(2003; 211 pages)
1. Family, community and patients' organizations
Helping people with diabetes
By P. Lefebvre, President-Elect, The International Diabetes Federation (IDF)
Diabetes today represents an unprecedented epidemic. The number of people with diabetes worldwide is estimated to be more than 180 million, a figure likely to double in the next 20 - 25 years. Diabetes is currently a disease that can be treated, but unfortunately not cured.
The International Diabetes Federation (IDF) is the global advocate for people with diabetes. It comprises 182 patients' associations in more than 140 countries. The current mission of the IDF is to work with its member associations to enhance the lives of people with diabetes through awareness, education and improvement of health and well-being.
Several studies have shown that a gap presently exists between the goals recommended for diabetes care and the care that patients actually receive. Achieving the recommended targets for diabetes control requires informed patients who are motivated to work with their health care providers. The IDF stresses the importance of:
- helping people with diabetes, their families and communities to achieve better control of the condition; and
- helping to train health care professionals, people with diabetes and their families to improve management of the condition.
In this respect, the IDF fully endorses the recommendations of the WHO Adherence Report. The strategy of the IDF for helping to improve adherence includes the identification of core strategic messages and definition of communication objectives targeted at people with diabetes, their families and health care professionals. Specific programmes include the development of standardized and reliable measurement tools. Special emphasis is put on helping patients in developing countries and minority groups.
The IDF also stresses the need for making essential drugs, such as insulin, and monitoring material, such as home blood-glucose monitoring, available and affordable to all people with diabetes in all countries.
The Work of the South African Depression and Anxiety Support Group
By Linda Woods, General Manager, South African Depression and Anxiety Support Group (SADASG)
Seven years have given the SADASG a long time to work on the issues of depression and anxiety and to fulfil our goals, which have been:
Getting patients to treatment. By having a voice on the line, which is often that of someone who has been through the feelings and emotions the patient is currently experiencing, and by being independent and trustworthy listeners we are able to give the caller the confidence to take the next step which is to visit a professional psychiatrist or psychologist. Our referral list includes not only psychiatrists and psychologists, but also general practitioners with the special skills needed to help patients to find the right answers to becoming well again.
Screening. Through our counselling line which is operated from 8 a.m. to 7 p.m. on six days a week, we have been able to give callers advice on their symptoms, whether caused by depression, bipolar disorder, obsessive - compulsive disorder, social phobia, panic disorder, generalized anxiety disorder or posttraumatic stress disorder. Our counsellors have been trained to ask pertinent questions, to help the caller to understand that their symptoms could be those of a real illness and to tell them what it could possibly be.
Adherence. A voice with the time to listen to patients' concerns, their side-effects, their self-doubt, and that can reassure them - often from first-hand experience, for example, that the side-effects they are experiencing are transient, normal and non-threatening and will usually disappear in time. That even though they are feeling so much better after 3 months, we would encourage them to stay on their medication for 6 to 12 months, as recommended by WHO guidelines.
Destigmatization. Through a concerted and targeted effort we currently send out a press article every single week. These articles include statistics and quotes from local South African experts, and guidelines on how to get the help that patients may need. They emphasize that treatment is nothing to be ashamed of these days. They feature patients with names, jobs, business men, and women and media personalities who are not ashamed and who can confirm that mental illness is an illness just like diabetes, or heart disease, or asthma, and patients can be helped. Radio programmes, television shows and the screening of 30-second public service advertisements as well as magazine and newspaper articles help to get our message out. Through corporate education programmes that address a diversity of companies we are able to achieve a more caring and open atmosphere in which to tackle these disorders.
Our sponsors, local and national government, industry and certain foundations have helped us play a huge role in opening up this critical field for patients with depression and anxiety disorders throughout
South Africa. We look forward to having the continued understanding and support of local government, with whom we could combine efforts to help patients at the community level.
Through our continued efforts, we can bring more people to treatment and improve levels of adherence. Thereby we can try to prevent some of the repercussions of depression becoming the number one illness causing death and disability in the world by 2020 as predicted by the World Bank and the World Health Organization.