabetic. In addition to the complications which can be associated with the feet of the diabetic, the diabetic must have regular interventions to include blood glucose control through a combination of diet, physical activity and medication. Diabetes is among the many non-communicable diseases (NCD) and often lasts a lifetime. Endocrinologists and other health care specialists are of the view that diabetes results from a combination of genetic, physiological, environmental and behavior factors. In moving ahead with the treatment of diabetes we are reminded by the United Nations Sustainable Development Goal #3 ensuring healthy lives and the promotion of well-being for all, at all ages. We need to embark on more public education campaigns to promote diabetes awareness in the society. There is also an urgent need to highlight the challenges those with diabetes face on a daily basis. Unlike Type 1 diabetes in which the patient cannot do much to prevent same, Type 2 diabetes if often preventable once the patient is well informed. Managing or caring for someone with a chronic condition like diabetes can be overwhelming at times, and therefore it is vital that extra effort to made to give support to those who are impacted by this life changing disease.

Wayne Campbell is an educator and social commentator with an interest in development policies as they affect culture and or gender issues.