One of the devastating effects of Tigray War and Siege is the health crisis since 80% of health facilities arelooted and destroyed. In addition no aid, including medication, has been coming in since long time ago. Patients especially those with chronic illness are suffering immeasurably. Let us share one paediatric diabetic patient’s story;
A 16 year old boy from Mekelle, came to Ayder hospital with a compliant of excessive thirst and excessive urination with bedwetting and significant weight loss for the last 3 months. His father is not around and he is the only one responsible to bring daily income to support the whole family (mother and two siblings) by working as an assistant for a Taxi driver. He kept working despite all symptoms till he became bedridden. Since 1 week prior to his admission, he started to experience abdominal pain, vomiting and change in mentation. When he arrived to our hospital; he was comatose, dehydrated, and malnourished. He was diagnosed with complicated type 1 DM (with moderate diabetic ketoacidosis, DKA). Despite all his complaints for 3 months and living in the capital city Mekelle, he came late because of obvious financial reasons. And to add onto that there is no medication in the health facility so his families took him to the holy water. Even after he came to our hospital, with complications, we could not do necessary investigations like serum electrolyte determination which is critical for the management of DKA. He needed specific IV fluids to manage his complication (DKA) but it isn’t available in the hospital pharmacy and even if it is available outside he couldn’t afford to buy. The other critical medication is insulin, crucial for acute and long term management of his case. Insulin hasn’t been available in our hospital since the past 6 months. We struggled to find regular insulin to manage and help him recover from his complication. Now, he is in our hospital, his mother can’t afford to buy anything. What are we going to provide him subsequently? We don’t have any answer. Now days, diabetic patients are not coming to follow-up clinics since there is no insulin and are returning back home barehanded. Because of this, they remain at home and it’s not difficult to think how much they suffer without medication, we have even heard reports of deaths at home. It is a luxury to think about diet and glycaemic control in DM patients in Tigray.
As a physician it is really hard to think about it and unfortunately it’s real in this century where medical care is advanced. But then, does the medical world know and realize about the situation? Are we part of the world medical community? If so, why is this community allowing diabetic patients in Tigray to be treated as if we are in the pre-insulin era?
It’s tough to be a physician in Tigray as we are left alone and flooded with unanswered questions rather than helping our patients. The international medical community can’t see and hear voices from the besieged Tigray and this case is the tip of the iceberg, to tell the world how our patients are suffering and we believe the international medical community will be part of the solution.
Solomon, 16 years old diabetic patient admitted to Ayder Hospital (Consent taken from him and his family)