May 17, 2016 | Summer 2016
This morning, we met with the Chief Health Officer (CHO) of Kagbere Community Health Center (CHC) at the Bombali District Medical Office. The CHO was very informed about diabetes and acknowledged that it is important for community members to be screened for the disease. In our interview, we interviewed the CHO on various topics such as the frequency of diabetes cases at Kagbere CHC, their relationship with CHWs, their day-to-day casework, and available resources for treatment. Much of the information gathered from Kagbere CHO largely agrees with the information we previously received from the Binkolo CHO and Kamabai health workers. The individuals we interviewed from Kagbere, Binkolo, and Kamabai each explained that diabetes cases in rural communities are rare, but that most people are unaware of their status. In other words, the prevalence of diabetes in rural communities is likely much higher than statistics suggest. In fact, when we asked the Kagbere, Binkolo, and Kamabai CHCs, each said that there would be tremendous interest in getting screened for diabetes if the strips can be distributed for free or sold at minimal cost.
Our wonderful conversation with Kagbere CHO concluded with getting in touch with two other CHOs, who are currently at a training session in Makeni. We have arranged to interview both CHOs early tomorrow morning. We also revisited Holy Spirit Hospital, where there is a diabetes support group for already diagnosed patients. In addition to the CHO interviews tomorrow, we plan to speak with a few individuals diagnosed with diabetes in order to accurately map the diagnosis and treatment pathways for diabetes in Sierra Leone.
Later in the day, we spoke with two Community Health Workers (CHWs) who report to the Kapethe Public Health Unit (PHU). The goal of our interviews was to understand 1) what CHWs know about diabetes and 2) how the health care system operates in rural settings. We interviewed both CHWs separately in their respective communities alongside a translator. The information we gathered suggests that CHWs are not familiar with diabetes or its symptoms. However, CHWs are relatively well trained to recognize the symptoms of malaria, pneumonia, and diarrhea, with diarrhea being the most common disease in both the rural communities we visited. Both CHWs visit community members (ranging from 200 to 800 people) every day, and pay special attention to children under 5 years of age, pregnant women, and breastfeeding women. In addition to monitoring the physical health of their communities, CHWs are also responsible for maintaining a healthy and sanitary environment. Although the CHWs we interviewed were not familiar with diabetes, they provided very useful information on what they do and what they know with regards to safeguarding the health of each community member.
Aside from our outings, we spent some time compiling our findings into a mapped pathway showing how individuals in both urban and rural settings get screened, diagnosed, and treated for diabetes. We are incredibly thankful to both the Kagbere CHO and Kapethe CHWs, who were extremely welcoming and patient in answering each of our questions. Moving forward, we plan to conduct interviews with a couple more CHWs and speak with a few diagnosed individuals.