Punctures that avoid amputations (Senegal)

The needle enters as a sting of any of the mosquitoes that flutter around it.No apparent howl.No notch on the face.Without waste of life, in sum.His expression vanished when his body stopped regulating the sugar he ingested.The time elapsed is, in fact, the culprit that the brightness does not shine again.Not even with the sweat that soaks the corners and forms a kind of garúa in this dependence without windows.

He is 55 years old, the serious, absent gesture, and just a voice to say his name.This anonymity prevents him from customizing the disease in men like him, with average complexion and beer to scissors, but at the same time serve as an example of thousands of people in their situation.He suffers diabetes and is the first day that passes at the Regional Hospital of Ziguinchor, in Senegal.His regrets are faint.The pressure, low.And the amount of blood glucose, above the 100 milligrams per deciliter: high enough to require the insulin that the doctor injected into the forearm.

has been on the edge of the diabetic coma .Now, the serum and the palm leaf that his wife escapes him from the lethargy that has been dragging for five years.The same that it carries as an insulin-dependent in a country with 292,000 cases of diabetes registered in 2014 and an related mortality of 11% according to the International Diabetes Federation (IDF).In the department of Casamance, where this medical center covers the needs of some 338,000 residents, the average resembles national figures.

In Casamance, in addition, there are some aggravating ones.The urban centers of this province do not have facilities such as Dakar, Saint Louis or Thiès, the three most populated cities in the country.Nor with their same services or with the same presence of international organizations.This Ziguinchor property, known as "Capital del Sur", covers several buildings and the specialties of cardiology, gastroenterology or the unit of sexually transmitted diseases.And patients, in a country where the minimum wage are 30 euro cents per hour of work (about 100 euros per month working full -time), they barely have enough money to cover a basic treatment that allows them to develop a full existence todespite the perpetuity of his illness.

"An insulin boat with quantity for four or five days costs about 1,500 francs [around 2.30 euros] and the syringe, which is used a week, 125 [20 cents]," explains Dienaba Badji, a social worker58 years that seem to be also exercising and administrative assistant.His previous experience in Dakar or Tamacunda, to the east, have made him turn to this corner of mangroves where he has been a decade."Here, five out of five cannot buy the minimum to be treated, that is, nobody," he resolves, "and this is not Europe.There are no means.After coronary conditions, diabetes is the second cause of death. ”

Senegal registered 292,000 diabetes cases in 2014 and a related mortality of 11%

In developed countries the disease is the seventh cause, according to the World Health Organization (WHO), but is emerging as one of the great epidemics of the future: the IDF figure in 387 million those affected worldwide;Half of them, without diagnosis, and forecasts an increase of 205 million more for four years.In this corner of Africa (as in so many others of the globe) this ailment involves severe precariousness of the health that brings blindness, bone or skin problems and even member amputations.All for not stopping a condition that does not remain life expectancy except by the obligatory blood controls and their corresponding insulin dose, a couple of times a day.

Among theSenegal diabetics - which could reach 421,000 in 2030, according to WHO - the vital horizon is reduced up to 13 years.In the country it is 63.2 on average, as collected by the Perspective Monde publication of the World Bank, which places it in 154 World Cup.Nothing accompanies the growth of its gross domestic product (3% continued in recent months and similar perspectives for the next) with the number of people who manage to face the disease.62.5% of those affected are not diagnosed, they estimate from the IDF.And those who are, can barely be constant with treatment.That is why they go (generally, too late) to this center.A weak remedy, because only temporarily caneter what should be continuous.“Here we have two glucometers, syringes and insulin, but it is not enough.Every night 2,000 francs [about three euros] and cannot afford more than four or five, so they improve a little but get worse again as soon as they come out, ”says Badji under the gaze of a woman who expels her fatigue based onSighs.

Among the WHO challenges contemplated in the so-called World Action Plan for the Prevention and Control of Non-Transmissible Diseases 2013-2020 is, as a first goal, to reduce mortality caused by cardiovascular or respiratory diseases, cancer ordiabetes.And the IDF has planned a set of purposes for its descent.This list goes through "optimizing human and health resources" or "strengthening institutional frameworks to guarantee consistent, innovative and effective responses" and achieve "the greatest possible benefits in relation to investment."Something that, in the case of Senegal, tries to carry out with a polarized health system, divided between private centers (unaffordable for a population that has 54% of its members under the threshold of poverty) and a poor public healingwhere services are paid at a lower price.

"How are they going to be treated if they are not even sensitized?" Asks Dr. Karim Sadio as he travels some chronicle walls, naked cuers and faded fans.“The objective is, in addition to the aid for access to medicines, which in schools is taught to prevent.At the moment, it is the children who alert the parents.These do not believe or go to natural therapies if they see that they are better, that the symptoms have referred, ”argues this expert after 15 of their 38 years, transgeting these corridors.

WHO predicts a 205 million increase in 20 years around the world
The solution, exposes the specialist, goes through a greater dissemination of the causes and signs of the disease and by doing pedagogy to recover healthy habits.Sedentary lifestyle, the greatest intake of fats and sugars or relegate homemade stews in favor of the industrial - practical that have been extended throughout the planet - have chronified diabetes in 9% of those over 18.A million and a half people die on earth annually because of them.Of that amount, 80% do so in countries with middle and low income.The IDF increases the figure to 4.9 million and computes a death every seven seconds because of diabetes.In spite of, they detail that one of every nine dollars spent in health matters allocated to something related to this ailment."Active life, maintaining the right weight, avoiding tobacco and an abundant proportion of fruits and vegetables in the diet are the best prevention measures," they warn from WHO, which adds: "A cheap blood test is the best to getan early diagnosis. ”

Something that is more than aware in this building raised in 1964, shortly after Senegal became independent from France.Here, the victims of this pandemic languish inStretches covered by the sheets placed by relatives, also responsible for providing them with food.And ‘Madame’ Badji - as all are directed to her - targets an aid between foreign and state groups so that the sick regain the voice.The energy and breath that makes them jump in each peck.Either of needle or mosquito.