“The world is facing a growing diabetes epidemic of potentially devastating proportions. Its impact will be felt most severely in developing countries.” World Health Organization and the International Diabetes Federation, 2007.
On December 20th, 2006, the General Assembly of the United Nations passed a landmark resolution recognizing diabetes as a ‘chronic, debilitating and costly disease with severe complications…’ This resolution designated World Diabetes Day (November 14th) as a United Nations Day to be observed every year starting in 2007.
In recognition of this first United Nations World Diabetes Day, the Indian Medical Council (IMC) of Greater St. Louis decided to partner with the United Nations in promoting awareness about the worldwide impact of diabetes and current diabetic management strategies. Dr. Anil Khosla, IMC president, helped to organize a dinner symposium for physicians featuring two endocrinologists from Washington University School of Medicine. Over 100 physicians attended the event, including numerous Indian physicians as well as members of the divisions of endocrinology and cardiology at Washington University. The program, which was underwritten in part by an educational grant from Eli Lilly, contrasted the differences between challenges of diabetic management in the developed world versus the developing world. Dr. Gary Tobin, Associate Professor of Medicine and director of the Diabetes Center of Barnes-Jewish Hospital spoke on ‘Management of the Hyperglycemic Patient: Awaiting the Arrival of the Perfect Storm.’ Dr. Santosh Gupta, Assistant Professor of Pediatrics and a pediatric endocrinologist, spoke on ‘Challenges of Diabetes for the Impoverished Patients in India.’
Dr. Gupta presented her experiences working at the Ramakrishna Mission (RKM) Hospital near Haridwar, India. She has spent several months during 2007 volunteering at this small non-profit hospital located in a small town six hours north of New Delhi. This hospital, which was founded by Swami Vivekananda over 100 years ago, is a 150 bed hospital that often has a hospital census of 300 admitted patients, including patients sleeping on the floor. In addition, there are close to 5000 patients seen annually in the outpatient clinics. The hospital provides free or low-cost (sliding scale) care and is supported entirely by donations. Due to a lack of funds, there is a chronic shortage of physicians, nurses and medicine.
Patients seen at this hospital have an average income between Rs 1500 to 2000 per month for a family of four. Consequently, these patients have limited access to medical care and often cannot afford medical treatments. It is estimated that for every 1 diabetic diagnosed in rural India, there are 3 undiagnosed diabetics. The profiles of diabetic patients at RKM hospital stands in stark contrast to diabetic patients in the developed world. In rural India, type II diabetics were typically younger with a mean age of 38 years old. They were also weighed significantly less with an average weight of 120lbs for males and 100lbs for females. These patients were more likely to be malnourished, anemic and suffer from complications such as neuropathy, retinopathy, nephropathy, diabetic foot ulcers and various cardiovascular events. Furthermore, they tend to die early, which has a devastating economic effect on these already impoverished families.
Dr. Santosh Gupta also took this opportunity to discuss her plans for the future. Along with her husband, Dr. Jitendra Gupta (a cardiologist at Washington University in St. Louis), she has decided to spend several months each year volunteering at RKM hospital. These two physicians recently retired from successful clinical practices and established the Manav Seva Foundation, a non-profit organization dedicated to service of humanity through medical volunteerism. Their foundation has received some promising initial monetary donations as well as commitments to volunteer at RKM hospital. A pulmonologist from North Dakota as well as a pediatrics resident at Washington University in St. Louis will spend two months in Haridwar at RKM. Drs. Gupta hope to expand the volunteer initiative at RKM in upcoming years through their Manav Seva Foundation. They draw inspiration from the words of Swami Vivekananda, founder of the Ramakrishna Mission:
‘Look upon every man, woman and everyone as God. You can not help anyone. You can only serve; serve the children of the Lord, serve the Lord himself if you have the privilege. You may invent an image through which to worship God, but a better image exists, the living man. You may build a temple in which to worship God and that may be good; but a better one, much higher one already exists: the human body.”
– Swami Vivekananda
For further information:
Manav Seva Foundation:
http://manavsevafoundation.blogspot.com/Ramakrishna Mission Hospital
http://www.cse.iitb.ac.in/~subhasri/rkm/index.htmUnited Nations World Diabetes Day
http://www.unitefordiabetes.org/campaign/resolution.html
