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Saving young lives in Mali

A huge increase in the number of children and youth living with type 1 diabetes (T1D) was recorded between 2007 and 2016 in the West African country of Mali.

A new study shows that this increase is likely due to improvements in diagnosis and care, resulting in fewer young people dying from T1D and complications.

Before Life for a Child joined forces with local partner Santé Diabète, in 2007, there were only 28 young people living with T1D in Mali. At this time, very limited care was available, and sadly most young people died within a couple of years of a T1D diagnosis. However, since Life for a Child began supporting Santé Diabète, support has been consistently provided for young people under the age of 26. This care is provided in partnership with the Mali government health services.

We started with the basics; providing young people with the insulin and supplies they needed to manage their T1D. Then in 2013, we ran a poster campaign in health facilities across the country, raising awareness of the symptoms of T1D to prevent deaths from misdiagnosis or late diagnosis of ketoacidosis—these were sadly very common before the intervention took place. A whopping thousand and six hundred posters in French and the local language Bambara were distributed to all diabetes clinics in all regions of Mali and the capital Bamako, as well as patient associations.

The campaign was very successful: More and more children were being diagnosed with T1D and referred to Santé Diabète for supplies and support.

The graph below shows the number of T1D cases between 2007 and 2016. The number of diagnosed cases of T1D rose sharply from low levels in 2007. There was a peak in 2014 – the year after the poster campaign.

Today over 700 young people are supported by Life for a Child and Santé Diabète across Mali. These young people have access to diabetes education materials and can connect with each other at education workshops.

The authors are hopeful that findings from this study will serve as advocacy material to help drive awareness on the impacts that interventions have on improving survival rates in less-resourced settings. Further, we are optimistic that these data will assist local sustainability efforts; the government is doing more and more to help.

This is an important study that shows basic provision of care saves lives. However, there is much more to do. The study explains that the number of young people with type 1 in Mali may still be underestimated, with young people dying undiagnosed. You can help us continue this important work by making a donation to Life for a Child today.

You can see the study here or email us to request a copy at info@lifeforachild.org.

Education session in Bamako

Landmark study: Cost-effectively improving care for young people living with diabetes in low-income countries.

An important Life for a Child / University of Pittsburgh study showing how low-income countries can reduce the rate of complications from type 1 diabetes (T1D) has been published by the academic journal Pediatric Diabetes.

Young people supported by Life for a Child live in in low- and middle-income countries with competing priorities for healthcare spending. Some governments only provide one component of care for their young citizens living with T1D (such as insulin) and many don’t provide anything at all.

“Consequently, the kinds of care that are offered to those with type 1 diabetes in these countries is often at a ‘minimal’ level. The bleak outcomes of this level of care include high mortality and the premature onset of devastating and costly chronic complications.” Dr. Graham Ogle, General Manager Life for a Child.

In order to support our local partners in their efforts to advocate for more government help for children with diabetes, we set out to demonstrate how effective even modest improvements in care provision can be.

We did this by looking at the costs and outcomes of diabetes care in six countries- Mali, Tanzania, Pakistan, Bolivia, Sri Lanka and Azerbaijan.

Specifically, we looked at the outcomes for young people receiving minimal and intermediate care. Minimal care was defined as twice daily human insulin injections with no self-blood glucose monitoring and minimal diabetes education. Intermediate care consists of multiple daily insulin injections, two to four blood glucose tests per day, diabetes education and HbA1c testing. For a comprehensive look at these definitions look at our 2018 study into levels of care.

Using a mathematical model we calculated the rate of a range of complications at different HbA1c levels over a 30-year period.

Mathematical modelling: Complications rates after 30 years

The graph above shows the 30-year complications rates at differing mean HbA1c levels, demonstrating the importance of reducing HbA1c.


The difference in chance of survival in each country depending on whether the young person is receiving ‘minimal’ or ‘intermediate care’.

As you can see, incidences of complications were lower for young people receiving intermediate care vs. minimal care. Intermediate care is the type supported by Life for a Child.

The study goes on to show that, although intermediate care is a little more costly to maintain than minimal care, acute and chronic complication costs are reduced and young lives are saved. This is a compelling argument for governments to increase provision of care for young people living with T1D.

Dr. Ogle is hopeful that the study will help to improve care: “Overall, these findings could greatly strengthen local efforts made by health care professionals, policymakers and advocates, who are working toward provision of acceptable type 1 diabetes care by their national health systems.”

View the study in Pediatric Diabetes or email us to request a copy at info@lifeforachild.org.

“It seemed like the sky has fallen down on us. We felt hopeless.”

Gahan is an 8-year-old boy from a small village in Bangladesh. He is a smart young man and hopes one day to become an engineer. As well as working hard at school, he loves to spend time outdoors with friends, playing cricket and badminton in the streets around his home.

Gahan’s father is a fisherman and his mother is a homemaker. He is their eldest son and has a 5-month-old little sister.

When Gahan was three years old his father was concerned to see his son losing weight, wetting the bed and often too tired to play outside with his friends. Over a number of weeks Gahan’s health deteriorated until it became so serious that they thought their child might die.

Gahan’s parents took him to the local hospital where they found that he had a very high blood glucose level. Staff quickly referred him to the Life for a Child partner center, which they knew would be better equipped to deal with Gahan’s diagnosis.

When the family arrived at the center they were disorientated and fearful.

“It seemed like the sky has fallen down on us. We felt hopeless.” Gahan’s Father.

Gahan was admitted to the hospital and doctors worked to stabilize his blood sugar. He spent 15 days and nights there, being nursed back to health, while his parents received diabetes education.

It was a steep learning curve. Gahan’s father said, “We had no idea about type one diabetes.” But, like most families dealing with a new type 1 diagnosis, they were forced to learn quickly, test, trial and find their way through the complex maze of management.

Thanks to initiatives like Spare a Rose, the family did not have to worry about finding the money to pay for Gahan’s insulin and supplies. The program manager at the center said, “Because of the very low income of his parents it would be very difficult for Gahan to manage his diabetes without the support of Life for a Child. His father said that the support is like a blessing from God.”

Gahan attends the Life for a Child partner center every two months to collect his insulin and supplies and has regular checkups with the team there.

Gahan’s diagnosis means he will continue to need access to insulin and blood glucose testing supplies every day. Can you Spare a Rose this February to help make sure Life for a Child can provide him with reliable and consistent care?


076 Rasika, age 24, India

My teacher, my mentor – Diabetes

I was 10 years old when I was diagnosed with Type 1 Diabetes, being in class 4th my mind was juggling in finding HCF (Highest common factor) and LCM (Lowest Common Multiple) of two numbers. My developing brain was full too in adaptive mode, it was taking the form whatever shape you want to give it. So it very well adapted to the schedule of taking four injections daily without much questioning. But unfortunately my parents’ brain was developed one, it was difficult for them to understand and accept the fact that their only child is suffering from chronic disease and she will have to be with it forever.

My parents tried to remain calm and act positive, and within months they too accepted my mentor Diabetes. Yes, my mentor, I believe everything has purpose in life. In the same sense, Diabetes has been my mentor and will continue to be until I go back to the earth.

From the day I had Diabetes till today, Diabetes has never failed me in living a disciplined life. It always makes sure that I am eating on time, with just little pricking before it, and I am eating healthy as well. People these days have lot of options for
food, especially unhealthy and junk food. So they look for mentors to guide them on what to eat and what not to eat. Well, I got lucky in this situation, my mentor takes care of all of this.

Discipline takes you a long way, it is one of the important qualities to possess to climb the ladder of success. And I feel fortunate enough for Diabetes to ingrain it in me since the right time. I have grown to be a disciplined adult.

My journey with Diabetes has always been a tangent graph, always reaching high. With scoring above 90 in 10th and 12th examination and being able to maintain cgpa of 8.78 in graduation, and being successful performer of the year in my current job, Diabetes was always there, as a Mentor, as a friend, as a companion to remind me I have to take care of myself, my health. There is no barrier living with Diabetes, it is a blessing to have it.

We need to change the outlook of how one takes Diabetes as, we need to understand that there can be no obstacles in the path which you are meant to achieve in this lifetime. We need to learn to convert all the obstacles into path-giver not path-taker. Life is not about google-maps giving us the paths to the destination, it’s about us with our hard work and discipline, creating the roads to our goals.

075 Neha, age 16, Pakistan

Fighting the Sweetness

This is the written script of all the traumas faced by an ordinary yet unique girl when she mentions all the peaks and troughs of her life.

It all started when I was in my 11th year of survival in this world, I was a chubby little creature. I was living my life to its fullest and was studying and crafting as usual. Everything was ‘flat as a pancake’ till one day the real obstacle came in the form of weight loss. I began to lose weight really fast (and by fast I mean REALLY FAST) I lost 10 kg in approximately 4 months, but everyone took it lightly blaming it on the diet. I went off board when I faced major hair loss. I had really long and healthy hair but by the end of 5th month it started to look more like a mouse tail. My family started to notice drastic changes in me and took me to a family doctor. He anxiously asked me for a blood test but guess what, I HAD REAL FEAR OF INJECTIONS. Being the little one I used my blackmailing skills and dragged it till 7 MONTHS and delayed it. But one day my family was really serious about it and took me to the LAB (I played the drama there too). Finally, the reports came *drum rolls* I WAS DIABETIC (wow). I didn’t know what was happening to me. Anxiety kicked in and at that time I really wanted someone to tell me that “Neha you’re strong and YOU CAN DO IT!”. In January 2016 I had my first insulin injection (very hard). My family tried everything to keep me away from those INJECTION BUDDIES but who knew that they were going to be my BESTIE’S FOR LIFE. My life was a piece of cake but who knew this cake was a little too sugary. After months of trial on insulin, I came to realize that THIS IS
PERMANENT AND I OWN IT. After you start owning your flaws you start working on them. I have had diabetes for almost 5 years now and I actually feel blessed (No I’m not crazy). Diabetes makes me stand out tall in the crowd and makes me unique amongst all. Sometimes I feel down when experiencing high sugar level but that’s not the end of the world . I’m living a stable life right now and ready to conquer the world.

“All you need to believe is YOU”

073 Jayesh, age 22, India

INSIDE ME

Deep in his eyes,
Lost was a man so wise.
The wet nurse of violence,
Gave fire to his silence.

Tears of frustration rolled down his cheek,
But the kind soul of his could never speak.
Screams became hushed,
Those dreams never were crushed

Expectations feed the frustrations,
Shattered were all those good actions.
Even the pride was lost,
B’coz it was

Depression, who came along…

But, it didn’t mean the end,
Decision was the leftover life not just to spend.
Overcoming the dead past wasn’t easy,
Even its thoughts made him dizzy.

Igniting the spark of big plan,
Determination was very clear to be the wholesome man.
Just endeavour implied deficiency,
Along sacrifices rose the win probability.

Tears into sweat, kind heart into stubborn igniter,
Nights into workouts, patho into fighter.
Struggle went long,
Everything seemed wrong

At last, the low spirit downed the knee,
As the aplomb triggered INSIDE ME.

074 Usman, age 16, Pakistan

Me and My Diabetes

Sugar has had negative effects on my life. This disease has swallowed up my many desires. Because of diabetes, society considers me a sick person that has no ability to do things. I wish I could join the Army but due to diabetes, I am not able to fulfill my desires. I have had problems with my sugar. I have to take insulin twice daily. Due to diabetes I have a difficult time eating and drinking when I am out with my friends.

I like a lot of sweet things. Because of diabetes, I have taken sweets out of my life. Often at relative’s weddings, I am very careful not to eat anything that would hurt my diabetes. Sugar also changes human behavior. The patient does not have control over himself. If sugar is low or high the patient may not be conscious, or he may have severe anger. In the meantime, he cannot properly handle his affairs.

Diabetes also affects my studies. I can’t perform in my studies the same way that a normal teenager can. I often go to bed early at night because of my diabetes. My parents are supporting me in fighting the disease – they often see me at night.

Children with diabetes feel more distressed. The use of insulin and other tests at an early age adds to the difficulty.

I have personally been suffering from this disease for the past six years and understand the disease to a great extent. If you fight with your heart against this disease, you will be able to overcome the disease. A few wishes can overcome
this disease and live a better life until the last days of life.

Fighting against this disease can be done by increasing the immune system.

072 Abdul M, age 21, Pakistan

Human Behavior

It’s my pleasure to introduce myself. My name is Abdul Moiz Kandorawala. I am 20 years old. I’m a BBA student at SZABIST University and single for the time being. My life journey until now has been more like a roller coaster ride with a lot of ups and downs and twists and turns. With the passage of time the ride has only gotten wilder, it’s at times really confusing, but somehow by the help of Allah I make it through.

I was born on 9th December 1998. According to my mother, she had no diseases while bearing me and I was conceived normally. I was born a healthy child, with no medical issues. I weighed around 6.2 kg. Everybody in my family was happy and excited to see me. I was the first and the only son of my family. Only five minutes after my arrival I felt the responsibility to become the right hand of my father as sons usually do who are born in a typical Pakistani family. Out of everybody my sister was the one who was most excited to see me. My family planned a dinner to celebrate my arrival. I started crawling when I was 6 months old and it took me another 6 months to take my first steps unassisted. My mother bought me a set of Legos and some more toys so I can play. I was very fond of toys, and no matter how much I got, I always wanted more. I didn’t start speaking at this moment but was very possessive about my toys, used to show anger if anyone tried to play with them. According to my mother I started speaking when I was 2 years old, my first word I spoke was Papa. My father always tried to indulge me in physical activities like Cricket, Badminton, etc. At the age of 2 my grandmother gifted me a car because I was really fond of cars.

My father got me admitted into the anchorage school at the age of 2.5 years, and I don’t exactly remember how the first day of my school was but it wasn’t a very good day. According to my Mom and my grandmother who took me to school on my first day I cried a lot. I got very nervous in this new environment, seeing so many kids, wearing the same clothes as me, it was very
confusing. I vaguely remember the activities of that day, the only thing I remember was that the teacher drew a sun on my hand. The first was only an hour long, after that I went back home with my mom and my daddy. It took me a month or so to settle in this new environment. I made some friends as I was really friendly, and liked to talk to everyone.

But it wasn’t until grade 2 that I made a real friend. My best friend’s name is Madni. Up till now his importance is more than anything in my life. I clearly remember that I used to go to school only for him, if for some reason I couldn’t go to school, he wouldn’t talk to me the next day. He has been there for me whenever I need him, he has always supported me in my difficult times, and he is still one of my best advisors. On my way back from school my grandfather use to buy me little treats to motivate me like gola ganda. I was an average student throughout my academic life and I still am. It was only once or twice that I miraculously scored an A. My parents have always supported me no matter how many marks I scored.

When I was in grade 4 I started developing interest in cricket. I used to play cricket on roads and when my summer vacation started me and my friend Saleem joined custom cricket academy. Me and my friend used to go to the training at 9 in the morning. The coach used to make us run before the training, and after the training we used to practice our fielding skills.

Now I will be telling you about my medical issues. Before going on Umrah I was perfectly alright, but during Umrah I started feeling some symptoms, like I used to feel a lot more thirsty, I used to get tired, I had to go to the washroom very often. I came back from Umrah on 20 February. Only three days later, on 23 February 2014 the day was Monday and I was just cleaning my room and searching for my notes because this year I had to appear for my O-level papers. Suddenly I felt down and my parents took me to the hospital. The doctors checked my blood sugar because there were some symptoms. And after some hours the doctor confirms that I am suffering from diabetes. I couldn’t believe that from now on I’ll have the label of a diabetic patient. From that day onwards I pray to Allah that helps me to fight this trouble. As after having this disease my father was heartbroken because I guess I was their only son. It is very easy to say that it is a life style that just to control your sugar level and it can be controlled if you have a discipline, but trust me it is not. My sister told me that my father told to my mother if he doesn’t want to study he can do whatever he wants, it’s perfectly alright, his health matters more. My mother told my father that don’t ever say that again because he will be weak and mother said that let be him a fighter and let him fight it out. This strength was given to me from my mother. I am injecting insulin 4 times in a day, but this disease has never gotten on my nerves. It all seems
very easy to a normal and a healthy individual but Allah knows how many tears I shed in front of him and ask for a better health. As when I pray I have a faith that if you pray before Allah and ask Him He will provide you beyond your imagination. Anything can happen if you please Allah. So we should strive every day, seek forgiveness from Allah, should never feel depressed or lost and should always be hopeful.

In my family there are 6 members, My parents, my 3 sisters and me. One sister is elder than me and two are younger. My family has a perfect relationship with me. As I am very close with my mother, I share every problem with her. My father used to motivate me in every moment. There is no disease in my family but only my grandfather has some blood pressure issue. My father is a very joyous person, I have hardly seen him taking any stress. The business that my father is doing right now, he inherited that from his father and I also plan to join my father in the expansion of his business.

This last year was a tough one for me, as I was on gap year, but Alhamdulillah I got into SZABIST. I’m pretty satisfied with where I am now. I try to be grateful and thankful to Allah at every step of my life. I feel that everything we go through involves the will of Allah, and Allah loves us more than 70 mothers, how can he choose anything bad for us? The story of my life shows a lot of problems but in the end I overcame all of them by the help of the All-Mighty.

071 Manahil, age 11, Pakistan

Diabetes Story…

Living with diabetes can be a challenging burden but it can be helpful to share your frustrations and successes and read about people’s similar experiences. We have identified the best diabetes blogs that aim to inspire, empower, and educate readers.

Diabetes is a group of diseases that impact how the body uses blood glucose and it effects around 29.1 million people in the United States.

070 Toyyaba, age 11, Pakistan

My Life With Diabetes…

I wish to live like others,
But it’s not possible because
My life with diabetes.

I wish to eat freely like others,
But it’s not possible because
My life with diabetes.

I wish to play like other girls,
But it’s not possible because,
My life with diabetes.

I wish I will be treated like others,
But it’s not possible because,
My life with diabetes.

I wish to smile like others,
But it’s not possible because,
My life with diabetes.

I wish I live strong and brave
But it’s not possible because,
My life with diabetes.

I wish I remove tear of my parents,
But it’s not possible because,
My life with diabetes.

I wish my mother sleep deeply,
But it’s not possible because,
My life with diabetes.

I wish my mother live freely,
I wish… my mother die freely
But it’s not possible because,
MY LIFE WITH DIABETES…