This month: the case of a patient previously diagnosed with diabetes who hadn't taken his medication for two years. This patient had arrived unwell at Mount Makulu in rural Zambia, but it’s something I encounter surprisingly often in Oxford too.
This particular patient had become increasingly dehydrated and unwell due to his increasing sugar levels. Luckily Clinical Officer Elyse was able to rehydrate him and start oral diabetic medication right away.
It again reminded me of a universal theme of patients all over the world - playing down their ill health and forgetting or choosing not to take their medication. It’s a constant battle for clinicians trying to keep them healthy.
In fact, chronic diseases (things like diabetes, hypertension, heart disease and cancer) are becoming more common in Africa with changing lifestyles and more Westernised diets. In time, promotion of a healthy lifestyle as prevention will soon become as important as infectious disease management in developing countries.
However, chronic diseases can be difficult to look after in resource-poor settings as the tests and medicines normally used are not widely available. For example, providing insulin for diabetic patients could prove logistically challenging. Also, clinical training has also tended to focus on the infectious diseases; certainly the Virtual Doctor’s Clinical Officers are more confident in treating malaria and TB than diabetes.
Chronic diseases are certainly one of the challenges facing developing nations.
Dr Fran Fieldhouse is the Virtual Doctors Head of Clinical Governance. Follow her @franvirtualdocs