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An estimated 31,000 people suffer the daily effects of diabetes in Lesotho. Each one has their own unique journey and experience in managing the ailment.
Unlike other chronic diseases, diabetes is mostly managed by the person who is diagnosed with it. This is why each diabetes story is as unique as the person telling it. For some, diabetes even helped them find purpose in life supporting others through their own diabetes journeys.
A 30-year-old midwife from Mphosong in Leribe, Ntoetse Ntšekhe has been living with type 2 diabetes for three years.
Although she is successfully managing her diabetes now, she admits the journey was not easy.
When she diagnosed, Ntšekhe was 27 years old and she was in complete denial.
“I saw the signs but I just didn’t want to accept it,” she recalls.
Ntšekhe says she noticed unusual changes in her body, such as excessive weight loss, hunger, excessive thirst, frequent urination, itching vulva, decreased libido, blurry vision, fatigue, changing moods, low blood sugar level, vomiting and painful thumb.
“I have been noticing some of these signs way back from when I was at NHTC (National Health Training College). As a health practitioner, I knew all these signs would mean I am diabetic, but I was in denial because of my age.
“One day, I was on duty, I tasted my urine and it was sweet; I used the B-gluconate machine and my blood sugar level was 29. It was too high. I started panicking knowing that at that level, my chances of collapsing were very high.
“I then went to Motebang hospital where it was later confirmed that I was diabetic. Since then, I promised myself that I will never fail to take my medication because I know that if not well managed, diabetes can be fatal,” Ntšekhe noted.
She said denial can be a common feeling among people when first diagnosed with type 2 diabetes, and she wants people to know that if they are struggling with denial, they are not alone.
Diabetes is a chronic, metabolic disease characterised by elevated levels of blood glucose or sugar, which leads over time to serious damage to the heart, blood vessels, eyes, kidneys and nerves.
The most common is type 2 diabetes, usually in adults, which occurs when the body becomes resistant to insulin or does not make enough insulin.
According to Ntšekhe, managing diabetes can come with challenges, but acceptance was her biggest challenge. “The sooner you accept your diagnosis, the sooner you can do something about it.”
Ntšekhe took her personal diabetes experience and knowledge to social media where she creates awareness on the disease, encouraging people to test for diabetes and manage it.
Diabetes is not terrible and there are many things one can do to prevent problems from diabetes such as monitoring blood glucose, watching your diet, keeping fit and taking pills regularly, she advised.
In response to the diabetic problem in Lesotho, a Swizz non-governmental organisation, SolidarMed Lesotho, has implemented nine projects in Mokhotlong and Butha-Buthe districts, with the aim of reducing non-communicable diseases like diabetes.
The organisation revealed that poor nutrition, sedentary lifestyles, eating unhealthy food which are rich in carbohydrates, processed or fatty food, not exercising regularly, are major contributors to the development of diabetes.
According to a 2021 Population Based Prevalence Survey conducted by SolidarMed, where 5000 participants were screened for diabetes and hypertension in Butha-Buthe and Mokhotlong. The exercise was for people aged 30 and above and of these, seven out of 100 females were diabetic, while three out 10 of males were found diabetic.
The survey further stated that only 36 percent of diabetic patients had their condition under control, through medication, and 64 percent had elevated blood glucose, indicating they were at increased risk of developing complications like kidney, heart failure or eye problem if their diabetes was not controlled.
Non-communicable disease technical advisor at SolidarMed, Dr ‘Mamakhala Chitja said the organisation has established a project named ComBaCal (Community Based Chronic Care Lesotho).
The project supports 23 government, CHAL and Red Cross hospitals and health facilities based in the two districts to respond to diabetic patients.
“This initiative is multi-disciplinary research for a development project that addresses the disproportionate health and socio-economic burden of non-communicable diseases like diabetes in Lesotho.
“It is a five-year project and funded by Swiss Agency for Development and Corporation and World Diabetes Foundation.
“The main activities include building capacity for health care workers on diabetes treatment and care through trainings, mentorship, supervision in collaboration with the ministry of health and district health management team,” Dr Chitja said.
She noted that the organisation supplies the health centres with basic diabetic equipment such as glucometers, blood pressure machines and weight skills used by health centres to screen, diagnose and monitor diabetic patients while on treatment.
Through this project, they managed to pilot facility based cardiovascular registers that helps health facilities to record diabetic and hypertension patients and to be able to monitor their progress.
In 2003, the diabetes community in Lesotho formed an association, with the objective of minimizing the impact of the disease by stepping up awareness campaigns in rural and all areas where people gather for clinical services for diabetes.
The association works in collaboration with the ministry of health and other partners in contributing towards the health of Lesotho’s citizens through various activities.
The president of the association, Motsamai Mokoto, encourages people living with diabetes to exercise regularly as it helps managing a wide range of ailments, both physically and mentally.
In the case of diabetes, he says, exercising specifically assists by lowering the blood glucose, blood pressure and cholesterol.
“Exercising is an important part of treating both type 1 and 2 diabetes. It also helps in blood circulation; this is very crucial. In the worst scenario, a diabetic person who does not excise may end up having some parts of their body, like legs, amputated as a result of poor blood circulation.
“Diabetes should not be considered in isolation. It is part of five risk factors for cardiovascular disease. Diabetes goes with hypertension. If someone has hypertension they must test for diabetes because in 80 percent of people of African descent, diabetes symptoms may not register.
“Ninety percent of people with diabetes are type 2 diabetes and every type of diabetes is dangerous. People must test for blood pressure, blood cholesterol, weight and measure the body mass index as part of the fight against diabetes. They must be encouraged people to lose at least 10 percent of their weight if they are overweight,” Mokoto pointed out.
He explained that unmanaged diabetes could result in serious complications such as vision loss, heart disease and chronic kidney disease.
During the commemoration of World Diabetes Day on November 14, 2023, WHO regional director for Africa, Matshidiso Moeti, pointed out that diabetes should be taken seriously not only by individuals living with, or at high risk of the condition, but also by healthcare professionals and decision-makers.
Moeti stressed that prevention by adopting a healthy lifestyle, combined with good nutrition rich in fruits and vegetables, being physically active, not using any tobacco products and alcohol, can massively reduce the risk of developing type 2 diabetes.
“Even though the emergency phase of the Covid-19 pandemic is over, the virus is still a threat to people living with diabetes. I urge everyone living with diabetes to adopt a healthy lifestyle and protect themselves by getting vaccinated against COVID-19.
“Today, I ask governments to invest in preventing diabetes and making essential oral anti-diabetes medicines, insulin, glucometers, and test strips available to all communities. This should be backed by training health workers in diabetes prevention and management at the district and community level towards improving service availability.
“I also ask governments to adopt and customize global targets for diabetes, as part of efforts to strengthen and monitor diabetes responses within national noncommunicable disease (NCD) programmes. I urge national authorities to strengthen surveillance systems to monitor the trends of diabetes and other NCDs at population level to be able to better plan for and manage diabetes,” Moeti urged. About 422 million people worldwide have diabetes, the majority living in low-and middle-income countries, and 1.5 million deaths are directly attributed to diabetes each year. Both the number of cases and the prevalence of diabetes have been steadily increasing over the past few decades, WHO reports.