Heroes of the Northern Cape: Stories from the Front Lines of South Africa’s Battle with Diabetes
Diabetes is the second-most common cause of death in South Africa. Lifestyle and diet choices are fueling the problem, but the country’s overburdened public health system is having trouble dealing with the nearly 10,000 new cases diagnosed each month. In the isolated Northern Cape province, diabetes treatment is especially hard to come by. With help from local healthcare professionals like Rita Venter, Project HOPE is working to change that.
“Sometimes it takes three or four months to get an appointment. I can’t wait for that time to give something to my patients. We have to do something now.”
That’s how Rita Venter, nurse and operations manager at a clinic in De Aar, describes the challenge locals face when trying to treat diabetes. De Aar is a remote railroad town in South Africa’s Northern Cape, about three hours by car from the closest major city.
“If we don’t have someone in town to help with health issues, nothing is going to happen…we have doctors but sometimes those appointments get cancelled and there are other delays,” she said.
Access to treatment isn’t the only problem. A healthy diet and active lifestyle are critical to treating and preventing diabetes. But in a small town like De Aar with limited opportunities for work, not everyone can afford the foods needed to control diabetes.
“There are a lot of socioeconomic problems within communities in the Aar region. Work is very scarce,” Rita told us.
It’s not just rural regions: In South Africa, diabetes is spreading everywhere, from isolated towns like De Aar to major cities like Johannesburg.
The Quiet Killer Stalking Africa’s Southern Tip
Between 1980 and 2014, the number of diabetes cases in sub-Saharan Africa skyrocketed from 4 million to 25 million. Despite being among the most developed countries on the continent, South Africa has some of its highest obesity rates – nearly 70% of South African women are overweight or obese.
Like other countries where diabetes is on the rise, diet is a major culprit. The national favorite is “pap” porridge, milled corn flour and milk similar to what would be called “grits” in the southern U.S. It’s typically topped with butter and syrup when available. These meals are cheap and convenient – but they’re also loaded with carbohydrates and sugar.
For some of Rita’s patients, spending money on more nutritious foods isn’t an option. She told us about a woman in her late 20s with high blood sugar and blood pressure over 200 who was struggling to find work.
“We found out that she ate only twice each day. And on those occasions, she ate only porridge. That’s all that was available in the house. Chicken was only available once or twice a week. Vegetables were a very scarce commodity,” she told us.
With diet and lifestyle factors playing such large roles in the development of diabetes, Rita says it’s often challenging to get patients to take treatment programs seriously and stick to them.
“The follow up was always a big problem… We had one lady who was about 69 years old, Betty, and she was one of those patients who started on medication and upgraded to insulin and Metformin at night and then she just disappeared,” Rita said “…And then after about three years, she came back because she felt bad. She had higher blood sugar, higher blood pressure, and then we had to start everything over again.”
Making Progress Against Diabetes in South Africa
Thanks to the dedication of Rita and other local health care workers who receive training from Project HOPE, some patients can make a full recovery. Rita was happy to discuss some of their successes at the clinic:
“Wilma, who was 23 years old, was diagnosed after a serious problem called diabetes ketoacidosis in which the body produces excess blood acids. She had to be admitted to the hospital and was started immediately on insulin, but thankfully within three months she was one of our star patients and she had the lowest blood sugar.”
In 2016, Project HOPE partnered with provincial Departments of Health in South Africa to implement the HealthRise program. Its aim is to provide expanded access to care for cardiovascular disease and diabetes among underserved populations in the Northern Cape and KwaZulu-Natal provinces.
Since then, we’ve worked with our partners in HealthRise to train over 320 healthcare workers and screen over 5,050 patients for diabetes and hypertension in both provinces. Before the program’s current phase, Project HOPE worked with the Department of Agriculture to help patients grow their own vegetable gardens to promote more nutritious food choices.
With continued effort from tireless healthcare administrators like Rita Venter, we hope to curb the spread of diabetes in South Africa. From what she shared with us, the appreciation is mutual.
“To take hands with an organization like Project HOPE and the way that we worked with those patients and the difference that we made was remarkable. To have people like that on an ongoing basis is a dream. To work with those people and to see that they also had a passion for the same things as me was very special for me.”