Tuesday, November 25, 2008

Medical Injustice: Don't get Type 1 Diabetes in Ghana (unless you're rich!)

Before I get into Night 4 of our hospital stay, I need to take a minute here to vent about injustice; specifically, the injustice perpetrated by medical product manufacturers and pharmaceutical companies to third world countries, such as Ghana.

Alexandra, as a Type 1 diabetic, has two very basic but very specific lifelong needs. She needs to check her blood glucose levels several times every day, and she needs to have insulin administered via multiple daily injections.

Alexandra is lucky. Not because she has Type 1 diabetes, but because she has parents who have the means and access to the things that she needs, in order to keep her alive. Not to draw too fine a point on this, without regular glucose monitoring and daily insulin injections, Alexandra will die.

I and my husband and our family will do all that we can to prevent that. We will ensure that she has her glucose levels tested as often as necessary, sometimes 6 or 7 times a day. And she will have the insulin injections that she needs to bring high sugar levels down, at least twice a day, but sometimes more. And she will be provided with appropriate and nourishing food to ensure that she will grow and thrive. It’s a tricky balancing act, but we are more than up to the task. We have our most precious commodity to consider.

Not many Ghanaian kids with Type 1 diabetes are as lucky as Alexandra. I spoke with Alex’s doctor last week, and told her that I was receiving a lot of online support from a wonderful network of parents of children with diabetes. In fact, I told her, besides the advice and encouragement, we had been offered additional glucose meters so that Alexandra could have an extra to bring to school, and one we could keep for an emergency.

When I mentioned this, Dr. Renner pointed out that the majority of her T1 patients didn’t have the glucose meters, because their parents couldn’t afford it. The meter that we bought, as soon as we were told of Alexandra’s diagnosis, cost equivalent $62. The meter strips, absolutely necessary meter strips, cost $40 for 50 strips. The lancets for the finger pricks are $20 for a box of 100. The insulin was about $17 per vial. We paid cash for all these things, and we continue to buy the strips on a regular basis. So far, I estimate, we’ve gone through about 250 strips. That would be close to $225.

Now, Dr. Renner told us, that because the parents can’t afford a meter, they don’t monitor their children daily. If they have an extra cedi or two, they might take the child to a local chemist who can check the sugar level there, for a fee. But usually, they wait and hope for the best, and if the child falls very sick, either due to low blood sugar (too much insulin) or high blood sugar (not enough insulin), then they take the kid to the hospital and admit him. It’s actually less expensive to admit a child to the hospital for a couple of days than it is to buy a meter and the needed strips.

What a sin. In the United States and elsewhere, the companies that manufacture glucose meters are giving these out free, like candy, to diabetics. Several parents on the support board had two, three or even five free meters in their house and were kind and generous enough to have them sent to me, through my Mom in N.J. We plan to donate these to the hospital.

Insurance in the U.S. covers diabetic needs, though it varies state to state. In Canada, it’s covered under social medicine. In the Ireland, and I suspect the U.K., they’re also covered. A friend of mine from Ireland told me that meter strips are free there; her husband is diabetic, so she knows. Ghana has National Health Insurance, but it only covers insulin, not the expensive strips. I estimate, in Alexandra’s lifetime (which I hope will be a very very long one), she may use 100,000 glucose meter strips. Isn’t that a frightening statistic? What typical Ghanaian family can afford that? None is the answer.

Don’t third world countries suffer the same medical tragedies as other developed countries? Don’t we have enough injustice here, in all other aspects of life? Shame on LifeScan and Bayer, and all of those other international glucose meter companies… couldn’t you donate a couple of these meters to the hospitals here? No, why not? I’ll tell you why -- because it’s not profitable, and that’s their bottom line. Not helping humanity, it’s to make a Buck or a Pound or a Euro.

Don’t average Ghanaian kids with Type 1 diabetes deserve the same chance to live as Alexandra?

Barb

P.S. I want to personally thank the wonderful people (especially you, Adjoa in Vancouver, B.C. and her sister here in Ghana who forwarded my blog) who have donated meters and strips, for either Alexandra's personal use, or as a donation to the teaching hospital for Type 1 diabetic kids. God bless you all.

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Originally published July 24, 2008 at Obroni Observations

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